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  1. Fatima T, Haji Abdul Rahim ZB, Lin CW, Qamar Z
    J Pak Med Assoc, 2016 Aug;66(8):1019-1023.
    PMID: 27524540
    This review will discuss the importance of Zinc in the maintenance of oral health. Zinc (Zn) is a trace element of valuable importance. In the oral cavity, it is naturally present at various sites such as dental plaque, dental hard tissues and saliva. It is proven to be effective against common prevalent oral health problems such as dental caries, gingivitis, periodontitis and malodour. It is being used in various oral health care products to control the formation of dental plaque and inhibiting the formation of dental calculus. It has the potential to sustain and maintain its elevated concentrations for a longer time particularly in the dental plaque and saliva on delivery from the mouth rinses and toothpastes. It has been reported that low concentrations of zinc have the capability to reduce dissolution and promote remineralization under caries simulating conditions. Most importantly low Zn2+ levels in the serum are useful as a tumour marker. Thus taking a note of its potentials, it can be concluded that zinc is a precious element for the maintenance of oral health.
  2. Qamar Z, Haji Abdul Rahim ZB, Chew HP, Fatima T
    J Pak Med Assoc, 2017 Jan;67(1):116-120.
    PMID: 28065967
    Dental enamel, an avascular, irreparable, outermost and protective layer of the human clinical crown has a potential to withstand the physico-chemical effects and forces. These properties are being regulated by a unique association among elements occurring in the crystallites setup of human dental enamel. Calcium and phosphate are the major components (hydroxyapatite) in addition to some trace elements which have a profound effect on enamel. The current review was planned to determine the aptitude of various trace elements to substitute and their influence on human dental enamel in terms of physical and chemical properties.
  3. Niazi FH, Qamar Z, Noushad M, Muhareb AKB
    Pak J Med Sci, 2022 1 18;38(1):34-39.
    PMID: 35035397 DOI: 10.12669/pjms.38.1.4780
    Objectives: To evaluate the effect of Rose Bengal (RB), methylene blue (MB) and curcumin used as a canal disinfectant on the extrusion bond strength (EBS) of FRCP (fiber reinforced composite resin) with canal dentin.

    Methods: The present invitro study was completed in 90 days approved by Riyadh Elm University. Forty premolars were extracted disinfected and decoronated. Mechanochemical preparation was done of canal space using 10k file widening canals sequentially with a 25K file with constant saline irrigation. Canal was dried condensed with gutta percha and sealer. Post space was prepared using peso reamer. Based on canal disinfection samples were divided into four groups. Group-1 MBP+17%EDTA, Group-2 RBP +17%EDTA, Group-3 Curcumin+17%EDTA and Group-4 5.25% NaOCl +17% EDTA. Following disinfection, the canal space of all specimens was washed with 17% EDTA for 120 sec. Post was cemented in canal space and cured. Specimens were placed on Universal testing machine (UTM) for EBS. The type of bond failure was evaluated using stereomicroscope. ANOVA and Tukey multiple comparison test was used to compare means.

    Results: Cervical third of Group-3 in which samples were disinfected with CP+17% EDTA displayed the maximum EBS (8.69±1.32 MPa). Whereas, the lowest EBS (3.30±0.54 MPa) was exhibited by the apical third of Group-4, where 5.25% NaOCl +17% EDTA was used as a canal disinfectant. The intragroup comparison demonstrated a declining trend of EBS from cervical to apical third in all investigated groups.

    Conclusion: Root canal dentin treated with different PS (MBP, CP, and RBP) demonstrated better EBS than the conventional disinfecting regime (NaOCl +17% EDTA). CP and RBP displayed better EBS than MBP.

  4. Qamar Z, Haji Abdul Rahim ZB, Neon GS, Chew HP, Zeeshan T
    Arch Oral Biol, 2019 Oct;106:104482.
    PMID: 31325718 DOI: 10.1016/j.archoralbio.2019.104482
    OBJECTIVE: The aim of the study was to determine demineralisation inhibition and remineralisation potential of poly-γ-glutamic acid with its possible mechanism of action on human dental enamel.

    METHODOLOGY: Three sodium-fluoride(NaF) concentration(0.01%w/v,0.1%w/v and 0.5%w/v respectively)and two poly-γ-glutamic acid(PGGA)concentration(1%w/v and 2%w/v respectively)were prepared in 0.1 M acetic acid(pH4.0)and deionized distilled water.For de/re-mineralisation study, tooth samples (18 teeth varnished, leaving a 2 mm2 window on the mid-buccal surfaces) were immersed in respective acidified NaF and PGGA solutions. The Ca2+ release/uptake was monitored with ISE over 72-hr with increasing pH every 24-h from 4.0 to 6.0.These teeth were later subjected to cross-sectional microhardness to determine integrated mineral recovery of enamel on increasing pH of respective acidified solution.In order to determine mechanism of PGGA,two concentrations of PGGA in deionized-water-solutions were used for tooth samples immersion followed by overnight drying then later subjected to Fourier Transform Infra-Red(FT-IR) analysis.The FT-IR analysis was also carried out on PGGA powder.For control,the experiment was repeated using hydroxyapatite(HAp)pellets.The density of PGGA solutions(1%and2%)was also measured to determine their dynamic viscosities.

    RESULTS: The ISE and microhardness testing revealed statistically significant (ρ ≤ 0.05) dissolution inhibition and remineralisation potential for tooth sample treated with acidified 2%PGGA. From the FT-IR spectra, it was observed that the profiles of the enamel and HAp surfaces treated with 1%-and 2%-PGGA solutions were similar to those of PGGA powder.It was found that the viscosity of PGGA increases with increasing concentration.

    CONCLUSION: The study implies that 2% PGGA is more effective than NaF as forms a coating layer to protect from demineralisation and promote remineralisation of the tooth surface.

  5. Niazi FH, Qamar Z, Tanvir SB, Noushad M, Dossary OBA
    Photodiagnosis Photodyn Ther, 2021 Sep;35:102405.
    PMID: 34153543 DOI: 10.1016/j.pdpdt.2021.102405
    OBJECTIVE: The purpose of the present study was bleached enamel reversal using conventional ascorbic acid (AA) and contemporary methods including Photodynamic therapy (PDT), Er, Cr: YSGG (ECL) on bond integrity to composite resin.

    MATERIAL AND METHOD: Forty sound permanent mandibular premolars were collected from a dental clinical setting and disinfected. All forty samples were mounted vertically in a rubber mold exposing only the clinical crown. All samples were bleached using Opalescence Boost Professional Teeth Whitening. After the bleaching procedure, each sample was randomly allocated into four groups according to surface treatment. Samples in group 1 were treated with methylene blue photosensitizer (MBP). Samples in group 2 were exposed to 10% sodium ascorbate. Samples in group 3 were treated with Er, Cr: YSGG laser (ECL). Samples in group 4 were not treated (control). All Samples were treated with 37% phosphoric acid and a bonding agent was applied. A bulk-fill composite was cured to all specimens and all samples were treated in a thermocycler. Specimens were placed in a universal testing machine for shear bond strength (SBS) testing. Descriptive statistics were associated by analysis of variance (ANOVA) and Tukey's post hoc test maintaining level of significance (p<0.05) RESULTS: The lowest SBS scores were achieved in the bleached enamel (BE) group (15.25±1.745 MPa). Whereas, the highest bond integrity was attained by AA group (32.23±1.854 MPa). Samples treated with ECL (31.87±1.659 MPa) and AA (32.23±1.854) were comparable (p>0.05). Samples treated with PDT exhibited significantly different SBS (22.41±1.258) compared to other experimental groups CONCLUSION: ECL showed a reversal effect of BE compared to AA and has the potential to be used in clinical settings. BE reversal using MBP needs further investigation.

  6. Niazi FH, Noushad M, Tanvir SB, Ali S, Al-Khalifa KS, Qamar Z, et al.
    Photodiagnosis Photodyn Ther, 2020 Mar;29:101665.
    PMID: 31978565 DOI: 10.1016/j.pdpdt.2020.101665
    BACKGROUND: In order to prove the idea that topical application of drugs can improve the clinical parameters affecting periodontal disease, a sound comparison should be made between topical therapeutic models. The aim of the present study was to assess the clinical efficacy of photodynamic therapy (PDT) and Salvadora persica (SP) gel as adjuncts to scaling and root planning (SRP) in the treatment of chronic periodontitis.

    METHODS: The selected patients were divided into three groups, Group I (PDT + SRP), Group II (SP + SRP) and group III (SRP alone). Clinical inflammatory periodontal parameters including plaque index (PI), bleeding on probing (BOP), probing depth (PD) and clinical attachment level (CAL) gain were assessed. Assessment of crevicular fluid interleukin (IL)-6 and tumor necrosis factor alpha (TNF-α) was performed using enzyme-linked immunosorbent assay technique. All measurements were recorded at baseline, 3 months and 6 months follow-up periods, respectively.

    RESULTS: A total of 73 patients completed the study. A significant improvement in the BOP was seen in Group II at both follow up visits when compared with other groups (p < 0.05). Only in Group-I that showed statistically significant reduction in moderate periodontal pockets at 3 months (p = 0.021), and significant reductions in deep pockets at 3-months (p = 0.003) and 6-months (p = 0.002), respectively. CAL gain also was reported to be seen in group-I at both visits (p < 0.05). Group- I and II significantly reduced the levels of IL-6 at 3-month period compared to Group-III. This reduction was further maintained by group-II and group-III at 6 months, respectively. TNF-α showed statistically significant decrease in Group II as compared to Group I and Group-III and this reduction was maintained by the end of 6-month visit (p = 0.045).

    CONCLUSION: Both the treatment modalities PDT and SP helped in reducing periodontal inflammation. PDT reported significant gain in clinical attachment level, whereas the SP significantly reduced the bleeding levels.

  7. Qamar Z, Alhaid ASM, Altami RM, Bachat AMW, Aldosseri DMS
    Eur Rev Med Pharmacol Sci, 2022 Dec;26(24):9480-9488.
    PMID: 36591857 DOI: 10.26355/eurrev_202212_30700
    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.

  8. Qamar Z, Zeeshan T, Alqahtani WMS, Alanazi A, Khalid Aqeel Almejlad N, Ahmed Khan T, et al.
    Photodiagnosis Photodyn Ther, 2023 Sep;43:103689.
    PMID: 37414110 DOI: 10.1016/j.pdpdt.2023.103689
    AIM: The chief aim of the study was to determine/equate the surface roughness (SRa) and shear bond strength (BS) of pretreated PEEK discs with contemporary air abrasion techniques, photodynamic (PD) therapy by curcumin photosensitizer (PS) and conventional diamond grit straight fissure bur adhered to the composite resin discs.

    MATERIAL AND METHOD: Two hundred discs of PEEK were prepared of 6 mm × 2 mm × 10 mm dimension. The discs were randomly divided into five groups (n = 40) for treatment, Group I: treatment with deionized distilled water (control group); Group II: PD therapy using curcumin PS; Group III: discs treated and abraded with air-borne particles (ABP) silica (30 μm particle size) modified alumina (Al); Group IV: ABP of alumina (110 μm particle size); and Group V: The PEEK were finished with 600-μm grit size straight diamond cutting bur installed in high speed hand-piece. The surface profilometer was used to evaluate the values of surface roughness (SRa) of pretreated PEEK discs. The discs were luted and bonded to discs of composite resin. The bonded PEEK samples were placed in Universal testing machine to evaluate shear BS. The type of BS failure for PEEK discs pre-treated with five regimes respectively was evaluated under stereo-microscope. The data was statistically analyzed using one-way ANOVA and the comparisons between mean values of shear BS were evaluated by Tukey's test (ρ≤0.05).

    RESULTS: The PEEK samples pre-treated with diamond cutting straight fissure burs displayed statistically significant highest value of SRa values (3.258± 0.785 µm). Similarly, the shear BS was observed to be higher for the PEEK discs pre-treated with straight fissure bur (22.37±0.78 MPa). A comparable difference but not statistically significant difference was observed between PEEK discs pre-treated by curcumin PS and ABP-silica modified alumina (ρ ≥ 0.05).

    CONCLUSION: PEEK discs pre-treated with diamond grit straight fissure bur displayed highest values of SRa and shear BS. It was trailed by ABP-Al pre-treated discs; whereas the SRa and shear BS values for the discs pre-treated with ABP-silica modified Al and curcumin PS did not show competitive difference.

  9. Zeeshan T, Qamar Z, Abdul NS, Soman C, Bamousa B, Marrapodi MM, et al.
    Technol Health Care, 2024;32(4):2685-2696.
    PMID: 38339947 DOI: 10.3233/THC-231814
    BACKGROUND: Commercially available oral rinses contain active ingredients with concentration that is claimed by manufacturers to be effective as antiplaque agent. To date there has been no mention of the effect of oral rinse on the adherence of early plaque colonizers in plaque formation and the concentration to be used before/after meals.

    OBJECTIVE: The chief aim of the study was to evaluate microbial retention on the salivary pellicle on treatment with oral rinses (CHX & EO)/PS (mimicking after meals use of mouth wash/PS).

    METHODS: Noordini's Artifical Mouth model was used for developing the single species biofilm with early microbial colonizers of oral biofilm (A. viscosus, Strep. mitis and Strep. sanguinis respectively). The microbial retention on use of oral rinses comprising of CHX and EO as an active ingredients respectively was compared with Curcumin PS. For evaluating the microbial retention, the pellicle with microbial inoculation was developed on the glass beads in the mouth model. Subsequently the respective single specie biofilm was exposed to the mouth wash and PS after inoculation. It mimicked as use of mouth wash/PS after meals. The bacterial count in the dental biofilm was evaluated on serial dilution (CFU/ml). Sterile deionized water was used as a negative control. For qualitative analysis, Scanning electron microscope (SEM) was used to evaluate the microbial count.

    RESULTS: From the data it was observed that for the treatment of single species experimental biofilm with commercially available mouth rinses (CHX & EO) and PS (curcumin), there was significant retention for S.mitis, S.sanguinis and A.viscosus. There was no significant difference observed between PS and CHX treated single species biofilm. Whereas a significant difference was observed between EO treated biofilms and CHX/PS treated biofilms (p⩽ 0.05).

    CONCLUSION: It can be concluded from the results that curcumin PS and CHX should not be used after meals whereas EO containing mouth rinse can be used to maintain the oral mocroflora.

  10. Al-Ghamdi ARS, Khanam HK, Qamar Z, Abdul NS, Reddy N, Vempalli S, et al.
    Photodiagnosis Photodyn Ther, 2023 Jun;42:103326.
    PMID: 36773753 DOI: 10.1016/j.pdpdt.2023.103326
    BACKGROUND: The present report assessed the efficacy of curcumin-mediated photodynamic therapy (CUR-mediated PDT) as an adjunct to antifungal gel treatment by evaluating the salivary interleukin-6 (IL-6) and matrix metalloproteinases-8 (MMP-8) levels together with Candida species counts in denture stomatitis (DS) patients.

    METHODS: In total, 50 DS subjects were randomly categorized into 2 groups: Group-1: subjects who received the antifungal gel treatment and Group-2: participants who received CUR-mediated PDT. The Sabourad Dextrose Agar and CHROMAgar were utilized for evaluating Candida species counts, while the Enzyme-Linked Immunosorbent Assay was employed to estimate the salivary levels of IL-6 and MMP-8. All clinical evaluations were performed at the baseline, 1 month, and 2 months.

    RESULTS: In total, group-2 subjects showed a significant decrease in Candida albicans (C. albicans) counts on both follow-ups (i.e., 1-month and 2-month) than group-1 participants. C. krusei count also reduced in group-2 subejcts than group-1 participants at the 2nd follow-up as compared to the baseline, nevertheless, a slight increase in C. krusei count was noticed in group-2 subjects at the 2nd follow-up than the 1st follow-up. The salivary IL-6 and MMP-8 levels in both groups reduced significantly at both follow-ups than the baseline. According to the stepwise logistic regression analysis, no statistically significant correlation was observed between Candida species count and other parameters such as age and gender of the patient, duration of DS, and frequency of treatment(s).

    CONCLUSION: CUR-mediated PDT is an efficaciousness therapeutic modality for alleviating Candida species counts on the surface of denture and the palatal mucosa, as well as improving the salivary IL-6 and MMP-8 levels in DS patients.

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