Faculty Publications (HBMCDM)

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Airflowing as an adjunctive treatment for periodontitis: A randomized controlled trial
(2024) Alsuwaidi, Salem; Shah, Maanas; Hakam, Abeer; Atieh, Momen A
Abstract Background: The aim of this randomized controlled trial was to assess clinical and patient-reported outcomes of subgingival instrumentation (SI) with adjunctive use of erythritol airflowing (EAF) compared to SI alone in the treatment of periodontitis. Methods: Twenty-six participants with Stage III/IV periodontitis requiring non surgical periodontal treatment were randomly allocated into two treatment groups: SI with EAF or SI alone. Clinical parameters of percentage of probing pocket depths (PPDs) of ≥5 mm, full mouth bleeding and plaque scores (FMBS and FMPS), and PPD values were recorded at baseline, and at 3- and 6-months posttreatment. A visual analogue scale was used to evaluate postoperative participants’ perception of pain, swelling, bleeding, bruising, and root sensitivity. The impact of periodontal treatment on quality of life was assessed using the General Oral Health Assessment Index (GOHAI) at six months. Results: A total of 26 participants with Stage III/IV periodontitis completed the 6-month follow-up. SI with or without EAF resulted in a statistically significant reductions in the FMBS, FMPS, PPDs, and percentage of PPDs of ≥5mmatthe 3- and 6-month follow-up visits. There was no statistically significant difference between the two treatment groups for any time interval. Participants receiving SI/EAF exhibited a higher reduction in FMBS compared to those in SI alone group at 3 (SI/EAF: 19.4 ± 11.9, SI alone: 30.1 ± 20.5; P = 0.12) and 6 months (SI/EAF: 14.3 ± 9.6, SI alone: 24.5 ± 18.2; P = 0.09). A lower percentage of sites with deep PPDs (≥5 mm) was also noted amongst participants in the SI/EAF group compared to SI alone at 3 months (SI/EAF:14.3±14.1, SI alone: 19.2 ±20.3; P = 0.48) and 6 months (SI/EAF: 8.3 ± 10.0, SI alone: 15.4 ± 17.4; P = 0.22). Patient-reported outcomes showed no significant differences between the two treatment groups, except in the psychosocial domain of the GOHAI at 6 months favoring the SI/EAF group (P = 0.03). Conclusions: Within the limitations of the study, the adjunctive use of EAF in addition to SI in the treatment of Stage III/IV periodontitis did not result in a significant improvement in clinical parameters. Limited improvement in the QoL with EAF could be achieved.
Reliability of sealer penetration measurement methods and assessment of dentine penetrability after endodonticre treatment: A correlation in vitro study
(2024) Amre R., Atmeh
Abstract: This study evaluated the reliability of sealer penetration measurement methods used with confocal laser scanning microscopy in correlation with the percentage of residual root filling and examined the effect of residual root-filling material on dentine penetrability after retreatment. Extracted teeth were randomly divided into different groups according to the obturation sealer used (n = 6); Bio Root RCS; MTA Fillapex; Bio-C and AH Plus. Root-filling material was removed before the secondary chemo-mechanical preparation and obturation using fluorescein labelled AH Plus. Multiplemicro-computed tomography scans were obtained followed by confocal laser scanning microscopy to measure the penetration of the labelled sealer into the dentinal tubules using four different methods. Measuring sealer penetration into radicular dentine using the penetration percentage method was found to be the most reliable. Dentine penetrability during retreatment did not seem to be affected by the type of residual root-filling material.
Xenogeneic Collagen Matrix Versus Free Gingival Graft for Augmenting Peri‐Implant Keratinized Mucosa Around Dental Implants: A Systematic Review and Meta‐Analysis
(2024) Momen A., Atieh; Maanas, Shah; Abeer, Hakam; Suhailah, Alshaali; Reem, Kasouha
Abstract Objectives: There is a growing evidence to suggest augmenting peri‐implant keratinized mucosa in the presence of ≤ 2 mm of keratinized mucosa. However, the most appropriate surgical technique and augmentation materials have yet to be defined. The aim of this systematic review and meta‐analyses was to evaluate the clinical and patient‐reported outcomes of augmenting keratinized mucosa around implants using free gingival graft (FGG) versus xenogeneic collagen matrix (XCM) before commencing prosthetic implant treatment. Material and Methods: Electronic databases were searched to identify observational studies comparing implant sites augmented with FGG to those augmented with XCM. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Results: Six studies with 174 participants were included in the present review. Of these, 87 participants had FGG, whereas the remaining participants had XCM. At 6 months, sites augmented with FGG were associated with less changes in the gained width of peri‐implant keratinized mucosa compared to those augmented with XCM (mean difference 1.06; 95% confidence interval −0.01 to 2.13; p = 0.05). The difference, however, was marginally significant. The difference between the two groups in changes in thickness of peri‐implant keratinized mucosa at 6 months was statistically significantly in favor of FGG. On the other hand, XCM had significantly shorter surgical time, lower postoperative pain score, and higher color match compared to FGG. Conclusions: Within the limitation of this review, the augmentation of keratinized mucosa using FGG before the placement of the final prosthesis may have short‐term positive effects on soft tissue thickness. XCM might be considered in aesthetically demanding implant sites and where patient comfort or shorter surgical time is a priority. The evidence support, however, is of low to moderate certainty; therefore, further studies are needed to support the findings of the present review.
Tip, torque and rotation of maxillary molars during distalization using Invisalign: a CBCT study
(2024) Ahmed, Ghoneima
Abstract Background: Desirable molar distalization by bodily movement is challenging and can be difcult to achieve. This study investigated changes in molar angulation (mesiodistal tipping), molar inclination (buccolingual torque) and rotation during distalization using clear aligner therapy (CAT). Materials and methods: This retrospective study included 38 cone beam computed tomographic images (CBCTs) taken for patients treated with molar distalization using CAT. The study evaluated pre- (T0) and post-treatment (T1) CBCTs of 19 adult patients (36.68±13.50 years) who underwent maxillary molar distalization using Invisalign® align ers (Align Technology, Inc., San José, CA, USA) with a minimum of 2 mm distalization. Changes in maxillary molar tip, torque and rotation were measured for 61 molars (183 roots). Paired t-test was used to evaluate the diferences between pre- and post-treatment readings. The level of signifcance was set at p≤0.05. The reproducibility of meas urements was assessed by the intraclass correlation coefcient (ICC). Results: Molar angulation did not show signifcant change after distalization (p=0.158) however, there was signifcant increase in buccal molar inclination (p=0.034) and mesiobuccal molar rotation (p<0.001). Conclusion: Molar distalization of 2 mm did not cause signifcant molar tipping. Maxillary molars showed signifcant buccal inclination (increased torque) and mesiobuccal rotation after distalization.
The effect of irrigation solution temperature and novel heat-treated rotary files on apical debris extrusion and canal preparation time
(2024) Amre R., Atmeh
Abstract: This study aimed to compare apical debris extrusion and canal preparation time with ProTaper Gold (PTG) and ProTaper Ultimate (PTU) files at different temperatures. Mesio-buccal roots of 60 mandibular first molars were distributed into six groups depending on the file type (PTG, PTU) and irrigation solution temperature (20, 37, 45°C). During instrumentation, extruded debris were collected and weighed to measure the mass in milligrams. The canal preparation time was recorded in seconds. ANOVA followed by Bonferroni post-hoc tests were used for analysis. The amount of debris extrusion was significantly higher in PTU, which was affected by the irrigation solution temperature (p <0.05). The difference in canal preparation time was not significant between the two file systems, however, it was significant between the different temperatures (p=0.001). Both file systems had shorter canal preparation times at 20°C. The irrigation solution temperature could influence the debris extrusion and time of canal preparation.
Open access databases of craniofacial cone beam computed tomography scans are vital for advancements in artificial intelligence
(2024) Sabarinath, Prasad; Jahanzeb, Chaudhry
Letter to the Editor Dear Editor-in-Chief, Dear Professor Lakshman P. Samaranayake, We recently read your editorial in the International Dental Journal, and concur with the views expressed. The call for action to wholeheartedly embrace artificial intelligence (AI) has been particularly loud in the speciality of dentomaxillofacial radiology. Residents at MBRU have ongoing research projects using AI and machine learning (ML) for understanding impacted maxillary canines in cone beam computed tomography (CBCT) images and panoramic radiographs. Although the university is relatively young, a large database of panoramic radiographs is available. Additionally, public databases of panoramic radiographs are also accessible. However, similar open-access CBCT databases are currently unavailable. The purpose of our correspondence is to emphasize the critical need to establish open-access repositories for CBCT scans. In the context of the growing importance of AI and ML, the creation of such databases will be instrumental in developing AI and ML methodologies that require large-scale datasets for optimal functionality. The robustness and generalizability of AI and ML algorithms are directly proportional to the size and diversity of the training datasets. Large datasets are indispensable for training models to recognize patterns, anomalies, and variations, ultimately leading to improved clinical decision-making. Open-access CBCT databases will provide the necessary breadth of diagnostic images to enhance the development and performance of these cutting-edge technologies. Since the lack of such a repository hinders the development and advancement of AI and ML in dentistry, we urge all stakeholders to work towards the creation of such databases. Establishing open-access, cloud-based CBCT databases can facilitate collaboration and innovation within the dental research community. The databases will permit large-scale, multicentre studies and also expedite research initiatives. In anticipation of the positive impact that the International Dental Journal will have in shaping the future of dentistry, thank you for your thoughtful consideration.
Enamel demineralization around orthodontic brackets bonded with new bioactive composite (in-vitro study)
(2024) Khamis, Amar Hassan; Al Taai, Nameer
Abstract Background: This study aimed to evaluate the effect of bioactive composite (ACTIVA) on enamel demineralisation when used as an orthodontic adhesive, compared to other adhesives. Materials and methods: Human upper premolars (n=64) were randomly divided into two equal groups; the first group stored the bonded teeth in deionised water for 30 days at 37°C, and the second group exposed the bonded teeth to acidic media. Each group was further subdivided into four subgroups, with eight premolars in each subgroup, based on the type of adhesive used to bond metal brackets: non-fluoride-releasing adhesive (Transbond XT), fluoride-releasing adhesive (Light Bond), light-cured, resin-reinforced glass ionomer (GC Fuji ortho LC), and bioactive restorative composite (ACTIVA BioACTIVE-RESTORATIVE). Enamel demineralization was assessed at baseline and after 30 days with a laser fluorescence device (DIAGNOdent™ Pen). Results: There were significant differences in fluorescence variation values (ΔFV) among all four tested adhesive systems in both water and acid groups after 30 days. Light Bond adhesive showed the highest fluorescence variation value, while glass ionomer showed the lowest, indicating less enamel demineralization around the bracket. ACTIVA had less enamel demineralisation in acidic media. However, there was no significant difference in enamel demineralisation between water storage and acidic media groups. Conclusion: ACTIVA (RMGIC + composite) exhibited less enamel demineralization than Light Bond; however, Fuji ortho LC showed the lowest enamel demineralization.
Novel method to delineate palatal rugae and assess their complexity using fractal analysis
(2022) Athanasiou, Athanasios E
Abstract: Palatal rugae constitute signifcant morphological landmarks, with wide clinical applications in forensics, insertion of mini-screws, and superimposition. Their morphology has been studied mainly with indices relevant to their qualitative characteristics. The present paper aims at presenting a new quantitative method to evaluate their complexity, by means of box-counting fractal dimension analysis, and to investigate its inter- and intra-rater reliability. Twenty maxillary plaster models were scanned for the needs of this study. A sequence of steps, including cropping of the mesh, ball pivoting, distance mapping and fractal dimension analysis, performed with Viewbox 4 software, was followed. Box-counting fractal dimensions were calculated as a measure of rugae’s complexity. Inter- and intrarater reliability were investigated, using Bland–Altman analysis. Fractal dimensions ranged from 1.274 to 1.491 (average: 1.412). Bland–Altman analysis of inter- and intra-examiner reliability demonstrated that the 95% limits of agreement ranged from − 0.012 to 0.011 and from − 0.004 to 0.004, respectively. The method is reliable and can be applied in research and forensics. It ofers comprehensive evaluation of the rugae’s complexity and a complete set of information about their outlines and height profles, with minimum user intervention.
Evaluation of Mental Foramen and Mandibular Canal Course and Location in an Emirati Subpopulation
(2024) Alazemia, Abdulaziz; Al Muhairi, Eman; Abdunabi, Farida; Chaudhry, Jahanzeb; Moharamzadeh, Keyvan; El Abed, Rashid; Jamal, Mohamed
Abstract Introduction and aims: Violations of the mandibular canal (MC) and mental foramen (MF)and subsequent injuries to their neurovascular bundle have been reported after surgical and nonsurgical dental procedures. Besides using advanced technologies such as cone-beam computed tomography (CBCT), clinicians should be aware of the anatomy and location of MCand MFin different populations. This study aims to describe the morphologic characteristics of the MF, MC, and its intrabony location in relation to the apices of mandibular posterior teeth in an Emirati subpopulation using CBCT. Methods: A total of 3700 CBCT scans were screened, and 154 scans that met the inclusion and exclusion criteria were randomly selected. The scans were assessed using 3-dimensional multiplanar imaging for the following structures: the location of MF and the MC course, its intrabony location, and its relationship to the apices of the mandibular posterior teeth. The data were analysed statistically using SPSS software. Results: The MC ran lingually and inferiorly at the posterior region and became more buccal and superior towards the MF. The distal root of the mandibular second molar was found to be the closest root to the MC (2.06 § 1.83 mm). Moreover, the most common location of the MFwasdistal to the contact area between the 2 premolars (0.83 § 1.84 mm) with a significant negative correlation to age (with and increase in age, the MF moves distally). The distance between the root apices and the MC was statistically significantly affected by age (positive correlation) and gender (male patients had a greater distance). Conclusions: The common course of the MC is lingual and inferior posteriorly and becomes more buccal and superior towards the MF, which is located mostly between the mandibular first and second premolars. Furthermore, the distal root of the mandibular second molar is the closest to the MC and has a positive relationship with age.
Alveolar ridge preservation versus early implant placement in single non-molar sites: A systematic review and meta-analysis
(2024) Atieh, Momen A.; Shah, Maanas; Hakam, Abeer; AlAli, Fawaghi; Aboushakra, Ibrahim
Abstract Objectives: The aim of this systematic review and meta-analyses was to evaluate the outcomes of alveolar ridge preservation (ARP) following extraction of non-molar teeth in comparison to early implant placement (EIP) in terms of clinical and radiographic changes, need for additional augmentation at the time of implant placement, patient-reported outcomes, and implant failure rate. Methods: Electronic databases were searched to identify randomized and nonrandomized studies that compared ARP to EIP. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Data were analyzed using a statistical software program. Results: A total of 106 studies were identified, of which five studies with 198 non molar extraction sockets in 198 participants were included. Overall meta-analysis showed significant differences in changes in midfacial mucosal margin (mean difference (MD) −0.09; 95% confidence interval (CI) −0.17 to −0.01; p= .03) and ridge width (MD −1.70; 95% CI −3.19 to −0.20; p= .03) in favor of ARP. The use of ARP was also associated with less need for additional augmentation at implant placement, but the difference was not statistically significant. Conclusions: Within the limitation of this review, ARP following extraction of non molar teeth has short-term positive effects on soft tissue contour, mucosal margin and thickness, and alveolar ridge width and height. It can also simplify future implant treatment by minimizing the need for additional augmentation
Three-dimensional computed tomography analysis of airway volume in growing class II patients treated with Frankel II appliance
(2024) Ahmed, Marwa Jameel; Diar-Bakirly, Samira; Hassan, Amar; Ghoneima, Ahmed
Objective: The purpose of this retrospective study was to assess the airway volume changes associated with the use of Frankel appliance (FR II) in Class II malocclusion patients using three-dimensional cone beam computed tomography (3D CBCT) imaging. Materials and methods: The sample consisted of 31 Class II malocclusion patients (mean age 9.24±1.93 years old, 17 males (54.8%) and 14 females (45.2%)) treated with FR II appliance by the same orthodontist for an average of 9 months±20 days. CBCT images were taken before and after treatment and upper airway volume changes were measured using Dolphin 3D software version11.0 (Dolphin Imaging, Chatsworth, CA) and statistically compared. Results: Airway volume of nasal cavity, nasopharynx, oropharynx, hypopharynx and the total airway volume significantly increased after the use of FR II appliance. In addition, significant increase was reported in maxillary base, inter-molar, inter-premolar and inter-canine width. Significant increase in soft tissue thickness was only recorded opposite to CV2. Conclusion: The use of the FR II appliance in growing subjects with Class II malocclusion led to a significant increase in the upper airway volume in addition to the anticipated dental and skeletal transverse expansion effects.
Presurgical Infant Orthopedic Videos on YouTube™: A Thematic Analysis of Caregiver Narratives
(2024) Alrubaiaan, Raed; Nair, Bhavana; Amir-Rad, Fatemeh; Aljanahi, May; Prasad, Sabarinath
Objective: Information regarding how caregivers cope when using presurgical infant orthopedic (PSIO) appliances is sparse. This study aimed to understand caregivers’ perspectives and experiences with contemporary PSIO treatment. Design: PSIO videos shared on the YouTube™ platform were used as the data source. Videos with caregivers were identified (n = 21) and portions with caregiver narratives were transcribed. This was followed by the application of a six-step thematic analysis as conceptualized by Braun and Clarke (2006, 2019). Results: Two themes were identified from the caregiver narratives in the PSIO videos. The Family Journey theme included reaction to diagnosis, choice of center, burden of care, care commitment, coping, and testimonials. The Information theme included PSIO techniques and PSIO benefits. Conclusion: Multifaceted challenges and coping strategies were described by caregivers during the PSIO phase. Caregivers remained committed to treatment despite the burden of care, were motivated by an understanding of the benefits of PSIO, and customized care based on their individual strengths and needs. Study results can help providers gain an understanding of what caregivers experience outside the clinical environment.
AI-based automated pre-processing and classification of impacted maxillary canines in panoramic radiographs
(2024) Abdulkreem, Ali; Alzaabi, Hessa; Alali, Kawther; Gonzalez, Angela; Chaudhry, Jahanzeb; Prasad, Sabarinath
Abstract: Objectives: Automating the digital workflow for diagnosing impacted canines using panoramic radiographs (PRs) is challenging. This study explored feature extraction, automated cropping, and classification of impacted and non-impacted canines as a first step. Methods: A convolutional neural network (CNN) with SqueezeNet architecture was first trained to classify two groups of PRs (91with, and 91without impacted canines) on the MATLAB programming platform. Based on results, the need to crop the PRs was realized. Next, artificial intelligence (AI) detectors were trained to identify specific landmarks (maxillary central incisors, lateral incisors, canines, bicuspids, nasal area, and the mandibular ramus) on the PRs. Landmarks were then explored to guide cropping of the PRs. Finally, improvements in classification of automatically cropped PRs was studied. Results: Without cropping, the area under the curve (AUC) of the Receiver Operating Characteristic (ROC) curve for classifying impacted and non-impacted canine was 84%. Landmark training showed that detectors could correctly identify upper central incisors and the ramus in ~98% of PRs . The combined use of the mandibular ramus and maxillary central incisors as guides for cropping yielded the best results (~10% incorrect cropping). When automatically cropped PRs were used, the AUC-ROC improved to 96%. Conclusion: AI algorithms can be automated to pre-process PRs and improve the identification of impacted canines.
Systemic azithromycin vs. amoxicillin/metronidazole as an adjunct in the treatment of periodontitis: a systematic review and meta-analysis
(2024) Atieh, Momen A.; Shah, Maanas; Hakam, Abeer; Alghafri, Meera
Introduction: Test your knowledge by first reading the article, then go to www.ada.org.au. Log on to the members site and click on Professional Information. Under Publications, follow the links to this month’s Quiz. Select the option that you think provides the best answer to each question. Click ‘Done’ and in an instant you’ll know how you scored. Remember to print out a copy of your score for your records. Completion of this quiz entitles you to 1 CPD hour. Please note the Editorial Office does not accept hard copies of completed questionnaires. The Quiz must be completed online and a printed copy of your results retained for CPD audit purposes.
Changes in oral home care and smoking habits during COVID‐19 pandemic: A cross‐sectional study
(2024) Atieh, Momen A.; Aldhanhani, Afrah; Shah, Maanas
Objectives: The coronavirus disease‐19 (COVID‐19) pandemic has caused disruption in the health behavior in many aspects of life. While hand hygiene was promoted as one of the precautionary measures to mitigate and contain COVID‐19, oral health and smoking might have received less attention in the media campaigns. The aim of this study was to examine health behavioral changes in terms of oral home care habits, smoking, and perception of dental care during the COVID‐19 pandemic. Material and Methods: An online survey was designed to assess oral home care, smoking habits, and attitude toward dental services of participants aged 18 years and older. The data were collected between September and November 2021. The strength of association between changes in oral home care habits, smoking, and attitude toward invasive/long dental procedures and each variable was measured by χ 2 analysis. Estimates of relative risk were also calculated for all variables. Predictors of avoiding dental procedures were estimated by a binary logistic regression. Results: A total of 532 participants, based in the United Arab Emirates, took part in this online survey with a response rate of 88.7%. The age of the participants ranged between 18 and 67 with mean age of 34.9 ± 9.0 years. The majority of the participants have adopted changes in their routine oral home care habits, with 82.1% of them changing the toothbrush more frequently. Participants who changed their oral home care habits were more likely to have received sufficient information on the importance of maintaining oral health. Likewise, the changes in smoking habits were significantly associated with receiving information on the relationship between smoking and the severity of the COVID‐19 (p < 0.001). Conclusions: The findings showed that positive behavior toward oral home care and smoking was noticed during the pandemic particularly when public receives sufficient and up‐to‐date information.
Evaluation of the antimicrobial efficacy of different nonsteroidal anti-inflammatory drugs alone or in combination with calcium hydroxide intracanal medicament: an in vitro study
(2024) Atmeh, Amre R.
Abstract: This study explored the antimicrobial efects of ketoprofen, piroxicam, and celecoxib alone or combined with calcium hydroxide (CH) against two strains of Enterococcus faecalis (E. faecalis) and assessed the infuence of such combinations on the pH of CH. Minimum inhibitory concentrations (MICs) of the three tested NSAIDs were determined. Tested pastes were placed into wells punched in seeded agar plates and the bacterial inhibition zones were measured. Antibioflm activity was assessed against 3 weeks of bioflm induced in bovine dentine blocks. The pH of the pastes was measured at fourtime intervals. MIC values were 3.12, 25, and 25 mg/ml for ketoprofen, piroxicam, and celecoxib, respectively, and were similar for both bacterial strains except for celecoxib, which showed 8% growth at the highest tested concentration against vancomycin-resistant E. faecalis. Ketoprofen had the largest mean inhibition zone that was comparable to CH. None of the six tested pastes exhibited antibioflm activity of a signifcant level in comparison to CH. A noticeable increase in the antibioflm activity was found when 20% NSAIDs were added to CH while maintaining an alkaline pH. Ketoprofen was found to be the most efective among the tested NSAIDs. Although its efect was comparable to CH, adding ketoprofen at a ratio of 20% resulted in 50% higher antimicrobial action than CH alone. Accordingly, incorporating NSAIDs in inter-appointment dressing has the potential to utilize their anti-infammatory, local analgesic, and antibacterial actions, which overcome the limitations of CH and improve the outcome of root canal treatment.
Awareness of Forensic Odontology among Dental Students and Faculty in Cyprus: A Survey-Based Study
(2023) Kaklamanos, Eleftherios G
Abstract: This study aimed to evaluate the awareness, comprehension, and practices concerning forensic odontology among dental students and faculty at a Dental School in Cyprus. An online, cross-sectional, descriptive survey, employing an adapted, self-administered questionnaire, was disseminated to all dental students and faculty at the School of Dentistry, European University Cyprus, in November 2022. The survey assessed participants’ demographic information and explored their awareness with questions alluding to knowledge, attitudes and practices in forensic dentistry. Of those surveyed, 47 faculty members and 304 students responded, yielding response rates of 66.2% and 80%, respectively. Statistical analysis, including Kendall’s tau test and χ 2 test were employed to examine correlations and associations, with Cramer’s V used to measure the strength of significant associations. The predetermined significance level was α = 0.05. Awareness levels were assessed through participants’ responses to specific questions in the survey. It was revealed that 87% of faculty and 65% of students were familiar with forensic odontology. A noteworthy 94% of faculty and 85% of students recognized teeth as DNA repositories. A high percentage, 98% of faculty and 89% of students, acknowledged the role of forensic odontology in the identification of criminals and deceased individuals. Awareness of age estimation through dental eruption patterns was evident in 85% of faculty and 81.6% of students. A substantial proportion (80% of faculty) maintained dental records, while 78% of students recognized the importance of dental record-keeping in ensuring quality care. Interestingly, 57% of students and 64% of faculty were aware of the possibility of dentists testifying as expert witnesses. The majority, 95.7% of faculty and 85% of students, concurred that physical harm, scars, and behavioral alterations predominantly indicate child abuse. The findings, revealing robust awareness among respondents, underscore the importance of enhancing faculty engagement in relevant seminars to further strengthen their knowledge. Additionally, emphasizing improved record-keeping practices for potential forensic applications emerges as a crucial aspect. These insights have implications for refining dental education in Cyprus and enhancing forensic practices by promoting ongoing professional development and emphasizing meticulous record-keeping within the dental community.
Physiochemical and mechanical characterisation of orthodontic 3D printed aligner material made of shape memory polymers (4D aligner material)
(2023) Ghoneima, Ahmed; Elshazly, Tarek
Abstract: Objectives: To conduct a physiochemical and mechanical material analysis on 3D printed shape-memory aligners in comparison to thermoformed aligners. Materials and methods: Four materials were examined, including three thermoformed materials: CA Pro (CP), Zendura A (ZA), Zendura FLX (ZF), and one 3D printed material: Tera Harz (TC-85). Rectangular strips measuring 50 × 10 × 0.5 mm were produced from each material. Five tests were conducted, including differential scanning calorimetry (DSC), dynamic mechanical analysis (DMA), shape recovery tests, three-points bending (3 PB), and Vickers surface microhardness (VH). Results: DSC recorded glass transition temperatures (Tg) at 79.9 ◦C for CP, 92.2 ◦C for ZA, 107.1 ◦C for ZF, and 42.3 ◦C for TC-85. In DMA analysis at 20–45 ◦C, a prominent decrease in storage modulus was observed, exclusively for TC-85, as the temperature increased. Notably, within the temperature range of 30–45 ◦C, TC-85 exhibited substantial shape recovery after 10 min, reaching up to 86.1 %, while thermoformed materials showed minimal recovery (1.5–2.9 %). In 3 PB test (at 30, 37, 45 ◦C), ZA demonstrated the highest force at 2 mm bending, while TC-85 exhibited the lowest. Regarding VH at room temperature, there was a significant decrease for both ZA and ZF after thermoforming. ZA had the highest hardness, followed by ZF and TC-85, with CP showing the lowest values. Conclusions: TC-85 demonstrates exceptional shape memory at oral temperature, improving adaptation, reducing force decay, and enabling, together with its higher flexibility, extensive tooth movement per step. Additionally, it maintains microhardness similar to thermoformed sheets, ensuring the durability and effectiveness of dental aligners.
Dentofacial characteristics of children and adolescents with foetal alcohol spectrum disorders: a comparison with matched controls
(2023) Al-Taai, Nameer
Background: Foetal alcohol spectrum disorders (FASD) include somatic and neurological developmental distur bances after prenatal alcohol exposure, including facial anomalies. However, the knowledge of the orthodontic skeletal and dental cephalometric relations in this group is limited. The aim of the study was to assess the dentofacial characteristics of children and adolescents with FASD and to compare them with a matched control group. Methods: The study group comprised all available children and adolescents diagnosed with FASD (>7 years of age) in whom good quality cephalograms were available. The control group comprised non-syndromic, orthodonti cally untreated children with normal occlusion and skeletal relations matched with age and gender. Cephalometric analysis included eighteen linear and angular measurements. The general linear model for repeated measures regard ing age, gender and the type of FASD was applied. Results: The group with FASD included 35 individuals (21 girls and 14 boys) aged 7–18 years including 21 with foetal alcohol syndrome. The mean age in the study and the control group was 12.8 years (SD, range 3.2, 7.1–18.1) and 13.0 (SD, range 2.9, 9.1–18.1), respectively. Statistically signifcant diferences between the groups were found in 15 out of 18 of the cephalometric measurements (83%). In children with FASD the mandible was more retrusive, the inci sors were more proclined and the mandibular incisors and the lips were more protruded when compared with con trols. There was no signifcant evidence of an infuence of age, gender or FASD type. Conclusions: Dentofacial characteristics of children and adolescents with FASD signifcantly difer from controls. Early orthodontic diagnosis and prophylaxis should play a part of the interdisciplinary care of patients in this group.
Comparing the softening effect of three gutta-percha solvents on different types of gutta-percha with different application durations.
(2023) Atmeh, Amre R; Abdunabi, Farida; Khamis, Amar Hassan
Introduction: During non-surgical endodontic retreatment, gutta-percha (GP) solvents are indispensable in difficult cases when used with mechanical removal, however studies comparing their efficacy against different types of GP are limited. The purpose of this study was to investigate the softening effect of three solvents on the conventional (CGP), cross-linked carrier-based (CLGP), and thermoplasticized (TGP) and compare the effect of time on the softening effect of the solvents. Methods: Tested GP were embedded in cuboidal blocks of stone with their upper surfaces exposed (1 mm diameter). Three commercial GP solvents based on D-Limonene (DL), Eucalyptol oil (EO), and orange oil (OO) were added to the exposed GP before an indenter (weight = 1Kg) was applied. Using a digital camera, the indentation depth was measured (mm) directly after applying the solvent and indenter (T = 0), and after 1, 2, and 3 min of application (T = 1,2,3). The means of indentation depth were calculated and compared using a twoway analysis of variance and Tukey’s post-hoc test to assess the effect of the types of solvent, GP for each application duration, and Friedman’s test to evaluate the effect of application duration on the softening effect of solvents. Results: The type of GP (F = 261.43, p < 0.001), type of solvent (F = 3.57, p = 0.015), and application duration (F = 53.088, p < 0.001) were all found to significantly affect GP softening. DL exhibited the highest and only significant effect on CGP after 1 min (p < 0.05), while OO had the only significant effect against CLGP when applied for at least 2 min (p < 0.05). Both OO and EO had significant softening effects on TGP instantly or after 1 min of application, respectively. Conclusions: The results of this study revealed that the softening effect of GP solvents varies depending on their type, their application duration, and the type of GP.

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