MATERIALS AND METHODS: This cross-sectional study comprised 2,000 schoolchildren aged 6-12 years. Sleep-disordered breathing symptoms were assessed with Arabic version of Pediatric Sleep Questionnaire (PSQ). Overweight/obesity was evaluated using body mass index (BMI) and their association with SDB was tested using a regression analysis model.
RESULTS: Overall, 23% of children were at high risk of SDB. Prevalence of habitual snoring was 15.9% and sleep apnea 4%. Boys were at higher risk of SDB than girls (p = 0.026), while age had no effect (p = 0.254). High-risk SDB had a strong association with sleep symptoms compared to low-risk SDB (p < 0.05). Sleep-disordered breathing increased significantly in overweight and obese children (p = 0.017 and p < 0.001, respectively).
CONCLUSION: Around 23% Saudi schoolchildren are at risk of SDB. Related symptoms were strongly associated with high risk of SDB. Overweight and obesity had a strong and progressive association with SDB.
CLINICAL SIGNIFICANCE: The results will help in identifying children at high risk of developing SDB and plan for early intervention to avoid the progression of SDB later in life.
MATERIALS AND METHODS: This prospective cross-sectional study comprised 78 growing children in the age range of 11-14 years with polysomnography (PSG)-proven OSA and 86 non-OSA corresponding controls. BMI, tonsil size (Friedman grading scale), and Mallampati score were determined for both groups, and related differences were assessed with a t-test, while their independent association with OSA severity was tested with a regression analysis. Statistical significance was set at p <0.05.
RESULTS: Male gender, BMI, tonsil size, and Mallampati score were significantly higher in the OSA group (p < 0.05). A significant correlation was recorded between the Mallampati score and OSA severity (p < 0.01), but not with BMI or tonsil size (p > 0.05). For every 1-point increase in the Mallampati scale, the apnea-hypopnea index (AHI) increased by more than five events per hour in the bivariate analysis and by more than three events per hour in the multivariate analysis.
CONCLUSION: Male gender, increased BMI, high tonsil, and Mallampati scores were clinical indicators of the presence of OSA. However, only Mallampati scale had a significant association with OSA severity. Clinical diagnostic indicators should be established and encouraged especially in community-based studies.
CLINICAL SIGNIFICANCE: Clinical diagnostic indicators are very useful in examining and screening children who are at risk of developing OSA as PSG is expensive and unsuitable for universal use in the pediatric population.
MATERIALS AND METHODS: An experimental GIC (ex-GIC) was prepared by mixing CHX-D powder with the powder of type II GIC to obtain 1% (w/w) concentration of CHX-D in the GIC. Antibacterial activity of this ex-GIC was tested against L. casei and A. viscosus using the agar diffusion method. The ex-GIC specimens were tested in their unset and set forms for each bacterium. For the unset group, specimens were placed in each agar plate immediately after manipulation and for the set group, specimens were placed in each agar plate, 1 hour after manipulation. The inhibition zones on the agar plate were recorded in millimeters immediately on placement of the specimen in the agar plate and after 48 hours. The reading was recorded and statistically analyzed for significant difference.
RESULTS: Mann-Whitney U test showed statistically significant difference in the inhibition zones produced by ex-GIC against L. casei and A. viscosus when both were compared in unset (p-value = 0.002) and set (p-value = 0.031) groups. For both the groups, the zone of inhibition against L. casei was greater. Though the unset group recorded wider zone of inhibition, the difference was not significant when compared with the respective set group. This was true for both the bacterial groups.
CONCLUSION: The 1% CHX-D-modified type II GIC showed antibacterial property against L. casei and A. viscosus and significantly higher activity against L. casei.
CLINICAL SIGNIFICANCE: Addition of 1% CHX-D to type II GIC showed evidence of antibacterial activity against organisms found in deep carious lesion and therefore may exhibit superior antimicrobial efficiency when used as an intermediate therapeutic restoration in deep cavities.
MATERIALS AND METHODS: An estimated 120 human root dentin disks were prepared, sterilized, and inoculated with E. faecalis strain (ATCC 29212) to develop a 3-weeks-old biofilm. The dentin discs were exposed to group I-control group: 5.25% sodium hypochlorite (NaOCl) (n = 20); group II-1% ALX + 5.25% NaOCl (n = 40); group III-1% alexidine (ALX) (n = 40) (Sigma-Aldrich, Mumbai, India); group IV-negative control: saline (n = 20). After exposure, the dentin disks were stained with the fluorescent live/dead dye and evaluated with a confocal scanning electron microscope to calculate the proportion of dead cells. Statistical analysis was done using the Kruskal-Wallis and Mann-Whitney U test (p < 0.05).
RESULTS: The maximum proportion of dead cells were seen in the groups treated with the combination of 1% ALX + 5.25% NaOCl (94.89%) and in the control group 5.25% NaOCl (93.14%). The proportion of dead cells presented in the 1% ALX group (51.79%) and negative control group saline (15.10%) were comparatively less.
CONCLUSION: The antibacterial efficiency of a combination of 1% ALX and 5.25% NaOCl was more effective when compared with 1% ALX alone.
CLINICAL SIGNIFICANCE: Alexidine at 1% could be used as an alternative endodontic irrigant to chlorhexidine, as alexidine does not form any toxic precipitates with sodium hypochlorite. The disinfection regimen comprising a combination of 1% ALX and 5.25% NaOCl is effective in eliminating E. faecalis biofilms.
MATERIALS AND METHODS: Sixty single-rooted permanent human teeth were chosen after considering the inclusion and exclusion criteria. The teeth were divided into two groups (n = 30). The test group was instrumented with TN files and the other with XPS according to manufacturer's instructions. CBCT images were taken before and after instrumentation to record the root canal distances from mesial, distal, buccal, and lingual borders of the root at 3, 5, and 7 mm distances from the root apex using a specific formula. Statistical analysis was done using the Statistical Package for the Social Sciences software program, version 20.0. The data were analyzed using the unpaired t test.
RESULTS: Both TN and XPS were safe for use in oval-shaped canals with moderate root curvature. However, the XPS showed higher buccolingual transportation as compared with TN at 3 mm from the apex and higher mesiodistal transportation at 3 and 5 mm levels from the apex as compared with TN.
CONCLUSION: Canal transportation has been detected in both systems; however, the values obtained were within the safe range (<0.3 mm). Overall, no significant difference was observed between TN and XPS (p > 0.05) in their canal transportation tendencies and centering ability.
CLINICAL SIGNIFICANCE: The study assesses the canal centering and transportation tendencies of the recently launched TN rotary system in extracted teeth with a combination of morphologies. The findings of the study are significant clinically as minimum transportation of the canal, minimal dentin removal, efficient disinfection, and three-dimensional obturation of the root canal are considered important factors in deciding the prognosis of endodontic therapy.
MATERIALS AND METHODS: The present study included the assessment of all the patients who underwent prosthetic rehabilitation by dental implants. An experienced registered prosthodontist was given duty for examination of all the cases from the record file data. Prosthetic complications in the patients were identified using photographs, radiographs, and all other relevant data of the patients obtained from the record files. All types of complications and other factors were recorded separately and analyzed.
RESULTS: While correlating the prosthetic complications in OSA patients grouped based on number of dental implants, nonsignificant results were obtained. Significant correlation was observed while comparing the prosthetic complications divided based on type of prosthesis. Fracture of the porcelain was observed in four and eight cases respectively, of screwed and cemented dental implant cases.
CONCLUSION: Some amount of significant correlation existed between the incidences of prosthetic complications and OSA.
CLINICAL SIGNIFICANCE: Proper history of the patients undergoing dental implant procedures should be taken to avoid failure.
MATERIALS AND METHODS: A cross-sectional survey was performed. Primary maxillary and mandibular anterior teeth of 1,800 children aged between 2 years and 6 years, who attended 20 pre-schools in National Capital Region Delhi, India, were examined by a single examiner, and a questionnaire was filled in person by the parent/guardian. Andreasen's classification was used to classify the traumatic injuries. The Chi-square test was used to statistically analyze the variation in traumatic dental injuries (TDIs) with age and gender. Multiple logistic regression was used to determine the influence of independent variables on the occurrence of TDIs.
RESULTS: The prevalence of TDIs was 17%. Significant and highly significant differences were found between boys and girls for cause and location of trauma (p < 0.05) and tooth type involved (p < 0.001) with boys being more prone to such injuries. The commonest cause of injury was due to falls and the location was playground. The teeth most commonly affected were the maxillary central incisors (36.9%) followed by maxillary lateral incisors (3.3%), and the least affected were the maxillary and mandibular canines (0.3%).
CONCLUSION: The prevalence of traumatic injuries to the anterior teeth in 2- to 6-year-old children in National Capital Region of Delhi, India, was 17%. There is a need to run educational programs to increase parents' awareness of the risks of dental trauma and emphasize preventive measures.
CLINICAL SIGNIFICANCE: Parents should be made aware of the widespread prevalence, risk factors, and consequences of trauma to primary dentition, so that they can seek appropriate care timely. The time elapsed between injury and dental care is of utmost importance.
MATERIALS AND METHODS: A cross-sectional study was done among 253 children of 5-, 12-, and 15-year-olds living in various orphanage houses of Selangor, Kuala Lumpur, Malaysia. Demographic data, and dietary and oral hygiene practices were collected through a structured questionnaire. Clinical examinations of children were conducted to assess oral health status and recorded in the World Health Organization oral health assessment form (1997). Stimulated saliva was collected for S. mutans and Lactobacilli levels. The statistical software, namely, Statistical Package for the Social Sciences version 19.0 was used for the analysis of the data.
RESULTS: The final data analysis included 253 children of which 116 (45.8%) were boys and 137 (54.2%) were girls. Overall, 140 (55.33%) children were caries-free and 113 (44.66%) children presented with caries (decayed/missing/filled surface >0). High levels of salivary microbiological counts (S. mutans and Lactobacilli), i.e., ≥105, stress the importance of necessary preventive oral health services. Treatment needs among orphan children showed that most of the children, i.e., 58 (22.9%), need preventive or caries-arresting care followed by 49 (19.4%) who require two-surface filling as an immediate measure.
CONCLUSION: From the results of our study, orphan children have low utilization of preventive and therapeutic oral health services. Urgent attention is required to plan a comprehensive dental health-care program to improve their oral health status.
CLINICAL SIGNIFICANCE: Parents are the primary caretakers of children, but woefully some of them have to lead their lives without parents, the latter either being dead or incapable of bringing up their children. Such a group of children is known as orphans. As oral health is an integral part of general health, it is essential for health-care policy makers to address oral health needs of this underprivileged group of society. This article highlights the risk factors and treatment needs among orphan schoolchildren.
MATERIALS AND METHODS: The study group comprised of 30 healthy subjects, 15 males and 15 females, aged between 24 years and 65 years. Samples were obtained from the exfoliated oral mucosa cells of buccal mucosa before and 12 days after exposing the patients to panoramic radiography.
RESULTS: The study reported that there was no significant increase in the number of micronuclei cells present before and after panoramic radiography. Positive correlation existed between age with pre- and postexposure micronuclei.
CONCLUSION: Diagnostic dental panoramic radiograph does not induce micronuclei in the target buccal epithelium cells. A positive correlation between age and micronuclei frequency was established.
CLINICAL SIGNIFICANCE: Panoramic radiographs does not induce cytotoxicity but increase frequency may be vulnerable to genotoxic effects in buccal mucosal cells. Hence, dental radiographs should be prescribed only when necessary.
MATERIALS AND METHODS: Forty Turkom-Cera ceramic disks (10 mm × 3 mm) were prepared and randomly divided into four groups. The disks were wet ground to 1000-grit and subjected to four surface treatments: (1) No treatment (Control), (2) sandblasting, (3) silane application, and (4) sandblasting + silane. The four groups of 10 specimens each were bonded with Panavia-F resin cement according to manufacturer's recommendations. The SBS was determined using the universal testing machine (Instron) at 0.5 mm/min crosshead speed. Failure modes were recorded and a qualitative micromorphologic examination of different surface treatments was performed. The data were analyzed using the one-way analysis of variance (ANOVA) and Tukey honestly significant difference (HSD) tests.
RESULTS: The SBS of the control, sandblasting, silane, and sandblasting + silane groups were: 10.8 ± 1.5, 16.4 ± 3.4, 16.2 ± 2.5, and 19.1 ± 2.4 MPa respectively. According to the Tukey HSD test, only the mean SBS of the control group was significantly different from the other three groups. There was no significant difference between sandblasting, silane, and sandblasting + silane groups.
CONCLUSION: In this study, the three surface treatments used improved the bond strength of resin cement to Turkom-Cera disks.
CLINICAL SIGNIFICANCE: The surface treatments used in this study appeared to be suitable methods for the cementation of glass infiltrated all-ceramic restorations.
MATERIALS AND METHODS: Sixty-three freshly extracted human maxillary central incisors were used for the study. The teeth were instrumented with K-flex files and obturated using lateral condensation technique with GP and AH Plus sealer. The teeth were divided into three retreatment groups, each group consisting of 21 teeth. Group I: D-RaCe desobturation files (D-RaCe); group II: ProTaper Universal retreatment files (PTUR); group III: Hedstrom files (H-file). After removal of GP, the teeth were split longitudinally and divided into three equal parts: Cervical, middle, and apical third. The middle and apical thirds of all root halves were examined using scanning electron microscope (SEM). The total surface area covered by the residual debris was evaluated using Motic Image plus 2.0 software. Statistical analysis was done by one-way analysis of variance (ANOVA) test with a p-value <0.05 used to determine significance and Tukey's multiple post hoc tests used for comparison between the groups, and 't' test was done for comparison between the thirds within the same group.
RESULTS: The PTUR retreatment files showed overall better performance compared with D-RaCe files and H-files. The PTUR files performed better at middle third compared with others. The PTUR files and D-RaCe files performed equally at apical third better than H-files.
CONCLUSION: ProTaper retreatment files are better compared with D-RaCe files and H-files for the retreatment of the previously endodontically treated teeth.
CLINICAL SIGNIFICANCE: Highest efficacy for the removal of GP was shown by ProTaper Universal System followed by D-RaCe and H-file.
MATERIALS AND METHODS: Twenty-one patients with implants were included in this study and implants were assessed by resonance frequency analysis (RFA). Bone levels of the implants were assessed by measuring mesial and distal bone levels from the periapical radiograph, and soft tissue was assessed from probing depth using a periodontal probe. Implants were assessed for stability and probing depth at pre-loading, at 3 months and 6 months post-loading. RFA and probing depth were statistically compared from different time points. Correlation of probing depth and marginal bone loss with implant stability was also determined.
RESULTS: The average change in implant stability quotient (ISQ) measurements from pre-loading to 6 months post-loading was found to be statistically significant (p <0.005). The average probing depth reduced from 1.767 mm at pre-loading to 1.671 mm at post-loading 3 months, and 1.600 mm at post-loading 6 months. At 6 months of function, radiographic examination yielded 0.786 mm mesial bone loss and 0.8 mm distal bone loss. It was found to be statistically significant (p <0.005) but within an acceptable range. No significant correlation was found between implant stability and bone loss; and implant stability and probing depth.
CONCLUSION: The study revealed an increasing trend in implant stability values with the time that indicates successful osseointegration. Increasing mean values for mesial and distal bone loss were also found.
CLINICAL SIGNIFICANCE: The success of dental implants is highly dependent on the quality of bone and implant-bone interface, i.e., osseointegration. The most important factors that influence the survival rate of an implant is initial stability. The present study found the changes in the peri-implant hard and soft tissues and implant stability. This article, while being a prospective study, may show the evidence of successful osseointegration by increasing trend in implant stability (RFA) values with time which can help to the clinician in the long-term management of implants.
MATERIALS AND METHODS: Dental students (n = 122) in their clinical years, year 3 (n = 37), year 4 (n = 44), and year 5 (n = 41) received training (two-hour introductory lecture on ICDAS, followed by a 90 min e-learning video, and practice sessions using extracted teeth and photographs) from a calibrated expert. After training, the students examined a prevalidated set of extracted teeth and assigned scores in two sessions. The intra- and inter-examiner agreement between students was analyzed using weighted kappa statistics and a focus group discussion was conducted for qualitative feedback.
RESULTS: The range of kappa values for intra-examiner agreement among the year 3, 4, and 5 students for ICDAS caries code (0.611-0.879, 0.633-0.848, and 0.645-1.000) and restoration code (0.615-0.942, 0.612-0.923, 0.653-1.000), respectively. The range of kappa values for inter-examiner agreement for year 3, 4, and 5 students with a trained expert for ICDAS caries code (0.526-0.713, 0.467-0.810, and 0.525-0.842) and restoration code (0.531-0.816, 0.682-0.842, and 0.645-0.928), respectively.
CONCLUSION: The ICDAS system is a promising tool for caries detection and its implementation in the curriculum was perceived by dental students as an effective method. In general, there was moderate to substantial agreement for ICDAS caries and restoration code between students of different academic year groups and with a trained ICDAS expert.
CLINICAL SIGNIFICANCE: ICDAS is a simple, logical, and evidence-based system for the detection and classification of caries. Introducing ICDAS to dental students enables them to detect caries in a reliable and reproducible manner irrespective of their past clinical experience and also significantly improves their caries detection skills.
PURPOSE: The purpose of this paper is to systematically review all the prosthetic techniques that have been used in the oral rehabilitation of patients with microstomia.
MATERIALS AND METHODS: Data sources, including PubMed, Google Scholar, SCOPUS and Web of Science, were searched for case reports and case series published through September 2017. Three investigators reviewed and verified the extracted data. Only case reports and case series on prosthetic rehabilitation in microstomia patients published in the English language were considered eligible.
RESULTS: A total of 212 records were identified from the database search. Forty duplicate records were removed. The remaining 172 articles were assessed for eligibility, and 139 articles were removed because they did not satisfy the inclusion criteria. A total of 34 cases (including 32 case reports and 1 case series) were finally included in the qualitative analysis. The review revealed the use of a modified impression technique with flexible and sectional trays to record impressions in patients with microstomia. Modified forms of oral prostheses ranging from sectional, flexible, collapsible and hinged dentures to implant-supported prosthesis were fabricated to overcome the limited mouth opening. The success of the prosthetic technique primarily depended on the extent of the microstomia and the nature of the cause of the microstomia.
CONCLUSION: Even though the patient acceptance of the prosthetic techniques summarized in the systematic review were high, long-term success rates for each option could not be assessed because of the short follow-up time in most of the included case reports and series.