BDJ Open最新文献

Context: Mineral Trioxide Aggregate (MTA) is a calcium silicate-based cement that potentially exhibits improved washout resistance when carboxymethyl chitosan or gelatin is incorporated. Gel-form MTA is a novel mineral trioxide aggregate formulated using construction industry-based technology. The present study was conducted to comparatively evaluate the sealing ability and adaptation to dentinal walls of gel-form MTA.

Materials and methods: This in-vitro study consisted of two groups: gel-form MTA and the conventional powder-liquid MTA. 10 samples per group were used for each of the tested parameters. Adaptation of the MTA to the dentinal walls was tested under the light microscope and measured using Image J software. Sealing ability was evaluated using a single aerobic bacterial leakage model. Appropriate statistical analysis was done for the obtained data. Adaptation of the MTA was analyzed using independent t-test and Friedman test, whereas the bacterial leakage was analyzed using chi-square test.

Results: On comparison of the adaptation property at coronal and apical thirds, there was no statistically significant difference between the groups (p = 0.071 and p = 0.638, respectively). However, while comparing the same in the middle one-third of the root, lesser gaps were identified in the gel-form MTA group (p = 0.013). One sample belonging to the conventional powder-liquid MTA group showed significant turbidity during bacteria leakage evaluation (p = 0.001) with the presence of E. faecalis in the count of 10³ colony forming units/milliliter.

Conclusion: The gel-form MTA shows a better adaptation to the dentinal walls at the middle third of the root and exhibits better sealing ability against bacterial leakage when tested for E. faecalis. The adaptation of gel-form MTA at coronal and apical third of the root was comparable to the conventional powder-liquid MTA.

Background: Majority of patients with Dento-Facial Traumatic Injuries (DFTI) seek initial care at an Emergency Department (ED). The timely management of DFTI is of utmost importance in determining long-term prognosis of the tooth and the patient's overall quality of life. Thus, knowledge and awareness of ED residents & physicians regarding the management of DFTI is crucial for better patient outcomes. Numerous studies have investigated the knowledge of ED specialists regarding initial management of dental trauma, however, scientific evidence in this domain is scarce in our region.

Objective: The aim of this study was to evaluate the knowledge and awareness of ED residents and physicians regarding diagnosis and management of DFTI using a web-based survey on REDCap.

Methods: An observational cross-sectional study was conducted among the ED residents and physicians of private and public hospitals in Karachi, Pakistan. Data was collected through a web-based questionnaire, sent via email to the participants. The survey comprised of questions assessing their knowledge regarding the diagnosis and management of various dental and maxillofacial injuries. Responses from the participants were graded as low, moderate or high knowledge levels according to a pre-determined criteria. Pearson's chi-square test was applied to determine the association between knowledge scores.

Results: The total response rate was 47.6%. Out of 116 participants, 49 (42%) responses were received from physicians and 67 (58%) from residents. The overall knowledge level of participants was low (46.6%) and there was no significant difference in the knowledge level between residents and physicians (p = 0.157). Participants who had received formal training in dental trauma (p = 0.038) and those with more years of clinical experience (p = 0.004) had higher knowledge scores, that were statistically significant.

Conclusions: The knowledge and awareness of ED residents and physicians in dental trauma management was generally low. Specialized training courses are required to provide timely and adequate management of traumatic dental injuries in order to improve patient-related outcomes.

Objective: This study was conducted to evaluate the antimicrobial efficacy and mechanical properties of two experimental self-disinfecting alginate preparations utilising two different antimicrobial agents; povidone-iodine and silver nanoparticles.

Methods: Alginate moulds were assigned into three groups. Additives-free control group, povidone-iodine-containing group, and silver nanoparticle-containing group. Discs from each group were obtained and assessed for their antimicrobial activities by the disc diffusion method against Staphylococcus aureus, Escherichia coli, and Candida albicans. For the elastic recovery analysis, each group was divided into 6 samples. Each sample was mixed according to its group specification and subjected to surface detail reproduction and elastic recovery according to ISO 1563:1990 specifications. All data were expressed as mean ± standard deviation for each group at the significance level of P < 0.05.

Results: Results revealed that the experimental self-disinfection alginate possessed broad-spectrum antimicrobial activities against the tested microorganisms, compared to the control group. No statistically significant differences in elastic recovery values between all tested groups (P < 0.05) were observed. For surface detail reproduction, all samples reproduced the 50 μm line.

Conclusion: Povidone-iodine as well as silver nanoparticles could be used efficiently for the sanitization of alginate moulds without adverse effects on detail accuracy or elastic recovery of the impression material.

Background: Broad challenges regarding the dental management of people with severe obesity experienced by general dentists have been minimally explored. The perspectives of the dental team regarding these multifaceted issues are currently unknown and they potentially impede the delivery of optimal dental care to this population and contribute to poor oral and general health.

Aims: Our qualitative study aimed to identify and explore barriers and enablers in the dental management of adults with severe obesity among dental professionals and support staff in Australia.

Methods: Focus groups and semi-structured interviews (n = 34 participants) were conducted with dental professionals (n = 23) and support staff (n = 11). Recordings were transcribed verbatim and synthesised using thematic, inductive analysis.

Results: Multiple barriers to adequate provision of dental care for people living with severe obesity in both general and specialist dental settings were identified. Key themes emerged related to the clinical challenges reported by participants in providing dental management for people living with severe obesity, appropriateness of existing bariatric dental service provision and safety of care. Enablers to access were identified, including increased availability of bariatric dental chairs, environmental modifications, education of both patients and the entire dental team and for guideline development.

Conclusion: The current study explored multiple barriers to optimal dental management of people living with severe obesity in both general and specialist dental settings. Enablers should be used to inform future practice. The optimisation of existing bariatric dental service provision requires urgent review with solutions guided by systemic change. Study findings suggest a review of current health systems, economics, access barriers, policies and procedures and education and training beyond the individual level are needed. Future directions to improve the dental management of people living with severe obesity are proposed.

Introduction: Oral submucosal fibrosis is a potentially life-threatening oral disease that significantly impacts physiological functions such as speech and swallowing while also diminishing the quality of life for patients. Currently, the mainstream treatment for oral submucosal fibrosis in clinical practice involves invasive glucocorticoid drugs such as injection therapy. However, this method often leads to intraoperative pain, anxiety, fear, and poor medical experience due to associated side effects.

Methods: There is an urgent need to actively explore new drugs and relatively noninvasive approaches for the treatment of oral submucosal fibrosis in order to enhance patients' medical experience and compliance. This has become a focal point of attention in clinical research. After conducting an extensive literature search, it was discovered that curcumin, a natural polyphenolic compound, exhibits potent anti-tumor, anti-inflammatory, antioxidant, anti-metastatic and anti-angiogenic properties. Moreover, curcumin holds significant clinical potential in the prevention and treatment of various diseases such as oral submucosal fibrosis.

Conclusion: This review presents a comprehensive elaboration encompassing the action mechanisms, biological activity, potential applications, and clinical characteristics of curcumin in the management of oral submucosal fibrosis, aiming to provide diagnostic insights and novel therapeutic perspectives for its prevention and treatment.

Background: Enhancing the antibacterial capabilities of dental materials by adding nanoparticles has been the subject of some research. However, the potential toxic effect of this material on the vital tissues should be investigated to avoid additional damage to the tissue.

Objective: This study aimed to validate the long-term cytotoxic and antibacterial properties of an epoxy resin-based endodontic sealer (AH Plus) with and without loading with silver gold nanoparticles (Nano Care Plus Silver Gold®).

Material and methods: The tested groups were Nano Care Gold (group I), modified resin sealer (m AH Plus; group II) and AH Plus served as a control group (group III). Agar diffusion was used to measure the antibacterial activity against Enterococcus faecalis. Using the MTT test, cytotoxicity assessment was carried out in accordance with ISO-10993-5 guidelines to assess the cells' viability as soon as possible and after two and four weeks. The t-test was used to statistically examine the data. The chosen significance threshold was P <0.05.

Results: Antibacterial results revealed that there was no difference in the diameter of the inhibition zones measured in all groups at 24 h. While in 48 and 72 h, the difference was statistically significant (p <0.05). In 48-h Nanogold was significantly higher than AH Plus when tested alone (p <0.05), however their mixture showed insignificant difference. After 72 h, the Nano gold was significantly higher than that of AH Plus & Nano gold mixture (p <0.05). Cytotoxicity result revealed there was a significant difference between tested groups at different intervals (p <0.001). For immediate measurements, values measured with the AH group were significantly higher than those of other groups (p <0.001). For the AH& nanogold group, there was no significant difference between values measured at different intervals (p = 0.578).

Conclusions: Silver gold nanoparticles have acceptable antibacterial properties and low cytotoxicity to be used as canal pretreatment prior to the application of the sealer or even incorporated with AH Plus sealer.

Introduction: Mental health issues are being reported increasingly amongst healthcare staff and students globally. The aim of this study was to investigate the frequency of common mental health issues amongst dental faculty members at multiple institutions in Pakistan.

Methods: Following approval from the institutional ethics review board, dental faculty members at 14 dental institutions were invited to participate in an online survey based on globally validated scales for mental health problems including the Patient Health Questionnaire (PHQ-9), and the Depression, Anxiety, and Stress Scale (DASS-21). Two open-ended questions were included in the survey to identify perceived factors contributing to poor mental health and recommendations for improving institutional support.

Results: A total of 200 faculty members out of provided their responses to the survey questionnaire but complete responses were provided by 183 participants which included 120 (65.57%) females, and 63 (34.43%) males. The total number of faculty members at the participating institutions was 426 and 183 responses translated into an overall response rate of 43%. Most participants were in the 31-40 years age-group (n = 81, 44.26%) followed by 25-30 year (n = 51, 22.87%) and 41-50 years (n = 40, 21.86%). The mean score on PHQ-9 was 6.51 (SD ± 5.4) while the mean DASS-21 score was 13.04 (SD ± 10.95). PHQ-9 Depression, and DASS-21 Depression, Anxiety, and Stress scores were all significantly positively correlated for the whole sample, and within each subgroup of each demographic factor. Job-related workload, lack of institutional support, financial limitations, and poor work life balance were identified as the main factors contributing adversely to the mental health of the participants.

Discussion: This study provides useful insights into the scale of mental health status amongst dental faculty members at 14 institutions in Pakistan. Underlying factors affecting the mental health of faculty members adversely were identified and recommendations are provided to address these challenges.

Introduction: Sugar is omnipresent in the current food environment and sugar consumption has drastically risen over the past century. Extensive evidence highlights the negative health consequences of consuming excess dietary sugars, leading the World Health Organization (WHO) and the American Heart Association (AHA) to devise guidelines to restrict sugar intake. According to the WHO's Global Oral Health Status Report of 2022, oral diseases and severe periodontitis are a massive public health problem, and dietary sugars are a modifiable risk factor.

Methods: We conducted a literature review using key databases to summarise the health effects of excessive sugar consumption and their potential role in periodontal inflammation.

Results and conclusion: Available evidence suggests that excess dietary fructose and sucrose can cause low-grade systemic inflammation; and induce dysbiosis in both gut and the oral microbiota. Also, dietary sugar is potentially addictive and hypercaloric and its overconsumption can lead to obesity, metabolic syndrome, and other risk factors for periodontal inflammation. Hence, an unbalanced diet with excess dietary sugars holds the potential to initiate and aggravate periodontal inflammation. In the modern food environment that enables and facilitates a high-sugar diet, adopting a diverse diet and restricting sugar intake according to WHO and AHA guidelines seem beneficial to systemic and periodontal health. Since clinical evidence is limited, future research should study the effectiveness of dietary interventions that control sugar consumption in preventing and managing the global public health problem of periodontal inflammation.

The global population ageing, and the pace of ageing is accelerating. Although people are living longer, these additional years are not being gained in health, and disability, chronic and long-term conditions increase with age. In response to the challenges of an ageing population, the United Nations and World Health Organisation declared 2021-2030 the Decade of Healthy Ageing, with the purpose of collaborative action to foster longer and healthier lives. This review explores the WHO public health framework for healthy ageing and global trends and policies, using the UK as an example of policy implementation. In response to the urgent need to consider the impact of ageing on oral health and oral healthcare systems, an integrated model for healthy ageing and oral health is proposed.

Purpose: Practicing oral habits beyond the normal age range is assumed to be due to underlying psychological disturbance and could result in a deformation of the orofacial structure. The first step in managing such a health condition is to evaluate its size. Thus, this study aimed primarily to assess the prevalence of oral habits among a group of school children aged from 5 to 7 years, in Cairo, Egypt. The secondary aim of the study was to investigate some possible related predictors along with the mother's perception of the child's oral health-related quality of life.

Methods: A Google form questionnaire was designed, utilizing the third domain of Nordic Orofacial Test-Screen (NOT-S), to assess the presence or absence of oral habits and their types, if reported. Also, there were two global rating items to test the child's oral health-related quality of life from the mother's prospection, along with one item to inquire if the mother thinks that the oral habits are harmful to the child. A total number of 23 schools in Cairo, Egypt were randomly selected, and the link to the Google form was distributed through the parent's groups on social media. All high-quality complete responses were analyzed using the SPSS program, and a Log-binomial regression model was constructed, to determine the significant predictors of practicing oral habits in children.

Results: Among the analyzed 1128 responses, the total number of answers to the third domain of interview part of NOT-S was 1235, with a response rate of (60.39%), no habits were reported in 635 children (51.4%), while nail biting was noted in 21.8%, bruxism in 17.9% and Sucking habits in 8.9%. In total, 63.8% of children who were reported by their parents to be the "only child" didn't practice any habit, and a higher prevalence of oral habits was detected in children with siblings. There was no detectable association between the mother's educational level and practicing any of the habits, although there was an association between the mother's educational level and their awareness of the harmful effect of oral habits on the child. The mothers' answers to the global rating items were not associated with any of the oral habits.

Conclusion: The most prevalent oral habit in the current study was the nail-biting habit. The presence of other siblings and the number of siblings were contributory factors in the occurrence of oral habits, while mothers' educational level was not associated with practicing oral habits. The mothers' awareness of the harmful effect of oral habits on the children was not satisfactory, and there was no association between oral health-related quality of life and the children's oral habits, from the mothers' perspective.