Evaluation of the Dentinal Shear Bond Strength and Resin Interface in Primary Molars after Pre-Treatment with Various Dentin Bio-Modifiers: An In Vitro Study.

Dentine adhesives have demonstrated great success with permanent teeth. Though the results in primary teeth are not well documented, some studies have demonstrated lower values of bond strength in primary teeth than those found in permanent teeth. The aim of this study was to compare and evaluate the effect of grape seed extract (6.5%) (Herbal Bio Solutions, Delhi, India), glutaraldehyde (5%) (Loba Chemie PVT. LTD., Mumbai), hesperidin (0.5%) (Herbal Bio Solutions, Delhi, India), and casein phosphopeptide-amorphous calcium phosphate (tooth mousse) (GC Corporation, Alsip, IL, USA) on the shear bond strength of dentine of primary teeth and to evaluate the resin tags at the resin tooth interface. Seventy-five caries-free human primary molars were collected, and their occlusal surfaces were ground flat. Dentin surfaces were etched using phosphoric acid. Then teeth were randomly assigned in sequential order to five groups according to the dentinal treatment method: Group I (Control group) (no treatment), Group II (5% glutaraldehyde), Group III (6.5% grape seed extract), Group IV (0.5% hesperidin), and Group V (CPP-ACP). Ten teeth from each group were assigned for Shear Bond Strength and five for SEM analysis. ANOVA and a post hoc least significant difference test (p < 0.05) were used for statistical analysis of the collected data. The grape seed extract group showed significantly increased shear bond strength than the control group (p < 0.05), and the mean length of resin tags in different dentine bio modifiers groups was also statistically significant (p < 0.05). The use of dentin bio modifiers such as 5% glutaraldehyde, 6.5% grape seed extract, 0.5% hesperidin, and CPP-ACP in the bonding process for primary teeth did not improve the dentinal bond strength.

Disinfection Efficacy of Laser Activation on Different Forms and Concentrations of Sodium Hypochlorite Root Canal Irrigant against Enterococcus faecalis in Primary Teeth.

Photoactivated disinfection with sodium hypochlorite (NaOCl) has improved primary root canal treatment outcomes. This in vitro study aims to assess and compare the disinfecting efficacy of 2.5% sodium hypochlorite solution and 5.25% sodium hypochlorite gel, without laser activation and accompanied by laser activation, on Enterococcus faecalis-contaminated primary teeth root canals. After one month of incubating extracted teeth specimens with E. faecalis, 36 specimens were randomly divided into two groups: Group A (conventional method without laser-activated irrigation) and Group B (with laser-activated irrigation). Each group was further divided into three subgroups, with six samples in each subgroup. Subgroup 1 received irrigation with normal saline, Subgroup 2 with 2.5% sodium hypochlorite solution, and Subgroup 3 with 5.25% sodium hypochlorite gel. Diode laser activation at 810 nm was used in Group B. Bacterial colony counts were measured before and after the intervention. Student's t-test and one-way analysis of variance (ANOVA) with Tukey's post hoc test were used for statistical analysis. The significance level was set at p < 0.05. Microbial analysis revealed no bacterial growth in samples irrigated with 5.25% sodium hypochlorite gel activated with the laser. Activation with the laser significantly (p = 0.02) improved the disinfection ability of the irrigant compared to the non-activation group. The disinfection ability of sodium hypochlorite gel was better than that of saline (p = 0.02); however, it was comparable to that of sodium hypochlorite solution (p = 0.67). Conclusion: Root canal irrigation with 5.25% sodium hypochlorite gel activated with an 810 nm diode laser resulted in complete eradication of Enterococcus faecalis, indicating its effectiveness as an endodontic disinfection treatment modality.

Comparison of Enamel Surface Integrity after De-Bracketing as Affected by Seven Different Orthodontic Residual Cement Removal Systems.

This study used seven different adhesive removal systems to evaluate and compare enamel surface integrity, heat generation, and time consumed during residual cement removal after de-bracketing. The sample size was 140 human premolars. Teeth were cleaned, mounted, and prepared for orthodontic bracket bonding. Brackets were then debonded using bracket-removing pliers. Teeth were randomly assigned to seven groups based on the residual cement removal system: Group 1: Stainbuster bur, Group 2: Renew diamond bur #129, Group 3: Renew carbide bur, Group 4: OneGloss Complete system, Group 5: Sof-Lex system, Group 6: Enhance Finishing and PoGo Polishing complete kit, and Group 7: Renew friction grip points. The enamel surface was evaluated for roughness before bracketing and after residual cement removal using surface profilometry. The time taken for cement removal was recorded using a digital timer, and heat generation was measured using a laser thermometer before and after cement removal. One-way ANOVA compared the pre- and post-values for enamel surface roughness, temperature, and time consumed. When comparing the difference between the post- and pre-finishing roughness using one-way ANOVA, the Renew diamond bur produced the roughest enamel surface post-removal with a mean of 4.716 µm, while the Sof-Lex recorded the lowest at 0.760 µm. The highest mean temperature was recorded with the Stainbuster bur at 5.545 °C, and the lowest temperature was recorded with the Enhance bur at 2.260 °C. The time for cement removal was the shortest with the Enhance bur at 12.2 s, whereas the time was the longest with the Renew diamond bur at 30.4 s. In conclusion, all the residual cement removal systems used in this clinically simulated study were not able to restore the original enamel surface smoothness. However, the 3M Sof-Lex produced the lowest enamel roughness but with more time consumption and heat generation. When selecting the best residual cement removal system to be used, clinicians should weigh the merits and demerits of each system based on the clinical judgement of the operator.

Perception of Minimum Interventional Dentistry among Dental Undergraduate Students and Interns.

Background: The philosophy of minimum interventional dentistry (MID) is to integrate prevention, remineralization, and minimal intervention for the placement and replacement of restorations. All branches of dentistry play an important role in practicing MID, and their primary goal is to realize that any restoration is of less biological significance than the healthy original tissue Objectives: The objective of this study was to assess the perception of MID among dental undergraduate students and interns in terms of knowledge, attitude, and practice at the College of Dentistry. Materials and Methods: This cross-sectional study was conducted among undergraduate students and interns at the College of Dentistry, Qassim University, Saudi Arabia. A self-administered questionnaire was distributed, which included basic demographic profiles and questions about the knowledge, attitude, and practices toward MID. The data were tabulated in MS Excel, and all statistical analyses were performed using SPSS version 21. Results: A total of 163 dental students were recruited, with senior students comprising 73% and interns comprising 27%. Male students were slightly more prevalent (50.9%) than female students (49.1%). About 37.6% of participants received training about MID during educational courses, while 10.3% received it during their internship. A statistical test revealed that the prevalence of interns who were trained in performing MID was significantly higher (p < 0.001). Conclusions: The majority of the participants demonstrated proper knowledge, attitude, and practice in different aspects of MID. Interns reported a higher rate of knowledge, attitude, and practice in MID compared to undergraduate students. However, more education and hands-on training about MID concepts during the college curriculum are necessary to attain better knowledge, attitude, and practices that could be useful for more conservative clinical practice.

Pediatric Dental Fluorosis and Its Correlation with Dental Caries and Oral-Health-Related Quality of Life: A Descriptive Cross-Sectional Study among Preschool Children Living in Belagavi.

AIM: This study aims to assess the prevalence of dental fluorosis and its association with dental caries, oral health behaviors, oral-health-related quality of life and parents' perceptions among preschool children in the 3-5-year-old preschool children living in the Belagavi district of Karnataka, a non-endemic fluorosis region. METHODS: A descriptive cross-sectional questionnaire-based study was conducted among 1200 individuals of the preschool population from 48 government-sponsored child-care development centers in Belagavi, Karnataka, over a three-month period. They were examined following the Dean's fluorosis index (1942) and dmft (decayed, missed, and filled) scores of the participants were also recorded. Parents' perception of oral health was assessed using the self-administered Early Childhood Oral Health Impact Scale (ECOHIS). SPSS software (version 20) was used for statistical analysis. Chi-square test computed categorical data. One-way ANOVA test was used for multiple group comparisons. p < 0.05 was considered statistically significant. RESULTS: Of the 1200 children examined, 10 (0.83%) children exhibited dental fluorosis. Of the 10 children having fluorosis, six had fluorosis present on two or more of their primary teeth, and four had fluorosis on four or more teeth. The mean dmft score was 3.01 ± 1.38 to 3.60 ± 1.72 in 3-5-year-old children, respectively, with statistical significance difference (p < 0.001). The mean score of oral health-related quality of life was 10.74 ± 2.06, which was significantly correlated to the child's age and parents' education level (p < 0.05). CONCLUSION: The study shows a negligible amount of prevalence of dental fluorosis in the non-endemic fluorosis residential district. It also elucidates that children from lower and lower-middle socioeconomic status are more prone to suffer from dental fluorosis as compared to other groups. The mean score of ECOHIS increased proportionally with the caries experience, indicating a significant relationship between the dmft and ECOHIS score. Deciduous dentition fluorosis is often neglected, especially in areas that are not considered endemic for fluorosis and with only optimum fluoride levels in their groundwater, which supports the disease's nature as multi-factorial and shows that a broader perspective is of prime importance to assess, diagnose, and prevent dental fluorosis among the preschoolers, thereby appraising their overall health and hygiene status.

Assessment of the Proximity of the Inferior Alveolar Canal with the Mandibular Root Apices and Cortical Plates-A Retrospective Cone Beam Computed Tomographic Analysis.

Various endodontic interventions often lead to iatrogenic damage to the inferior alveolar nerve present in the inferior alveolar canal (IAC). The purpose of the present study was to analyze the relationships of IAC with the root apices of mandibular teeth and with the mandibular cortical plates. MATERIALS: 116 cone beam computed tomography (CBCT) scans were examined and the shortest distance of IAC with the root apices of mandibular canines, premolars and molars, and with cortical plates was analyzed. The data were statistically analyzed using SPSS. RESULTS: The shortest mean distance between IAC and lingual cortical plate (LCP) was found in the third molar area, and between IAC and buccal cortical plate (BCP) in the second premolar area. A high incidence of 60% direct communication (DC) was present in mandibular second molars; 38% in mandibular third molars; 13% in mandibular second premolars; 12% in mandibular first molars; and 1% in mandibular first premolars. CONCLUSION: Anteriorly, IAC was found to be significantly present in close approximation to the roots of mandibular canines. Posteriorly, IAC was found to be in significant proximity to the distal roots of mandibular second molars.

Mechanical and antibacterial efficacy of photo-sonodynamic therapy via methylene blue-loaded nanoparticles over dental implants for treating peri-implantitis.

AIM: This study aimed to evaluate the mechanical (i.e., flexural modulus [FM], flexural strength [FS], and surface roughness [Ra]) and antibacterial efficacy of photo-sonodynamic therapy via methylene blue-loaded poly(D,L-lactide-co-glycolide) nanoparticles (MB-loaded PLGA NPs) over dental implants for potential treatment of peri-implantitis. METHODS: PLGA NPs were synthesized via a solvent displacement method. After the synthesis and confirmation of MB-loaded PLGA NPs via physical (Scanning Electron Microscope [SEM]) and chemical characterization (Fourier transform infrared spectroscopy [FTIR]), the mature dental biofilm of Porphyromonas gingivalis was produced over the surfaces of dental implants. Then, the bacterial viability assessment of the following five study groups was performed: group-I (diode laser treatment); group-II (PDT/MB-loaded PLGA NPs treatment; group-III (ultrasound treatment); group-IV (ultrasound/PLGA NPs-MB treatment); and group-V: control group included the samples without any treatment. Finally, the FS, FM, and Ra of the samples was assessed. RESULTS: Under the SEM, the NPs were spherical homogeneous particles having round morphology ranging approximately 100 nm in size without aggregation. The FTIR spectra of PLGA NPs and MB-loaded PLGA NPs demonstrated absorption peaks at approximately 1000 cm-1 to 1200 cm-1 and around 1500 cm-1 to 1750 cm-1. The greatest level of P. gingivalis killing was exhibited by ultrasound/MB-loaded PLGA-NPs-treated samples. The FS was statistically significantly greater for control group samples than any other group (i.e., 100.28 MPa; p<0.05). The FM and Ra ranged between 3.31 and 3.58 GPa and between 0.18 and 0.20 µm without any statistically significant difference between the control and experimental groups (p>0.05), respectively. CONCLUSION: Within the limitations of this study, the application of photo-sonodynamic therapy via MB-loaded PLGA NPs demonstrated the greatest antibacterial activity against P. gingivalis without deteriorating the surfaces and compromising the mechanical properties of dental implants.

Impact of Ceramic Material and Preparation Design on Marginal Fit of Endocrown Restorations.

Background: The aim of this study is to investigate the impact of ceramic material and preparation design on the marginal fit of endocrown restorations. Methods: Forty endocrown restorations were CAD/CAM-fabricated for forty extracted maxillary first premolar teeth. Samples were divided into two groups (n = 20) according to the ceramic materials used: Celtra Duo and Vita Enamic. Each group was divided into two subgroups (n = 10) according to the preparation design: with no intraradicular extension and with 3 mm intraradicular extension. The marginal gap was examined using a digital microscope. Results: Celtra Duo without intraradicular extension recorded the least mean marginal gap (7.74 ± 1.55 µm), while Group Celtra Duo with 3 mm intraradicular extension recorded the highest mean marginal gap (29.54 ± 6.32 µm). Group Vita Enamic recorded a lesser marginal gap (18.03 ± 12.11 µm) than group CD (Celtra Duo) (18.64 ± 12.05 µm). There is a statistically non-significant difference between the two groups of materials (p = 0.873). There is a statistically significant difference between the two tested preparation designs (p < 0.001). Conclusion: All groups recorded a marginal gap within clinically accepted values. Material selection may influence the fitting of restorations. Intraradicular extension for endocrown restorations adversely affects the marginal fit, however, the marginal gap is still within the clinically accepted range.

Influence of Open Apex on Working Length Determination Using Cone-Beam Computed Tomography and Apex Locators: A Comparative In Vitro Study.

Objectives: The aim of this study is to assess the effect of open apex on working length (WL) determination with aid of cone-beam computed tomography (CBCT) and electronic apex locators (EALs). Methods: Thirty-two extracted human mandibular premolars were selected, and apical 5 mm was removed. Root canals were prepared from the apical to the coronal direction of the canal using peeso reamers up to size 5 (retrograde) to simulate open apex. The samples were analyzed by CBCT, and WL was established (CWL) by a radiologist. An endodontist prepared the access cavities, and visual working length (VWL) was recorded. The samples were embedded in a freshly mixed alginate mould up to cementoenamel junction. Each root canal length was measured with two different EALs-Root ZX mini and i Root. The measurements were repeated 3 times by using a digital caliper, and the mean was recorded by the endodontist who was blinded to the results of the CWL. The recorded data was statistically analyzed using the SPSS software. Results: The results of this study showed statistically significant difference between VWL and i Root, CWL and i Root, and Root ZX mini and i Root (p < 0.05). Amongst EALs, a superior accuracy was noted for Root ZX mini than as compared to i Root. However, no statistically significant difference was seen between Root ZX mini and CWL (p > 0.05). Conclusion: The present study showed that CWL is as accurate and reliable as VWL which is the gold standard. Amongst EALs, Root ZX mini performed more accurately than i Root. Preexisting CBCT scans should be used as an advantage in determining WL.

Assessment of Parental Knowledge towards Space Maintainer as an Essential Intervention after Premature Extraction of Primary Teeth.

This study assessed parents' knowledge about space maintainers as an interceptive strategy after premature loss of primary teeth. Methods and Material: A cross-sectional questionnaire-based descriptive study was conducted on a sample of 600 parents; 456 (76%) were females, and 144 (24%) were males, recruited from an outpatient dental clinic at Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia. The questionnaire consisted of two sections; the first section collected sociodemographic data of participants, and the second section gathered parental knowledge of space maintainers. The research ethics committee granted ethical approval, and informed consent was obtained before participation. Results: 600 parents participated in this study. The total mean knowledge score regarding space maintainers was 7.97 ± 3.38. The mean knowledge score was 7.06 ± 2.99 for male parents and 8.26 ± 3.45 for female parents. The difference in the mean knowledge score between female and male parents was statistically significant (p < 0.001). Additionally, there was a statistically significant difference in the knowledge score and parents' age groups, with parents having the highest knowledge in the 30−40 age group (p = 0.0197). There was a positive correlation between knowledge scores and the number of children. Parents with one child showed less knowledge than those with two to four children (p = 0.0121). Conclusions: Participants' knowledge regarding space maintainers was 49.8%, which is considered inadequate. It was deemed essential to increase knowledge among parents about space maintainers as an interceptive approach after premature loss of primary teeth.

Comparison of Retention between Conventional and Nanofilled Resin Sealants in a Paediatric Population: A Randomized Clinical Trial.

Background: This study compared conventional-resin-sealant versus nanofilled-sealant retention at different intervals. Methods: A double-blinded split-mouth randomized control trial was performed on sixty-two children aged from six to nine years. Participants with one pair of contralateral permanent first molars with deep fissures or noncavitated carious lesions were randomly selected for sealant application. Conventional resin sealant was applied on one molar and nanofilled sealant on the contralateral molar. Evaluations were performed at one, three, six, twelve and eighteen months to check for retention. The chi-squared test, McNemar test, Wilcoxon signed-rank test and Friedman test were used for statistical analysis. Results: Conventional resin sealant showed complete retention in 91.4%, 86.2%, 74.1%, 62.1% and 55.2% of the teeth, and nanofilled sealant showed complete retention in 89.7%, 81%, 77.6%, 69% and 67.2% of the teeth, at the end of 1 month, 3 months, 6 months, 12 months and 18 months evaluation, respectively. Each sealant exhibited a statistically significant change (p < 0.05) in the retention rate during the evaluation period. However, when both the sealants were compared with each other, there was no statistically significant difference in any phase. At the end of 18 months, caries development was observed in 13.8% of the teeth sealed with conventional sealant, and in 10.3% of the teeth sealed with nanofilled sealant. Conclusion: At eighteen months, the nanofilled resin sealant exhibited complete retention in 12% more teeth than the conventional sealant. However, the difference was not statistically significant. The nanofilled resin sealant yielded an acceptable performance in sealing the occlusal pits and fissures of mandibular permanent first molars, compared to conventional pit-and-fissure sealants.

Fracture Resistance of Root-Canal Treated Premolars Restored with Dentin Replacement Materials: An In-vitro Study.

PURPOSE: Conservative restorations of endodontically treated premolars have yielded mixed results. The present study aimed to compare fracture resistance of endodontically treated premolars with Class II mesial-occlusal cavity preparations, restored with either Smart Dentin Replacement (SDR; Dentsply Sirona) material, Biodentine (Septodont) or ceramic inlays. MATERIALS AND METHODS: Thirty-two extracted premolars were randomly divided into four equal groups (n = 8): Group 1 served as a control group with teeth left intact; teeth in the remaining three groups received root canal treatment followed by a mesio-occlusal cavity preparation. These crowns were restored with: Biodentine in group 2, SDR in group 3 and ceramic inlays in group 4. A computer-controlled Instron universal testing machine subjected all specimens to compressive load until failure. Force at failure and fracture mode (above or below the cementoenamel junction) were recorded. The data were analysed using Fisher's exact test and one-way ANOVA followed by the post-hoc Tukey's test. Statistical significance was set at p < 0.05. RESULTS: The lowest mean load at failure was recorded for the inlay group. Loads at failure were statistically significantly higher for teeth restored with Biodentine than with SDR (p = 0.012) and ceramic inlays (p = 0.007). There were no statistically significant differences between the groups in terms of fracture mode (p = 0.440). CONCLUSION: Endodontically treated premolars with mesial-occlusal cavity preparation restored with Biodentine were more resistant to fracture than those restored with either SDR or ceramic inlays. Biodentine may prove a promising material to restore endodontically treated teeth with one missing proximal wall.

Effect of Different CAD/CAM Milling and 3D Printing Digital Fabrication Techniques on the Accuracy of PMMA Working Models and Vertical Marginal Fit of PMMA Provisional Dental Prosthesis: An In Vitro Study.

Background: Minimal evidence exists on the efficacy of different digital manufacturing techniques in the fabrication of precise dental working models and provisional prosthesis. Aim of study: The objective was to evaluate the effect of two digital fabrication techniques (CAD/CAM milling and 3D printing) on the accuracy of PMMA working models and marginal fit of PMMA provisional prosthesis. Materials and methods: Two abutment teeth of modified typodont were prepared. A reference stone model was fabricated, and an optical impression was performed to obtain a CAD reference model. Four CAM milled working models and four printed working models were fabricated. CAD software was used to design the provisional prostheses. Group A tested four milled provisional prosthesis, and group B tested four 3D printed prosthesis. The 3D accuracy of working models was assessed by superimposition of the control reference working model on the CAD test working model. A stereo-optical microscope was used to assess vertical marginal fit of the provisional dental prosthesis. Student's t and Mann-Whitney U tests were utilized to compare the two groups. Results: Results showed no statistically significant difference between the two tested groups. Conclusion: The two digital working model fabrication techniques recorded comparable accuracy. Similarly, 3D printed provisional prosthesis showed comparable marginal fit to the CAD/CAM milled ones.

Team-Based Learning in Prosthodontics Courses: Students' Satisfaction.

The goal of this cross-sectional observational study was to assess dental students' satisfaction regarding team-based learning (TBL) methodology in prosthodontics courses taught at College of Dentistry, Princess Nourah bint Abdulrahman University, Saudi Arabia. Undergraduate dental students at second, third, fourth, and fifth years were taught prosthodontics courses through traditional and TBL pedagogies. TBL sessions consisted of preparation, readiness assurance, and application. At the end of each prosthodontics course, the students were asked to complete a self-administered questionnaire that was divided into four sections to assess the effect of TBL on the following parameters: information acquisition, interpersonal skills improvement, classroom environment, and the students-instructors interaction. The responses of the questionnaire followed the Likert scoring method (scaled from 1 to 5). The t-test and ANOVA statistical analyses were performed using SPSS. Results. The response rate to the questionnaire was 86%. There were a significant relationship and correlation between TBL pedagogy and student satisfaction (P values ≤ 0.05) for all levels. The means of the responses for the second and fifth years were 4.36 and 4.56, respectively, where the means for the third and fourth years were 3.54 and 3.59, respectively. The parameter notably affected by TBL was interpersonal skills enhancement. All students strongly agreed that TBL enhances personal flexibility and boosts their self-esteem. Conclusion. Students showed positive perceptions about TBL pedagogy in terms of active engagement, knowledge acquisition, and improvement of interpersonal skills leading to more efficient learning outcome.

Monolithic Endocrown Vs. Hybrid Intraradicular Post/Core/Crown Restorations for Endodontically Treated Teeth; Cross-sectional Study.

The gold standard for restoring Endodontically Treated Teeth (ETT) with successful clinical longevity requires having minimal invasive preparations and maximal tissue conservation. Many dentists still consider hybrid post/core/crown to be the first choice for restoring ETT. Endocrown is a viable alternative treatment modality to hybrid post/core/crown. This study aims to assess the proper judgment of dentists working in Riyadh, Saudi Arabia on the use of monolithic endocrown versus hybrid post/core/crown for restoring ETT. The IRB of Princess Nourah Bint Abdulrahman University (PNU) Institutional Review Board reviewed this study. The questionnaire was validated and electronically distributed. The participants were pre-informed that their responses are completely anonymous and used for professional purposes only. The questionnaire surveyed dentists working in Riyadh, Saudi Arabia, about their preference for different ETT restorative modalities at various clinical scenarios. Data were analyzed using One-way ANOVA and t-test. All P-values of < 0.05 were considered statistically significant. A total of 275 responses were collected; 61.45% were females and 38.55% males. 56% of them were general practitioners, while 16% were consultants. Prefabricated post/core was the most preferred technique among the participants (18.55%), followed by endocrown (12.36%), and lastly, cast post/core (8.73%). The amount of remaining tooth structure was the most influential in the treatment selection (30.18%), followed by the presence or absence of 1-2 mm ferrule (17.82%). Interocclusal space (12.36%) was the least influential factor. Endocrown recorded 63.27% as the most preferred line of treatment in case of insufficient inter-occlusal space. 40.36% preferred endocrown for patients with occlusal risk factors. The amount of the remaining tooth structure and the tooth position significantly affect the treatment options of the participants. Endocrown was the most preferred treatment modality for restoring ETT for patients with occlusal consideration.

Interfacial Adhesion of a Semi-Interpenetrating Polymer Network-Based Fiber-Reinforced Composite with a High and Low-Gradient Poly(methyl methacrylate) Resin Surface.

The research aimed to determine the tensile bond strength (TBS) between polymerized intact and ground fiber-reinforced composite (FRC) surfaces. FRC prepregs (a reinforcing fiber pre-impregnated with a semi-interpenetrating polymer network (semi-IPN) resin system; everStick C&B) were divided into two groups: intact FRCs (with a highly PMMA-enriched surface) and ground FRCs (with a low PMMA gradient). Each FRC group was treated with: StickRESIN and G-Multi PRIMER. These groups were further divided into four subgroups based on the application time of the treatment agents: 0.5, 1, 2, and 5 min. Next, a resin luting cement was applied to the FRC substrates on the top of the photo-polymerized treating agent. Thereafter, weight loss, surface microhardness, and TBS were evaluated. Three-factor analysis of variance (p ≤ 0.05) revealed significant differences in the TBS among the FRC groups. The highest TBS was recorded for the intact FRC surface treated with G-Multi PRIMER for 2 min (13.0 ± 1.2 MPa). The monomers and solvents of G-Multi PRIMER showed a time-dependent relationship between treatment time and TBS. They could diffuse into the FRC surface that has a higher PMMA gradient, further resulting in a high TBS between the FRC and resin luting cement.

Awareness and Practice of Oral Health Measures in Medina, Saudi Arabia: An Observational Study.

The aim of this observational study is to investigate the oral health status and practices in the multicultural community of Medina, Saudi Arabia. A cross-sectional questionnaire was distributed that asked about oral health, dental and periodontal conditions, personal attitudes toward dental care, and smoking habits. Cross tabulation with chi-squared testing was carried out to investigate the association of toothbrush usage and smoking with several variables. Four-hundred and sixty subjects enrolled in the study. The majority of the respondents were students and Saudi males. More than 75% of the participants had neither a family dentist nor dental insurance; 7% were smokers, 84% used a toothbrush, 17% used dental floss and 34% used miswak (a teeth cleaning twig made from the Salvadora persica tree). Some of the individuals complained of tooth sensitivity, halitosis and bleeding gums. The main reason for dental visits was pain, with 23% of the participants having never visited a dentist. Tooth brushing was significantly associated with gender, nationality, occupation, education, marital status, having kids and dental insurance (p ≤ 0.05). Tobacco consumption was significantly associated with age, occupation, education level, marital status, having children, having bleeding gingivae and halitosis. Effective dental education programs are needed to improve dental knowledge and awareness in the Medina community.

Antimicrobial Capacity and Surface Alterations Using Photodynamic Therapy and Light Activated Disinfection on Polymer-Infiltrated Ceramic Material Contaminated with Periodontal Bacteria.

This study determined the antimicrobial efficiency of light-activated disinfection (LAD) and photodynamic therapy (PDT) on polymer-infiltrated ceramic network (PICN) material contaminated with three periodontal bacteria and explored if PDT and LAD cause PICN surface alterations. Sixty PICN discs were contaminated with Tannerella forsythia, Porphyromonas gingivalis, and Treponema denticola and randomly divided into five groups (n = 12 samples/each) according to the treatment groups: Group PDT-PDT (630 ± 10 nm diode laser) with methylene blue; Group DL-808 nm diode laser in contact mode without photosensitizer; Group MB-methylene blue without light application; Group CHX-0.12% chlorhexidine digluconate solution and; Group NT-no treatment. Each disc was then placed in tubes containing phosphate buffered saline (PBS) and vortexed for 30 s to remove the remaining bacteria from the discs. A total of 10× serial dilutions were performed followed by plating of 30 µL of suspension on Brucella agar plates. The colony forming units (CFU) were calculated after 72 h. PICN discs with the attached biofilms were used for confocal microscopy investigation for live/dead bacterial viability. A random single sample from each group was selected to study the bacterial adherence and topographical alterations on PICN discs under scanning electron microscope (SEM). The PDT group showed higher reduction for each bacterial species and total counts of bacteria assessed followed by the DL group (p < 0.05). When compared with MB group, the two laser groups were significantly superior (p < 0.05). The MB group did not show significant differences for any bacteria when compared to NT. The bacteria with the CHX group and DL groups appeared dead with few areas of surviving green stained bacteria. The PDT group showed the highest dead cell count (p < 0.05). PDT and DL groups indicate no significant changes on the surface compared to the sterile PICN discs on visual assessment. Photodynamic therapy produced superior periodontal bacteria reduction over the surface of PICN surface. PDT group showed higher reduction for each bacterial species and total counts of bacteria assessed followed by the DL group. Both PDT and DL treatment strategies are effective without producing surface alterations on PICN.

Familiarity and implementation of academicians of dental schools regarding the application of photodynamic therapy in dentistry: A need to incorporate in the dental curriculum.

BACKGROUND: The present cross-sectional study aimed to evaluate the knowledge, behavior, and attitudes of academicians from dental schools in Riyadh, Saudi Arabia towards the use of photodynamic therapy (PDT) in dentistry. METHODS: A self-administered questionnaire to a total of 289 academicians from the dental training faculty (DTF) was distributed to six dental schools in Riyadh, Saudi Arabia during 3 months of the study period. The questionnaire consisted of four main sections with 17 items that dealt with: demographic data, awareness, and knowledge of dental academician regarding PDT technique, and the interest of the dental academician in implementation the PDT technique, detailed knowledge, and background about PDT use followed by the role and integration of PDT technique and its theoretical knowledge in the curriculum and clinical practice. Quantitative data were analyzed using frequency distribution. To estimate if general demographics of the participants affect DTF responses regarding PDT knowledge and teaching experience multivariate statistical analyses were carried out according to gender, age, professional experience, and academic rank regarding selected questions. RESULTS: A total of 238 questionnaires (response rate: 82.3 %) were returned for the analysis. Females responded higher than males. More than 50 % of respondents were age 50 years and less. It is shown that 63 % of DTF indicates familiarization regarding PDT and 67 % and 70 % strongly agree to the fact that PDT should be incorporated in the dental curriculum and important to acquire knowledge regarding PDT for teaching undergraduate. A remarkable number of 87 % and 74 % showed high interest in participating in lectures and workshops related to PDT and therefore clinically applying the technique in clinical practice, respectively. Multivariate analysis showed a statistically significant difference between the level of knowledge and correct answers with age, professional experience of teaching and academic rank. CONCLUSION: Although the DTF involved in the present study demonstrated average knowledge regarding PDT, they, however, consider significantly important and showed a keen interest in acquiring PDT knowledge and adding it in the dental curriculum.

Graphene oxide-based experimental silane primers enhance shear bond strength between resin composite and zirconia.

Despite various mechanical and chemical surface-pretreatment methods, long-term bonding of resin composite to dental zirconia (ZrO2 ) remains a major concern. In this study, graphene oxide (GO) sheets were infused into two commercially available primers and the enclosed mould shear bond strength (EM-SBS) of resin composite to ZrO2 was evaluated. Twelve fully sintered ZrO2 blanks were pretreated and randomly allocated to four groups according to the primers used: RelyX (RX); GO blended RelyX (RXGO); Monobond-S (MB); and GO blended Monobond-S (MBGO). The resin composite stubs were bonded onto the pretreated ZrO2 surfaces and analysed at baseline and after storage in distilled water for 2 and 4 months. The experimental primers blended with GO sheets influenced the surface morphology, visualized as increased surface roughness, and slightly increased the water contact angle measurements. Moreover, the infusion of primers with GO increased the mass fraction (wt%) of carbon and oxygen. The highest EM-SBS values were found for RXGO, with mean (SD) EM-SBS values of 26.4 (3.7) MPa and 21.5 (5.1) MPa after 2 and 4 months of storage, respectively. Infusion of silane primers with nanometre- to micrometre-size GO sheets enhanced the SBS between resin composite and ZrO2 .