كلية طب الأسنان||College of Dentistry

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Genomic Landscape of Multidrug Resistance and Virulence in Enterococcus faecalis IRMC827A from a Long-Term Patient
(2023) Rahaf Khalid Al-Quwaie; AlJindan, Reem; Razan Aldahhan; Alquwaie, Rahaf; J. Francis Borgio; Reem AlJindan; AlEraky, Doaa M.; Noor Barak Almandil; Sayed AbdulAzeez; Doaa Mostafa AlEraky
We report on a highly virulent, multidrug-resistant strain of Enterococcus faecalis IRMC827A that was found colonizing a long-term male patient at a tertiary hospital in Khobar, Saudi Arabia. The E. faecalis IRMC827A strain carries several antimicrobial drug resistance genes and harbours mobile genetic elements such as Tn6009, which is an integrative conjugative element that can transfer resistance genes between bacteria and ISS1N via an insertion sequence. Whole-genome-sequencing-based antimicrobial susceptibility testing on strains from faecal samples revealed that the isolate E. faecalis IRMC827A is highly resistant to a variety of antibiotics, including tetracycline, doxycycline, minocycline, dalfopristin, virginiamycin, pristinamycin, chloramphenicol, streptomycin, clindamycin, lincomycin, trimethoprim, nalidixic acid and ciprofloxacin. The isolate IRMC827A carries several virulence factors that are significantly associated with adherence, biofilm formation, sortase-assembled pili, manganese uptake, antiphagocytosis, and spreading factor of multidrug resistance. The isolate also encompasses two mutations (G2576T and G2505A) in the 23S rRNA gene associated with linezolid resistance and three more mutations (gyrA p.S83Y, gyrA p.D759N and parC p.S80I) of the antimicrobial resistance phenotype. The findings through next-generation sequencing on the resistome, mobilome and virulome of the isolate in the study highlight the significance of monitoring multidrug-resistant E. faecalis colonization and infection in hospitalized patients. As multidrug-resistant E. faecalis is a serious pathogen, it is particularly difficult to treat and can cause fatal infections. It is important to have quick and accurate diagnostic tests for multidrug-resistant E. faecalis, to track the spread of multidrug-resistant E. faecalis in healthcare settings, and to improve targeted interventions to stop its spread. Further research is necessary to develop novel antibiotics and treatment strategies for multidrug-resistant E. faecalis infections.
Effect of CeO2/spherical silica and halloysite nanotubes engineered for targeted drug delivery system to treat breast cancer cells
(2023) Layan Almulla; Ravinayagam, Vijaya; Alghamdi, Norah; Alghamdi, Wejdan; Sarah Almofty; Almulla, Layan; Vijaya Ravinayagam; Almofleh, Ali Awad; Tanimu, Gazali; Dafalla, H.; Jermy, B. Rabindran
Cerium oxide nanoparticles (CeO2 NPs) and flavonoid curcumin that has been widely studied for treating diseases involving high reactive oxygen species (ROS). In nanotherapeutics, the particle size, shape, metal oxide dispersity and surface properties of nanocarriers are vital for drug delivery and therapeutic efficiency. Here, cisplatin release behavior on cerium impregnated two different shaped nanocarriers, CeO2/monodispersed spherical silica (Sil) and CeO2/halloysite (Hal) nanotube was studied for potential anti-cancer therapies. For comparison, CeO2 impregnated mesoporous silica MCM-41, SBA-16, Hydroxyapatite and clay were prepared. Subsequently, the nanocomposites were coated with curcumin (25% wt/wt), and cisplatin (Cp) functionalization (5% wt/wt). 5wt%CeO2/Hal/Cp and 5wt%CeO2/Sil/Cp samples were pegylated using lyophilization technique. Physico-chemical analyses revealed the nanosized distribution of CeO2 and functionalization of cisplatin and curcumin. Cp release was studied using automated Franz cell and dialysis membrane techniques. The different structured nanocarriers delivering mechanism was studied by determining the drug kinetic release using four different kinetic models (first order, second order, Higuchi and Korsmeyer-Peppas). In vitro cytotoxicity assay of nano formulations along with free cisplatin and curcumin (Cur) were tested against the breast cancer cell line (MCF-7) for multiple timepoints by MTT assay. The results reveled the efficacy of 5wt%CeO2/Sil/Cp/Cur nanoparticles in delivering cisplatin. On the other hand, 5wt%CeO2/Hal/Cur nanoparticles enhanced the uptake of curcumin in comparison to free curcumin. Overall, pegylated CeO2/Silica nano formulation demonstrated an effective carrier to cisplatin for potential treatment of breast cancer.
Denture care and oral health-related quality of life among complete denture wearers in Eastern Province of Saudi Arabia
(2023) Aljubran, Hussain; Hend Alshammary; Alamoudi, Marwah; Alramadan, Hassan; Nazir, Muhammad; Muhammad Nazir
Abstract Introduction This study aimed to evaluate denture care and hygiene and oral health-related quality of life (OHRQoL) among complete denture (CD) wearers in the Eastern Province of Saudi Arabia. Methodology This cross-sectional study was conducted on CD wearers in the Eastern Province of Saudi Arabia. A pre-tested questionnaire was administered among study participants. Questionnaire was divided in three sections: (1) patients' demographic data, (2) awareness and maintenance of CD and (3) OHRQoL. Independent sample t-test and one-way ANOVA test were performed. Results The study included data of 300 participants with 71% of males and 28% of females. Majority of participants (82.7%) cleaned CD daily, removed CD while sleeping (88.0%) and knew that unhygienic dentures can cause oral infection (92.7%). Only 19.3% used denture cleansing tables, 41% used toothpaste, and 60.7% rinsed CD with water. Regarding OHIP-DENT domains, highest score was for functional limitation domain (2.20 ± 1.67) and the lowest for handicap domain (0.94 ± 1.09). The mean OHIP-DENT score of the sample was 12.02 ± 8.52. Females (p = 0.006), participants below 65 years of age (p = 0.029), non-Saudis (p = 0.042), those with university education (p = 0.030) and low monthly income (p = 0.045) and participants who visited dentist due to problem with CD (p = 0.041) demonstrated significantly higher mean OHIP-DENT score. Conclusion Majority of participants demonstrated appropriate denture care behaviours because they were aware of the importance of denture care and hygiene. Female gender, age below 65 years, non-Saudi nationality, university education, low monthly income and visiting dentist due to problem were related to poor OHRQoL.
Biochar-layered double hydroxide composites for the adsorption of tetracycline from water: synthesis, process modeling, and mechanism
(2023) Zubair, Mukarram; Dana Essam Alhashim; El-Qanni, Amjad; Mohammad Saood Manzar; Alqahtani, Hissah A.; Al-Ejji, Maryam; Mu’azu, Nuhu Dalhat; AlGhamdi, Jwaher M.; Haladu, Shamsuddeen A.; Al-Hashim, Dana; Ahmed, Syed Z.
Antibiotic-contaminated water is a crucial issue worldwide. Thus, in this study, the MgFeCa-layered double hydroxides were supported in date palm–derived biochar (B) using co-precipitation, hydrothermal, and co-pyrolysis methods. It closes gaps in composite design for pharmaceutical pollutant removal, advances eco-friendly adsorbents, and advances targeted water cleanup by investigating synthesis methodologies and gaining new insights into adsorption. The prepared B-MgFeCa composites were investigated for tetracycline (TC) adsorption from an aqueous solution. The B-MgFeCa composites synthesized through co-precipitation and hydrothermal methods exhibited better crystallinity, functional groups, and well-developed LDH structure within the biochar matrix. However, the co-pyrolysis method resulted in the LDH structure breakage, leading to the low crystalline composite material. The maximum adsorption of TC onto all B-MgFeCa was obtained at an acidic pH range (4–5). The B-MgFeCa composites produced via hydrothermal and co-pyrolysis methods showed higher and faster TC adsorption than the co-precipitation method. The kinetic results can be better described by Langmuir kinetic and mixed order models at low and high TC concentrations, indicating that the rate-limiting step is mainly associated with active binding sites adsorption. The Sip and Freundlich models showed better fitting with the equilibrium data. The TC removal by B-MgFeCa composites prepared via hydrothermal, the highest estimated uptake which is around 639.76 mg.g−1 according to the Sips model at ambient conditions, and co-pyrolysis was mainly dominated by physical and chemical interactions. The composite obtained via the co-precipitation method adsorbed TC through chemical bonding between surface functional groups with anionic species of TC molecule. The B-MgFeCa composite showed excellent reusability performance for up to five cycles with only a 30% decrease in TC removal efficiency. The results demonstrated that B-MgFeCa composites could be used as promising adsorbent materials for effective wastewater treatment.
Comparison between Different Bulk-Fill and Incremental Composite Materials Used for Class II Restorations in Primary and Permanent Teeth: In Vitro Assessments
(2023) Ibrahim, Maria Salem; AlKhalefah, Ahmed Saleh; Alsaghirat, Abdullah Ali; Alburayh, Read Ahmed; Maria Salem Ibrahim
Introduction: Several advantages, including improved aesthetics and conservative cavity preparation, made resin-based composite (RBC) a popular restorative material. However, several limitations come with RBC restorations such as the necessity for proper isolation of the tooth and an incremental layering for the material due to the limitations of the depth of cure. Despite these advantages and limitations, the usage of these restorative materials is increasingly being expanded due to the advancement made since their introduction. To overcome some of the limitations, several types of RBC restorations were developed. Materials and Methods: Four different RBC materials used for class II restorations in primary and permanent teeth were compared: Z350 XT Filtek™ Universal Restorative (ZXT), Filtek™ Bulk Fill Flowable Restorative (FBF), Beautifil-Bulk Flowable (BBF) and Tetric™ N-Flow (TNF). Flexure strength, elastic modulus, surface roughness, microhardness and microleakage were assessed using standard methods or previously published protocols. The data and differences between the groups were analyzed using One-way analysis of variance (ANOVA), Tukey’s multiple comparisons, Kruskal–Wallis and Wilcoxon rank-sum (Mann–Whitney) tests. Results: The study found that BBF (86.24 ± 7.41 MPa) and ZXT (64.45 ± 11.52 MPa) had higher flexural strength than FBF (50.89 ± 8.44 MPa) and TNF (50.67 ± 9.40 MPa), while both exhibited the highest values of surface roughness. Elastic modulus was the highest with BBF, which was not statistically significant from FBF or ZXT (p > 0.05). ZXT (109.7 ± 7.83 VH) exhibited the highest value of microhardness, which was statistically significant from the other three materials (p < 0.0001). Microleakage was assessed after thermocycling for 20,000 cycles to simulate two years in the mouth. FBF (70%) exhibited the most resistance to microleakage. Conclusions: Different types of RBC restorations exhibit different characteristics. The clinician needs to choose the most appropriate restorative material based on different clinical scenarios.
The Effect of Salbutamol and Budesonide Pediatric Doses on Dental Enamel and Packable and Flowable Composites: Microhardness, Surface Roughness and Color
(2023) Ibrahim, Maria Salem; Alatiyyah, Fatimah Mohammed; Mohammed, Khawla Abbas; Alhawaj, Hibah Nouh; Balhaddad, Abdulrahman A.; Ibrahim, Ahmed Salem
Objective: To assess and compare the effects of two pediatric anti-asthmatic medication doses on the microhardness of enamel and microhardness, surface roughness and color of restorative materials. Methods: Human enamel samples and packable and flowable composite restorations were used. The samples were exposed to Salbutamol (0.6 mL/6 mL saline) and Budesonide (2 mL/2 mL saline) via a custom-made chamber connected to a nebulizer. Medication administration was conducted for 10 days. The samples were brushed with an electronic brush in a continuous and circular mode for 10 s after 10 min of medication administration. Assessments of microhardness, surface roughness and color were carried out at three different time intervals: baseline (T0), 5 days (T1) and 10 days (T2). One-way analysis of variance (ANOVA), a two-sample t-test and a Bonferroni multiple comparison test were used to analyze the data and compare between the groups. Results: Both medications significantly (p < 0.05) decreased the microhardness of the enamel and composite samples after 10 days. Both medications lowered the surface roughness of both types of composite with a greater effect observed after 10 days of Budesonide administration (p < 0.05). Both medications had comparable detectable color change on both types of composite with a greater effect observed after 10 days of Budesonide administration (p < 0.05). Conclusion: Salbutamol and Budesonide significantly decreased microhardness in the enamel samples. Both medications affected the properties of packable and flowable composites. The packable composite showed more resistance to microhardness changes. Both medications showed a clinically detectable change in the color of packable and flowable composites.
Clinical outcomes of single full-coverage lithium disilicate restorations: A systematic review
(2023) Al-Dulaijan, Yousif A.; Nabras Alrayes; Yousif Aldulaijan; Aldulaijan, Hajer A.; AlSharief, Mishali; Aljofi, Faisal E.; Ibrahim, Maria S.
Introduction Lithium disilicate glass–ceramic (LDC) restorations exhibit microorganism infiltration, recurrent caries, pulpal lesions, periodontal inflammation, and cement exposure to the oral environment over time. All these factors lead to restoration failure. This systematic review aimed to investigate the clinical outcomes of LDC full-coverage crowns (FCC) in permanent teeth compared with those of other full-coverage restoration materials. Materials & Methods Search strategies were developed for four databases: Web of Science, OVID, PubMed, and Scopus. Data extraction and quality appraisals were performed by two independent reviewers. Data on the presence of caries, post-operative sensitivity, and periodontal changes were extracted from the included clinical studies. In addition to the outcome measures, data on the sample size, study groups, method of restoration fabrication, type of impression, and type of abutment were recorded. Results We retrieved 3989 records for the title and abstract screening. Of these, 19 clinical studies met the inclusion criteria. The overall quality of the included studies indicates a low risk of bias. Most studies reported no pulpal involvement, recurrent caries, or post-operative sensitivity and presented a favorable periodontal response after the cementation of LDC-FCC during different follow-up periods. Conclusion Based on the endodontic and periodontic clinical responses of natural tooth abutments and their supporting periodontium, LDC-FCC can be considered a clinically successful restorative option.
Cone-Beam Computed Tomography and Histological Findings for Socket Preservation Techniques Using Different Grafting Materials: A Systematic Review
(2023) Madi, Marwa; Almindil, Ibrahim; Alrassasi, Maria; Marwa Madi; Zakaria, Osama; Alagl, Adel S
Objective: Socket preservation techniques have been used to maintain the ridge dimension following tooth extraction. The materials used influence the quality and quantity of newly formed bone. Therefore, the aim of this article was to systematically review the literature reporting both histological and radiographic outcomes of socket preservation techniques after tooth extraction in human subjects. Material and method: A systematic electronic search was performed in the electronic databases. English language clinical studies that were published between 2017 and 2022 and included both histological and radiographic findings for the test and control groups. Our primary search produced 848 articles, and of these, 215 were duplicate studies. A total of 72 articles were then eligible for full-text reading. Results: The review included eight studies that met its inclusion criteria. Three outcomes were compared in the included studies. The percentage of newly formed bone ranged from 21.34 ± 9.14% to more than 50% of new bone formation. The materials that showed more than 50% of newly formed bone formation were demineralized dentin graft, platelet-rich fibrin, freeze-dried bone allograft, corticocancellous porcine, and autogenous bone. Four Studies did not report the percentage of the residual graft materials, while those who reported showed a variable range of a minimum 1.5% to more than 25%. One study did not report the changes in horizontal width at the follow-up period, while other studies ranged from 0.6 mm to 10 mm. Conclusion: Socket preservation represents an efficient technique to preserve the ridge contour with satisfactory newly formed bone in the augmented site and maintaining the vertical and horizontal dimensions of the ridge.
Inorganic Compounds as Remineralizing Fillers in Dental Restorative Materials: Narrative Review
(2023) Bin-Jardan, Leena Ibraheem; Leen Almutairi; Dalal Almadani; Almoabid, Hadi A.; Alessa, Mohammed A.; Almulhim, Khalid S.; AlSheikh, Rasha N.; Khalid S. Almulhim; Ibrahim, Maria S.; Al-Zain, Afnan O.; Balhaddad, Abdulrahman A.
Secondary caries is one of the leading causes of resin-based dental restoration failure. It is initiated at the interface of an existing restoration and the restored tooth surface. It is mainly caused by an imbalance between two processes of mineral loss (demineralization) and mineral gain (remineralization). A plethora of evidence has explored incorporating several bioactive compounds into resin-based materials to prevent bacterial biofilm attachment and the onset of the disease. In this review, the most recent advances in the design of remineralizing compounds and their functionalization to different resin-based materials’ formulations were overviewed. Inorganic compounds, such as nano-sized amorphous calcium phosphate (NACP), calcium fluoride (CaF2), bioactive glass (BAG), hydroxyapatite (HA), fluorapatite (FA), and boron nitride (BN), displayed promising results concerning remineralization, and direct and indirect impact on biofilm growth. The effects of these compounds varied based on these compounds’ structure, the incorporated amount or percentage, and the intended clinical application. The remineralizing effects were presented as direct effects, such as an increase in the mineral content of the dental tissue, or indirect effects, such as an increase in the pH around the material. In some of the reported investigations, inorganic remineralizing compounds were combined with other bioactive agents, such as quaternary ammonium compounds (QACs), to maximize the remineralization outcomes and the antibacterial action against the cariogenic biofilms. The reviewed literature was mainly based on laboratory studies, highlighting the need to shift more toward testing the performance of these remineralizing compounds in clinical settings.
Denture Adhesive Utilization and Associated Factors among Dental Practitioners in the Eastern Province, Saudi Arabia
(2023) Gad, Mohammed M.; Almusallam, Mayyasah O.; Almarar, Fadak H.; Alhanoof K. Aldossary; Aldossary, Alhanoof K.; Nawaf A. Alghamdi; Yasser S. Alssaialiy; Nawaf I. Alghamdi; Alghamdi, Nawaf I.; Nazir, Muhammad A.
Background: Denture adhesives (DAs) enhance denture retention and stability, thus improving functions of removable prostheses. However, the adverse effects of DAs on denture foundation area were also reported. The clinical use of DAs among dentists has not been investigated in Saudi Arabia. Therefore, this study aimed to evaluate utilization of DAs and associated factors among dental practitioners in Saudi Arabia. Methods: This cross-sectional study included dental professionals practicing in both public and private sectors in the Eastern Province of Saudi Arabia. A self-administered pilot tested questionnaire was distributed among participants. The questionnaire has questions related to demographic information, knowledge and awareness, and the utilization of DAs. Bivariate and multiple logistic regression analyses were performed. Results: The study included 279 participants with a response rate of 79.03%. The majority of participants (61.6%) were below 35 years of age, males (56.6%), general dentists (57.3%), and worked in the private sector (59.9%). Less than half of the participants (39.4%) used DAs in their dental practice, and 64.5% recommended using DAs when needed. The most reported complications of DAs included inflammation (58.40%), ulcers (35.10%), and whitish color (31.20%) of denture foundation area. A vast majority (83.90%) reported that DAs improve retention of the dentures. About 55.2% of the participants were taught about DAs in their undergraduate programs, 12.5% attended continuing education, and 21.5% updated their knowledge about DAs. Multiple logistic regression showed that those who attended continuing education activities (adjusted OR = 2.41, p = 0.036) and updated their knowledge about DAs (adjusted OR = 4.43, p = < 0.001) were significantly more likely to use DAs in their dental practice. Conclusion: A minority of dental practitioners used DAs in their practices. Attending continuing education programs and updating knowledge of DAs were significantly associated with DAs utilization.
Effect of Different Scaling Methods on the Surface Topography of Different CAD/CAM Ceramic Compositions
(2023) Turki Ali Alshehri; Aly, Nourhan M.; Alghamdi, Maram M.; Maram Alghamdi; Sultan Akhtar; Akhtar, Sultan; Madi, Marwa
This study evaluated the effect of ultrasonic and manual scaling using different scaler materials on the surface topography of computer-aided designing and computer-aided manufacturing (CAD/CAM) ceramic compositions. After scaling with manual and ultrasonic scalers, the surface properties of four classes of CAD/CAM ceramic discs: lithium disilicate (IPE), leucite-reinforced (IPS), advanced lithium disilicate (CT), and zirconia-reinforced lithium silicate (CD) of 1.5 mm thickness were evaluated. Surface roughness was measured before and after treatment, and scanning electron microscopy was used to evaluate the surface topography following the performed scaling procedures. Two-way ANOVA was conducted to assess the association of the ceramic material and scaling method with the surface roughness. There was a significant difference in the surface roughness between the ceramic materials subjected to different scaling methods (p < 0.001). Post-hoc analyses revealed significant differences between all groups except for IPE and IPS where no significant differences were detected between them. CD showed the highest surface roughness values, while CT showed the lowest surface roughness values for the control specimens and after exposure to different scaling methods. Moreover, the specimens subjected to ultrasonic scaling displayed the highest roughness values, while the least surface roughness was noted with the plastic scaling method.
Dental Anxiety Among Physicians: Relationship with Oral Problems, Dental Visits, and Socio-Demographic Factors
(2023) Alkuwaiti, E.; Alshubaili, R.; AlZahrani, N.; Khusheim, S.; AlMunif, R.; Alharbi, N.; Muhammad Ashraf Nazir
Purpose: The purpose of study was to investigate dental anxiety (DA) and its relationship with oral health problems, dental visits, and socio-demographic factors among physicians. Patients and Methods: This cross-sectional study was conducted on physicians working in Dhahran, Khobar, Dammam, and Qatif cities of the kingdom of Saudi Arabia. The study included physicians (general practitioners, residents, specialists, and consultants) working in the public and private sectors. Modified Dental Anxiety Scale and World Health Organization's Oral Health Questionnaire for Adults were used to evaluate DA, oral health problems, and dental attendance.Results: The study included data from 355 participants with a mean age of 40.13 +/- 10.45 years. There were 57.2% of non-Saudi and 42.8% of Saudi participants in the study. Bad dental experience in the previous dental visit was reported by 40% of participants, which was significantly related to DA (P = 0.002). Only 9.60% of participants had no DA, whereas 41.10% demonstrated low DA, 23.4% moderate DA, 18.9% high DA, and 7% extreme DA. Common oral problems included tooth sensitivity (65.40%), tooth cavities (45.90%), bleeding gums (43.10%), and bad breath (36.90%). More than half of participants (58.3%) visited the dentist during the last year and dental pain was the most common reason for dental visits (31.3%). Saudi participants demonstrated significantly increased DA than non-Saudis (P = 0.019). DA was significantly related to tooth sensitivity (P = 0.001), tooth cavities (P = 0.002), dry mouth (P = 0.044), and bad breath (P = 0.005). The participants with difficulty in biting foods (P > 0.001) and feeling embarrassed due to the appearance of teeth (P < 0.001) demonstrated significantly higher DA.Conclusion: This sample of physicians showed a high prevalence of DA, oral problems, and dental visits due to pain. DA was significantly related to physicians' negative dental experience, tooth sensitivity, dental decay, dry mouth, and bad breath.
The Toothbrushing Effects on Surface Properties and Color Stability of CAD/CAM and Pressable Ceramic Fixed Restorations—An In Vitro Study
(2023) Mahrous, Amr A.; Ahmed Alkadi; Alqahtani, Faisal; Aljar, Yousif; Mohammed Gad; Taymour, Noha; Alotaibi, Abdulkareem; Amr A. Mahrous; Gad, Mohammed M.
Pressable ceramic restorations have been introduced and investigated, and found comparable to CAD/CAM ceramic in terms of mechanical properties; however, the effect of toothbrushing on the pressable ceramic has not been thoroughly investigated. The objective of the current study was to assess the effect of artificial toothbrushing simulation on the surface roughness, microhardness, and color stability of different ceramic materials. Three lithium disilicate-based ceramics (IPS Emax CAD [EC], IPS Emax Press [EP]; (Ivoclar Vivadent AG), and LiSi Press [LP] (GC Corp, Tokyo, Japan)) were examined. For each ceramic material, eight bar-shaped specimens were prepared and subjected to 10,000 brushing cycles. Surface roughness, microhardness, and color stability (∆E) were measured before and after brushing. Scanning electron microscopy (SEM) was used for surface profile analysis. The results were analyzed using one-way ANOVA, Tukey’s post hoc test, and paired sample t-test α = 0.05. The findings revealed a non-significant decrease in the surface roughness of EC, EP, and LP groups (p > 0.05), and both LP and EP have the lowest surface roughness values (0.64 ± 0.13, 0.64 ± 0.08 µm) after brushing, respectively. Toothbrushing showed a decrease in the microhardness of the three groups: EC and LP, p < 0.001; EP, p = 0.012). EP showed the lowest hardness value after brushing (862.45 ± 273.83). No significant changes (∆E) were observed in all groups (p > 0.05); however, the EC group was found to be considerably affected by color changes, in comparison to the EC and LP groups. Toothbrushing had no effect on surface roughness and color stability of all tested materials, but it decreased the microhardness. Material type, surface treatments, and glazing of ceramic materials contributed to the surface changes in the ceramic materials, necessitating further investigations in terms of the toothbrushing effect with different glazing as variables.
Fracture Load of 3D-Printed Interim Three-Unit Fixed Dental Prostheses: Impact of Printing Orientation and Post-Curing Time
(2023) Alkhateeb, Reem I.; Rand Baher AlDamanhori; Hadeel Saud AlGaoud; Rand Rasheed AlShubaili; Mohammed Gad; Gad, Mohammed M.
The fracture resistance of 3-unit interim fixed dental prostheses (IFDPs) fabricated using digital light processing (DLP) additive technology with different printing parameters is neglected. Therefore, this study investigates the effect of different printing orientations and different post-curing times on the fracture resistance of 3-unit IFDPs fabricated from two three-dimensional (3D) printed resins, NextDent, C&B (CB), ASIGA, and DentaTOOTH. A 3-unit dye was scanned, and an IFDP was designed. A total of 300 specimens (150/materials, n = 10) were printed and divided into three groups according to printing orientations (0°, 45°, 90°) per material. Each orientation was subdivided into five groups (n = 10) considering the post-curing time (green state as control, 30, 60, 90, and 120 min). All specimens underwent thermocycling (5000 cycles). Each specimen was fitted onto the die and loaded until fracture using a universal testing machine with a loading rate of 1 m/min. Data were analyzed using ANOVA and post hoc Tukey test (α = 0.05). The result showed that printing orientation had a significant effect on the fracture load for both ASIGA and NextDent materials (p < 0.05). The highest fracture load was recorded with 45° orientation, followed by 0° orientation and 90° orientation showed the lowest values per respective post-curing time. Post-curing time increased the fracture load (p < 0.05). Post-curing time had a positive effect on the fracture load. As the post-curing time increased, the fracture resistance load increased (p < 0.05), with 90 and 120 min showing the highest fracture load. The 0° and 45° printing orientations have a high fracture load for 3D-printed IFDPs, and an increased post-curing time is recommended.
Inflammatory response to epoxy resin and calcium silicate sealers preheated with different temperatures: an in vivo study
(2023) Alhindi, Omar H.; Omar Omar; Alhawaj, Hussain; Omar, Omar
To determine the impact of heat exposure of different sealers on inflammatory cytokine secretions and tissue response in vivo.
Effect of Denture Disinfectants on the Mechanical Performance of 3D-Printed Denture Base Materials
(2023) Nora S. Alkaltham; Reem A. Aldhafiri; Al-Thobity, Ahmad M.; Soban Q. Khan; Aljubran, Hussain; Ijlal Shahrukh Ateeq; Khan, Soban Q.; Hussain Aljubran; Gad, Mohammed M.
Denture care and maintenance are necessary for both denture longevity and underlying tissue health. However, the effects of disinfectants on the strength of 3D-printed denture base resins are unclear. Herein, distilled water (DW), effervescent tablet, and sodium hypochlorite (NaOCl) immersion solutions were used to investigate the flexural properties and hardness of two 3D-printed resins (NextDent and FormLabs) compared with a heat-polymerized resin. The flexural strength and elastic modulus were investigated using the three-point bending test and Vickers hardness test before (baseline) immersion and 180 days after immersion. The data were analyzed using ANOVA and Tukey’s post hoc test (α = 0.05), and further verified by using electron microscopy and infrared spectroscopy. The flexural strength of all the materials decreased after solution immersion (p < 0.001). The effervescent tablet and NaOCl immersion reduced the flexural strength (p < 0.001), with the lowest values recorded with the NaOCl immersion. The elastic modulus did not significantly differ between the baseline and after the DW immersion (p > 0.05), but significantly decreased after the effervescent tablet and NaOCl immersion (p < 0.001). The hardness significantly decreased after immersion in all the solutions (p < 0.001). The immersion of the heat-polymerized and 3D-printed resins in the DW and disinfectant solutions decreased the flexural properties and hardness.
Assessment of Bacterial Sealing Ability of Two Different Bio-Ceramic Sealers in Single-Rooted Teeth Using Single Cone Obturation Technique: An In Vitro Study
(2023) Doaa Mostafa AlEraky; Rahoma, Ahmed M.; Abuohashish, Hatem M.; AlQasser, Abdullh; AlHamali, Abbas; Abbas Ali Abbas AlHamali; AlShoalah, Hussain M.; Hussain Mohammed A Al Hussain; Zakrya hussain ali alsaghah; Rifaat, Shimaa
The long-term success of root canal treatment requires the prevention of bacterial leakage between canal walls and root canal obturation. In this study, we compared the leakage of Enterococcus faecalis in thirty single-rooted mandibular premolars divided into three groups. The roots in two experimental groups were obturated using a single-cone obturation technique with two different bio-ceramic sealers (MTA Fillapex and CeraSeal) while the roots in the conventional group were obturated using the lateral condensation technique with an epoxy resin sealer (AH Plus). A bacterial leakage test was carried out using a modified microbial leakage model. In the MTA Fillapex group, 30% of the specimens showed a positive sign for bacterial leakage, while 80% of samples in the CeraSeal group leaked. In the AH Plus group, 50% of specimens had bacterial leakage in the canals. The variation of the average number of days between the groups was not found to be significantly different. Taken together, bio-ceramic sealers with single-cone obturation demonstrated comparable results to the resin-based sealer with lateral condensation technique in terms of sealing efficiency against Enterococcus faecalis. Additionally, MTA Fillapex could provide a better sealing ability than CeraSeal bio-ceramic sealer.
Dental Anxiety Screening and Management Practices in Dental Practice in Eastern Province, Saudi Arabia
(2022) AlMuhaish, L.; Luba AlMuhaish; Alhanoof AlArfaj; Maha AlGhannam; Abuhassan, S.; Asiri, A.; Nazir, M. A.
PURPOSE: The purpose of the study was to investigate dental anxiety (DA) screening and management practices among dental professionals in Saudi Arabia. The study also evaluated correlation between patients' self-reported DA and dentists' ratings of patients' DA. PARTICIPANTS AND METHODS: This cross-sectional observational study included dentist/patient pairs (N = 279) from the Eastern Province of Saudi Arabia. The dentists responded to a questionnaire about their DA screening and management practices and they evaluated patients' DA using the visual analogue scale (VAS). In addition, patients responded to the Modified Dental Anxiety Scale (MDAS) to measure their DA. RESULTS: About 15.1% of dentists reported using a published scale for screening DA in dental practice and Corah's Dental Anxiety Scale and Dental Fear Survey were their main scales. However, 69.2% reported directly asking their patients about DA. The use of DA management technique was reported by 89.6% of the dentists. Approximately half of the participants (53%) reported receiving DA training in their undergraduate dentistry programs and 65.2% expressed their interest in continuing education courses related to DA. In multiple logistic regression analysis, statistically significant factors associated with DA screening practice included gender (AOR = 0.46, P = 0.037), place of work (AOR = 3.68, P = 0.039), and interest in continuing education courses (AOR = 3.21, P = 0.015). Monthly income (AOR = 0.20, P = 0.029) and directly asking patient about DA (AOR = 6.15, P = 0.025) were significant factors associated with management of patients with DA. The study also showed a significant but weak correlation between DA evaluated by the dentists and DA reported by the patients (rho = 0.185, P = 0.002). CONCLUSION: The present study showed a low prevalence of DA screening practices among dentists. Dentists' rating of patients' DA weakly correlated with patients' self-reported DA.
Influences of Different CAD/CAM Ceramic Compositions and Thicknesses on the Mechanical Properties of Ceramic Restorations: An In Vitro Study
(2023) Turki Ali Alshehri; Madi, M.; Passent Ellakany; Marwa Madi; Alameer, S. T.; Al-Harbi, F. A.
The aim of this study was to assess the influences of different CAD/CAM ceramic compositions and thicknesses on the surface roughness and hardness of ceramic restorations. Four different ceramics were used in the current study: lithium disilicate (LD), leucite reinforced (LE), advanced lithium disilicate (ALD), and zirconia-reinforced lithium silicate (ZLS). Each group included 30 specimens subdivided into three different ceramic thicknesses (0.5, 1 and 1.5 mm thicknesses). The microhardness was measured for all the specimens using a microhardness testing machine, while the surface roughness was measured using a non-contact optical profilometer at three intervals (before toothbrushing and after toothbrushing, with and without toothpaste). Three-way and two-way ANOVA were used to determine the factors influencing the surface roughness and microhardness. There was a significant difference in the surface roughness between the studied groups for all the thicknesses. The findings showed that ALD had the lowest surface roughness, while ZLS showed the highest surface roughness. Moreover, ALD, followed by ZLS, had the highest hardness, while LD and LE had the lowest hardness values. Regarding the thicknesses, both the 0.5 and 1 mm ceramic thicknesses showed a significantly lower surface roughness than the 1.5 mm thickness, while the 1.5 mm thickness showed a significantly higher microhardness than the 0.5 mm thickness. The surface roughness and hardness were significantly affected by the ceramic composition and type of filler. It is recommended to use 1.5 mm-thick ceramic materials for the fabrication of definitive full-coverage ceramic restorations, while veneers require 0.5 mm-thick materials. ALD is a promising CAD/CAM material that can be used for the fabrication of restorations with a proper strength in both anterior and posterior regions.
Predictive Artificial Intelligence Model for Detecting Dental Age Using Panoramic Radiograph Images
(2023) Lujain Fahad AlThumairy; Reem Abdullah AlThukair; Albassam, Basmah; Alsheikh, Ghoson; Albluwi, Lama; Althukair, Reem; Alhareky, Muhanad; Alamri, Abdulaziz; Abdulaziz Saeed M Alamri; Suliman Shahin
Predicting dental development in individuals, especially children, is important in evaluating dental maturity and determining the factors that influence the development of teeth and growth of jaws. Dental development can be accelerated in patients with an accelerated skeletal growth rate and can be related to the skeletal growth pattern as a child. The dental age (DA) of an individual is essential to the dentist for planning treatment in relation to maxillofacial growth. A deep-learning-based regression model was developed in this study using panoramic radiograph images to predict DA. The dataset included 529 samples of panoramic radiographs collected from the dental hospital at Imam Abdulrahman Bin Faisal university in Saudi Arabia. Different deep learning methods were applied to implement the model, including Xception, VGG16, DenseNet121, and ResNet50. The results indicated that the Xception model had the best performance, with an error rate of 1.417 for the 6–11 age group. The proposed model can assist the dentist in determining the appropriate treatment for patients based on their DA rather than their chronological age

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