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In modern dentistry, radiographic imaging is crucial for examining the connection between the maxillary sinus floor and the root apices of the maxillary posterior teeth, particularly when the periapical region is affected by pathology that could result in infectious, inflammatory, or traumatic changes in the maxillary sinus. This study aimed to investigate the prevalence of periapical pathologies in the maxillary posterior teeth and their relationship with maxillary sinus mucosal thickening by using cone-beam computed tomography scans. This retrospective study was conducted on 420 digitized CBCT images which were scanned in sagittal, axial, and coronal views. Out of 420 total images, 223 (53.1%) were of males and 197 (44.9%) were of females. The data were analyzed using SPSS version 28. A total of 2936 posterior maxillary teeth were tested for periapical pathology (PP), 1477 on the right side and 1459 on the left side. In terms of gender, there was no significant relationship between PP in maxillary posterior teeth on both sides and mucosal thickness of the maxillary sinus (p > 0.05). A significant relationship was found between PP in maxillary posterior teeth on both sides and maxillary sinus mucosal thickening (p < 0.05). This study concluded that the prevalence of periapical pathology in the maxillary posterior teeth was significantly associated with a rise in the incidence of maxillary sinus mucosal thickening. Moreover, the primary causative factor for the pathophysiology of the odontogenic maxillary sinus was the periapical pathology in both maxillary first molars.

BACKGROUND: Dental caries is one of the most common diseases around the world. The newly erupted permanent posterior teeth are at great risk due to the complex occlusal morphology of pits and fissures, infraocclusion and incomplete maturation of enamel. Pit and fissure sealants are the treatment of choice in such conditions. OBJECTIVES: To compare the successful outcome of pit and fissure sealants bonded with etch-and-rinse adhesive system and self-etch adhesive systems in newly erupted permanent first molars. METHODS: This randomized clinical trial was conducted at the Fatimah Jinnah Dental Hospital from June 2017 to May 2019. Children aged between 6 to 9 years who fulfilled the inclusion criteria were recruited for this study after parents’ consent. Patients were randomly divided into two groups by the lottery method. Thirty patients with 60 first molar teeth in Group A were treated with etch-and-rinse adhesive system, while the other thirty patients with 60 first molar teeth in Group B were treated with self-etch adhesive system. After adhesive placement, all children received the same fissure sealants in newly erupted maxillary and mandibular permanent first molar. Each group was clinically evaluated at 6 and 12 months follow-up visit. Modified United States Public Health Service (USPHS) criteria were used for direct clinical evaluation of successful outcomes such as sealant retention and marginal discoloration. RESULTS: Successful outcome was statistically significant in Group B compared to Group A (60% vs. 30% p= 0.020) at 12 months follow-up. Stratification analysis was performed with respect to age in which a successful outcome was not significant (p= 0.43) between groups for 6 to 7 years of age, while it was significant (p= 0.012) between groups in 8 to 9 years of age children. CONCLUSION: Self-etch adhesive system is better than etch-and-rinse adhesive system in terms of long-term sealant retention. In addition, the bonding procedure is simple with relatively short clinical application time therefore it would offer great benefit to clinicians in treating pediatric patients.

Over the previous years of the 20th and 21st centuries, there has been a progression in the field of bonded esthetic restorations. At the present time, the inclination of dentists toward the smart monochromatic shade of composite is flourishing owing to the fact that it decreases the requirement of a range of composite shades, curtails the waste of unconsumed composite shades, lessens chair side interval, abolishes the shade selection, and decreases dependency on shade-selecting methods. Smart monochromatic composite is known to obtain the color of the adjacent tooth structure in which it is placed. Therefore, the current literature elucidates the several features of innovative and revolutionary monochromatic composites including color stability, mechanical and optical properties, and shade-matching capability that could have a positive impact potentially over other resin composites.

Semantic image segmentation is a vast area of interest for computer vision which has gained exceptional attention from the research community. It is the process of classifying each pixel in respective category. In this paper, we exploit the problem of scene understanding and perform the segmentation by combining different classification models as a feature encoder and segmentation models as a feature decoder. All of the experiments were performed on Camvid dataset. It covers a wide range of real-world applications such as autonomous driving, virtual/augmented reality, indoor navigation, etc.

Omnichroma is a smart monochromatic material and is believed to attain the shade of the surrounding tooth structure in which it is placed. However, the color stability of this material is unknown. Therefore, this study was conducted to evaluate the effect of different pH beverages on the color stability of the Omnichroma composite and its comparison with micro-hybrid composite resin. Sixty extracted human maxillary premolars of different shades, viz. A2, A3, B2 and B3, were selected in equal numbers. A Class V cavity was prepared on the buccal and palatal sides of each tooth. After the cavity preparation, etching of the cavity was performed with 35% phosphoric acid followed by bonding. The prepared cavities were then filled with Omnichroma composite resin on the buccal side and Filtek Z250 composite on the palatal side. The baseline color measurements of all tooth samples were performed by a spectrophotometer. The teeth were then divided into three groups, the Pepsi group, coffee group and milk tea group. Five teeth from each shade, viz. A2, A3, B2 and B3, were immersed in 10-mL of Pepsi, coffee, and milk tea for 14 days. After the completion of the 14 days, the teeth were rinsed and kept in distilled water for 24 h. Finally, a spectrophotometer was used to calculate the color alteration value ΔE. Mean difference in ΔE values of the samples before and after immersion in different beverages was calculated and analysed by SPSS 25. One-way ANOVA test was applied to compare groups. Further stratification was performed using the Post-Hoc Tukeys test. Samples immersed in milk tea showed a statistically significant difference (p < 0.05) in A2, A3, and B2 shades of the OM-milk tea group in comparison with the FT-milk tea group. In summary, the immersion of teeth in beverages with a different pH and colorants showed an apparent alteration in the color of both the smart monochromatic and micro-hybrid composites. Hence, the type of resin composite material should be selected wisely depending on the patient’s drinking and social habits.

A contemporary knowledge of root canal treatment (RCT) is a prerequisite for a successful outcome. Studies observed that General Dental Practitioners (GDPs) were not abreast of current endodontic knowledge due to a lack of continuing dental education, not following the treatment protocols that they had learned in their undergraduate program, and overlooking the evidence-based current endodontic practices. Therefore, this study was intended to assess the awareness, attitude, and clinical endodontic practices among General Dental Practitioners in Saudi Arabia. This cross-sectional questionnaire-based study was conducted among all 312 GDPs working in Saudi Arabia. The questionnaire consisted of socio-demographic details and 23 questions regarding current endodontic practices. The collected data was analyzed using the SPSS Version 21 (Chicago, IL, USA). The chi-square test was applied to explore the influence of gender, workplace, and the years of professional activity on the materials and techniques employed in the RCT procedure. The study results showed that of all respondents, 159 (51.0%) were males, 153 (49.0%) were females, and 286 (91.7%) were Saudi nationals. Most of the GDPs, i.e., 204 (65.4%) practiced in private hospitals or clinics whereas 108 (34.6%) practiced in Government hospitals. Root canal treatment on all teeth had been performed by 196 (62%) of the practitioners. Association of gender with demographic details and endodontic practices revealed a statistically significant difference between both genders with respect to region, nationality, type of RCT treated on the tooth, and the technique used to measure the working length (p < 0.05). Furthermore, years of professional experience and workplace significantly affect endodontic practices (p < 0.05). This study concluded that most of the general dental practitioners complied with quality standard guidelines showing a positive attitude toward endodontic practices. Furthermore, irrespective of gender, most of the steps in endodontic procedures revealed a significant association with years of professional experience and the workplace.

Endodontic flare-up or post-operative pain occurs when debris such as necrotic pulp tissue, dentin chips, irrigants, and microorganisms are extruded from the apical foramen intraoperatively into the periradicular tissue during root canal instrumentation. This study compared the amount of apical debris extrusion of the root canal dentin layer after using reciprocating and rotary file systems (WaveOne, ProTaper Next and ProTaper Gold). Sixty extracted human maxillary central incisors with one canal and closed apex were included in the study. Samples were randomly and equally divided into three groups (n = 20) according to the file systems used for preparation of the root canal. Teeth in the WO group were instrumented by WaveOne, while the PTN group were instrumented by ProTaper Next, and teeth samples in the PTG group were cleaned and shaped by ProTaper Gold. The mean apically extruded debris weight in grams was estimated using the modified Myers and Montgomery experimental model. Analysis of variance (ANOVA) test was used for the comparison of debris weight in three groups. Post hoc LSD test was applied for pairwise comparison of debris weight. The α value of significance was 0.05. The WO group had significantly lower mean debris weight than the PTN and PTG groups (p = 0.001). Post hoc pairwise comparison revealed that there was a statistically significant difference in mean debris weight between the WO group and PTN group (0.0215 vs. 0.0341, p = 0.001); and the WO group and PTG group (0.0215 vs. 0.0324, p = 0.003). Root canal preparations with different file systems were associated with apical extrusion of the debris from the root canal dentin layer. However, the WaveOne system resulted in a comparatively lower amount of apical debris layer extrusion than the ProTaper Next and ProTaper Gold rotary file systems.

Dental anxiety is one of the most common conditions present amongst the masses globally. It is this fear that makes individuals avoid seeking dental treatment which results in a deteriorated oral health-related quality of life (OHRQoL). Discrepancies exist in the prevalence of dental anxiety based on gender, education levels, level of deprivation of a society and its socioeconomic status. In this study, a sample size of 522 respondents was collected. Kuppuswamy’s socioeconomic status scale and modified dental anxiety scales were used to collect the necessary data. These data were analyzed by cross tabbing and chi-square test of significance was applied to assess the association between dental anxiety and other factors. Female gender was significantly associated with dental anxiety with p-value = 0.03. Higher education levels and dental anxiety also displayed significant associations with each other, with a p-value of 0.048. Seventy-six percent of the individuals of lower socioeconomic status were prone to be more dentally anxious. Dental anxiety was more significant in individuals with higher levels of education in our study. Respondents who were part of a lower socioeconomic class were also more prone to being anxious while receiving dental treatment. Knowing the factors that cause dental anxiety can help dentists effectively manage and treat their patients.

Background Matrix metalloproteinases (MMPs) catalyzes the degradation of the extracellular matrix components and have a major role in many physiological processes including wound healing. In the current study, we examined the correlation of baseline MMPs 1, 2, 7, and 9 expressions with periapical wound healing after surgical endodontic treatment. Methods 27 patients aged between 15 and 57 years presenting with chronic apical periodontitis or chronic apical abscess of an anterior tooth with previously attempted or failed root canal treatment were included in this study. During surgical endodontic treatment, tissue from the periapical lesion sample was collected and used for gross histopathological analysis as well as mRNA expression analysis of MMPs 1, 2, 7, and 9. Patients were recalled for follow-up after 6 months to evaluate the healing status both clinically and radiographically and healing was correlated with baseline MMP expression. Results Out of 27 patients, healing was observed in 15 patients at the end of 6 months, and in 21 patients after 12 months.. Six patients showed no healing even after 12 months. Analysis of baseline MMP 1, 2, 7, and 9 expression levels with healing status showed the mean relative expression of MMP2 and MMP9 to be considerably increased in the non-healing group as compared to the healing group. Conclusion Overexpression of MMP2 and MMP9 may be considered as a potential prognostic biomarker for periapical wound healing after surgical endodontic treatment. However, further studies are desirable to establish its precise relationship with periapical wound healing.

Objective: To compare the removal efficacy of propolis and calcium hydroxide medicaments from the root canal using manual irrigation with sodium hypochlorite. Methods: A randomized controlled trial was conducted at the Department of Restorative Dentistry and Endodontics, College of Dentistry, King Faisal University for two months. Thirty single-rooted upper or lower permanent anterior teeth with sound root and closed apex were selected. After cleaning and shaping of canal by protaper rotary, teeth were randomly divided into two groups. In group “A,” propolis paste was placed while calcium hydroxide was placed inside root canals in group “B,” followed by temporary restoration. After seven days, intracanal medicament was removed using 25 # K file and irrigated canal by 5 ml of 3.0% sodium hypochlorite. A final irrigation of 2-ml of 17% EDTA for three minutes followed by 1-ml of normal saline was performed. A diamond disc was used to cut the crowns of the teeth from cemento-enamel junction and divide the roots into two halves. These sectioned halves were then observed under a stereomicroscope at 7X magnification and analyzed using Adobe Photoshop. Magnetic lasso tool was used to calculate the percentage of residual medicament in the canals by comparing the pixel proportion of the medicament with the total pixel proportion of the canal. Paired t-test was used to see the difference in the number of remaining remnants between propolis and calcium hydroxide. A p-value of less than 0.5 was considered statistically significant. Results: A statistically significant difference (p-value < 0.001) was observed in the percentage of remaining remnants between propolis (23.22%) and calcium hydroxide (38.58%) after thorough irrigation with sodium hypochlorite. Conclusion: Propolis is superior to calcium hydroxide in terms of their removal potency from the root canal after thorough irrigation with sodium hypochlorite. doi: https://doi.org/10.12669/pjms.37.7.4241 How to cite this:Ahmed MA. Removal efficacy of propolis/calcium hydroxide medicaments from the root canal. Pak J Med Sci. 2021;37(7):---------. doi: https://doi.org/10.12669/pjms.37.7.4241 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Dental caries is the most prevalent disease in primary, mixed, and permanent dentition. Many preventive and treatment strategies were used in the last decades. Silver diamine fluoride (SDF) is a promising nontoxic material which proves to be a turning point concerning conservative dentistry if the patient and dental practitioners are adequately educated regarding it. Several advantages have been reported related to the use of SDF, including the procedure being pain-free and drill-free, patient- and doctor-friendly caries control strategy, and management of dentinal hypersensitivity.

BACKGROUND: Dentine hypersensitivity is one of the most common chief complaints of patients observed by dentists in their practice. However, there is a lack of universal consensus over the selection of reliable treatment modality. OBJECTIVES: To compare the effectiveness between dentine desensitizer and self-etch adhesive in patients complaining of moderate to severe dentine hypersensitivity pain. METHODS: A total of 254 patients with moderate to severe dentine hypersensitivity were randomly divided into Group A (Single Bond Universal Agent) and Group B (Seal & Protect Agent) according to the treatment provided. Sensitivity was assessed by means of mechanical (probing) and evaporative (air blast) stimuli. Discomfort Internal Scale (DIS) was explained to patients. DIS scores were recorded after one minute and one month following the application of both agents. Descriptive statistics were calculated. Stratification was done to control confounder and post stratification chi-square test was also applied. RESULT: The statistically significant difference (p= 0.000) in effectiveness between the two groups was observed. The mean discomfort internal scale score at baseline, after 1 minute and after 1 month in Group A was 3.65 ± 0.60, 2.33 ± 0.64 and 0.41 ± 0.71 respectively, while in Group B, it was 3.55 ± 0.58, 2.40 ± 0.62 and 0.72 ± 0.92 respectively. Overall, 86.6% patients observed improvement in dentinal sensitivity in Group A while in Group B only 67.7% patients reported reduction in sensitivity. CONCLUSION: Self-etch adhesive significantly reduces dentin hypersensitivity, immediately after one minute of its application and is effective for a period of one month compared to desensitizing agent.

Introduction. Dental anxiety is a common occurrence in patients undergoing dental treatments, especially in children. The success in paedriatric dental treatments and patient comfort depends on controlling the level of patient’s anxiety in clinical settings. This study is aimed at evaluating the efficacy of different techniques applied for the reduction of dental anxiety in paediatric patients. Material and Methods. One hundred and sixty participants were divided into 4 groups; each group having 40 patients as follows: group I: mobile application “little lovely dentist,” group II: YouTube® “dental video songs,” group III “tell-show-do,” and group IV “control.” Dental prophylaxis treatments were provided to all the participants. Initial anxiety levels were noted during the patient’s education phase by measuring heart rate with pulse oximeter and distress level with facial image scale, at the same time in each group, respectively. The postoperative anxiety was noted later with the same methods, after the application of anxiety reduction techniques. The data obtained were entered in the statistical package for the social sciences software, version 25. One-way ANOVA and paired t -test for matched groups were used to compare mean values of the 4 groups, in this study to determine their effectiveness. A p value of ≤0.05 was considered as statistically significant. Results. The mean age of patients in group 1 was 6.8 ± 2.1 years, group 2: 8.15 ± 2.27 years, group 3: 7.5 ± 2.3 years, and group 4: 7.27 ± 1.68 years. The intragroup comparisons of heart rate and facial image scores have shown a significant difference in before and after dental treatment procedures. Marked reduction in heart rate and facial image scale scores were found in patients belonging to group 1 (mobile applications) and group 2 (dental video songs). An increase in heart rate and facial image scale scores was seen in group 3 (tell-show-do) and the control group. Conclusion. The paediatric dental anxiety is a common finding in dental clinics. Behavior modification techniques like smartphone applications, “little lovely dentist,” and “dental songs” can alleviate dental anxiety experienced by paediatric patients. The “tell-show-do” technique although most commonly used did not prove to be beneficial in the reduction of the anxiety levels.

Dental health care workers around the world are in a constant state of fear and anxiety because they work in a constrained space of the dental practice. During routine dental procedures, they are exposed to aerosol and splatter. These airborne particles pose a great risk of transmitting contagious infections to health care workers and patients, especially in an era of social distancing due to COVID-19. The current study was conducted to evaluate contamination amount, duration, the distance of aerosol, and splatter produced after cavity preparation using a two-hole and four-hole handpiece. The study was performed on a dental manikin in a dental simulation laboratory at the College of Dentistry, King Faisal University Al Ahsa. The dental manikin was set to a reclined position to simulate the clinical operatory position of the patient for dental restorative procedures. Aerosol and splatter were collected on Grade 1 qualitative cotton cellulose filter paper. These were placed on adhesive tape extending from the headrest of the dental manikin in six different directions (2, 4, 6, 8, 10, and 12 o’clock) for up to 60 inches and on certain positions of the operator and assistant such as the chest, head, forearms, upper leg, and inside facemask. Class V cavity preparation was done by the principal investigator at a specific time of 3 min on tooth #11 using a two-hole high-speed handpiece, then on the next day, Class V cavity preparation was performed on tooth #21 by a four-hole handpiece. High volume suction was used throughout the cavity preparation. Immediately after cavity preparation, the first filter paper disc was replaced with new ones in all positions. The second set of filter papers was removed after 30 min. Transparent grids were used to count the contamination area on the filter paper disc. No statistically significant difference was found in the mean amount of aerosol and splatter produced by both handpieces, however, a statistically significant difference was found in an amount of aerosol and splatter produced at a 12, 24, and 36 inches distance immediately after cavity preparation and 30 min after cavity preparation, regardless of the type of handpiece used. It is advisable to refrain from removing the personal protective barriers immediately after the procedure within the vicinity of the dental practice. The use of other adjuncts such as high volume suction to reduce the spread of aerosol and splatter is also recommended.

The selection of an accurate tooth shade has always been a challenging task for dental practitioners in restoring the natural appearance of teeth. Various factors can influence shade selection, such as different lighting conditions, clearness and opaqueness of teeth, eye fatigue, aging and color vision problems. It is imperative to have a sound knowledge about the concept of shades and its selection protocol for obtaining good esthetics outcomes. To attain the best esthetics, four elementary contributing factors are essential: exact position, shape, surface texture and shade. The current analysis focuses on several features of shade, sensitivity of shades, optical properties of the teeth, visual and innovative instrumental techniques for shade selection, protocols for shade selection and factors affecting dental shade selection.

Despite sufficient knowledge of good oral hygiene habits, dental students still suffer from oral health problems owing to dietary habits, obesity, and a sedentary lifestyle. This cross-sectional study was conducted to evaluate an association of BMI (body mass index), diet, physical activity, and oral hygiene practices with DMFT (decayed, missing, and filled teeth) of male dental students and interns at King Faisal University, Saudi Arabia, from August to September 2020. One hundred and eighty-five male participants completed the study questionnaire. The questionnaire consisted of sociodemographic information and nineteen close-ended questions about current diet, physical activity, and oral hygiene practices. Students&rsquo, height (cm) and weight (kg) were measured to calculate BMI. The principal investigator performed the oral clinical examinations for the DMFT status in the dental clinic. The chi-square test was used for the dichotomous variables and a t-test was used for the continuous variables. Linear and multinomial logistic regression were performed to detect the significant predictors of the DMFT score. The mean age of participants was 22.29 &plusmn, 2.13 years, and the BMI was 24.94 &plusmn, 3.36 (Kg/m2). Parents&rsquo, higher education and income levels were significantly (p &lt, 0.001) associated with a higher BMI. Most dietary variables, especially sugar products, and low physical activity, were significantly (&lt, 0.047) associated with higher BMI. All oral hygiene practices, except miswak and mouthwash, were significantly (&lt, 0.003) associated with higher BMI. Decayed and missing teeth were significantly (&lt, 0.001) higher in the overweight and obese. A simple linear regression analysis demonstrated association between BMI and decayed teeth, with an R = 0.35 (&lt, 0.001), BMI and missing teeth had an R = 0.12 (p = 0.867), BMI and filled teeth had an R = 0.15 (p = 0.033), and BMI with DMFT had an R = 0.33 ((&lt, 0.001). This study demonstrated a strong significant association of the decayed and missing teeth with higher BMI levels. In addition, BMI was significantly associated with diet and physical activity, despite acceptable oral hygiene practices.

Objectives The aim of this study was to evaluate the patient’s knowledge, attitude, and practice of cross-infection control in dentistry during coronavirus diseases 2019 (COVID-19).Materials and Methods This cross-sectional observational study was conducted at Altamash Institute of Dental Medicine, Karachi from June 2020 to August 2020. A total of 775 patients participated to fill questionnaire. After scrutiny, 25 questionnaire forms were excluded due to incomplete information. Questionnaire was divided in to four sections. First section obtained patients sociodemographic information, while knowledge of patients regarding cross-infection control during COVID-19 pandemic was evaluated in second section. Similarly, the purpose of third section was to assess attitude and fourth section was designed to evaluate practice. Likert’s 3-point scale was used for registration of participant’s response. The reliability of questionnaire was assessed through Crohnbach’s α (α = 0.74). Statistical analysis was performed after entering data in to SPSS version 25. Independent t-test was used to evaluate the difference in patients’ knowledge, attitude, and practice. A p-value ≤ 0.05 was considered as statistically significant.Results Majority of the participants agreed that COVID-19 is a highly contagious disease (631, 97%) and daily screening of staff, dental assistants, dentists, and patients is necessary (568, 75.7%) along with proper sterilization of instruments and disinfection of dental operatory (650, 86.66%). A large number of participant also agreed that proper disposal of waste is utmost important for cross-infection control (601, 80.24%) and patient's waiting area should also be marked with social distancing sign (620, 82.66%). However, when asked about the common route of COVID-19 transmission in dentistry, 341 (45.5%) participants disagreed that it is not through aerosol (water droplets) generated during dental procedures.Conclusions Dental health professionals should take additional measures to educate dental patients on mechanism of potential spread of COVID-19 through the aerosols and droplets generated during dental procedures. They should also encourage the dental patients to be vigilant and question the cross-infection control measures practiced by the dentist to whom they go for dental treatment, and to decrease their chances of acquiring an infection during their visit to the dental office.

BACKGROUND: Numerous researchers have attempted to improve the mechanical properties of glass ionomer cement since 1972. In this study, ultrasonic curing treatment was introduced during the mixing of glass ionomer cement (GC Fuji IX) to facilitate intimate mixing, compaction and adaptation of residual glass particle which consequently improves densification of the material. OBJECTIVE: To assess the influence of ultrasonic treatment on the microhardness of glass ionomer cement (GC Fuji IX) and compare it with the conventionally cured method. METHODS: A total of 40 specimens (2 × 2 mm) were fabricated and equally divided into two groups: Group I (conventional curing method) and Group II (ultrasonically cured). For Group II, an ultrasonic scaler was used which provides energy to ensure proper mixing of material without leaving any air bubbles or unmixed particles. Vicker’s hardness test was employed to generate the average microhardness values by making three indentations at different points on each specimen. Statistical Package for Social Sciences (SPSS) Version 17 was used, employing independent samples T test to compare the difference in microhardness values between two curing groups. RESULTS: The average surface hardness value for conventional cured GIC was 62.21 ± 13.61 while ultrasonically cured GIC exhibited a higher mean microhardness value of 66.37 ± 12.83. Additionally, the average microhardness values produced by the two groups showed statistically significant differences (p value < 0.035). CONCLUSION: Ultrasonic excitation treatment leads to intimate mixing and accelerated hardening of glass ionomer cement thereby enhancing its microhardness and reducing early weakness.

Objectives: To Determine the efficiency of wax removal from denture baseresin using hot water at a range of temperatures with added detergentand to Study the effectsof mechanically modified surfaces of denture base resin on the efficiency of dewaxing usingthe above techniques. Settings: Eastman Dental Institute University Of London UK. Period:Jan 2007 to June 2007. Material and Methods: In this study cast acrylic rods 13 mm longand 6 mm in diameter were used. Three different surfaces were prepared for each rod,described as Polished, Abraded & Grooved. Nine experimental groups, each consisting of tenspecimens were mechanically modified were contaminated with modeling wax, and then thosein each group were subjected to agitation in hot water with detergent at different range oftemperatures. The surfaces were then examined for traces of wax using Raman spectroscopy.Results: The spectrum for each specimen demonstrated peaks at different wavelengths andvarying intensities, the spectra demonstrated traces of wax on abraded surfaces showedleast wax when dewaxed at 100°C as compared abraded surfaces dewaxed at 65°C and 85°C temperatures respectively. Conclusion: The rough surfaces (abraded or grooved) showedmore wax retention as compared to polished surfaces. These surfaces are usually prepared bythe dental technician in a belief that modifying the ridge-lap area of the teeth will increase thebond strength between the teeth and the denture base. Residual wax can still remain on thetooth surface even after dewaxing it at 100˚C with detergent added to the water.

Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), potassium nitrate, and sodium monofluorophosphate are desensitizing agents that help in reducing teeth sensitivity. However, indecisive evidence exists regarding their efficacy. Therefore, this study was conducted to compare the desensitizing efficacy of casein phosphopeptide-amorphous calcium phosphate and potassium nitrate with sodium monofluorophosphate agents after in-office vital bleaching. A randomized controlled trial was conducted on 2011 patients. The patients were randomly and equally divided into the CPP-ACP group (group 1), potassium nitrate with sodium monofluorophosphate group (group 2), and placebo gel (group 3). The upper and lower anterior teeth including the first premolar were isolated with a rubber dam, then the bleaching agents were applied on the labial surface of all the teeth, followed by light activation for 15 min. The procedure was repeated 3 times with an interval of 5 min in-between. After carrying out the bleaching procedure, patients were given a desensitizing gel or placebo gel in unmarked syringes with an instruction to apply it every 12 h for up to 3 days. The intensity of pain was recorded using a discomfort interval scale (DIS). A decrease in pain was observed 24 h after the application of the desensitizing gel in groups 1 and 2. However, in group 3, the pain persisted, with 46 (69.69%) patients having moderate pain and 14 (21.21%) developing severe pain over time. A significant difference in discomfort level with time was noted in group 1 (p = 0.015) and group 2 (p = 0.036). However, no significant difference was found in group 3 (p = 0.085). It was concluded that both desensitizing agents performed exceptionally well in reducing teeth sensitivity.

Objectives: To assess the efficacy of mineral trioxide aggregate (MTA)pulpotomy in mature permanent teeth with irreversible pulpitis due to carious exposure. Placeand Duration: The study was conducted in the Department of Operative Dentistry, AltamashInstitute of Dental Medicine from 05-01-2016 to 05-07-2016. Methodology: A total of 70 teethof 70 patients with irreversible pulpitis were treated with mineral trioxide aggregate (MTA)pulpotomy. The patients were re-evaluated after 2 months. All patients were asked whether theyhad experienced spontaneous pain, pain on chewing or pain stimulated by hot/cold and thetreatment was counted as successful in case of no post-operative symptoms. Results: Efficacyof pulpotomy treatment with mineral trioxide aggregate in symptomatic mature permanentteeth with irreversible pulpitis and normal periapical periodontium was 88.57%. Conclusion:MTA pulputomy is a good alternative treatment for cases of irreversible pulpitis in permanentteeth with mature roots and normal apical periodontium. However, long term clinical trials andhistological assessment is desirable.

Objective To compare the anesthetic efficacy of 2% Lidocaine with 1:80,000 epinephrine and 0.5% Bupivacaine with 1:200,000 epinephrine in one-visit root canal treatment in patients with symptomatic irreversible pulpitis. Methods A total of 60 patients presenting with symptomatic irreversible pulpitis with normal periapical tissues on periapical radiography of mandibular 1st and 2nd molars, reporting moderate to severe pain as assessed by visual analogue scale (VAS) for at least 24 hours were included in this study. All patients received local anesthesia via the inferior alveolar nerve block technique by the investigator. These patients were randomly allocated into two groups in which first group received 2% lidocaine with 1:80,000 epinephrine and the second group received 0.5% bupivacaine with 1:200,000 epinephrine. Patients were instructed to rate the intensity of pain during root canal treatment which was then noted on visual analogue scale (VAS). Results The average age of the patients was 34.15±9.49 years, in which 32 (53.3%) were male and 28 (46.7%) were female. The anesthetic efficacy was significantly high in bupivacaine as compared to lidocaine local anesthesia group (76.7% versus 40%; P=0.004). Conclusion The administration of bupivacaine anesthetic agent for inferior alveolar nerve block (IANB) injections can be a better and appropriate pain management aid as compared to lidocaine during root canal treatment of patient with symptomatic irreversible pulpitis.

Objective To assess the level of parents knowledge about the emergency management of tooth avulsion in Eastern Province and Riyadh. Methods A cross-sectional study was carried out by means of a questionnaire-based internet survey in which 1201 parents from Eastern Province and Riyadh participated. The questionnaire contained 10 closed-ended questions and was used to assess the knowledge of parents about the emergency management of avulsed teeth in Eastern Province and Riyadh. Chi-square test was used for data analysis. Results In response to closed-ended questions, the statistically significant result was obtained for the history of child dental trauma in which 35% (P=0.04) of parents reported history of dental trauma in their children. These parents were belong to Eastern province (51%) and Riyadh (49%). Furthermore, only 31.3% of the parents were aware of possible storage media for transportation of avulsed tooth while 68.7% (49.5% in Eastern Province and 50.5% in Riyadh) were unaware (P=0.02) of it. Conclusion That the majority of the parents were unaware of emergency management for tooth avulsion in two densely populated regions of Saudi Arabia. Education of parents should be initiated at a national level.

Water is an essential component of glass ionomer cement. Water balance is probably the most important and least understood mechanism with the glass ionomer cement. Excessive water in glass ionomer produce weak cement while less amount of water produce cement which is relatively stronger initially but later results in the weakening of the cement. Water present in glass ionomer cement is classified according to its nature of being held in to the cement as tightly bound and loosely bound. The amount of loosely bound water loss from various composition of glass ionomer cement remains unknown.The study was conducted at the Department of Materials, Queen Mary University of London. Two different composition of glass ionomer cements were used in this experiment in which the amount of water absorbed by the different compositions of cement on 1, 3, 7 and 14 days were evaluated and the loss of water was measured after that period until the loss became constant. A total of 25 samples of each GIC composition, 5 samples were immersed in water for 24 hours, 5 in water for 3 days, 5 for 7 days and 5 for 14 days. The remaining 5 samples were directly placed into the desiccator without immersing it in the water. The total water content of both glass ionomer cements was calculated from its chemical composition. The samples were weighed every hour for first 3 hours and then every 24 hours until the weight of the sample became constant. Samples placed in water for 1, 3, 7 and 14 days were dried before weighing with a tissue.The amount of water uptake in all the compositions was not that significant in relation to time. In case of Fuji IX, amount of water loss percentage did not vary with increasing time interval. The water loss was rapid in the first 24 hours but it slowed down with time and became constant after 3 days however in Ketac molar water loss slightly varied with time interval.It is concluded that the amount of water uptake in both glass ionomer cement is not significant in relation to time. The loss of loosely bound water becomes constant with time after 24 hours for both compositions of glass ionomer cements.

The aim was to determine the cytotoxicity of Khat (Catha edulis (Vahl) Forssk. ex Endl) on normal oral fibroblasts (NOFs) and SCC4 (squamous carcinoma cells) along with expression of α-smooth muscle actin (α-SMA) in fibroblasts. Khat filtrate was prepared to obtain a concentrated viscous solution. NOFs and SCC4 cells were cultured in biological cabinets and were grown in Dulbeccos’ modified Eagles medium. Frozen cells were thawed at 37 °C and cell seeding was per-formed. NOFs and SCC4 cells were seeded on 96 well plates and allowed to attach. The medium was removed and a fresh medium containing different concentrations of Khat was added. The group without Khat served as a negative control and 4% paraformaldehyde as the positive control. Cell viability was assessed using the MTT assay and effect of Khat on fibroblast and SCC4 pheno-types was evaluated by immunostaining. Analysis of variance was used to assess data (p &lt, 0.05). NOF 316 showed cell death in response to 4% paraformaldehyde, 12.5, 6.25, and 3.12 mg/mL of Khat. The highest concentration of Khat (25 mg/mL) failed to cause cytotoxicity of NOF 316. NOF 319 and NOF 26 displayed cell death at all concentrations of Khat, however, cytotoxicity was not dose dependent. NOF 18 and SCC4 cells showed dose-dependent cell death. NOF 316 showed α-SMA expression after 1 mg/mL of Khat exposure. Not all fibroblasts were α-SMA-positive, sug-gesting specific activation of a subset of fibroblasts. Khat is cytotoxic to NOF and SCC4 cells. Fur-thermore, it can also cause activation and phenotypic changes in oral fibroblasts, indicating a po-tential role in progression of oral squamous cell carcinoma.

An outbreak of novel coronavirus disease (COVID-19) in China has influenced every aspect of life. Healthcare professionals, especially dentists, are exposed to a higher risk of getting infected due to close contact with infected patients. The current study was conducted to assess anxiety and fear of getting infected among dentists while working during the current novel coronavirus diseases (COVID-19) outbreak. In addition, dentists&rsquo, knowledge about various practice modifications to combat COVID-19 has been evaluated. A cross-sectional study was conducted using an online survey from 10th to 17th March 2020. The well-constructed questionnaire was designed and registered at online website (Kwiksurveys) and validated. A total of 669 participants from 30 different countries across the world responded. After scrutiny, completed questionnaires (n = 650) were included in the study. Statistical analysis was performed using SPSS version 25. Chi-Square and Spearman correlation tests were applied to control confounders and assess the relation of dentists&rsquo, response with respect to gender and educational level. More than two-thirds of the general dental practitioners (78%) from 30 countries questioned were anxious and scared by the devastating effects of COVID-19. A large number of dentists (90%) were aware of recent changes in the treatment protocols. However, execution of amended treatment protocol was recorded as 61%. The majority of the dentists (76%) were working in the hospital setting out of which 74% were from private, and 20% were from government setups. Individually we received a large number of responses from Pakistan and Saudi Arabia, but collectively more than 50% of the responses were from other parts of the world. Despite having a high standard of knowledge and practice, dental practitioners around the globe are in a state of anxiety and fear while working in their respective fields due to the COVID-19 pandemic impact on humanity. A number of dental practices have either modified their services according to the recommended guidelines to emergency treatment only or closed down practices for an uncertain period.

Many investigators reported the amount of fluoride release from glass ionomer cement. However, the work on fluoride release from GIC containing fluoroapatite and hydroxyapatite is scarce. Therefore, this study was conducted to find out the amount of fluoride release from Glass ionomer cement containing fluoroapatite and hydroxyapatite.The study was conducted in the Department of Materials, Queen Marry University of London. A total of 108 samples equally divided in to three groups namely fluoroapatite added GIC, Hydroxyapatite added GIC as an experimental group and unmodified GIC as a control group. The specimens were prepared by mixing powder and liquid in the ratio of 1:1. Amount of fluoride released was measured by Ion electrode method at 1, 3, 7, 14, 21 and 28 days.On day 1, the combination of FA +GIC showed the highest amount of fluoride release followed by the control group (GIC) whereas the combination of HA+GIC released the least amount of fluoride. On day 7, the amount of fluoride release started declining in all three groups. The amount of fluoride release continued decreasing on day 21 in which combination of FA +GIC and the control group are shown to release equal amount of fluoride whereas the combination of HA+GIC gave the least activity the amount of fluoride release fall to a minimum level in all three group by day 28.It is concluded that addition of fluoroapatite into GIC has significant effect on the amount of fluoride release as compared to GIC alone; however, addition of hydroxyapatite into GIC has no additive effect on the amount of fluoride release.