Inhibitory Effect of Traditional Endodontic Irrigants versus LED activated Photosensitizer Curcumin Microbes of Saudi Arabian Infected Dental Pulp.

The success of an endodontic therapy is combinational, dependent on mechanical preparation of canal and chemically detriment of microbial load. Therefore the use of an efficient irrigant is necessary having potential for eradicating the population dependent endodontic microbes. The main aim of the study was to evaluate and compare the antimicrobial potential of commonly used endodontic irrigants and LED light activated curcumin against the endodontic microbial variants of Saudi Arabian population. The 170 infected pulp samples were collected in nutrient broth and streaked on four types of agar plates for each sample after 24 hours of incubation at 37°C. Later after incubation for one day, the microbes were identified under the microscope and the number of microbial colonies. Using well method anti-microbial efficacy of three experimental groups with traditional endodontic irrigants (5.25% NaOCl, 2.0% CHX and 17.0% EDTA), LED light activated photosensitizer and one negative control (NaCl) was evaluated. The photosensitizer and 17.0% EDTA displayed to have efficient anti-microbial potential against E. fecalis and Streptococcal species reducing the colony count and increased radius of 4.3mm (Curcumin)/ 4.1mm (17.0% EDTA) and 3.2mm (Curcumin)/ 3.0mm (17.0% EDTA) showing anti-bacterial effect on the agar plates trailed by 5.25% NaOCl but statistically no significant difference was observed. On contrary 5.25% NaOCl showed strong potential against Staphylococcus and C. albicans species. Overall it can be concluded from the results 5.25% of NaOCl have stronger anti-microbial potential than 17.0% EDTA, CHX and NaCl against endodontic species of Saudi Arabian population.

Use of photosensitizers activated by photodynamic therapy on the canal disinfection of radicular dentin bonded to Dimethacrylate-based glass fiber post: an assessment of pushout bond strength.

OBJECTIVE: The present lab-based investigation aimed at evaluating the canal disinfectants using photodynamic therapy (PDT) using different photosensitizers, conventional NaOCl, a mixture of doxycycline, citric acid, and a detergent (MTAD) and their impact on the bond strength of glass fiber post to radicular dentin. MATERIALS AND METHODS: Forty extracted human premolars were gathered and disinfected. The decoration was performed up to the cementoenamel junction. Using the crown down technique cleaning of the canal was done following rinse with distilled water. All canals were dried with paper points and obturated with gutta-percha. Post space was prepared using peso reamers and samples were randomly allocated into four groups following different disinfection regimes: Group 1 - Methylene blue photosensitizer (MBP) + MTAD; Group 2 - RBP (Rose Bengal photosensitizer) + MTAD; Group 3 - CP (curcumin photosensitizer) + MTAD and Group 4 - 2.25% NaOCl + MTAD (control). Following disinfection, the canals were dried and the post was placed and cemented within the canal. Samples were dissected at coronal, middle, and apical third and placed in a universal testing machine for push-out bond strength (PBS). Debonded surfaces were evaluated for failure modes. PBS was examined using a one-way analysis of variance (ANOVA). The means of PBS were compared using Tukey multiple comparison tests with a significance threshold of (p<0.05). RESULTS: Group 3 canals disinfected with CP and MTAD had the highest PBS at two levels: cervical (9.57±1.21 MPa), middle (6.37±0.79 MPa), and group 2 canal space disinfected by RBP and MTAD had the maximum PBS in apical portion (5.35±0.42 MPa). No significant difference at all root levels between group 2 (RBP + MTAD) and group 3 (p>0.05). Canal irrigation with group 1 (MBP + MTAD) and group 4 control (2.25% NaOCl + MTAD) exhibited comparable PBS at all three levels of the root. CONCLUSIONS: CP, MTAD, RBP and MTAD for canal disinfection and bonding of glass fiber post to radicular dentin demonstrated comparable bond values at all three root levels and can be recommended in clinical settings after further investigations.

The effect of selected commercially available mouth-rinses vs. curcumin photosensitizers in an artificial mouth model mimicking their use before meals on early colonizers single species biofilm.

OBJECTIVE: The aim of the study was to determine the bacterial-adherence to the experimental pellicle pretreated with commercially available oral-rinse/ photosensitizer (mimicking use of oral-rinse/ photosensitizer before meals). MATERIALS AND METHODS: An artificial mouth (NAM) system was used for the development of single-species biofilm (Actinomyces viscosus, Streptococcus mitis and Streptococcus sanguinis respectively). Two commercially available oral-rinses containing active ingredients [Essential oils (EO) and Chlorhexidine gluconate (CHX) were used. Curcumin photosensitizer (PS) was used as a photosensitizer against the microbes. For the adherence study, the experimental pellicle on the beads (in the capillary tubes of the NAM system) was pretreated with the oral-rinse and photosensitizer before the inoculation of bacteria; this would resemble the use of rinse/ photosensitizer before meal. The bacterial population of the biofilm was determined using serial dilution assay and expressed as colony forming unit per ml. Deionized distilled water was used in place of oral-rinse/photosensitizer and served as a negative-control. For the qualitative study, bacterial population viewing was carried out using Scanning Electron Microscope (SEM). RESULTS: It was observed that on treatment with the oral-rinses the bacterial population of S.mitis, S.sanguinis and A.viscosus (adherence) was significantly reduced where the reduction was less for EO-based oral-rinse compared with that of CHX and curcumin PS in the following sequence EO

Level of Self-Perceived Knowledge Regarding Oral and Maxillofacial Surgery and Dental Surgery among Dental Undergraduates and Graduates in Saudi Arabia.

For evaluating the level of self-confidence of dental undergraduate, graduates and postgraduates regarding Oral and Maxillofacial Surgery and Dental Surgery (OMFS and DS) and to assess the teaching curriculum at Saudi Dental Institutes using a validated modified survey form developed by the Association of British Academic and Oral Maxillofacial Surgeons (ABAOMS). The undergraduate students (level 11 and 12), graduates and postgraduates with more than two years of experience after completing education from Saudi Arabian Dental Institutes responded to the questions of modified ABAOMS survey form assessing various areas of OMFS and DS curriculum. It was a cross-sectional study, conducted in Saudi Arabia from June 2021 to September 2021. In order to assess the difference between the respondents independent sample t-test was applied. Further to evaluate the correlation between confidence levels for carrying out OMFS and DS procedures and curriculum Spearman's rho test was applied. Majority of the respondents in these three groups expressed of having sufficient knowledge to undertake their own clinical practice. In general the responses were favorable except for the low confidence level in performing minor surgical procedures. It can be concluded from the responses to modified ABAOMS questionnaire displayed the level of confidence in taking independent clinical practice, carrying out minor oral surgical procedures and identifying malignant and non-malignant lesions. Respondents of all three levels felt comfortable in extractions using the surgical forceps or elevators, removal of broken down roots, and recognizing the potentially malignant and malignant lesions of the human oral cavity.

Effect of photosensitizers on modulating bond strength of different luting cements used for cementation of resin modified composite fiber posts.

OBJECTIVE: The aim of the study was to evaluate the tensile BS of FPs luted with conventional and self-adhesive resin modified GIC cement on disinfection of post-space radicular dentin with various photo-activated photosensitizer (chitosan, TB and Clp6). MATERIALS AND METHODS: Sixty-six orthodontically extracted mandibular pre-molars were selected on specific exclusion/inclusion criteria, trailed by thorough debridement of plaque/calculus and disinfected by immersion in Chloramine T trihydrate solution for 48 hrs. The selected teeth were sectioned from the cement-enamel junction removing the crown. The radicular region of the samples was entrenched perpendicularly in heat cure resin modified acrylic. The pulpal tissue was detached using K-files trailed by canal shaping with ProTaper Next rotary NiTi (Dentsply Sirona, Gloucestershire, UK) files under continuous irrigation with NaOCl. The canals were dried using paper points trailed by obturation by Pro Taper Next Obturators gutta-percha points (Dentsply, UK) coated with ADSEAL (Meta Biomed, Chungcheongbuk-do, South Korea). After incubation for seven days in an environment mimicking oral cavity, post space was created using peso reamers. The space was disinfected by G1: chitosan 3 mg/mL; G2: 13-15 mg/mL TB and G3: Clp6. After photo-irridation the FPs were luted with conventional (n=11) and resin modified self-adhesive cement (n=11) for each group respectively. The specimens were incubated for 48 hrs prior to tensile BS testing. The type of bond fracture/failure was evaluated under 30x magnification. The tensile BS was statistically analyzed using ANOVA trailed by Tukey's test to respective groups. RESULTS: FPs luted using self-adhesive resin modified cement with prior to disinfection by TBs displayed highest tensile BS 291.47 N ± 5.36. On the contrary, post-space disinfected by Clp6 displayed statistically significant (p ≤ 0.05) lowest bond strength (276.62 N ± 4.31). Intra-group analysis displayed statistically significant difference in bond strength of the luting dental materials (p ≤ 0.05). CONCLUSIONS: The self-adhesive resin modified cement revealed utmost bond strength on pre-treatment of post-space with respective photo-activated photosensitizer (chitosan, TB & Clp6) in contrast to conventional GIC.

The Level of Self-Perceived Knowledge Regarding Temporo-mandibular Disorders among the Saudi Arabian Dental Professionals Working in Dental Institutes or Universities vs. Clinics or Hospitals.

Temporo-mandibular disorders (TMDs) are considered as one of the most common type of oro-facial pain. The basic knowledge regarding examining, diagnosing and treating the TMDs is part of the dental curriculum designed by the Saudi Dental Council. But till date it is not reported how the dentists working in dental institutes/universities and clinics/hospital of Saud Arabia make an attempt to diagnose and treat TMDs cases. Therefore, the main aim of the study was to evaluate the level of self-perceived TMD knowledge among the dentists working in Saudi Arabia and to compare the between those working in dental institutes/universities (Group I) and clinics/hospital (Group II). On prior ethical approval from Riyadh Elm University, the participants graduated from various universities of Saudi Arabia with more than two years of experience were randomly selected. They were asked to fill a previously validated questionnaire to evaluate them regarding their knowledge regarding TMDs diagnosis and therapy. It was observed only 9.09% of participants working in dental institutes/universities considered their knowledge as very good whereas it was higher (36.36%) among the participants working in clinics/hospitals. Of all respondents working in dental institutes/universities 7.23% attempted to diagnose and treat TMDs, slightly higher number of respondents (9.09%) working in hospitals/clinics attempt to treat patients with TMDs. A strong relationship was observed for both groups between the knowledge for TMDs and attempt to diagnose/ treat TMD patients (p≤0.05). The level of knowledge for TMDs is better among the dentists working in dental clinics or hospitals than those in dental institutes or universities. But in general it is still insufficient in both groups of dentists. Therefore, it should be considered to raise the level of knowledge regarding TMD among the dentists of Saudi Arabia, particularly to make them able for referring to the right specialist for diagnosis, treatment or interdisciplinary management.

Awareness comportment and attitude of dental practitioners for photodynamic therapy during COVID-19 pandemic: a global survey.

OBJECTIVE: The aim of the study is to evaluate the awareness, comportment and attitude/perception of dentists regarding the use of photodynamic (PD) therapy before and during COVID-19 pandemic around the globe. SUBJECTS AND METHODS: An online survey was performed by sending out an online questionnaire comprising 21 questions among dental practitioners working in four different countries: Saudi Arabia, Pakistan, Malaysia and United Kingdom. The survey evaluated dental practitioners' level of awareness about the PD therapy, comportment and attitude for its implication and prevalence in daily clinical practice. For statistical significance the Chi-square analysis with Spearman Correlation coefficient was conducted to assess the sub-groups and correlating the factors with the level of awareness of the dental practitioners. RESULTS: A total of 1,219 dental practitioners from four different countries (Saudi Arabia, Pakistan, Malaysia and United Kingdom) responded to the questionnaire. The median age of the respondents was 37, 34, 36 and 39 respectively. The majority of dental practitioners demonstrated to have an acceptable level of awareness regarding PD therapy. Nearly 76%, 74%, 79% and 80% of the individuals from Saudi Arabia, Pakistan, Malaysia and United Kingdom respectively were aware of the role/mechanism of action of the PD therapy. Moreover, in preponderance, practitioners were confident that the effect of PD therapy will not be reduced in patients infected with COVID-19. The majority of dental practitioners were convinced that successful dental treatment due to PD therapy is linked majorly with therapies done in relation to four major dental specialties: prosthodontics, endodontic, restorative dentistry and periodontology. Approximately more than 90% of the dentists were sure that the rate of COVID-19 transmission can be reduced by using PD therapy in oral treatments. The dental practitioners from Saudi Arabia (91%), Pakistan (82%), Malaysia (83%) and United Kingdom (82%) were contented to learn about PD therapy for its use in clinical practice. Nearly more than 95% of the practitioners from the four countries were keen to attend the lectures/hands-on workshops regarding PD therapy to enhance their skills and knowledge. More than 80% of dentists do not refuse the peripheral role of PD therapy with their patients. CONCLUSIONS: The respondents from the four countries displayed passable level of awareness regarding basic information of PD therapy and its clinical implication in dental specialty. Nevertheless, there is a need to develop awareness regarding the use of PD therapy among dental practitioners during their undergraduate program. Furthermore, lectures and hands-on workshops should be arranged to train dental practitioners in order to enhance their skills for its solicitation in clinical practice. It is perceived by the dentists in the four countries that the use of PD therapy can effectively reduce COVID-19 rate of transmission.

Gender Predilection of Saudi Arabian Population by a New Proposed Model Based on the Mesio-Distal Dimensions of the Teeth.

In the dental specialty forensic odontology, dimensions of tooth structure is being used to predict gender of a particular population in case accidents and mass disasters. Therefore the aim of our study was to develop a modified based on the mesio-distal dimension of teeth in Saudi Arabian population. The pretreatment orthodontic cast models of patients reporting to Riyadh Elm University, Riyadh, Saudi Arabia to measure the mesio-distal dimensions of all the teeth from permanent second molar of right quadrant to second molar of the left quadrant for both maxillary and mandibular arch with the help of an electronic devices. A significant difference was observed in mesio-distal dimensions for between males and females for canines, premolars and first molars (p≥0.05) except for incisors and second molars. On multi-variate logistic regression analysis a final model was developed which included permanent maxillary right canine (13), permanent mandibular left lateral incisor (32) and permanent mandibular left canine (33). The current modified sex predictive model for Saudi Arabian population displayed 80% accuracy for sex prediction. Based on the specificity of the modified model it can be recapitulated the model has a potential for gender prediction of Saudi Arabian population.

A Bibliometric Analysis of Top 100 Cited Articles on Dental Caries during 2000-2019.

The citation count of an article plays a vital role to indicate its' impact on the particular specialty. The main aim of the study was to identify the top 100 cited articles published in relation to dental caries during last twenty years from January 2000 to December 2019. The Scopus database was searched to retrieve top 100 cited articles and ranked according to the number of citations. Further analysis was conducted to determine the altmetric score, study type, impact factor of the journals, year of publication, authors' name, affiliated institute and the country of origin. The authors agreed on two keywords 'Caries' and Dental caries' to perform online search. The data were analyzed using SPSS software version 20 (IBM, USA). The citation count for top 100 cited articles ranged between 560-123. The journals publishing highest number of articles on dental caries included Journal of Dental Research (n=25) and Caries Research (n=14). During the first five year interval 2000-2004 highest number of articles were published (n=51) majorly from various institutes of USA (n=35) and UK (n=14). In preponderance studies published included literature reviews (n=45) and randomized controlled trials (n=15). This bibliometric analysis helps to identify the trends and research progress in cariology in addition, serve as an aid for future researches.

Regression Equations for Age Estimation of South Asian Population from Cells of Human Dental Pulp.

Due to improved healthcare services the human life expectancy has improved, therefore the interest of understanding the effect of age on number of dental pulp cells count has increased being key for maintaining vitality of the tooth. The aim of this study was to investigate correlations between numbers of dental pulp cells odontoblasts (OCs), subodontoblasts (SOCs) and fibroblasts (FCs) with age, within different age groups for Pakistani and Saudi Arabian populations. A total number of 220 tooth samples were included in the study, comprising of 55-teeth for individuals aged groups between 6-30 years and 31-85 years for Group I and Group II of both Pakistani and Saudi Arabian populations respectively. The qualitative research was conducted at Riyadh Elm University, Riyadh, Saudi Arabia from February 2019 to July 2019. Regression equations (RE) for the estimation of individuals' age from dental pulp cell count were developed. The values of the correlations obtained for each RE indicate good fits for the equations obtained. The pulp cells were observed to upsurge till third decade of life, later were observed to decline with increasing age. Pearson correlation revealed positive relation between number of dental pulp cells with age for Group I whereas a significant negative relationship for individuals above 30 years above. RE generated using number of OCs, SOCs and FCs for determination of age with standard error estimate was ±3 and ±6 years for Pakistani population Group I (6-30 years) and Group II (31-85 years) respectively whereas, for Saudi Arabian population Group I and Group II it was ±4 years and ±9 years. The age estimates made by the number of dental pulp cells were not statistically significantly different (p>0.05) from chronological age.