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Background Dental implant placement carries a risk of iatrogenic damage to adjacent root surfaces. Purpose To classify and understand different types of trauma to the tooth root body by dental implants. Materials and methods This prospective case series included 43 implants placed between February 2017 and June 2020 that had primary stability and were in a position that accidentally invaded the adjacent teeth. The type and degree of the injury were evaluated clinically and radiographically. Tenderness, mobility, and sensitivity tests of the injured teeth were conducted at different visits. Implant failure was confirmed by the presence of implant mobility during the healing period. Results Overall, 43 patients had root injuries due to dental implant surgeries. Regarding the 43 injured roots, 32 developed transient tenderness to percussion, 16 developed variable degrees of resorption in the cementum, three lost pulp sensitivity and one had persistent tenderness to percussion. No injured teeth were lost. In three patients, implant periapical lesions were confirmed radiographically as radiolucency near the apex of the involved implants. Out of the 43 implants, 11 failed and were removed within 6 months, with an implant failure rate of (25%). Conclusions Root damage after implant surgery varies depending on the type and severity of injury. Periodic clinical and radiographical examination is necessary to monitor root resorption and implant integration and to rule out pulp necrosis.

Purpose Different approaches have been proposed to treat malocclusion secondary to the treatment of maxillofacial trauma. This study aimed to investigate the efficacy of prosthodontic treatment, orthodontic treatment, and implant-supported rehabilitation for the management of secondary malocclusion after maxillofacial trauma. Study selection: We searched five electronic databases and hand searched eight journals. The types of studies included were randomized controlled trials, cohorts, case–controls, and case series with at least eight patients with maxillofacial trauma and postoperative malocclusion. These studies used prosthetic treatment and implant-supported rehabilitation for secondary malocclusion after maxillofacial trauma. Risk of bias of eligible studies to be included in the final analysis was assessed independently by two authors using a tool for methodological quality assessment and synthesis of case series and case reports. Results After initial screening and identification of titles and abstracts, full text of 44 articles were found and evaluated against inclusion criteria. Of these 42 articles were excluded and remaining two were included in the review. Both the studies were case series with moderate to high risk of bias. Conclusions Both prosthetic treatment and implant-supported rehabilitation have the potential to restore secondary malocclusion after maxillofacial trauma. However, because less number of well-designed studies with high risk of bias were included in this systematic review, the findings should be interpreted with caution. Well-designed high-quality studies are required to draw definitive conclusions.

Compared with vital teeth, changes in chemical and physical properties along with alterations in tooth structure after root canal treatment increase the possibility of root fracture. These aspects need to be considered in selecting materials used in the restoration of endodontically treated teeth, specifically the fabrication of posts and cores for this purpose. This study aimed to measure the apical extension of fracture in teeth subjected to root canal treatment and restoration by post- and core-fabricated materials. Forty extracted maxillary central incisors were included in the experiment and subdivided into experimental and control groups. Root canal treatment was performed for teeth in the control group, and the accessed cavity was restored with direct composite restoration. The experimental groups were restored using computer-aided design/computer-aided manufacturing (CAD/CAM) milled posts and cores of polymer-infiltrated ceramic network (PICN), zirconia and metal. Then, the cores were restored with metal crowns, subjected to a compression test to record the fracture resistance, and examined to evaluate the extension of root fracture apically. The results of the compression test were expressed in Newtons. The extension of root fracture was measured in millimeters using metric pictures of the samples taken by stereomicroscopy. The data were analyzed using ANOVA with Tukey's HSD, and a P-value of

Introduction: The COVID-19 pandemic is likely to increase anxiety levels within the community and in particular medical students who are already considered psychologically vulnerable groups Since the COVID-19 outbreak, no study has yet estimated the effect of this pandemic on university students in the UAE or its impact on the psychological well-being of medical students Methods and Materials: We surveyed 1485 medical (comprising medical and dental) and non-medical university students across 4 emirates within the UAE We used an online platform to assess knowledge, sources of information, changes in hygienic behavior, perceptions of fear and worry and anxiety levels using the generalized anxiety disorder 7 (GAD-7) scale The GAD-7 score was measured at three time points: during hospital visits for medical/dental students, before the introduction of online learning and after online learning for all students Results: The majority of students demonstrated high levels of knowledge and utilized reliable sources of information Non-medical students exercised higher compliance with social restrictions, while medical students practiced better hand hygiene Almost half of students reported anxiety levels ranging from mild to severe with females reporting higher anxiety scores during hospital visits (OR=2 02, 95% CI, 1 41 to 2 91) and medical students reporting lower anxiety levels in comparison to dental students (OR=0 61, 95% CI, 0 45 to 0 84) Medical students reported higher levels of anxiety during their clinical rotations which decreased with the introduction of online learning, yet, non-medical students’ anxiety levels increased with online learning Conclusion: This study provides important information on the initial response and anxiety levels in university students across the UAE during the COVID-19 pandemic The findings from our study can be used to support the development of effective screening strategies and interventions to build psychological resilience among university students during the COVID-19 pandemic or any other public health emergencies in the future © 2020 Saddik et al

Objective The aim of this study was to measure the fracture resistance and failure modes of root-filled teeth restored with three different computer-aided design/computer-aided manufacturing (CAD/CAM)-fabricated post and core assemblies. Methods Thirty extracted intact maxillary central incisors were used in the study, and the teeth were endodontically treated and sectioned to a root length of 16 mm. The samples were divided into three groups (n = 10) according to the mean of the dimensions at the cervical portion of the root. The posts and cores were fabricated with CAD/CAM technology using metal, zirconia, and polymer-infiltrated ceramic network (PICN) material. The posts were luted using resin cement, and then, metal crowns were fabricated, cemented, and then subjected to a compression to determine the fracture resistance force. Fracture of the post and core or fracture of the root above the level of the acrylic resin was considered as a favorable fracture, while nonfavorable fractures were those where the root fracture occurred below the level of the acrylic resin. Statistical analysis was carried out using SPSS software, and one-way analysis of variance was used to analyze root fracture resistance in Newton. The number of failure modes, post-core fractures and/or root fractures was calculated. The differences between study groups were revealed using the chi-square test. Results The results of ANOVA revealed a nonsignificant difference in the resistance to fracture among the study groups (P = 0.114). The failure modes were nonfavorable for all metal and zirconia samples and seven PICN samples. However, three PICN samples exhibited a favorable represented by core fracture without root fracture. Conclusion There was no significant difference between metal and zirconia samples in terms of nonfavorable fracture, while few PICN samples exhibited a favorable fracture. PICN material can be used in the fabrication of post and core assemblies using CAD/CAM.

Objectives The aim of this study was to investigate the response of THP-1 monocyte-derived macrophages following exposure to titanium dioxide nanoparticles (TiO2 NPs) and microparticles (TiO2 MPs) in an in vitro system. Design THP-1 monocytes were maintained in RPMI medium and transformed into M0 macrophages using Phorbol 12-myristate 13-acetate (PMA). TiO2 particle size characterization was performed using scanning electron microscopy (SEM) and dynamic light scattering (DLS) technology. A viability study using an XTT assay was performed by treating THP-1-derived macrophages with TiO2 NPs ( Results There was no significant change in the viability of THP-1 monocytes after treatment with TiO2 NPs and MPs. The uptake of both particles was confirmed and showed an increase in ROS generation, and the MPs produced more ROS than NPs. The increase in ROS generation with NPs was concentration-dependent. Conclusion Uptake of TiO2 NPs and MPs in macrophages at subcytotoxic levels generate ROS in a size- and dose-dependent manner.

Background: Dental implant surgery in atrophied maxilla has many risks, in some patients simultaneous sinus lifting with implant placement must be performed to increase the chances of successful implant which can cause implant migration. The aim of this study was to illustrate different surgical approaches to remove displaced dental implants into the maxillary sinus. Methods: Eleven patients were diagnosed with implant migration into the maxillary sinus. Radiographs were taken to identify the exact location of these implants which showed that they can be displaced in four anatomical area: sinus floor above the alveolar bone, near the junction of the sinus and nasal floor, near the floor of the orbit, and the most posterior aspect the sinus. The surgical removal was performed through four different trans-oral approaches depending on the location of the displaced implant. The surgical challenges, duration of surgery and postoperative complications were reported.Results: The least challenging surgical intervention was noted when removing the displaced implants from the floor of the sinus. More challenges were experienced during the surgical removal of anteriorly displaced implants near the nasal cavity using the Caldwell-Luc technique (anterior window) with noted difficulty to differentiate between the nasal cavity and maxillary sinus. Implant displacement into the maxillary sinus roof near the orbital floor can be technically challenging due to surgical access and the proximity of vital anatomical structures. Bleeding from the pterygoid venous plexus was profound with posterior lateral approach. Discussion: The choice of the appropriate surgical approach to retrieve displaced dental implants into the maxillary sinus depends on the implant’s location and the surrounding vital anatomical structures.

Basema Saddik,1,2 Amal Hussein,1 Fatemeh Saheb Sharif-Askari,2 Waad Kheder,3 Mohamad-Hani Temsah,4 Rim Adnan Koutaich,5 Enad Sami Haddad,5 Nora Marwan Al-Roub,5 Fatema Adel Marhoon,5 Qutayba Hamid,2,5 Rabih Halwani2,5 1Department of Family and Community Medicine, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; 2Sharjah Institute of Medical Research, College of Medicine, University of Sharjah, Sharjah, United Arab Emirates; 3College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates; 4Prince Abdullah Ben Khaled Celiac Disease Research Chair, Department of Pediatrics, Faculty of Medicine, King Saud University, Saudi Arabia; 5Department of Clinical Sciences, College of Medicine, University of Sharjah, Sharjah, United Arab EmiratesCorrespondence: Rabih Halwani Email rhalwani@sharjah.ac.aeIntroduction: The COVID-19 pandemic is likely to increase anxiety levels within the community and in particular medical students who are already considered psychologically vulnerable groups. Since the COVID-19 outbreak, no study has yet estimated the effect of this pandemic on university students in the UAE or its impact on the psychological well-being of medical students.Methods and Materials: We surveyed 1485 medical (comprising medical and dental) and non-medical university students across 4 emirates within the UAE. We used an online platform to assess knowledge, sources of information, changes in hygienic behavior, perceptions of fear and worry and anxiety levels using the generalized anxiety disorder 7 (GAD-7) scale. The GAD-7 score was measured at three time points: during hospital visits for medical/dental students, before the introduction of online learning and after online learning for all students.Results: The majority of students demonstrated high levels of knowledge and utilized reliable sources of information. Non-medical students exercised higher compliance with social restrictions, while medical students practiced better hand hygiene. Almost half of students reported anxiety levels ranging from mild to severe with females reporting higher anxiety scores during hospital visits (OR=2.02, 95% CI, 1.41 to 2.91) and medical students reporting lower anxiety levels in comparison to dental students (OR=0.61, 95% CI, 0.45 to 0.84). Medical students reported higher levels of anxiety during their clinical rotations which decreased with the introduction of online learning, yet, non-medical students’ anxiety levels increased with online learning.Conclusion: This study provides important information on the initial response and anxiety levels in university students across the UAE during the COVID-19 pandemic. The findings from our study can be used to support the development of effective screening strategies and interventions to build psychological resilience among university students during the COVID-19 pandemic or any other public health emergencies in the future.Keywords: COVID-19, anxiety, medical students, GAD-7, United Arab Emirates

Aim: The aim of this study was to investigate variations in the number of roots and root canals in first permanent lower molars (FPLMs) using cone beam computed tomography (CBCT). Materials and Methods: A total of 640 CBCT images were analyzed using SIDEXIS XG software version 2.62 (Sirona Dental Systems, Bensheim, Germany). The entire root anatomy of FPLMs was investigated in three dimensions and the number of roots, root canals, and the number of canals per root were recorded. Statistical analysis was performed using the Statistical Package for the Social Sciences (SPSS) software, version 24, (IBM Corporation, USA) to determine the relationship between root anatomy and gender, age, or tooth location (right or left side). Results: The majority of FPLMs had two roots (96%), whereas the remaining 32 FPLMs (4%) had three roots. Almost two-thirds of the sample (62.7%) had three root canals, whereas only three cases (0.4%) of the FPLMs had six canals. When comparing bilateral differences in the distribution of root canals, it was determined that a quarter of FPLMs (24.1%) had an unequal number of canals. Moreover, there were differences in the number of additional canals between the mesial and distal roots with 17.5% of the former having three canals as compared with only 0.5% of the distal root. Interestingly, not more than one canal was observed in all additional root cases. No significant differences were observed in the number of canals between males and females or between right and left sides of the examined FPLMs (P > 0.05). Conclusion: Dental clinicians should be aware of the presence of an additional root in 4% of FPLMs, and about a quarter of the cases (27%) had an extra middle mesial canal in the mesial root, which was found to be more prevalent in middle age groups.