Saudi Journal of Oral Sciences

An insight into the 50th-anniversary edition of Ingle's Endodontics Abdullah R AlShammery Saudi Journal of Oral Sciences 2020 7(1):1-2

Bioactive glass in dentistry: A systematic review Kashmira Sawant, Ajinkya M Pawar Saudi Journal of Oral Sciences 2020 7(1):3-10 Bioactive glass (BAG) is a benevolent biocompatible material used as an adjunct to various materials used in dentistry. BAG is proved to have a beneficent effect in promoting material–tissue bond. The objective is to analyze significant information available in the literature regarding application of BAG in dentistry. A literature search of electronic databases, including PubMed, Google Scholar, and ResearchGate using the keywords: (Dentifrice OR Dentifrices) OR (Toothpaste OR Toothpastes) AND (Treatment) AND (Dentin OR Dentine OR Tooth) AND (Hypersensitivity OR Sensitivity) AND (Dentifrício OR Dentifrícios) AND (Tratamento OR Tratamentos) AND (Dentinária OR Dentina OR Dente) AND (Hipersensibilidade OR Sensibilidade). The papers found were analyzed regarding title and abstract contents to eliminate the ones that were out of context and not relevant to the review. After this first filter, 31 papers were selected, in which the full-text available was considered of good quality and relevant to the context. The languages of the papers were predominantly English and articles published before 1999 were excluded. The material BAGs are currently used for implant coating, bone grafting, dentin desensitizer, and restorative materials. The current paper reviews the significant developments of BAGs in clinical application, especially dentistry.

Effect of veneering material and technique on the fracture resistance of porcelain-veneered zirconia crowns Yousif Essam Ezzat, Mohammed A Al-Rafee Saudi Journal of Oral Sciences 2020 7(1):11-17 Context: Different porcelain veneering materials and techniques are used for the fabrication of porcelain-veneered zirconia crowns. Aim: The aim of this study was to examine the effects of different veneering materials and techniques (layering or over pressing) on the fracture resistance of zirconia-based crowns. Materials and Methods: A prepared molar tooth was scanned using computer-aided design/computer-aided manufacturing technology to create a master metal die. The scanned dies was used to produce forty zirconia copings. The zirconia copings were divided into four groups (n = 10) based on the veneering technique used, as follows: over pressing using Cercon Ceram press (PR1), IPS e.max ZirPress (PR2), layering using IPS e.max Ceram (LR1), and VITAVM9 (LR2). All crowns were cemented using glass-ionomer cement and thermocycled for 3000 cycles, between 5°C and 55°C. They were then loaded using a universal testing machine (3.7-mm ball and 0.5-mm/min crosshead speed) until failure. One-way ANOVA with Bonferroni corrections for multiple comparisons was used for the statistical analyses. Results: The means and standard deviations for failure loads were 1420 ± 54 N, 1797 ± 31 N, 1698 ± 36 N, and 2120 ± 73 N for the PR1, PR2, LR1, and LR2 groups, respectively. The differences in failure loads were statistically significant (P < 0.05) among the different test groups. Failure was predominantly due to adhesive failure in the PR1 and PR2 groups, whereas core fracture occurred more often in the LRI and LR2 groups. Conclusion: The fracture resistance of zirconia-based crowns was affected by the veneering materials and techniques used.

The effect of sports on oral health in Riyadh city: A cross-sectional study Abdulrahman Al Saffan, Rawan Marey Alshahry, Samar Abdulrahman Alrwissan, Zainab Abdulatif Aljanoubi, Raghad Abdulaziz Alswailem Saudi Journal of Oral Sciences 2020 7(1):18-23 Background: The global sports nutrition industry has skyrocketed regarding its total worth which has led to an enormous inflow of a variety of supplemental products. All of which are advertised to help the consumer achieve the desired body shape. The increased consumption of all sorts of protein and carbohydrates supplements have been reported to play a significant role in hastening dental decay. Materials and Methods: A cross-sectional study was conducted by the distribution of printed questionnaires among amateur bodybuilders/powerlifters in 13 gyms and fitness centers in addition to a 4-day event entitled “Fitness, healthy living and sports investment event”. A total of 1314 men and women participated in completing the questionnaire. Results: The majority (60.5%) of the participants were males and non-smokers (62.0%). Most of the participants reported using nutritional supplements (73.1%). Nearly, half the participants reported the use of >7 nutritional supplements per week (48.6%). A statistically significant result was found in regards to the relationship between increased consumption of dietary supplements and poor oral health. The methods of oral hygiene reported, appear to be insufficient. Conclusion: It is evident that amateur weightlifters and bodybuilders are a new risk group for developing dental caries. Therefore, more attempts must be made to raise the awareness regarding the implications of increasing the consumption of carbohydrates, proteins and the sugary sports drinks on oral health, and the accompanied salivary dehydration during and after workouts, which may aggravate the decaying process.

Prevalence of dental fear among male students studying in National Guard schools in Riyadh: A cross-sectional study Abed Al-Hadi Hamasha, Rakan B Aldosari, Ziyad M Osamie, Mohammed M Aldosari, Abdulaziz H Fakih, Abdullah M Alonazi Saudi Journal of Oral Sciences 2020 7(1):24-28 Aims: The aim of the study is to measure the prevalence and factors associated with dental fear among National Guard male middle schools students. Subjects and Methods: A cross-sectional analytical study was conducted among 468 students aged 10–17 years. The assessment tool of this study was a self-reported questionnaire filled by students or their legal guardians. The questionnaire included 33 questions; including students' demographics and experience in dental fear. Furthermore, questions related to the most frightening factors as well as factors that make students feel better in dental clinics. Data analysis was conducted using SPSS software. Frequency distributions with numbers and percentages of demographics, frightening factors, and comforting factors were conducted. Results: The response rate was 87%. Dental fear was reported by 29.1% of the sample. Tooth extraction was feared the most (49%) followed by root canal treatment (16%). The main sources of fear were related to dental procedures and noise from drilling teeth. The fear was originated from children own experience (41%) and only 13% relate their fear to what they heard from other people's experience. Variables reduced fear were female dentists (73%), the good reputation of the dentist (55%), and elegance and cleanness of the clinic (47%). The good appearance and neatness of the dentist, attitude of the receptionist, and decreased waiting time were not major factors in reducing dental fear. Conclusion: Dental fear was present in 29% of schoolchildren and was mostly related to tooth extractions and drilling noise. Dentist's explanation of the dental procedure and her attitudes were reported as helping factors in reducing dental fear.

Effect of varnish containing casein phosphopeptides-amorphous calcium phosphate and fluoride on surface microhardness of enamel – An in vitro study K L Girish Babu, Priya Subramaniam, Sangeeta Teleti Saudi Journal of Oral Sciences 2020 7(1):29-34 Background: Fluoride varnish is one of the professionally applied topical fluoride agents. The ease of application of fluoride varnishes has led to its popularity in pediatric dentistry. Aim: The aim of the study is to evaluate and compare the effect of varnish containing casein phosphopeptides-amorphous calcium phosphate (CPP-ACP) and fluoride (MI Varnish®) with that of varnish containing only fluoride (Fluor Protector®) on surface microhardness (SMH) of enamel. Materials and Methods: Enamel blocks were cut from the 90 premolar teeth samples. The samples were divided into three Groups (A, B, and C) consisting of 30 blocks each. Varnish containing CPP-ACP with fluoride was applied on samples of Group A and varnish containing only fluoride was applied on the samples of Group B. Group C was used as control group; without any varnish application. After varnish application, these samples were subjected to pH cycling. Following, SMH was assessed using SMH tester machine. Results: The mean values of SMH for Group A were 488 ± 6 vickers hardness number (VHN), Group B were 485 ± 12 VHN, and Group C were 448 ± 12 VHN. Conclusion: There was no significant difference in the SMH of enamel between the varnish containing CPP-ACP and fluoride, with that of varnish containing only fluoride.

A cross-sectional study to assess the level of dental anxiety prevailing in undergraduate dental students in Riyadh Elm University Umbreen Noor Muhammad, Julie Susan Rajan Saudi Journal of Oral Sciences 2020 7(1):35-39 Objective: This study was designed to evaluate dental anxiety (DA) level in undergraduate dental students in Riyadh Elm University and its relation with gender and to assess whether the level of DA changes over the whole course of study. Materials and Methods: In this cross-sectional study, the self-reported Modified DA Scale (MDAS) questionnaire was used. The minimum and maximum scores, scored from MDAS, were 5 and 25, respectively. The level of DA was categorized into less anxious (5–11), moderately anxious (12–18), and severely anxious (≥19). Results: The overall response rate was 86% (158 males and 274 females). The mean MDAS from all the participants was 12.06, with 4% of males and 7% of females being severely anxious and 53% of males and 60% of females being moderately anxious. The females were reported to be more anxious than males (P < 0.05). The level of anxiousness was significantly decreasing (P = 0.000) with each successive year of the study. The most anxious situation of all dental procedures was the injection of local anesthesia, followed by noise generated from dental instruments. Conclusion: Female undergraduate dental students and preclinical students were more anxious when compared with males and students of the clinical years, respectively. There is a need for proper dental health education, exposure to clinics, and counseling therapy from the early years of dental training to reduce the level of anxiety.

Causes of root canal treatment failure: A prospective study in Makkah City, Saudi Arabia Mohsen K Aljabri, Jamal A Kensara, Ayman O Mandorah, Monammed A Sunbul Saudi Journal of Oral Sciences 2020 7(1):40-45 Aim: The aim of the study is to identify the causes of root canal treatment (RCT) failures in Makkah City. Materials and Methods: The study used a prospective cohort study design, using a clinical examination, treatment, and follow-up. The study summarized the data of 131 patients presented to the Endodontic Department in King Faisal Hospital, Makkah, in the Western region of Saudi Arabia and included patients with failed RCT aged 16 years or older without any systemic disorder. Results: Of the 131 patients, the most common factor for root canal failure was underfilling (71.0%), followed by coronal leakage (42.7%), overfilling (16.8%), missed canal (16.0%), iatrogenic (6.1%), leaked canal and anatomic (1.5%), and 3.1% for unknown causes. Fifty-two (39.7%) were female and 79 (60.3%) were male. One hundred and three (78.6%) were 18–40 years old, whereas 28 (21.4%) were 40 years old and older. For tooth type, 34 (26.0%) had an anterior root canal, 39 (29.8%) had a molar root canal, and 58 (44.3%) had a premolar root canal. Conclusion: Considering the limitations of the present study, it was determined that endodontic treatment failures mostly occurred in underfilled root canals, followed in number by coronal leakage. Premolars had a higher failure rate than did anterior and molar teeth.

Comparison of dental health, treatment needs in visually impaired and normal healthy school-going children of 6–14-year age group Sunil Kumar, Rishi Tyagi, Namita Kalra, Amit Khatri, Deepak Khandelwal, Dhiraj Kumar Saudi Journal of Oral Sciences 2020 7(1):46-51 Introduction: This research aimed to evaluate and compare the oral health status and treatment required for visually impaired children and normal healthy school-going children in New Delhi and to investigate the factors that influence oral health. Subjects and Methods: The study was conducted in 420 children who were equally divided into visually impaired children and normal healthy children. Oral health status was recorded, which includes dental caries, plaque, debris, and gingival status in both groups. The Chi-square test was used, and statistical significance was fixed at (P < 0.05). Results: The total caries experience (Decayed, Missing, and Filled Surface + decayed, missing, filled surface) was found to be more in normal healthy children 2.72 than the visually impaired children 2.22 and it was found to be statistically significant (P < 0.05). Oral hygiene simplified index of normal healthy children and visually impaired children were 0.74 and 1.33, respectively, and found to be statistically significant (P < 0.05). The gingival index of normal healthy children was 0.10 found to be greater than visually impaired children 0.08. Visually impaired children required more treatment needs than normal healthy children. Conclusions: Visual impairment can actively limit these children maintaining good oral hygiene, and hence, it is important to create awareness, proper oral health guidance, and periodically screening to avoid complicated treatment needs in these children.

Outcomes of Class II composite restorations placed by dental students: An observational study Ghada L AlOtaibi, Rwan Aldakheel, Haifa Alhussein, Shahd Alrowili Saudi Journal of Oral Sciences 2020 7(1):52-55 Introduction: Main objectives of restoring the teeth is to remove the caries and replace the tooth structure to restore form and function. This radiographic study aimed to determine the defective Class II composite restorations in permanent teeth placed by the undergraduate dental students in a private dental school. Materials and Methods: A retrospective analysis of bitewing radiographs of Class II composite restorations placed by the clinical dental students of 2017–2018 year was assessed to determine the defective restorations. Bitewing radiographs were examined to record voids, open contact, residual caries, open margin, defective restoration, and acceptable composite Class II restorations. Results: A total of 1514 permanent teeth filled with composite Class II restorations were assessed using bitewing radiographs. Almost 935 teeth showed signs of failure of Class II restorations. Reasons for the failure of most of the Class II composite restoration were due overhang 197 (13.01%), followed by voids 184 (12.15%), open contact 167 (11%), poor contour 165 (10.88%), open margin 135 (8.91%), and residual caries 87 (5.75%). A significant difference between male and female students was observed with regard to voids (P = 0.026), overhang (P = 0.016), and open margins (P = 0.001) of the Class II composite restorations. Conclusion: Overhang was the most common, and residual caries was the least common defects observed in the bitewings. Male dental students placed higher defective composite Class II restorations compared to the female dental students.