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  1. Venugopal A, Marya A, Karobari MI
    Br Dent J, 2021 07;231(1):3.
    PMID: 34244625 DOI: 10.1038/s41415-021-3238-y
  2. Marya A, Venugopal A, Vaid N, Alam MK, Karobari MI
    Pain Res Manag, 2020;2020:6677929.
    PMID: 33488889 DOI: 10.1155/2020/6677929
    Fixed orthodontic treatment has been compromised at many levels during the pandemic period, as clinics underwent a prolonged lockdown and patients could not be treated regularly. With the end of the pandemic nowhere in sight, may be it is time to put newer tools, such as clear aligner therapy, for better use. Fixed orthodontic appliances by nature are not always self-limiting, which, if left unmonitored over a long period may cause undesirable side effects, pain, and discomfort. The undesired tooth movements that may occur with arch wire-guided mechanics in addition to problems with cut wires or removed brackets may be minimized with the use of aligners. While the benefits of using aligners are for all to see, they do require extensive planning and careful evaluation of the progress. This article reviews the advantages of using aligners during the pandemic period and how it can be beneficial in helping orthodontists resume their practice.
  3. Marya A, Steier L, Karobari MI, Venugopal A
    Dent J (Basel), 2021 Aug 05;9(8).
    PMID: 34436002 DOI: 10.3390/dj9080090
    Dental biofilm is often found to be the source of bacteria that releases toxins, peptides, lipopolysaccharides as well as organic acids, which lead to gingival inflammation and tooth caries. Further, the persistent plaque may result in the continued destruction of the surrounding soft and hard tissues. During fixed orthodontic therapy, arch-wires, brackets, and elastic modules have been shown to be sites of significant plaque accumulation, making it difficult for a patient to maintain proper oral hygiene. The problem most dentists face is that they cannot visualize this biofilm completely to be able to carry out efficient plaque removal. Visual assessment is, to date, the most common method for plaque visualization, and various indexes have been demonstrated to be sufficient for quantification of the amount of plaque present. However, the problem is that visual assessments are inconsistent, operator dependent and often subjective, which can lead to inconsistency in results. Fluorescence is one such method that can be explored for its use in effective plaque identification and removal. Literature has it that dentists and patients find it particularly useful for monitoring oral hygiene status during treatment. Fluorescence has the capability of offering clinical orthodontists and researchers a new method of detection of demineralization during orthodontic treatment, furthermore, for efficient removal of orthodontic adhesive cements, fluorescent light may be used in conjunction with high-speed burs to deliver fast, less time consuming, and safer results. The benefit of direct visual treatment using fluorescence enhanced theragnosis is that the patient receives controlled and guided therapy. It has multiple benefits, such as early diagnosis of caries, biofilm identification, and even helps to achieve improved treatment outcomes by better resin selection for esthetic procedures.
  4. Alam MK, Alfawzan AA, Haque S, Mok PL, Marya A, Venugopal A, et al.
    Front Pediatr, 2021;9:651951.
    PMID: 34026687 DOI: 10.3389/fped.2021.651951
    To investigate whether the craniofacial sagittal jaw relationship in patients with non-syndromic cleft differed from non-cleft (NC) individuals by artificial intelligence (A.I.)-driven lateral cephalometric (Late. Ceph.) analysis. The study group comprised 123 subjects with different types of clefts including 29 = BCLP (bilateral cleft lip and palate), 41 = UCLP (unilateral cleft lip and palate), 9 = UCLA (unilateral cleft lip and alveolus), 13 = UCL (unilateral cleft lip) and NC = 31. The mean age was 14.77 years. SNA, SNB, ANB angle and Wits appraisal was measured in lateral cephalogram using a new innovative A.I driven Webceph software. Two-way ANOVA and multiple-comparison statistics tests were applied to see the differences between gender and among different types of clefts vs. NC individuals. A significant decrease (p < 0.005) in SNA, ANB, Wits appraisal was observed in different types of clefts vs. NC individuals. SNB (p > 0.005) showed insignificant variables in relation to type of clefts. No significant difference was also found in terms of gender in relation to any type of clefts and NC group. The present study advocates a decrease in sagittal development (SNA, ANB and Wits appraisal) in different types of cleft compared to NC individuals.
  5. Venugopal A, Mohammad R, Koslan MFS, Sayd Bakar SR, Ali A
    Materials (Basel), 2021 May 06;14(9).
    PMID: 34066461 DOI: 10.3390/ma14092414
    The environmental condition in which the Royal Malaysian Airforce is currently operating its aircraft is prone to corrosion. This is due to the high relative humidity and temperature. With most of its aircraft being in the legacy aircraft era, the aircraft's main construction consists of the aluminium 2024 material. However, this material is prone to corrosion, thus reducing fatigue life and leading to fatigue failure. Using the concept of either Safe Life or Damage Tolerance as its fatigue design philosophy, the RMAF adopts the Aircraft Structure Integrity Program (ASIP) to monitor its structural integrity. With the current problem of not having the structural limitation on corrosion-damaged structure, the RMAF has embarked on its fatigue testing method. Finite Element (FE) studies and flight tests were conducted, and the outcome is summarized. The conclusion is that the longeron tested on the aircraft can withstand the operational load, and its yield strength is below the ultimate yield strength of the material. These research outcomes will also enhance the ASIP for other aircraft platforms in the RMAF fleet for its structure life assessment or service life extension program.
  6. Al-Ahmadi AO, Assiry AA, Khan SDAA, Marya A, Venugopal A, Karobari MI
    Case Rep Dent, 2021;2021:5444257.
    PMID: 34336303 DOI: 10.1155/2021/5444257
    Congenital absence of more than 6 teeth except the third molar is known as oligodontia. It can affect both primary and permanent dentitions. The affected individuals usually demonstrate esthetic, functional, and psychological concerns. The present case report is about a 4-year-old female patient with multiple missing (both primary and permanent) teeth with esthetic and social problems. On extraoral examination, the patient demonstrated upper lip relapse due to missing anterior teeth. On physical examination, no other abnormality was detected in relation to the hair, appendages, or presence of a cleft. On intraoral and radiographic examination, 21 teeth were missing, which included both the primary and the permanent tooth buds. To encourage a positive behavioral change, it was decided to carry out prosthetic intervention using a modified fixed Nance appliance and acrylic teeth. After the replacement of the missing teeth, a marked improvement in the profile and esthetics was seen.
  7. Venugopal A, Mohammad R, Koslan MFS, Shafie A, Ali A, Eugene O
    Materials (Basel), 2021 Sep 25;14(19).
    PMID: 34639959 DOI: 10.3390/ma14195562
    The airframe structures of most fighter aircraft in the Royal Malaysian Airforce have been in service for 10 to 20 years. The effect of fatigue loading, operating conditions, and environmental degradation has led to the structural integrity of the airframe being assessed for its airworthiness. Various NDT methods were used to determine the current condition of the aircraft structure after operation of beyond 10 years, and their outcomes are summarized. In addition, although there are six critical locations, the wing root was chosen since it has the highest possibility of fatigue failure. It was further analyzed using simulation analysis for fatigue life. This contributes to the development of the maintenance task card and ultimately assists in extending the service life of the fighter aircraft. Using the concept of either safe life or damage tolerance as its fatigue design philosophy, the RMAF has adopted the Aircraft Structural Integrity Program (ASIP) to monitor the structural integrity of its fighter aircraft. With the current budget constraints and structural life extension requirements, the RMAF has embarked on the non-destructive testing method and engineering analysis. The research outcome will enhance the ASIP for other aircraft platforms in the RMAF fleet for its structure life assessment or service life extension program.
  8. Marya A, Venugopal A, Karobari MI, Messina P, Scardina GA, Subramanian AK
    Int J Dent, 2021;2021:9963329.
    PMID: 34630566 DOI: 10.1155/2021/9963329
    In the Southeast Asian region, various policies have been advocated by health regulatory bodies that entail protective measures such as face masks, gloves, maintaining distance in public areas, and more. These protective measures are aimed at helping reverse the growth rate of the coronavirus. Dentists in this region have incorporated several changes to their practices to help minimize risks of person-to-person transmission inside dental offices. This narrative review aimed to provide an in-depth overview of the current situation in the Southeast Asian region regarding the use of teledentistry during the pandemic. Teledentistry involves the transfer of patient information across remote distances for online consultation and treatment planning. A few years back, it used to be a lesser-known entity but has seen an exponential rise in its incorporation into dental practices all around the Association of Southeast Nations (ASEAN) region. Many clinics in the Southeast Asian region have started using online consultations to ensure that patients can be diagnosed or followed up during their treatment. Teledentistry is the clear answer in the coming months as it will help reduce the risk of virus transmission and help patients get access to oral healthcare and dentists to see their patients. This article reviews the current pandemic situation in the ASEAN region, the recent evidence, and the scope of teledentistry. It also provides recommendations for the future and sheds light on the different types of teledentistry and how it can be incorporated into practices by regulatory authorities in this region.
  9. Karobari MI, Assiry AA, Mirza MB, Sayed FR, Shaik S, Marya A, et al.
    Int J Dent, 2021;2021:6625126.
    PMID: 33747083 DOI: 10.1155/2021/6625126
    Introduction: Patients experience various levels of discomfort during orthodontic treatment, i.e., after placement of separators, orthodontic implant placement, and archwire placement and during debonding. Various pain control methods have been developed to relive pain during debonding, i.e., finger pressure (FP), elastomeric wafer (EW), and stress relief (SR).

    Aim: To analyse various pain scales commonly used to determine the effect of different pain control methods during debonding of orthodontic brackets. Study Design. A comparative cross-sectional study performed on a sample of 60 patients (n = 60) including 14 males and 46 females who were ready for debonding and who were divided into three groups, i.e., finger pressure (FP), elastomeric wafer (EW), and stress relief (SR).

    Materials and Methods: A 100 mm Visual Analog Scale (VAS) was used to record the pain intensity for each tooth. Another scale known as Pain Catastrophizing Scale (PCS) was used to evaluate the patient's general attitude towards pain perception. The armamentarium and operator were kept same for all the patients. Statistical analysis used was the Kruskal-Wallis test, used for intergroup and intragroup comparison of pain scores.

    Results: Lowest total pain score was recorded in the FP group (P=0.043) on intergroup comparison, while on intragroup comparison, higher pain scores were recorded in lower anterior region (P=0.02) in all three groups. There was no significant difference between the pain scores reported by the male and female subjects.

    Conclusion: FP is an effective method of pain control. And teeth in the anterior region of lower and upper arches are more sensitive to pain. In terms of cognitive-affective constructs, although the VAS has been widely used in previous studies, the PCS has been detailed to show the most reliable association with physical discomfort and emotional distress.

  10. Sharif Nia H, Kaur H, Fomani FK, Rahmatpour P, Kaveh O, Pahlevan Sharif S, et al.
    Front Psychiatry, 2021;12:692498.
    PMID: 34408679 DOI: 10.3389/fpsyt.2021.692498
    Objective: The aim of this study was to translate and evaluate the validity and reliability of the Impact of Events Scale-Revised (IES-R) among the Iranian general population during the coronavirus disease 2019 (COVID-19) pandemic. Method: This study was methodological cross-sectional. It was conducted on an Iranian public population from April to July 2020 which was during the COVID-19 pandemic. Construct validity was determined through exploratory factor analysis (EFA) and confirmatory factor analysis (CFA) with a total of 500 adults recruited via online data gathering. Reliability was checked through the average inter-item correlation (AIC), Cronbach's alpha, and McDonald's omega. Convergent and divergent validity was determined using Fornell and Larcker's approach. Results: The results showed that the Persian version of IES-R had three factors, including intrusion (six items), avoidance (seven items), and hyperarousal (five items), that explained 59.22% of the total variance of the IES-R. The CFA findings indicated that all goodness-of-fit indices confirmed the model fit. The Cronbach's alpha, McDonald's omega, composite reliability (CR), and maximal reliability were excellent, and the three factors have good convergent validity. Conclusion: The findings of this study indicated that the Persian version of the IES-R scale is efficient and useful to assess post-traumatic stress disorder among Iran general population in the COVID-19 outbreak.
  11. Marya A, Karobari MI, Selvaraj S, Adil AH, Assiry AA, Rabaan AA, et al.
    Int J Environ Res Public Health, 2021 May 29;18(11).
    PMID: 34072456 DOI: 10.3390/ijerph18115848
    OBJECTIVE: Healthcare workers in general are at a high risk of potential infections with COVID-19, especially those who work with aerosol generating procedures. Dentists fall in this category, as not only do they operate with aerosol generating procedures but also operate within a face-to-face contact area.

    METHODS: A structured self-administered questionnaire was developed at Najran University and provided to the participants for data collection. The data collected included information on risk perception and incorporation of measures for protection against COVID-19 to gauge the attitude of dentists during this period. Also, clinical implementation of various protective measures was reviewed.

    RESULTS: Of the n = 322 dentists that answered the questions, 50% were general dentists and 28.9% were dentists working at specialist clinics, while the remaining 21.1% of dentists were employed in academic institutions. Among the newer additions to the clinic, 36.3% of dentists answered that they had added atomizers to their practices, followed by 26.4% of dentists that had incorporated the use of UV lamps for sterilization. We found that 18.9% dentists were using HEPA filters in their clinics, while 9.9% of dentists were making use of fumigation devices to control the risk of infection. One-way ANOVA was also carried out to demonstrate that there was a statistically significant difference (p = 0.049) between groups of dentists utilizing HEPA filters, UV lamps, atomizers, and fumigation devices to prevent the spread of SARS-CoV2 across their workplaces.

    CONCLUSION: Dentists are aware of recently updated knowledge about the modes of transmission of COVID-19 and the recommended infection control measures in dental settings. A better understanding of the situation and methods to prevent it will ensure that the dental community is able to provide healthcare services to patients during the pandemic.

  12. Karobari MI, Maqbool M, Ahmad P, Abdul MSM, Marya A, Venugopal A, et al.
    Biomed Res Int, 2021;2021:6657167.
    PMID: 34746305 DOI: 10.1155/2021/6657167
    Background: Citation analysis has emerged to play a significant role in recognition of the most useful areas of research. Endodontic microbiology has been a topic of interest for endodontists as well as periodontists and oral surgeons. This bibliometric analysis is aimed at identifying and reporting the characteristics of the top 50 cited articles on endodontic microbiology.

    Methods: The articles were identified through a search on Web of Science (WoS), property of Clarivate Analytics database published on endodontic microbiology. The citation information of the selected articles was recorded. The Journal of Endodontics, International Endodontic Journal, Oral Surgery Oral Medicine Oral Pathology Oral Radiology and Endodontology, Dental Traumatology, and Australian Endodontic Journal were searched in the search title. Descriptive and bivariate analyses were performed using a statistical software package SPSS. Statistical analysis was performed using Shapiro-Wilk, Kruskal-Wallis, Post hoc, Mann-Kendall trend, and Spearman-rank tests.

    Results: The 50 most cited articles were published from 1965 to 2012 with citation count varying from 1065 to 103 times. The total citation counts of articles recorded were 11,525 (WoS), 12,602 (Elseviers' Scopus), and 28,871 (Google Scholar). The most prolific years in terms of publications were 2001, 2002, and 2003, with five publications each, followed by 2005 with four. The year with most citations was 1998, with 1,330 citations, followed by 1965 and 2001, with 1,065 and 1,015 citations, respectively. A total of 136 authors contributed to the top 50 most cited articles with 27 corresponding institutions from 12 different countries. The most common methodological design was in vitro study, followed by clinic-laboratory study, literature review, systematic review and meta-analysis, and animal study.

    Conclusions: The present study provided a detailed list of the top 50 most cited and classic articles on microbiology in endodontics. This will help researchers, students, and clinicians in the field of endodontics as an impressive source of information.

  13. Shetty H, Shetty S, Kakade A, Shetty A, Karobari MI, Pawar AM, et al.
    Sci Rep, 2021 11 09;11(1):21914.
    PMID: 34754049 DOI: 10.1038/s41598-021-01489-8
    The volumetric change that occurs in the pulp space over time represents a critical measure when it comes to determining the secondary outcomes of regenerative endodontic procedures (REPs). However, to date, only a few studies have investigated the accuracy of the available domain-specialized medical imaging tools with regard to three-dimensional (3D) volumetric assessment. This study sought to compare the accuracy of two different artificial intelligence-based medical imaging programs namely OsiriX MD (v 9.0, Pixmeo SARL, Bernex Switzerland, https://www.osirix-viewer.com ) and 3D Slicer ( http://www.slicer.org ), in terms of estimating the volume of the pulp space following a REP. An Invitro assessment was performed to check the reliability and sensitivity of the two medical imaging programs in use. For the subsequent clinical application, pre- and post-procedure cone beam computed tomography scans of 35 immature permanent teeth with necrotic pulp and periradicular pathosis that had been treated with a cell-homing concept-based REP were processed using the two biomedical DICOM software programs (OsiriX MD and 3D Slicer). The volumetric changes in the teeth's pulp spaces were assessed using semi-automated techniques in both programs. The data were statistically analyzed using t-tests and paired t-tests (P = 0.05). The pulp space volumes measured using both programs revealed a statistically significant decrease in the pulp space volume following the REP (P  0.05). The mean decreases in the pulp space volumes measured using OsiriX MD and 3D Slicer were 25.06% ± 19.45% and 26.10% ± 18.90%, respectively. The open-source software (3D Slicer) was found to be as accurate as the commercially available software with regard to the volumetric assessment of the post-REP pulp space. This study was the first to demonstrate the step-by-step application of 3D Slicer, a user-friendly and easily accessible open-source multiplatform software program for the segmentation and volume estimation of the pulp spaces of teeth treated with REPs.
  14. Bhavikatti SK, Karobari MI, Zainuddin SLA, Marya A, Nadaf SJ, Sawant VJ, et al.
    PMID: 34281099 DOI: 10.3390/ijerph18137162
    Background-chlorhexidine (CHX) is most commonly used as a chemical plaque control agent. Nevertheless, its adverse effects, including teeth discoloration, taste alteration and calculus build-up, limit its use and divert us to medicinal herbs. The purpose of the study was to evaluate the phytochemical composition, antioxidant potential, and cytotoxic effects of Mimusops elengi Linn extract (ME) over normal human cultured adult gingival fibroblasts (HGFs). Methods-in vitro phytochemical screening, total flavonoid content, antioxidant potential by DPPH and Nitric Oxide (NO) radical scavenging activity, and cytotoxic effects of ME extracts over HGF were explored. The viability of HGF cells was determined using 3-(4,5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT), neutral red uptake, and trypan blue assay after treatment with different concentrations of CHX and ME (0.3125 to 10 µg/mL). Results-ME showed some alkaloids, glycosides, saponins and flavonoids exhibited relatively moderate-to-good antioxidant potential. Increasing the concentration of CHX and ME from 0.3125 to 10 µg/mL reduced cell viability from 29.71% to 1.07% and 96.12% to 56.02%, respectively. At higher concentrations, CHX reduced the viability of cells by 52.36-fold compared to ME, revealed by MTT assay. At 10 µg/mL concentration, the mean cell viability of CHX and ME-treated cells was 2.24% and 57.45%, respectively, revealed by a neutral red assay. The viability of CHX- and ME-treated HGF cells estimated at higher concentrations (10 µg/mL) using trypan blue assay was found to be 2.18% and 47.36%, respectively. A paired t-test showed significance (p < 0.05), and one-way ANOVA difference between the mean cell viability of CHX- and ME-treated cells at different concentrations. One-way ANOVA confirmed the significant difference between the viability of CHX- and ME-treated cells. Conclusions-The cytoprotective and antioxidant effects of ME emphasize its potential benefits. Therefore, it could emerge as a herbal alternative and adjunct to conventional oral hygiene methods, that can diminish periodontal tissue destruction.
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