MBRU Theses & Dissertations

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Accuracy of three-dimensional printed guide plate for indirect bracket placement: one-piece verses segmented, an in Vitro study
(2022) Alyammahi, Bayan Esmaeil
Background: An accurate placement of brackets is a key element of the comprehensive treatment process of orthodontics to achieve an ideal occlusion. Orthodontic brackets can be directly placed on tooth surfaces or indirectly. Aim: To compare the accuracy of indirect bonding techniques in moderate, and severe crowding cases using three-dimensional printed one-piece transfer tray and segmented trays. Digital models with virtual brackets were considered as the control group. Four points were selected in each tooth to perform the analysis. From the midpoint of each bracket to the mesial margin (CM= center mesial), distal margin (CD =center distal), occlusal/ incisal margin (CI= center Incisal/occlusal) and gingival margin (CG= center gingival). Shapiro-Wilk was used to test the normality of continuous variables. The Mann-Whitney test, Kruskal-Wallis H test was used. A P-value of less than 0.05 will be considered significant in all statistical analyses. Results: There were statistically significant differences between models with moderate crowding bonded using full, segmented transfer trays and control for CD12, CD21, CI25 (P < 0.001). While the rest of the measurements showed no significant differences between models with moderate and severe crowding bonded using full, segmented transfer trays and control (P=1.0). Conclusion: The one-piece and the segmented indirect 3D printed transfer trays are accurate in the severe and moderate malocclusion.
Airflow for initial non-surgical treatment of peri-implantitis: a systematic review and meta-analysis
(2022) Almatrooshi, Aisha
Background: Non-surgical treatment of peri-implantitis may help in reducing microbial load and inflammatory parameters. The potential clinical benefits of using different treatment approaches, in the initial non-surgical treatment phase, particularly the airflow, are still not clear. The aim of this systematic review and meta-analyses was to evaluate the outcomes of non-surgical treatment of peri-implantitis using airflow method in terms of changes in periodontal parameters, peri-implant marginal bone level, postoperative pain/discomfort and patient satisfaction. Methods: Electronic databases were searched to identify randomized controlled trials (RCTs) that compared airflow with mechanical debridement using ultrasonic/curettes. The risk of bias was assessed using the Cochrane Collaboration’s Risk of Bias tool. Data were analyzed using a statistical software program. Results: A total of 316 studies were identified, of which, five RCTs with 288 dental implants in 174 participants were included. Overall meta-analysis showed more reduction in probing pocket depths at one to three months (mean difference (MD) -0.23; 95% confidence interval (CI) -0.50 to 0.05; P = 0.10) and six months (MD -0.04; 95% CI -0.34 to 0.27; P = 0.80) in favour of airflow, but the difference was not statistically significant. The use of airflow was associated with significant reduction in bleeding on probing and increase in peri-implant mucosal recession. The differences in plaque score, peri-implant marginal bone level changes, and patient reported outcomes between airflow and mechanical debridement were not statistically significant. Conclusions: The short-term clinical and radiographic outcomes following non-sugical treatment of peri-implantitis using airflow or mechanical debridement were comparable. The airflow has short-term positive effects on reducing bleeding on probing. Further evidence from RCTs are still required to substantiate the current findings.
Alveolar Ridge Preservation: a Cochrane Systematic Review and Metaanalysis
(2022) Ahmad, Sara Ali Hussain
Background: Alveolar bone changes following tooth extraction can compromise prosthodontic rehabilitation. Alveolar ridge preservation (ARP) has been proposed to limit these changes and improve prosthodontic and aesthetic outcomes when implants are used. Aim: To evaluate the effects of various materials and techniques for ARP after tooth extraction compared with extraction alone or other methods of ARP in patients requiring dental implant placement. Materials and Methods: Electronic databases were searched to identify randomized controlled trials (RCTs) on the use of ARP techniques with at least six months of follow-up. The risk of bias was assessed using the Cochrane Collaboration’s Risk of Bias tool. Data were analysed using a statistical software program. Results: A total of 16 RCTs with 524 extraction sockets in 426 participants were included. The meta-analysis showed a very low certainty evidence of a reduction in loss of alveolar ridge width (mean difference (MD) -1.18 mm, 95% confidence interval (CI) -1.82 to -0.54; P = 0.0003) and height (MD -1.35 mm, 95% CI -2.00 to -0.70; P < 0.0001) in favour of xenograft when compared to extraction alone. There are no significant differences in the need for additional augmentation or implant failure between xenograft and extraction alone. No serious adverse events were reported with most trials indicating that the procedure was uneventful. Conclusion: ARP techniques may minimise the overall changes in residual ridge height and width six months after extraction but the evidence is very uncertain. There is no evidence of any clinically significant difference between different grafting materials and barriers used for ARP.
Anterior teeth root inclination prediction derived from digital models: A comparative study of plaster study casts and CBCT images Mahmoud Dastoori MSc, University College London, 2007 DDS, Ajman
(2017-08) Dastoori, Mahmoud
Aim: To assess the accuracy of digital models generated using commercially available software to predict anterior teeth root inclination characteristics and compare the results to relevant data obtained from CBCT images. Materials and Methods: Following sample size calculation and after evaluation of inclusion and exclusion criteria, pre-treatment maxillary and mandibular plaster models and the corresponding CBCT scans of 31 patients attending a private orthodontic clinic in Beirut, Lebanon, were randomly selected. The subjects represented both genders (males: 10; females: 21), ranging in age from 12 to 40 years. Plaster models were scanned using the high resolution of an Ortho Insight 3D ™ scanner (Motion View Software, Chattanooga, Tennessee, USA) and CBCT scans were taken using a Kodak 9500 Cone Beam 3D System (Carestream Health, Inc., Rochester, New York, USA). Elaboration of plaster models and CBCT data were performed according to specific technical steps. The Shapiro-Wilk test was used to test normality of measurements per tooth and crosstabulation to examine the independency between categorical variables. Statistical analysis was performed using χ2 test of association. If the measurements were II normally distributed, the t-test and ANOVA were used to examine two or more continuous independent variables. In cases of non-normality of measurements, the Mann-Whitney and Kruskal-Wallis tests for multi-comparison of continuous data were employed. To evaluate the reliability and consistency of the investigator, the paired t-test was used. P-value was set as ≤ 0.05 in all statistical analyses. To determine the intra-examiner error of the measurements, records of 5 random patients were selected and all measurements were repeated twice by the author after a two week interval and the correlations computed using intra-class correlation coefficient (ICC). Results: The maximum disparity in angle between images derived from digital models and CBCT data was almost 40 degrees (upper left canine). The disparity in upper right canines was similar. The upper and lower canines produced the worst results, followed by the lower lateral incisors. The upper central incisors showed the best results, although the maximum angle of difference exceeds 20 degrees (with the median only around 8 degrees). There was no statistically significant difference in measurements of difference between long axes of the root by using the two methods in each tooth (MDBLAR) according to Angle classification. Observation of the cases showed that the software frequently estimates angulations leading to overlapping of adjacent roots; a clinically unfeasible situation in the absence of extensive root resorption or root morphology variation. Errors were higher for canines and lower for central incisors. There was no correlation of errors between teeth. Conclusions: Root morphology imaging prediction is not a primary function of this software and this study confirmed its limitation as a sole tool in routine clinical applications. At III present these predictions cannot be considered accurate or reliable unless correlated with a radiographic image.
Anterior teeth root morphology prediction as derived from digital models: A comparative study of plaster study casts and natural teeth from dry skulls
(2018) Magkavali-Trikka, Panagiota
Aim: To assess the accuracy and reliability of the digital images of dental models generated by specific commercially available software in predicting root morphology characteristics in comparison to the corresponding natural teeth. Materials and Methods: The initial sample of 56 natural teeth derived from14 dry human skulls with permanent dentition. From the 14 dry skulls, there were 11 mandibles and 3 maxillae. The inclusion criteria used in this study were that all the teeth should derive from permanent dentition of adults and should present normal crown morphology. Primary teeth, teeth with abnormal tooth morphology and restorations, and jaws resembling craniofacial anomalies or syndromes were excluded. Based on these criteria, one maxillary right lateral incisor was excluded since it had a fractured crown. Therefore, the total number of the sample of teeth used was 55. The sample size calculation required 43 teeth. Upper and lower dental arch impressions, utilizing alginate material, were taken and plaster study models were fabricated. The maxillary and mandibular plaster models were ii scanned using the Ortho Insight 3D laser scanner. Using the Ortho Insight 3D software (version 4.0.6), measurements, to the nearest 0.01 mm, were recorded by locating relevant landmarks using the intrinsic linear measurement function of the software. Based on these landmarks, the software produced virtual roots for the selected teeth. Then both the scanned casts and their root predictions were exported in stereolithography (STL) files. All corresponding 55 natural teeth were removed from the upper and lower jaws of the dry skulls and scanned using the Identica extraoral white-light scanner in order to calculate their actual root morphological characteristics. In order to acquire the whole tooth geometry, the teeth were scanned twice, once to acquire the crown and the cervical part of the root, and a second time to acquire the remaining part of the root, including the apex. The two scanned segments were joined in software by superimposing them along their common part. Finally, the accuracy of the digital models generated by the Ortho Insight 3D laser scanner in predicting root morphology characteristics was assessed by comparing these results to the corresponding measurements of the 55 natural teeth. The long axes of the tooth models obtained from the software prediction and the scanning of the actual teeth were computed and the discrepancy between them evaluated. Results: The error of the method was evaluated by repeating the measurements on 14 teeth. The differences in root mean squared error (RMSE) of superimposition of the two scanned segments (crown - root) of each tooth ranged from -0.006 to 0.010 mm. The differences in RMSE of superimposition of each tooth on its corresponding cast ranged from -0.040 to 0.057 mm. Both these error ranges showed acceptable accuracy. The error in calculating the angulation between the predicted and actual long axes ranged from -3.2 to 2.3 degrees (95% limits of agreement: -3.7 to 3.2). iii The predicted tooth angulation was found to differ significantly from the actual angulation, both statistically and clinically. The angle between the predicted and actual long axes ranged from 2.0 to 37.6 degrees (average: 9.7 degrees; median: 7.4 degrees). Conclusions: Based on the results of this study, the degree of error is higher for mandibular central incisors and maxillary lateral incisors, and lower for maxillary central incisors and mandibular lateral incisors. Further investigations and improvements of the software are needed before it can be considered clinically effective.
The anteroposterior effect of rapid maxillary expansion using bone-borne VERSUS tooth-borne expander: A comparative study
(2022) AlNashmi, Nashmi Qais
Background: In orthodontics, slow, rapid, and surgically assisted maxillary expansions are commonly performed to correct maxillary constriction, posterior crossbite, and crowding. Ideally, this treatment approach is recommended in growing (i.e., pediatric and adolescent) patients, as it requires a mid-palatal suture that is not fully fused. There is limited understanding on the relative efficacy of bone- and tooth-borne expanders for maxillary expansion. Aim: To assess and compare dentoskeletal changes in maxilla and mandible after RME using bone- and tooth-borne expanders in adolescent patients. Materials and Methods: This study compares 18 subjects (10 females and 8 males, with an average age of 14.4±1.3 years) who received tooth-borne RME; and 18 subjects (12 females and 6 males, with an average age of 14.7±1.4 years) who received bone-borne RME. Specific three-dimensional landmarks were used in order to compare skeletal and dental changes in tooth-borne and bone-borne expanders. Data was analyzed using Shapiro-Wilk, Paired t, Wilcoxon, and Mann-Whitney tests, in addition to Pearson correlation. A P-value of less than 0.05 was considered significant in all statistical analyses. Results: In the tooth-borne group the following parameters showed a significant difference after expansion (P <0.05 ): molar width, intermolar width, molar buccal tipping in the transverse plane, and Pog-FH in the vertical plane. In the bone-borne group, a significant difference after expansion (P <0.05 ) was recorded for the following parameters: linear intermolar relation, palatal bone width, intermolar width, and interpremolar width. Comparison of the post- ii expansion results of both groups revealed that the bone-borne group exhibited less molar buccal tipping. Conclusion: There was significant transverse change reported after expansion in both the bone-borne and tooth-borne groups, with less significant of dental tipping in the former. Nevertheless, both groups displayed limited sagittal and vertical changes when correlated to the transverse changes.
Are asthma and airway allergy associated with increased root resorption following orthodontic treatment? A systematic review
(2020) Al-Saqi, Reem Kais
Aim: Asthma and airway allergy have been implicated with root resorption development following orthodontic treatment. The objective of this study was to investigate systematically the relevant literature. Materials and Methods: Search without restrictions for published and unpublished literature and hand searching took place. Data on root resorption in patients with asthma or allergy having undergone comprehensive orthodontic treatment were reviewed. The risk of bias was assessed using the Newcastle-Ottawa Scale. Results: From the initially retrieved records, three cohort and two case-control studies met the inclusion criteria. The studies reported conflicting results and the risk of bias assessment revealed shortcomings in various domains. Conclusions: The information regarding the association of asthma and airway allergy with root resorption following orthodontic treatment is contradictory and further research is warranted. However, until more data become available good practice would suggest that it is important to identify patients with asthma or airway allergy and consider the possible implications.
Assessment of Anterior Maxillary Labial Bone Thickness Using Cone-Beam Computed Tomography: A Retrospective Analysis
(2022) Al Ali, Fawaghi
Background: The morphological variations observed in labial bone thickness (LBT) around maxillary anterior teeth can affect the three-dimensional placement of dental implants and its long-term outcomes; making it imperative for clinicians to thoroughly examine the LBT prior to tooth extraction. Aim: To measure LBT in relation to the six anterior maxillary teeth at different levels along the long axis and the distance between cemento-enamel junction and bone crest (CEJ-BC) based on Cone-Beam Computed Tomography (CBCT) scans retrieved from patients’ records and identify any association with patients’ characteristics. Materials and Methods: A total of 100 CBCT scans were evaluated by one calibrated examiner. The thickness of the labial bone was measured perpendicular to the long axis of the tooth at 1, 3 and 5 mm from the alveolar crest (LBT-1, LBT-3, LBT-5, respectively) and CEJBC using medical imaging viewer. Results: CBCT scans of 58 females and 42 males with a mean age of 39.7 ± 9.5 years were included. A high variation of CEJ-BC was observed (range 0.55 – 3.90 mm). Statistically significant higher CEJ-BC values were associated with males and increased age (> 50 years). The overall means of LBT-1 were 0.76 ± 0.26, 0.79 ± 0.26 and 0.83 ± 0.37 mm; LBT-3: 0.92 ± 0.36, 1.05 ± 0.46 and 1.03 ± 0.48 mm; LBT-5: 1.17 ± 0.52, 0.80 ± 0.45 and 0.81 ± 0.40 mm for central-, lateral incisors and canines, respectively. The LBT was less than 1 mm in 74.2% ii of all maxillary anterior teeth with central incisor being the thinnest site (85%). No significant association between LBT and patient characteristics was observed. Conclusion: The CEJ-BC distance is greater in males and increases with age, particularly in those older than 50 years. The LBT in the six maxillary anterior teeth is predominantly thin (< 1 mm) and has no correlation to age or gender. An increased LBT was observed at 3 mm level when compared with LBT-1 and LBT-5. Such variability should be taken into consideration when planning for immediate implant placement.
Assessment Of Anxiety Levels Among Patients Attending Oral Surgery Department At Hamdan Bin Mohammed College Of Dental Medicine In United Arab Emirates
(2019) Alansaari, Albatool
Objectives: To assess the dental anxiety levels among patients attending Oral Surgery department at Hamdan Bin Mohammed Dental Clinics (HBMCDM) and to identify factors influencing dental anxiety level among the patients attending Oral Surgery department. Methods: A cross-sectional study using a Likert-scale questionnaire was conducted to collect quantitative data from 206 patients at the Oral Surgery Clinics at (HBMCDM). Dubai, U.A.E. Descriptive analysis as well as independent-t test and Chi-Square Test to compare and determine the associations of the dental anxiety scores between groups was carried out using IBM-SPSS for windows version 24.0 (SPSS Inc., Chicago, IL). Results: The prevalence of dental anxiety (MDAS score of 13 or more) of the 206 patients was 72.33% with overall severity represented by a mean score of 15.50 (SD ± 5.4). The maximum anxiety scores were reported for: planning to going to the dentist for treatment, sitting in the dentist’s waiting room, having a tooth drilled, having teeth scaled and polished, having a local anesthetic injection, and having an extraction/surgical procedure with the following anxiety scores respectively 2.12, 2.21, 2.70, 1.92, 3.05 and 3.50. There was a significant high dental anxiety average score among females 16.42 (SD ± 5.54) compared with that among males 14.65 (SD ± 5.16), p-value was 0.02. The average dental anxiety score increases significantly by education level (p-value 0.02). There is statistically significant difference between average dental anxiety scores among student 17.44 (SD ± 6.09) compared with the employee 14.92 (SD ± 5.34) and the unemployed 17.24 (SD ± 4.78) (p-value 0.03). However, there were no relation between dental anxiety scores and age of the patient, marital status, dental history and history of bad dental experience. The best-recorded technique to reduce patients’ dental anxiety was communication strategies (51% of the respondents) and followed by Tell-Show-Do techniques (33.0%). Conclusion: From the study, it can be concluded that dental anxiety levels among patients in United Arab Emirates was significantly high especially in relation to teeth extraction and dental surgical procedures and the least anxiety scores were reported for scaling and polishing.
Assessment of the Knowledge of United Arab Emirates Dentists of Child Maltreatment, Protection and Safeguarding
(2016-08) Al Hajeri, Hind
Background: Child safeguarding, governed by international, national and local laws, is the responsibility of all members of society. Members of the dental team are in a unique position to recognize Child Abuse and Neglect (CAN) in dental practice and in the wider society. Objective: To assess the awareness of dentists in the United Arab Emirates (UAE) with regards to child maltreatment, child protection and child safeguarding. Materials and Methods: A cross-sectional survey of 381 UAE dentists was conducted. Questions related to the knowledge and practice of CAN and related safeguarding issues were tabled and cross tabulated against demographic variables. Statistical analysis was carried out using Chi-square, t-test, ANOVA and Pearson’s correlation test. Statistical significance was set as p <0.05. Results: 39.4 %(n=152) of the participants had suspected CAN (mean1.3 CAN cases in the last 5 years); male dentists suspected more CAN than female dentists, however, orthodontists, paediatric dentists (p=0.000) and female dentists (p=0.001) were more knowledgeable about diagnosing CAN. Paediatric dentists attended more CAN-related postgraduate training (p=0.000) than other specialties. Amongst other results, 53.5% (n=204) were not aware of child protection guidelines,58.1% (n=224) and 54.1% (n=206) had undergraduate and postgraduate training about CAN issues respectively and 90.8% (n=346) believed that CAN should be addressed. Barriers to dentists referring CAN cases for child protection were; fear of family violence (59.6%, n=227), lack of knowledge of referral process (60.2%,n=228) and lack of diagnosis certainty (54.9%, n=206).UAE dentists qualified in Western and Asian countries had significantly fewer barriers for child protection (p=0.022)than the Arab and Gulf Cooperation Council qualified dentists. Conclusions: The UAE dentists surveyed witnessed CAN with an average of 1.3 cases in the last 5 years. Many variables (such as gender, specialty, and country of qualification) affected the dentist’s knowledge of CAN and the practice of child safeguarding. Despite agreeing that CAN is an issue that should be addressed, a majority were not aware of the local child protection guidelines and had perceived barriers preventing them from arranging a child protection referral. Female dentists, orthodontists and paediatric dentists scored significantly higher in recognizing CAN cases compared to male dentists and other specialties (general dental practitioners, restorative dentists and oral surgeons).Training and practice recommendations were made. Knowledge of CAN did not necessarily mean more practice of child protection. There was no correlation between those who scored high in CAN knowledge and the CAN practice scores.
Assessment of The Quality Of Endodontic Retreatment On A Postgraduate Endodontic Clinic In Hbmcdm (2008-2015)
(2017-08) Alharmoodi, Reem
INTRODUCTION The main objective of endodontic therapy is to prevent or cure apical periodontitis by shaping and cleaning the endodontic pulp space and provide three dimensional obturation. However, shaping and cleaning the entire canal system can be a challenge particularly in retreatment cases which are generally considered high difficulty endodontic cases. AIM The aim of this study is to assess endodontic retreatment outcomes in terms of quality of obturation, causes of endodontic failure and healing on a postgraduate clinic. MATERIALS AND METHODS A total number of 223 radiographs of patients who had received endodontic retreatment during the period (2008-2015) at Hamdan Bin Mohammed College of Dental Medicine- Mohammed Bin Rashid University were selected (For the period between 2008 to 2012 the Institute was called Boston University). Unreadable radiographs due to technical errors and superimposed anatomical structures, third molars, cases treated by faculty and incomplete treatments were all excluded. From the original sample of 223, in total 24 iii radiographs were discarded. The final sample thus consisted of 199 root canal fillings of 140 patients treated by the endodontic residents. All radiographs were individually evaluated for the density of the root filling and the distance between the end of the root canal filling and radiographic apex based on a six-point scoring system. Subsequently, teeth were reviewed and follow up periapical radiographs were exposed. The outcome of healing was assessed using the Periapical Index (PAI) scoring system. RESULTS The results of the study revealed that 78.9% of the endodontic retreatments were homogeneity and length acceptable. The corresponding figure was only 13.1% before endodontic treatment and was statistically significant. Conversely, homogeneity and length unacceptable before endodontic retreatment was 47.2% reducing to a mere 2.5% after retreatment. The results were statistically significant (P<0.001). CONCLUSION There was a significant improvement in outcome after endodontic retreatment on the postgraduate endodontic clinic. The success rate of endodontic retreatment was over 70% which is in line with the endodontic literature. Radiographic follow up confirmed some 60% improvement in healing rate following endodontic retreatment.
Association between type II diabetes and apical periodontitis: a critical review and before/after study on the outcome of endodontic treatment in an emirati adult population
(2020) AlMutawa, Alaa Tariq
The work presented here consists of two distinct parts. Part 1: A Critical Review of the literature Background: Diabetes has been found to be associated with increased risk of infections, impaired immune response and delayed wound healing. Studies have found that these complications contribute to an increased prevalence of periapical lesions and decreased endodontic success. Aim: To critically review the literature with regards to the association between apical periodontitis and diabetes. Materials and Methods: An extensive search was carried out using MEDLINE (ovid), Embase, Pubmed, The Cochrane Central Register Search of controlled trials, and Cochrane Reviews to identify suitable human-based studies. These studies included adult participants, a diabatic and a control group, and used a radiographic assessment of periapical radiolucency. Results: The critical review included 11 studies conducted between 1989 to April 2019. From these studies, 4 studies found a significantly higher prevalence of apical periodontitis in diabatic patients compared to non-diabatic patients before endodontic treatment while 7 studies found significantly higher prevalence of apical periodontitis after endodontic treatment in diabatic than non-diabatic cases. Conclusion: An association was found between diabetes and apical periodontitis before and after Endodontic treatment. Part 2: Association between Type II Diabetes and Apical Periodontitis before and after Endodontic Treatment in an Adult Population in the United Arab Emirates Background: Diabetes Mellitus is one of the most common systemic disorders. Diabetes Mellitus results in hyperglycemia which can affect the healing of the dental pulp. Clinical studies have shown a higher prevalence of periapical lesions in uncontrolled diabetes although the exact relationship is not clearly understood. Aim: To determine the association between Type II diabetes and apical periodontitis (AP) before and after Endodontic treatment in an adult population in the United Arab Emirates. The null hypothesis that Type II diabetes has no effect on the size of AP lesions was tested. Materials and methods: A sample of 50 patients with Type II diabetes were selected from a database in a specialist Endodontic unit who had received endodontic treatment on one tooth. These were matched in terms of age and gender with a non-diabetic control group who received Endodontic treatment on the same tooth. For each group, the size of the AP lesion was recorded using the Periapical Index (PAI) scoring system preoperatively and 1 to 4 years post endodontic treatment. The 50 diabetic patients were made up of 27 controlled and 23 uncontrolled (HbA1c value of 8% or higher) diabetics. Results: The mean PAI score for the uncontrolled diabetic group (n=23) prior to endodontic treatment was 3.3 compared to 2.3 for the matched non-diabetic control group. The Wilcoxon sign rank test revealed that this was statistically significant (p=0.002) indicating that uncontrolled Type II diabetes influences the size of the AP lesion. These figures were reduced to a mean PAI score of 1.9 in the uncontrolled diabetic group and 1.5 in the healthy control group in the post endodontic treatment periapical radiographs. The corresponding mean PAI value prior to endodontic treatment were 2.4 and 2.7 in the controlled diabetic patients and their matching control group respectively. The differences were not statistically significant (p=0.13). For the sample as a whole (n=50), the mean PAI value for both diabetic and non-diabetic groups reduced to 1.7 and 1.6 respectively post Endodontic periapical radiographs. The Wilcoxon sign rank test revealed a statistically significant improvement in healing in both these groups (p<0.001). PAI scores, prior to Endodontic treatment, were significantly higher in the uncontrolled diabetic group compared to the controlled diabetic group. In all cases the Endodontic treatment significantly reduced the size of the AP lesions.
Attitude and Use of Rubber Dam During Endodontic Procedures in the United Arab Emirates
(2017-08) Alnuaimi, Hind
Introduction: Rubber dam is an essential adjunct in endodontic treatment that was introduced as early as 1864. It prevents swallowing of medicament, instruments and irrigating solutions, debris and retracts soft tissue. Although it makes a significant difference to endodontic treatment success, surprisingly it is not used routinely by many General Dental Practitioners. Aim: To evaluate the attitude and the use of rubber dam during endodontic procedures by final year undergraduate dental students and General Dental Practitioners, in the United Arab Emirates. Materials and Methods A questionnaire, consisting of 16 questions, was designed and distributed among the target population of 100 final year undergraduate dental students of Ajman University. The same questionnaire was also disseminated among 90 General Dental Practitioners. As well as the use of rubber dam, the survey also focused on other related factors such as latex allergy. The data gleaned from the questionnaires were analysed and presented in tables or bar charts. Statistical tests were also applied to check for significant differences (p< 0.05). Results: The completed returned questionnaires 90 (90%) by undergraduate dental students and 89(99%) by General Dental Practitioners were tabulated and analysed to establish trends. It was found that rubber dam was used routinely by 91.1 % of the undergraduate dental students. This figure, however, dropped dramatically to 46% with General Dental Practitioners. One of the main reasons cited by General Dental Practitioners for not using rubber dam was that of patients’ preference. For endodontic treatment of posterior teeth, 95.5% of the undergraduate dental students used rubber dam compared with only 24.7% of the General Dental Practitioners and this was statistically significant (P < 0.05) . The study also revealed that only 70% of dental students intended to use rubber dam for endodontic procedures in practice after graduation. Conclusions: The use of rubber dam on posterior teeth was 95.5% among the undergraduate dental students compared with 24.7% with General Dental Practitioners. The corresponding figures for anterior teeth was 50% and 20.2% for undergraduate dental students and General Dental Practitioners, respectively. For General Dental Practitioners, it was found that the use of rubber dam decreased with increasing postgraduate experience.
Attitude of Ajman University Dental Undergraduate Students and Residents to Vital and Non-Vital Bleaching
(2017) Alzaabi, Aaesha
The management of tooth discoloration has become a challenge, especially as people are keeping their teeth for longer. Discoloration can affect both primary and secondary teeth alike. The causes of tooth discoloration are multifactorial with different parts of the tooth taking up different stains. Bleaching can improve the whiteness of teeth significantly and at the same time is considered to be a conservative aesthetic procedure. To evaluate the attitude of undergraduate dental students to vital and non-vital bleaching. Additionally, to review and identify the best evidence papers for single tooth bleaching. Objectives of the study was to evaluate the attitude of undergraduate dental students to vital and non-vital bleaching. Additionally, to review and identify the best evidence papers for single tooth bleaching. Materials and methods used for this study is in two parts. For the first part of the work, a 12-point questionnaire was designed and distributed among the target population of final year dental students and residents at Ajman University. As well as confidence in providing vital and non-vital bleaching, the survey also focused on a number of other issues such as opinion on delivery of bleaching by non-dental professionals and the teaching received on bleaching. The data gleaned from the questionnaire were analysed and presented in the form of tables and bar charts. Statistical tests were also applied to check for significant differences (P<0.05). The second part of the study was a comprehensive literature review to identify the best method for single tooth bleaching (intra-coronal bleaching). The results of the review were successfully applied to two single tooth bleaching cases. Results found that the completed returned questionnaires 201(100%) were analysed and the data tabulated. It was found that undergraduate dental students were more confident at providing vital than non-vital bleaching and this was statistically significant (P<0.000001). Eighty-four percent of the students agreed that vital bleaching was safe compared with 80% for non-vital bleaching. On the other hand, only 5% agreed that it was safe for beauty salons to provide bleaching. This finding was also statistically significant (P<0.00001). A literature search on intra-coronal bleaching yielded 78,588 papers. Two of these papers were deemed best evidence papers and they were clinical trials. Both papers compared the efficacy of different intra-coronal bleaching techniques. The bleaching protocols obtained from the papers was applied successfully to treating two complex cases of single tooth bleaching cases. It is concluded that undergraduate dental students were more confident in carrying out vital than non-vital bleaching. The great majority do not agree with the concept of beauty salons providing bleaching. Carbamide peroxide and sodium perborate can provide similar aesthetic results as hydrogen peroxide if applied correctly.
The best clean catch method to collect none contaminated sample in non-toileted child
(2021) Alteneiji, Meirah
Background: Urinary tract infection (UTI) is the most common bacterial infections affected infants and younger children. To discover UTI, urinalysis is the test used to identify bacteria in the urine. Urinalysis is examined by three methods, visual examination, microscopic exam, and dipstick test. The common methods for sampling in non-toilet-trained children involve clean catch, urine bag, urine pad, in-out catheterisation urine, and suprapubic aspiration. Aim: The aim of this literature review is to explore the best methods to collect CCU sample from non-toilet-trained child without contamination. Methodology: When searching the literature, the systematic approach method was used. The search strategy used PIO from (population, intervention, and outcomes). The search results were generated using three electronic databases relevant to the review: Cumulative Index to Nursing and Allied Health Literature (CINAHL), Medline, and PubMed. The quality of each study was evaluated using CASP tool. Searches were conducted between November 2020 to April 2021 because of the due of the deadline. An inclusion and exclusion criteria were established to determine which literature will be included in the review and which will be excluded. Included articles were eligible if they were in English language, full text article, published between 2010 and 2020, the sample is children or infants needs clean catch urine collection, nontoilet child and infants who need urine collection, and qualitative and quantitative papers and not systematic review. Results: Total of seven papers, four were randomised controlled trials and three were cohort studies addressed the clean catch method in non-toileted infants to collect none contamination urine sample. 9 Conclusion: The most used method to collect urine sample in this age is obtaining a cleancatch urine sample, however this method took an average of more than one hour to collect sample.
Changes In Children’s Oral-Health-Related Quality Of Life Following Dental Rehabilitation Under General Anesthesia In The United Arab Emirates
(2019) Obaid Al Antali, Kholoud
Background: Early Childhood Caries (ECC) is one of the most common childhood diseases in preschool children. Many young pediatric patients with ECC receive Dental treatment under Dental General Anesthesia (DGA). Changes in Oral Health-Related Quality of Life (OHRQoL) can be used to assess the outcome of DGA treatment. The aim of our study was to assess whether dental rehabilitation of young UAE children under DGA improved OHRQoL for children and their families. Materials and Methods: A cross sectional study, using a pre-and-post design survey to evaluate changes in OHRQoL following comprehensive dental treatment under GA was conducted. A total of 173 parents completed Early Childhood Oral Health Impact Scale (ECOHIS) before and three to six months after their children mean age 4.6 (+ 1.86 years) underwent comprehensive dental treatment under DGA by a specialist pediatric dentist in a pediatric dental clinic in Al Ain City, Abu Dhabi Emirate during a year period from 1st March 2017 to 28th February 2018. The ECOHIS and its effect size (ES) served to evaluate children's OHRQoL, the Wilcoxon signed-rank, Internal consistency and the Kruskal-Wallis test were used for statistical analyses. Results: A total of 244 patients who fulfilled the inclusion criteria were included in the study pre-operatively. However, 71 participants did not complete the post-operative questionnaire and a total number of 173 parents completed the pre- and post-operative ECOHIS questionnaires, and this accounted for 71% response rate. The mean dmft of the children prior to the treatment was 13.8 (+ 3.07). Pain and eating problems among children and parents feeling upset and guilty were the most frequently reported impacts at baseline. The overall ECOHIS scores decreased significantly (p < 0.001) after DGA treatment, revealing a large ES for the child (2.19) and family (2.79) sections of the ECOHIS. The change in the child’s self-image and social interaction scores was statistically related to their caries experience. Conclusion: DGA treatment resulted in significant improvement in all child and family physical, psychological and social aspects of oral health quality of life. There is a need for studies to involve more children including those with special needs and medically compromised children in all of the UAE emirates and also studies for surveying the effect of DGA on OHRQoL of school age children, with the questionnaires being completed by children themselves and not their parents/guardians.
Characteristics of pediatric dental treatment provided under general anesthesia in Dubai, United Arab Emirates - A retrospective analysis
(2021) Abdo, Mohammad Motea
Background: Dental general anesthesia (DGA) is a widely used technique in pediatric dentistry. Several researchers have examined their DGA cases and tried to pinpoint the primary cause leading to it. Furthermore, factors affecting the success rate of DGA are a widely investigated topic in the literature. However, in the UAE there is a notable paucity of properly conducted studies specifically relating to this subject. Aim: This study was set out to analyse characteristics of dental treatment provided for children under General Anesthesia (GA) and review any differences of treatment between Special Health Care Needs (SHCN) and healthy patients. Materials and Methods: A retrospective analysis was conducted on the data that was collected from the electronic records of all patients who underwent any dental treatment under GA in the period between January 1 st 2016 up until the 29th of February 2020. Data included sociodemographic status of patients, preoperative information such as diagnosis and justification of GA, intraoperative information including treatment details and duration, and post-operative information such as follow-up rates and morbidities. Results: The study population consisted of 98 patients. Majority of the sample were males (62.2%), and the mean age was 5.4 years. 26 out of the 98 children had a medical condition and were categorized as ASA II. Results of the study showed that the most common diagnosis leading to GA is Early Childhood Caries (ECC) and the most common justification is lack of cooperation due to young age. The study also showed that nearly half the patients missed their one-week, 3-months and 6-months follow-up visits. Further dental treatment was needed for 23 (23.5%) patients which were delivered under local anesthesia in the dental chair. Out of the 23 patient who received further treatment (60.9%) were due to new carious lesions. Four (4.08%) out of the 98 children had a repeat GA episode. SHCN patients received significantly more interventive measures and significantly less pulp therapies than healthy patients. The ratio of fissure sealants was 3.65 sealants per SHCN patient compared to 0.77 sealants per healthy child. Conclusion: A more comprehensive treatment plan which consists of fewer pulp therapies was adopted to treat SHCN children accompanied by a notable increase in preventive interventions when compared to healthy patients. Frequently missing recall appointments following DGA increased the likelihood of developing new carious lesions and consequently increased the need for further dental treatment.
Clinical Crown Length Changes and Gingival Recessioa Development in Anterior Teeth Associated with Orthodontic Treatment: A Systematic Review and Meta-Analysis
(2018) Bin Bahar, Budoor
AIM: To systematically investigate and appraise the quality of the available evidence regarding clinical crown length changes and gingival recession development following orthodontic treatment. MATERIALS AND METHOD: A search without restrictions for published and unpublished literature and hand searching was performed. Data on incisor clinical crown length changes and gingival recession development following orthodontic treatment were reviewed. Measurements before and after orthodontic treatment, as well as case-control studies, were considered. Relevant information was extracted, methodological quality was evaluated using the ROBINS-I tool (Risk Of Bias In Nonrandomized Studies of Interventions) and the random effects model was used to combine the retrieved data. RESULTS: Ten studies following patients for up to 6 years after orthodontic treatment were finally identified. Clinical crown length increased after orthodontic treatment and during retention. However, in general, no differences were noted iii between the groups that underwent proclination compared to the non-proclination group. Moreover, orthodontic treatment seemed to increase the odds for a patient to exhibit gingival recession in at least one tooth, compared to before treatment. In addition, orthodontic treatment seemed to increase the odds for a patient to exhibit gingival recession in at least one mandibular incisor, compared to before treatment or the untreated controls. CONCLUSIONS: The present systematic review and meta-analysis showed that some increases in gingival recession prevalence may be encountered after orthodontic treatment. Although clinical crown length increases during orthodontic treatment and retention, overall no statistically significant differences were noted between incisors having undergone proclination compared to the non-proclination group. More high quality studies are needed in order to further elucidate possible associations.
Clinical crown length, gingival recession development and sagittal inclination changes in incisors associated with orthodontic treatment: a retrospective study
(2018) Abdulkader, Shatha
AIM: To retrospectively investigate the clinical crown length changes and the development of gingival recession in the labial aspect of the maxillary and mandibular incisors associated with orthodontic treatment and relate them to the observed changes in their sagittal inclination. MATERIALS AND METHODS: Eighty-two consecutive subjects, treated by means of fixed orthodontic appliances in both dental arches, with good quality pre- and post-treatment dental casts and lateral cephalometric radiographs, were selected from the archives of a private orthodontic clinic. Incisor clinical crown length before and after orthodontic treatment, as well as the presence or absence of recession, were measured on digitized study models. Sagittal inclination changes were assessed on lateral cephalometric radiographs and categorized as proclination, retroclination or no change (±1°). Spearman’s correlation coefficient, one-way analysis of variance and chi-square tests were used for analysis. RESULTS: The mean change of clinical crown lengths for the maxillary incisors was from -0.24 to 0.01 mm, and for the mandibular, from 0.06 to 0.10 mm. The inclination changes were -1.78° and 1.03°, respectively, but no correlations were observed with changes in clinical crown length. Overall, no statistically significant differences were observed regarding clinical crown length changes and the presence of gingival recession between proclination, retroclination and no change groups. CONCLUSIONS: The change of incisor inclination during treatment did not seem to affect labial clinical crown length increases and gingival recession development in this specific sample.
Clinical Outcomes of Single Implant Supported Versus Implant Supported-Fixed Prostheses in Dubai Health Authority Clinic
(2019-08)
Background: Whether implant-supported fixed prostheses have worse clinical outcomes than single implant-supported prosthesesis controversial. Aim: This study aimed to assess the clinical outcomes of single implant-supported prostheses and implant-supported fixed prostheses placed in Al Badaa Dental Center in Dubai Health Authority (DHA). Materials and methods: This retrospective study compared biological and technical complications among single implant-supported prostheses and implant-supported fixed prostheses in a time framed sample of all patients who received dental implants between January 2009 and December 2016. Cantilevered implants, implants supporting complete dentures or removal partial dentures and any case involving a sinus lift procedure or bone grafting were excluded. The records of all eligible cases were assessed for prosthetic complications including screw loosening or fracture and ceramic de-lamination. Mesial and distal bone height around the implants were measured on digital radiographs by one examiner. Results: A total of 455 patients (151 males; 304 females) had 1673 implants. The mean age of males (53.7 years, SD 14.6) was significantly greater than that of females (49.3 years, SD 12.9, p< 0.001). The lower left and right posterior sextants were the most frequent sites for implants while the lower anterior sextant was the least common. Mean mesial crestal bone loss in implant supported-fixed prostheses was significantly greater (1.14mm, SD 0.63) compared to single implant-supported prostheses(0.30mm, SD 0.43,p<0.001).Mean distal crestal bone loss was also significantly greater (1.29mm, SD 0.71) in implant supported-fixed prostheses than in single implant-supported prostheses (0.36mm, SD 0.54,p<0.001). Mean crestal bone loss mesially and distally in patients with a medical condition (N=165) was significantly greater compared to medically fit patients (N=290, p<0.001). Mean mesial and distal bone loss was significantly greater around implants placed in the lower anterior sextant compared to all the other sites (p<0.001). A total of 66 cement retained implants had significantly more complications than expected compared to the 1607 screw retained implants (Fisher’s Exact test, p<0.001). Conclusion: Implant supported-fixed prostheses have greater bone loss than single implant-supported prostheses. Age, position in the mouth and having a medical condition are factors that influence bone loss.

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