Masters (HBMCDM)

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The influence of insertion torque values on the failure and complication rates of dental implants: A systematic review and meta-analysis
(2021) Almoselli, Mohamed Ahmed
Background: The influence of using different insertion torque values on clinical and radiographic outcomes of implant therapy is unclear in the current literature. The aim of this systematic review and meta-analysis was to evaluate the implant outcomes and complications rates using high insertion torque values compared with those using regular insertion torque value levels. Methods: Randomized controlled trials (RCTs), non-randomized controlled clinical trials (NRCCTs), prospective and retrospective cohorts were searched for in electronic databases and complemented by hand searching relevant dental journals. The risk of bias was assessed using the Cochrane Collaboration’s Risk of Bias tool for randomized and non-randomized studies. Data were analyzed using a statistical software. Results: A total of 718 studies were identified, of which, nine studies were included with 1229 dental implants in 684 participants. The meta-analysis of RCTs showed that the overall implant failure rate was not notably in favour of any insertion torque value and the difference between the two groups was not statistically significant (risk ratio 0.85; 95% confidence interval 0.07 to 10.52; P = 0.90). None of the RCTs was registered. The secondary analyses of non-RCTs iii did not either show any statistically significant difference. Overall meta-analysis did not show any significant differences in peri-implant marginal bone loss or biological/technical complications between high (≥ 50 Ncm) and regular insertion torque (< 50 Ncm). Conclusions: There is insufficient evidence to support the use of high or regular insertion torque even with immediate implant restoration/loading. The short-term implant failure rates, changes in marginal bone level and complication rates were comparable when high or regular insertion torques were used for implant placement. The wide confidence interval indicated that results
A Survey of the Application of the Shortened Dental Arch by Dentists in the UAE
(2021) AlHmoudi, Haleimah Saeed Ali
Background: The Shortened Dental Arch (SDA) is a dentition of no more than twenty teeth with an intact anterior region but a reduced number of occluding pairs of posterior teeth. The SDA concept is a valid treatment option in cases in which anteriors and premolars can provide adequate aesthetics, function, and occlusalstability. It focuses on providing the partially dentate patient with the advantages of oral functionality, improved oral hygiene, comfort, while avoiding overtreatment and its unnecessary cost. Aim: To evaluate the general attitude of dentists in the UAE towards the SDA concept and its application in their practice. Materials and Methods: This is a cross-sectional study utilizing an online voluntary and anonymous questionnaire. The questionnaire was sent to all dentists registered with Emirates Medical Association (EMA). The questionnaire consists of 17 questions which comprise demographics, awareness, application in dental practice, preferred treatment modality, and risks and benefits associated with SDA. This survey was carried out during the period ranging from June till October 2020. The data was analyzed using SPSS Statistics. Results: The response rate reported was 40.3%. There is a general awareness of the SDA concept among UAE dentists (n=237, 65.8%); however, it is not usually applied in clinical practice (n=196, 54.7%). Specialists were more aware about the concept and applied it more frequently in their clinical practice than the General Dental Practitioners (GDPs) (P-value = 0.000, 0.041 respectively). Female dentists (n=71, 60.7%) preferred to provide molar support iii to their SDA patients more frequently than male dentists (n=109, 45.8%) (P-value 0.006). Respondents agreed that SDA was associated with the risks of teeth migration (n=211, 59.9%), tooth wear (n=196, 55.8%), and/or Temporomandibular Disorder (TMD) (n=163, 45.3%). Implant was found to be the treatment of choice for many of the participants (n=169, 46.6%) to replace missing molars followed by acrylic Removal Partial Denture (RPD) (n=129, 35.5%). Conclusion: Within the limitations of this study, most of the dentists who responded to this survey are aware of the SDA concept and have a positive attitude about it. However, they do not frequently apply it in clinical practice. The preferred treatment modality for SDA by many dentists in UAE is implants followed by acrylic RPD. Dentists in this study prefer to propose SDA to patients with limited financial resources and medically compromised patients.
Risk factors for dental implant failure: A 10-year retrospective study
(2021) AlZarooni, Fatima
Background: Owing to the high long-term survival rates of osseointegrated dental implants it has become increasingly used as the treatment of choice to replace missing teeth in the past few decades. Nevertheless, implant failures and loss may occur as a result of biological and technical complications. Aim: To identify the risk factors associated with early and late implant failures in patients treated at Dubai Health Authority (DHA) and establish risk assessment model. Materials and Methods: A total of 645 patients aged ≥18 years had 830 failed implants at DHA between 2010 and 2019. The data was manually collected from records available at DHA and then analyzed using logistic regression analysis. The collected data was divided into two sub-categories; systemic-/patient-related factors, and implant-/site-related factors. The strength of association between the frequency of early and late implant failure and each variable was measured by chi-square analysis. Differences were considered statistically significant at P < 0.05. For systemic and patient-related factors, the patient was considered the unit of analysis. For implant-related factors, the implant was considered as the statistical unit. Results: Out of 14191 implants inserted during the observation period, 721 implants failed before loading (5.1%) and 109 implants failed after loading (0.8%). More than half of late failed implants (59.3%) were single implant and (57.0%) were screw-retained prostheses. A significant association was observed between implant failure and histories of treated ii periodontitis (P < 0.0001), previous implant failure (P < 0.0001), and irregular dental attendance (P = 0.006). Implants inserted in the posterior region in both arches had a significant impact on implant failure with more early and late implant failures (P < 0.0001). The other variables did not influence early or late implant failures. Conclusion: Within the limitations of this retrospective study, the analysis identified plausible risk factors for early implant failure, namely history of treated periodontitis, previous implant failure and irregular dental attendance that would allow clinicians to identify those at risk and ensure continuous peri-implant supportive care. Further studies are necessary to achieve more robust understanding on potential risk factors for implant failures and to provide effective preventive and therapeutic protocols.
Erosive potential of drinks consumed in Dubai.
(2021) ALDeekan, Ebraheem S E
Background: Most of the consumed soft drinks are acidic in nature, regular consumption of these drinks which contain the main source of extrinsic acid in diet may result in dental erosion. Although studies have tested drinks for chemical parameters internationally, limited studies have been conducted on drinks in Dubai. The aim of this in vitro study was to evaluate the erosive potential of different soft drinks in Dubai by determining the pH, titratable acidity and concentrations of phosphate, calcium, and fluoride in a variety of commercially available drinks in Dubai. Materials and methods: Twenty-four commercially available soft drinks in Dubai were selected for this in- vitro study. The drinks were divided based on their carbon dioxide (CO2) contents into carbonated and non-carbonated drinks. All drinks were stored according to the manufacturers’ recommendations prior of conducting the study.The properties of each product were analyzed to measure their Acidity (pH), Titratable Acidity (TA), Fluoride (F), Calcium (Ca) and Phosphate (PO4). Inductively Coupled Plasma-Atomic Emission Spectrometers (SGIMADZU ICPE-9820) was used to calculate the mineral contents of tested juices at room temperature. Results: The highest and lowest pH values were 4.38 & 2.79 which recorded for Orange juice (Rauch) and Sun cola (sun top) respectively. On the other hand, 3.6 and 0.11 were the highest and lowest titratable acidity values, which recorded for Mixed fruit lemon (Almarai) and Barbican- strawberry, respectively. Among both carbonated and non-carbonated drinks, the highest and lowest Ca values were 55.6 and 1.98 which were measured for orange juice (Rauch) and blue raspberry (Vimto) respectively. Both highest and lowest reading were ii among the non-carbonated drinks. In carbonated drinks, 7.83 was the highest Ca level measured for Power horse energy while 2.18 was the lowest value measured for Lemon IceTea (Lipton). Among all carbonated drinks, phosphate was not detected apart from Barbican-apple juice which contains 39.55ppm phosphate. On the other hand, the values of phosphate among non-carbonated were ranged from 447.63 to 19.04 for orange juice (Rauch) and Berry mix (sun top) respectively. the mean and standard deviation of calcium levels for both carbonated and noncarbonated were 3.31(2.21) and 9.96(12.16) respectively. Mean (SD) for phosphate were 39.55(0) and 140.67(134.33) for carbonated and noncarbonated drinks correspondingly. pH means were 3.23(0.12) and 3.4(0.44), while means titratable acidity were 0.24 (0.19) and 0.52 (0.78) for carbonated and noncarbonated, respectively. Kruskal-Wallis test was used to compare the means of all variables between carbonated and noncarbonated drinks. only difference in calcium level was statistically significant (p˂0.05). The means of pH and Calcium were compared with data of mineral waters and treated waters which revealed significant difference with all tested drinks at (p˂0.05). Conclusion: All drinks had erosive potential with fruit juices having the lowest mean pH and lowest mineral contents. The association between minerals and pH are high.
Development of a dental reference data set for Emirati children and adolescents based on the Demirjian’s method
(2021) Al Haj, Sharifa
Background: The ability to predict the difference between chronological age (CA) and dental age (DA) is an important aid in the accurate diagnosis and treatment planning process in the pediatric population. Aim: To establish a Dental Reference Data Set (DRDS) of Emirati children aged between 5 to 15 years. Materials and Methods: Dental Panoramic Tomography (DPTs) of 139 Emirati children aged 5 to 15 were to conduct a retrospective case-note cross- sectional study and used to establish a DRDS. The Tooth Development Stages (TDS) system described by Demirjian (1973) was used to assess all the permanent teeth on the left side of the Mandible. Results: The mean maturation score of the Emirati population compared was not statistically significant from that of the French-Canadian children (males P value = 0.723, females P value = 0.664). Emirati children’s DA was higher compared to the Canadian standards. The mean difference between DA-CA in girls and in boys was 1.21 and 0.79 years respectively (p <0.001). Using a normalization methodology, self-weighted scores were developed for Emirati girls and boys. Conclusion: The results demonstrated that the Demirjianmethod was suitable for estimating the dental age in a group of Emirati children.
Parents Perception Toward Infants Teething in Dubai, United Arab Emirates
(2021) Almatrouk, Sarah Fahad
Background: Teething is a normal physiological phenomenon of the continuum of dental development during which the tooth moves from its intraosseous position within the jaw until it reaches the oral cavity. It begins around six months of age with the lower primary central incisors' eruption and is completed by three years. Many parents assume the certainty of the presence of signs and symptoms associated with teething. Aims: This study aimed to assess parental knowledge and beliefs regarding the teething process and investigate parental practices to alleviate symptoms associated with teething in Dubai, United Arab Emirates (UAE). Materials and Methods: A cross-sectional survey conducted using a self-administered questionnaire distributed to parents in Dubai, UAE. The questionnaire contained three sections eliciting demographic characteristics and assessing parents’ knowledge, beliefs, and practice regarding teething. The chi-square test was used to analyse relationships (knowledge, beliefs, and practices) and (demographic characteristics). Kolmogorov-Smirnov test was used to measure the ii normality of the scores. A p-value of less than 0.05 was considered significant in all statistical analyses. Results: Overall, 323 participants were included in the final analysis, with the majority of the participants being females (mothers) aged 30-39 years old (39.6%). Increased drooling, desire to bite, gum irritation, fever, and sleep disturbance were the most reported symptoms of teething stated by 282 (87.3 %), 279 (86.4 %), 278 (86.4 %), 277 (85.8%), and 264 (81.7%) of the parents, respectively. Most of the participants, 194 (61%) reported that their child was moderately distressed. Around (39.9%) of the participants reported that their child distress lasted for more than a week. Our study found that (57.9%) and (36.8%) of parents received their advice regarding managing teething symptoms from relatives and pediatricians, respectively. The level of knowledge about teething was significantly associated with the participants' age with the middle age group having a better knowledge. (p-value= 0.045). Conclusions: Most of the parents had misconceptions about the signs that typically occur during teething. A common lack of knowledge about teething among parents should encourage dental healthcare providers to educate parents and other healthcare providers regarding the teething process and the management of its potential sign and symptoms.
Hall Versus Conventional Preformed Metal Crowns: Radiographic Identification by Pediatric Dentists
(2021) Mohanraja, Sahaana
Background: It is assumed that Conventional preformed metal crowns (PMCs) are usually well adapted to the primary molars, while it has been claimed that the Hall technique (HT) PMC is an oversized, poorly fitting crown with overhanging margins. PMCs, if present in children, are usually identifiable on routine bitewings. Aim: To investigate if pediatric dentists (PDs) were able to identify or perceive any radiographic differences between HT PMCs versus conventional PMCs and to assess the perception and acceptability of HT by PDs over time. Method: An online cross-sectional questionnaire of 25 questions survey was sent via global dentistry society groups, to PDs across the globe between 1 st January to the 31st March 2020. It included 10 randomly selected bitewings showing PMCs (five HT and five conventional). A score out of 10 was calculated for the PMCs detection. T-test, Pearson’s and Fischer’s Chisquare, and Odd Ratios (OR) were calculated (p<0.05). Results: Responses of dentists (N=476) from 58 countries were obtained, with 97% reporting that they used PMCs in their practice. The majority (98.7%) had heard/understood HT, while 79% used it. There was a clear shift, towards supporting the use of the HT, over time with an opinion change OR of 11.154 [95% confidence interval (CI): 6.006- 20.715]. More than two thirds (67%) of the PDs thought that there was no radiographic difference between HT and iii conventional PMCs (out of the 10 bitewings provided), and only five PMCs were identified correctly [average correct score of 4.9 (±1.73) out of 10]. The remainder (33%) who thought there were differences, scored higher than those who had the opposite view (5.31±1.22, and 4.68±1.9 respectively, p<0.00001) No one managed to identify all the 10 PMCs correctly, however, the participants were able to successfully identify HT PMCs on bitewings 4.63 times more than conventional PMCs (OR for successfully identifying HT PMCs; 24.857 [CI: 15.059- 41.028] compared to an OR for successfully identifying conventional PMCs; 5.361 [CI: 3.089- 9.304], p<0.0001). Conclusion: Most of the surveyed PDs identified the PMC type in only half of bitewing radiographs provided. Despite that they perceived that there was no clear radiographic difference between HT and conventional PMCs on bitewings radiographs, the chance of them recognizing HT PMCs on these bitewings was almost five times higher than conventional PMCs. There was a clear supportive shift in opinion over time, for the use of the HT.
Sugar Composition and Level of Commercially Available Infant Formulae in the United Arab Emirates
(2021) Awad, Rawan Osama Ahmed
Background: Infant formulae are a primary source of nutrition during the first years of life. Frequently, sugar is added to these formulae, which can lead to different adverse health problems including early childhood caries, if consumed excessively or with bad feeding habits. Aim: To assess the amount and type of dietary sugars in commercially available infant formulae in the UAE. Materials and Methods: This study involved measuring sucrose, glucose, and fructose in 71 different brands of commercially available infant formulae for retail sale in the UAE. Organic and non-organic milk-based, and soy-based formulae recommended for healthy infants from birth until three years of age were included. Hydrolyzed rice, lactose-free, and goat milk formulae were also included. The experimental analysis was conducted in a private laboratory in Dubai. The process of quantifying sugars was performed using high-performance liquid chromatography with refractive index detection (HPLC-RI), with the limit of detection (LOD) set at 0.1 g/100ml. Sugar values were determined and compared with nutritional labels. Descriptive analysis was performed using tables. Comparison between this study’s findings, data on the products’ labels, World Health Organization (WHO) standards, and The European Society for Pediatric Gastroenterology Hepatology and Nutrition (ESPGHAN) Standards for infant formulae was done. Results: Out of the 71 samples, 23 had detectable sugar levels. 12 samples had glucose, one sample had fructose, and 10 samples had sucrose. Of all infant formulae products that were analyzed, 10 were found to have sugars contributing to more than 5% of total energy intake. ii All infant formulae packages had carbohydrates levels mentioned on the labels, but very few mentioned details about the added sugar content. Conclusions: Many infant formulae products consumed by infants and young children in the UAE were found to contain sugars that exceed the standard recommended intake. Tighter regulations that monitor the amount of sugar in infant formulae are needed. Guidelines for a comprehensive labelling system that accurately discloses the sugar levels are required to reduce adverse health problems secondary to excess sugar consumption in early childhood.
Pediatric dentists preference of general anesthesia endotracheal intubation route and their perception of a modified oral intubation technique
(2021) Alderei, Najla Salim Balaswad
Aim: Pediatric airway management in light of notable modifications in endotracheal anesthesia armamentarium is an essential aspect in the pediatric population undergoing general anesthesia (GA). We aimed to assess Gulf Cooperation Council (GCC) pediatric dentists’ preference of GA endotracheal intubation and their perception regarding a modified technique of oral intubation using a Ring, Adair and Elwyn “RAE” tube during dental treatment under general anesthesia. Methods: A web-based questionnaire was circulated via social media platforms and emails to pediatric dentists practicing in the GCC. It included demographic variables and questions about preference, familiarity and perception of pediatric dentists related to a modified oral intubation method using an oral RAE tube. Responses were analyzed by using χ2 and Exact Fischer’s test. Statistical significance was set as p <0.05. Results: A total of 73 pediatric dentists who perform dental treatment under GA responded. Male pediatric dentists were more familiar with RAE tube than females (p=0.031). Sixty-four percent of respondents (n=18) within the age 36-45 agreed on the proposed modified technique (p=0.027). Over 83.3% (n=15) out of 18 with ≥ 21 years of experience believed that the modified technique will cause difficulty when compared to nasal intubation (n=0.009). Conclusion: The results of this study indicated that 79.5% of the studied sample considered nasal intubation as the route of choice, despite the fact that they believe it was associated with more complications. The majority of GCC pediatric dentists were unfamiliar with the RAE tube. Interestingly, these results showed 50.7% level of agreement in utilizing a modified oral intubation technique using RAE tube. Therefore, it is recommended that further research should be undertaken and hands on workshops are conducted to familiarize GCC pediatric dentists with the feasibility and easiness in performing dental procedures under GA without tube interference.
Characteristics of pediatric dental treatment provided under general anesthesia in Dubai, United Arab Emirates - A retrospective analysis
(2021) Abdo, Mohammad Motea
Background: Dental general anesthesia (DGA) is a widely used technique in pediatric dentistry. Several researchers have examined their DGA cases and tried to pinpoint the primary cause leading to it. Furthermore, factors affecting the success rate of DGA are a widely investigated topic in the literature. However, in the UAE there is a notable paucity of properly conducted studies specifically relating to this subject. Aim: This study was set out to analyse characteristics of dental treatment provided for children under General Anesthesia (GA) and review any differences of treatment between Special Health Care Needs (SHCN) and healthy patients. Materials and Methods: A retrospective analysis was conducted on the data that was collected from the electronic records of all patients who underwent any dental treatment under GA in the period between January 1 st 2016 up until the 29th of February 2020. Data included sociodemographic status of patients, preoperative information such as diagnosis and justification of GA, intraoperative information including treatment details and duration, and post-operative information such as follow-up rates and morbidities. Results: The study population consisted of 98 patients. Majority of the sample were males (62.2%), and the mean age was 5.4 years. 26 out of the 98 children had a medical condition and were categorized as ASA II. Results of the study showed that the most common diagnosis leading to GA is Early Childhood Caries (ECC) and the most common justification is lack of cooperation due to young age. The study also showed that nearly half the patients missed their one-week, 3-months and 6-months follow-up visits. Further dental treatment was needed for 23 (23.5%) patients which were delivered under local anesthesia in the dental chair. Out of the 23 patient who received further treatment (60.9%) were due to new carious lesions. Four (4.08%) out of the 98 children had a repeat GA episode. SHCN patients received significantly more interventive measures and significantly less pulp therapies than healthy patients. The ratio of fissure sealants was 3.65 sealants per SHCN patient compared to 0.77 sealants per healthy child. Conclusion: A more comprehensive treatment plan which consists of fewer pulp therapies was adopted to treat SHCN children accompanied by a notable increase in preventive interventions when compared to healthy patients. Frequently missing recall appointments following DGA increased the likelihood of developing new carious lesions and consequently increased the need for further dental treatment.
Effects of non-compliant intraoral distalizers on the soft tissue profile, A systematic review
(2021) Kaouche, Zahir Zouheir
Background: Practicing orthodontists have special interest in Class II malocclusion cases as they constitute a significant percentage of the cases they treat. Maxillary molar distalization is the most frequently used nonextraction treatment in the correction of Class II malocclusion to establish a Class I molar and canine relationships. The common and unwanted side effect of these intraoral methods is the mesial shift of premolars and incisors leading to anchorage loss which might affect the profile and soft tissues of the patient. Aim: The objective of this systematic review is to look at the soft tissue effects associated with the use of non-compliant intraoral distalizers for the correction of Class II malocclusion. Materials and Methods: The systematic search included Cochrane Library, PubMed, Scopus and Ovid journals identifying 4 prospective or retrospective studies matching the inclusion criteria. The inclusion criteria considered were Class II malocclusion cases using noncompliant intraoral tooth-borne distalizers, a control group of untreated Class II patients or non-compliant intraoral skeletal-borne distalizers. The main outcome assessed were the soft tissue effects including the nasolabial angle, upper and lower lips to E-plane. Secondary outcomes included the degree of incisor anchorage loss. Appliances with conventional or skeletal anchorage designs were considered for the review. The Final articles included were three non-randomized retrospective studies and one prospective study. The date of the last search was May 15, 2021. The methodological index of non-randomized studies (MINORS) was used to assess the articles included. The studies had close results and assessed to have high risk of bias. Results: In total, 436 studies were identified for screening, and 4 studies were eligible. The mean change in the upper lip to E-plane varied from 0.1mm to 0.7mm. The mean change in lower lip to E-plane varies from 0.0mm to 0.6mm. While the mean change in nasolabial angle showed an increase of 1.7 (15.5) degrees. Dental changes were also assessed. The SNupper incisor mean change ranged from 0.1 degrees with the use of distal screw appliance to 5.0 with the use of the pendulum. The mean change in the overjet was 0.0mm with the use of bone anchored pendulum appliance BAPA. The values increased with the use of other types of distalizers with the highest value of 1.5mm with the use of the distal jet. The first premolars can also be affected with the use of distalizers. However, using a skeletally anchored distalizer can lead to distalization of the first premolars as reported by (Polat-Ozsoy, 2008) with the use of BAPA with a mean change of -2.7mm when measured from a vertical plane. Mesialization of the first premolars happened when a conventional pendulum appliance was used with a mean change of 4.0mm. Conclusion: There is no significant difference in the nasolabial angel, upper lip and lower lip positions, and hence the soft tissue profile of the patient with the use of various types of noncompliant intraoral distalizers when treating Class II malocclusion cases. The use of skeletally anchored distalizers had fewer side effects on the soft tissue measurements, however these differences were not significant.
Effect of supine and upright positions on airway dimensions in patients with obstructive sleep apnea
(2021) Abdullah, Maryam
Aim: The aim of the study was to assess the effect of supine vs upright imaging positions on airway dimensions in patients with obstructive sleep apnea (OSA). Materials and methods: This retrospective study included three-dimensional (3D) data of 30 subjects diagnosed with OSA. Patients’ ages ranged from 26 to 60 years (35.7 ± 2.3 years). Subjects were scanned with a low-dose multiplanar CT scanner in a supine position using X-vision EX, (Toshiba Medical Systems, Otawara-Shi, Japan) at a voxel size of 0.4 mm and a second scan in an upright position using iCAT CBCT scanner (Imaging Sciences International, Hartfield, PA) at the same voxel size. Airway volume was measured at the level of the nasal cavity, nasopharynx, oropharynx, and hypopharynx using Dolphin imaging software (version 11.5; Patterson Dental Supply, Chatsworth, CA). The differences in the measurements in both positions were compared using Student’s t-test and p ≤ 0.05 was considered statistically significant. Results: Significant statistical differences were reported between the measurements at the two positions. The nasopharynx and oropharynx area were significantly less when measured at the supine position. The airway volume measured at the nasal cavity and hypopharynx did not show significant differences between both positions. Conclusion: The patient’s position during the imaging session significantly affects the airway measurements. Airway volume measurement recorded when patient scanned in supine position shows less values than those recorded with upright scanning position.
Effect of Voxel Size on the Accuracy of Airway Volumetric Measurements Using Cone Beam Computed Tomography
(2021) Alhawi, Worod Naeem Khaled
Aim: The purpose of this retrospective study was to evaluate the accuracy and reliability of the airway volume, dental, and skeletal parameters measured digitally on cone beam computed tomography scans (CBCTs) using airway model scanned with different resolutions. Material and method: This retrospective study was performed using CBCT images obtained from an artificial model of airway made by an acrylic airway model scanned at different voxel sizes, timing, and segmentation levels. CBCT scans were divided into four groups according to the voxel size of each scan (0.2, 0.25, 0.3 and 0.4). Airway volume parameters were measured using Dolphin 3D (Dolphin Imaging & Management solutions, Chatsworth, California, USA) software version 11.95. Reliability and accuracy were assessed by using intraclass correlation and Student’s t-test. A P-value of less than 0.05 was considered significant. Results: The intra- and inter-examiner reliability were high for all measurements. Significant statistical differences were detected among airway volume measured at variable voxel size, scanning time, and segmentation level however, no significant differences were found in the skeletal and dental parameters. These results suggested that the airway measurements vary according to the voxel size, scanning time and segmentation level. Conclusion: Airway volume measurements vary depending on the voxel size, scanning time and segmentation level of CBCT scans. Clinicians and researchers should be aware of the effect of the voxel size and scanning resolution on the airway measurements since this could affect the clinical judgement of critical cases.
Do the various interceptive interventions improve the position of palatally displaced permanent canines? A meta-analysis
(2021) Habib, Ahlam
Background: Extraction of maxillary primary canines (Cs) and other interceptive interventions in the mixed dentition have been suggested to increase the rate of normal eruption of palatally displaced permanent canines (PDCs). However, the information on the overall effect on PDCs position has not been yet summarized in an evidencebased manner. Objective: To assess whether this practice improves the position of PDCs and to investigate the quality of the evidence. Search methods: Unrestricted searches in 8 databases and manual searching of the reference lists in relevant studies were performed up to March 2021 (Medline via PubMed, CENTRAL, Cochrane Database of Systematic Reviews, Scopus, Web of Science, Arab World Research, ClinicalTrials.gov, ProQuest Dissertations and Theses Global). Selection criteria: We looked for data on the positional changes of PDCs (mesial ii inclination, vertical position, canine crown cusp tip to midline) from randomized controlled trials, assessing the various interceptive interventions. Data collection and analysis: Following study retrieval and selection, relevant data were extracted, and the risk of bias was assessed using the Cochrane Risk of Bias 2 Tool. Exploratory synthesis and meta-regression were carried out using the random effects model, and the overall quality of the available evidence was assessed with the Grades of Recommendation, Assessment, Development, and Evaluation approach. Results: Five studies (3 at low risk of bias) were identified, involving 238 individuals, followed for up to 18 months post-intervention with orthopantomograms or cone beam computed tomography. Exploratory data synthesis showed that PDCs’ position improved more in the extraction sites compared to non-extraction. Analysis of the studies at low risk confirmed the above observations (6 and 12 months). Improvements were observed in patients using headgear after extraction of the Cs compared to extraction alone, but not in patients with double extraction of Cs and first molars. The quality of available evidence was rated as moderate at best. Conclusions: Interceptive interventions in the mixed dentition may improve the position of PDCs. However, further studies are warranted in order to determine the clinical significance of the changes.
The effect of varying concentrations of hydrogen peroxide on bovine enamel and dentine
(2021) Alnaqbi, Nouf Khalfan
Background: Bleaching has become a popular treatment option for aesthetic management of discolored teeth. Bleaching is a conservative approach in aesthetic dentistry compared to other invasive restorative treatment modalities such as indirect veneers and crowns. While bleaching is successful and effective, several studies have documented structural changes such as increased roughness, decreased microhardness, and decreased enamel strength, as well as a decrease in mineral content (calcium, phosphate, and fluoride) and the emergence of clinical symptoms such as dentin hypersensitivity and gingival irritation. Aim: The aim of this study was to investigate the effects of varying concentrations of hydrogen peroxide (HP) on bovine enamel and dentine in term of calcium, magnesium, and phosphorous ion release. Materials and Methods: Bovine enamel and dentine discs were sectioned, prepared and treated with different concentrations of carbamide peroxide (CP) including 10%, 15%, and 20% CP, and 35% HP. Negative control group was saline solution, and the positive control group was vinegar (N=5). All solution samples were analyzed for ion release using a calcium, magnesium and phosphate meter. Results: Treatment with 35% HP resulted in statistically significant increase in the amount of calcium and magnesium ions released from both enamel and dentin samples (p <0.05 ). Treatment with CP 10-20% caused statistically significant increase in the amount of magnesium and phosphate ions released from enamel and dentin samples (p <0.05). Conclusions: From the results of this study, it can be concluded that tooth whitening with CP (10-20%) and high concentrations of HP (35%) can have detrimental effects on the structure of both enamel and dentin by increasing the dissolution of their mineral components.
Evaluation of the root and canal morphology of maxillary and mandibular premolars in an Emirati subpopulation using cone beam computed tomographic data: A retrospective study
(2021) Almehrzi, Hanadi Rashed
Background: Missed canal anatomy is one of the most common cause of endodontic therapy failure. Numerous studies have reported that maxillary and mandibular premolars have a complex internal canal configuration, which can vary according to race and geographic origin. Therefore, a thorough knowledge and understanding of the root and canal morphology is crucial, to ensure successful outcome of root canal treatment. Aim: To describe the root and canal morphology of Maxillary and Mandibular first and second premolars in Emirati subpopulation by analyzing the 3-dimentional data from Cone-beam Computed Tomographic (CBCT) images. Materials and Methods: This is a retrospective study, in which 360 CBCT scans of patients treated at Healthpoint Dental center (Mubadala, Abu Dhabi), United Arab Emirates, between 2017-2018, were obtained and analyzed. The institutional review board approval was obtained to collect and analyze the CBCT scans for the purpose of this study. All CBCT scans at HDC were acquired using Orthophos SL (Dentsply Sirona, USA) by the same technician using the following imaging protocol; 85 Kv, 7 mAs, with exposure time of 5 seconds and voxel size of 0.15 mm. Two evaluators reviewed and recorded the findings twice with an intersession of 30 days. They recorded the number and shape of roots and categorize the canal morphology based on Vertucci classification (VC). Results: Most of maxillary first premolars had 1 root (52.1%), while only 0.9% had 3 roots. Type I VC was the most common canal configuration (53.8%). The majority of maxillary second premolars had 1 root (91%). Type I was the most canal configuration (47.4%), followed by Type III (32.4%). Most of mandibular first and second premolars had 1 root (77.3% and 97%, respectively) and Type I was the most common canal configuration (70.4% and 94.9%, respectively). C-shape canals were markedly noticed in mandibular first premolars with prevalence of 22.7%. Conclusion: This is the first study to investigate the root and canal morphology of maxillary and mandibular premolars in an Emirati subpopulation using CBCT. Our data showed great variations in the root and canal morphology of maxillary and mandibular premolars in Emirati populations. The prevalence of C-shaped canal in mandibular premolars in Emirati population is considered relatively high (22.7%) in comparison to other populations.
Evaluation of root and canal morphology of mandibular permanent anterior teeth in Emirati subpopulation: A cone-beam computed tomography study
(2021) Albannay, Bader
Background: Failure in mandibular permanent anterior teeth is almost due to missed second canal. Advanced techniques such as using a dental operating microscope and cone-beam computed tomography (CBCT), one important tool is knowing the prevalence of the second canal in mandibular permanent anterior teeth in different populations. There were no studies have been conducted to examine the root canal morphology in mandibular permanent anterior teeth in the Emirati population. Aim: To examine the root and canal morphology of mandibular anterior teeth an determine the prevalence of the second canal in the Emirati population using CBCT. Materials & Methods: A total of 176 CBCT scans were randomly selected and obtained from Health Point Dental Center, Abu Dhabi. These scans were reviewed, and the canal configurations iii were categorized according to Vertucci’s classification. Results: A total of 176 scans were evaluated. All of the examined mandibular central and lateral incisors had one root. Only 1.5% of the examined mandibular canines had two roots. Almost 43.5% and 37.5% of the examined central and lateral incisors had a second canal, respectively. Whereas only 6.5% of the examined canines had two canals. Generally, Type I Vertucci canal configuration was the most common in all examined teeth (70.5%), followed by Type III (28%), type V (1%) while Type II was the least common configuration (0.5%). Regarding age groups, there was a statistically significant difference in the frequencies of left central incisor canal types between the groups (p40 years for the mandibular anterior. Regarding gender, it was highly symmetrical between male and female. In the analysis of bilateral symmetry of the types of Vertucci classification in the mandible anterior teeth, type I Vertucci classification had the highest incidence of bilateral symmetry canines (90%), lateral incisors (66%), and central incisors (48%), followed by Type III canines (10%) lateral incisors (30%) and central incisors (34%), while Type V had the least incidence of symmetry. Conclusions: This study shows a high prevalence of the second canal in mandibular anterior teeth in the Emirati population. More attention should be given to detect the additional canals and the use of CBCT might be recommended as an effective diagnostic tool to identify this canalConclusions: This study shows a high prevalence of the second canal in mandibular anterior teeth in the Emirati population. More attention should be given to detect the additional canals and the use of CBCT might be recommended as an effective diagnostic tool to identify this canal.
Evaluation of the mental foramen and the mandibular canal course in emirati population: a cone-beam computed tomography study
(2021) Alazemi, Abdulaziz
Background: The mandibular canal (MC) is an important bony structure presents in the mandible that contains a bundle of nerves and vessels including the inferior alveolar nerve (IAN) and the mandibular division of the trigeminal nerve (V3). During surgical or non-surgical dental treatment physical damage can occur to the contents of the inferior alveolar canal. Therefore, a comprehensive knowledge of the anatomy of the MC, its variants and relation to other anatomical structures is essential in the prevention and management of any damages to the IAN during surgical and non-surgical endodontic therapies involving mandibular teeth. It has been recommended to use CBCT to locate the MC course and relation to mandibular teeth prior to endodontic surgical procedures. Furthermore, due to its availability and its conservative nature, CBCT have been used as a tool to study the morphological characteristics of the MC, its course and its intra-bony location of different ethnic groups. Aim: The aim of this study was to Describe the morphological characteristics of the MC, its intra-bony location, and relation to the apices of mandibular posterior teeth in an Emirati subpopulation, using CBCT. Material and methods: This was a retrospective study designed to analyze the cone-beam computed tomography scans of Emirati patients who were treated at Healthpoint Dental Center (Mubadala, Abu Dhabi), United Arab Emirates, between 2017- 2018. 3700 CBCT scans were taken during that period as part of a treatment plan and 154 scans were selected for this study according to inclusion/exclusion criteria. Every patient treated at HDC signs a consent form which allows for research use of available patient data. All CBCT scans were acquired using Orthophos SL (Dentsply Sirona, USA) using a standard imaging protocol (CBCT at HDC are taken by same technician, using same CBCT machine with same parameters; 85 Kv, 7 mAs, with exposure time of 5 seconds and voxel size of 0.15 mm). The data were extracted and anonymized to remove all patient identifiers. The principal investigator (author) evaluated all scans on diagnostic quality monitors. Results: 154 CBCT scans were examined. Examining the selected patients’ scans details showed that 72 patients (46.8%) were female, while 82 patients (53.2%) were male. Selected patients’ age ranged from 16 to 71 years; more specifically, 26% were younger than or aged 30, 28.5% were between 31 and 40 years and 45.5% were older than 40 years. Overall, the mean distance of the mental foramen (MF) in relation to the line between the mandibular premolars was distal by 0.83mm ± 1.84. The mean distances of the root apices with the superior border of the MC in relation to the second premolar, mesial and distal roots of the first molar and mesial and distal roots of the second molar were 4.02mm ± 2.02, 4.54mm ± 1.96, 4.07mm ± 2.08, 2.58mm ± 1.79 and 2.06mm ± 1.83 respectively. The mean distances between the buccal aspect of the mandible with the MC in relation to the second premolar, mesial and distal roots of the first molar and mesial and distal iii roots of the second molar were 3.59mm ± 1.03, 4.52mm ± 1.13, 5.05mm ± 1.21, 5.11mm ± 1.27 and 4.83mm ± 1.36 respectively. The mean distances between the lingual aspect of the mandible with the MC in relation to the second premolar, mesial and distal roots of the first molar and mesial and distal roots of the second molar were 2.79mm ± 1.03, 1.92mm ± 0.8, 1.68mm ± 0.68, 1.77mm ± 0.69 and 1.73mm ± 0.74 respectively. The mean distances between the inferior border of the mandible with the MC in relation to the second premolar, mesial and distal roots of the first molar and mesial and distal roots of the second molar were 6.6mm ± 1.61, 5.52mm ± 1.41, 5.16mm ± 1.24, 5.11mm ± 1.36 and 5.46mm ± 1.51 respectively. Statistical analysis showed that for the MF location there is no significant deference found between males and females (males -0.3mm ± 2.2 and females -0.5mm ± 2.4) (P=0.635). however, the distances between root apices of mandibular teeth to the MC was significantly higher in males compared to females. Interestingly, all mean distances were higher in males compared to females except for the distance between the lingual aspect of the mandible and the IAC in relation to the mesial root of the second molar where females had greater distance compared to males (males 1.4mm ± 0.7 females 1.9mm ± 0.7) (P < 0.001). The statistical analysis showed that there is a negative relationship between age and the location of the MF in relation with the premolars (P<0.001). On the other hand, distances between the root apices and the IAC have a significant positive relationship with age. Conclusion: The most common location of the mental foramen is distal to the contact area between the mandibular first and second premolars (0.83mm ± 1.84), and this distance have a negative relationship with age. The distal root of the mandibular second molar is the closest root to the mandibular canal (2.06mm ± iv 1.83). The distance between the root apices of the mandibular teeth and the mandibular canal has a positive relationship with age and gender, as young female patients have smaller distance than older male patients. The common course of the canal being more lingual and inferior posteriorly and becoming more buccal and superior towards the mental foramen.
Effect of usage and autoclaving on the cyclic fatigue resistance of heat-treated nickel-titanium instrument
(2021) Alshehhi, Aisha Abdalla Ali
Background: Nickel-titanium (NiTi) instruments are often reused in endodontic treatment for economic reasons. Thus, cleaning, disinfection, and sterilization of these endodontic instruments are essential. Several studies have shown that additional heat treatment during the sterilization of NiTi instruments affects their physical properties. Some researchers concluded that sterilization has a detrimental impact on the physical properties of NiTi files. However, others found that sterilization for up to 10 cycles does not increase the risk of NiTi failure. Aim: To evaluate the effect of usage and sterilization on the cyclic fatigue resistance of a heat-treated NiTi instrument (ProTaper Gold). Materials and Methods: Thirty ProTaper Gold NiTi F2 files (length 25 mm) were used in this study. The files were assigned to three groups: Group I, new files (control group); Group II, files that underwent autoclave sterilization at 134 °C for 30 mins; and Group III, files that were prepared in a standardized J-shaped endo block followed by autoclave sterilization. Each NiTi file was rotated in an artificial curved metal block using a custom-made device in a repetitive up and down motion in a dynamic mode until fracture occur. The duration taken for the fracture to occur was recorded and translated into a number of cycles to failure (NCF). A digital micro-caliper was used to measure the length of the broken fragment. Following the cyclic fatigue test, all fractured fragments were examined under a scanning electron microscope to determine the topographic characteristics of the damaged surfaces. The data was analyzed using SPSS. The NCF was compared across the three groups using ANOVA, and fragment length using the Kruskal-Wallis test. A p-value of 0.05, was considered significant in all experiments. Results: There was no statistically significant difference in the number of cycles to failure (NCF) among the three classes (P = 0.292.). Scanning electron microscopy revealed the typical features of cyclic fatigue failure of each fracture surface. Conclusion: Under the limitations of this analysis, the findings provide precursory evidence that single canal file use and a single autoclave sterilization cycle do not affect the cyclic fatigue resistance of heat-treated nickel-titanium endodontic instrument (ProTaper Gold).
A retrospective analysis of biological complications of implant-supported fixed dental prostheses
(2021) Almutairi, Zainab
Background: In the past few decades implant supported fixed dental protheses has become widely accepted treatment option for replacing missing teeth. Despite their high survival rate, complications such as peri-implant diseases are common. Aim: To evaluate patient-, implant- surgical- and prosthetic-related risk factors that are associated with peri-implant diseases, identify prevalence and predictors of peri-implant diseases. Materials and Methods: A retrospective study of 162 patients who received 301 dental implants was conducted to evaluate the prevalences and risk indicators for peri-implant mucositis and peri-implantitis. The data were analyzed using the binary logistic regression to evaluate different risk indicators peri-implantitis. Results: The prevalence of peri-implant mucositis at the patients and implant levels were 44.4% and 38.2%, respectively. For peri-implantitis, the prevalence at the patient level was 5.6%, while the prevalence at the implant level was 4.0%. Patients diagnosed with peri-implant mucositis were more likely to be irregular attenders of peri-implant maintenance while those diagnosed with peri-implantitis were likely to be smokers, had history of treated periodontitis or did not attend of regular peri-implant maintenance visits. Conclusion: Within the limitations of this retrospective study, the analysis identified plausible risk indicators, namely smoking, history of treated periodontitis and irregular peri-implant ii maintenance visits, that would allow clinicians to identify those at risk and ensure continuous peri-implant supportive care.

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