Ibrahim Alshahrani

3D-Geomorphometrics tooth shape analysis in hypodontia

Assessment of tooth morphology is an important part of the diagnosis and management of hypodontia patients. Several techniques have been used to analyze tooth form in hypodontia patients and these have shown smaller tooth dimensions and anomalous tooth shapes in patients with hypodontia when compared with controls. However, previous studies have mainly used 2D images and provided limited information. In the present study, 3D surface-imaging and statistical shape analysis were used to evaluate tooth form differences between hypodontia and control patients. Eighteen anatomical landmarks were recorded on the clinical crown of the lower left first permanent molar of 3D scanned study models of hypodontia and control subjects. The study sample group comprised of 120 hypodontia patients (40 mild, 40 moderate, and 40 severe hypodontia patients) and 40 age- and sex-matched controls. Procrustes coordinates were utilized to scale and superimpose the landmark coordinate data and then were subjected to principal component analysis (PCA). Subsequently, differences in shape as well as size were tested statistically using allometric analysis and MANOVA. Significant interaction was found between the two factor variables “group” and “sex” (p < 0.002). Overall expected accuracies were 66 and 56% for females and males, respectively, in the cross-validated discriminant-analysis using the first 20 PCs. Hypodontia groups showed significant shape differences compared with the control subjects (p < 0.0001). Significant differences in tooth crown shape were also found between sexes (p < 0.0001) within groups. Furthermore, the degree of variation in tooth form was proportional to the degree of the severity of the hypodontia. Thus, quantitative measurement of tooth shape in hypodontia patients may enhance the multidisciplinary management of those patients.

Conversion of palatal rugae pattern to scanable Quick Response code in an Arabian population

Backgroud/purpose Palatal rugae (PR) are situated in the anterior part of the hard palate and possess unique and stable characteristics that can be used in human identification. Their pattern of orientation is established early in life and remains stable thereafter. The purposes of this study were to convert PRP into alphanumeric codes in order to generate scanable Quick Response (QR) codes, to demonstrate uniqueness of PRP using the codes in the study population, and to determine the sexual dimorphism of PRP in the study population. Materials and methods Orthodontic dental casts of 256 Saudi male and female patients were photographed after ensuring standardization. Individual rugae characteristics, strength and their displacement from incisive papilla and midpalatine raphe were recorded in the form of an alphanumeric code which was subsequently converted to a QR code. Computer assisted check was performed for possible match in the 256 alpha numeric codes while QR codes were scanned using a bar code scanner to determine uniqueness. Sexual dimorphism of palatal rugae (PR) was also analysed. Results All alphanumeric codes of the study population were unique. Mean number of PR in males and females differed significantly (P = 0.0001). Differences in rugae characteristics and strengths in males and females were also present. Conclusion The alphanumeric and QR code of the rugae pattern are unique for each individual and can be used for digital record keeping and person identification. A high degree of sexual dimorphism in PR exists in the studied Arab population studied.

Effect of two-step and one-step surface conditioning of glass ceramic on adhesion strength of orthodontic bracket and effect of thermo-cycling on adhesion strength

PURPOSE The adhesion strength of orthodontic brackets bonded to dental glass ceramics was evaluated after ceramic surface was treated with two-step and one-step surface conditioning systems, and subjecting to thermo-cycling. MATERIALS AND METHOD A total of forty specimens were fabricated from silica based glass ceramic (lithium disilicate) by duplicating the buccal surface of maxillary first premolar. The specimens were randomly assigned to two experimental groups (n = 20), group one specimens were treated with two-step surface conditioning system (IPS ceramic etching gel™ and Monobond plus™) and group two specimens were treated with one-step surface conditioning system (Monobond etch and prime™). The surface roughness of the specimens after treatment with two-step and one-step surface conditioning system was measured using non-contact surface profilometer. Ten randomly selected specimens from each group were subjected to thermo-cycling and the remaining ten served as baseline. The shear bond strength of the specimens was measured using universal material testing machine. The adhesive remnant index score was calculated, and the results of surface roughness and bond strength were tabulated and subjected to analysis of variance and post hoc tukeys test at a significance level of p < 0.05. RESULTS The results of the study showed that the specimens treated with two-step conditioning system had higher surface roughness and bond strength than one-step conditioning system. The majority of the specimens treated with both two-step and one-step conditioned specimens showed adhesive failure after subjecting thermo-cycling. CONCLUSIONS Traditional two-step conditioning provides better bond strength. The clinical importance of the study is that, the silane promoted adhesion significantly reduces on exposure to thermo-cycling.

Efficacy of Yttrium (III) Fluoride Nanoparticles in Orthodontic Bonding

Our study evaluated the adhesion strength and antibacterial effect of a conventional orthodontic composite resin blended with yttrium fluoride (YF₃) nanoparticles. Yttrium fluoride nanoparticles (NP) were added to the conventional orthodontic composite resin (Transbond XT) at concentrations of 1%, 2%, and 3% (w/w), and the blended composite resins were labeled as NP1, NP2, and NP3, respectively. A total of 60 extracted human premolars was randomly allocated to four groups of 15 samples (n = 15). Orthodontic brackets were bonded using the conventional (control) and experimental composite resins (NP1, NP2, and NP3). The adhesion strengths of the composite resins were determined using a universal testing machine. The debonding sites were assessed and scored using the adhesive remnant index (ARI). The antibacterial effect of YF₃ nanoparticles against Streptococcus mutans was assessed by the viable cell counting method. For the same, 40 composite disc specimens were prepared using the control and experimental composite resins (n = 10). The data was analyzed by one-way ANOVA and Tukeys post hoc analysis. In all the tests, the significance level was determined to be 0.05. The highest adhesion strength values were found in the control group (11.61±0.23) and the lowest values were found in the NP3 group (10.49±0.17). A significant difference was observed between the control and experimental groups, NP2 and NP3 (P < 0.05). NP1 group showed insignificant (P = 0.388) adhesion strength values compared with the control group. There was no significant difference between the ARI scores of the conventional and experimental groups (P > 0.05). The highest colony forming units (CFU) were found in the control group (75.85±1.15) and the lowest CFU were found in the NP1 group (2.24±1.14). A significant difference between the mean CFU of the conventional and experimental composite groups was observed (P < 0.05). Despite higher antibacterial activity in the NP1 group compared with NP2 (P = 0.146) and NP3 (P = 0.117), the difference was not significant. Similarly, no significant difference was observed between NP2 and NP3 groups (P = 0.97). Our results suggested that yttrium fluoride nanoparticles, blended with a conventional resin at 1% concentration, demonstrated significant antibacterial effect and did not compromise adhesion strength.

Prevalence of dental caries among male students aged 15–17 years in southern Asir, Saudi Arabia

Background Dental caries had been studied by several studies in Saudi Arabia among different age groups and at various places. According to World Health Organization (WHO), assessment of caries at 15 years of age is more meaningful. The objective of this survey was to assess the prevalence of dental caries among 15–17-year teenage students in Abha, Saudi Arabia. Results of the present study can be used as baseline data for future oral health interventions for the population. Methods A stratified cluster random sampling was followed in selecting the students. The clinical data was collected using dentition status component of WHO oral health assessment form 2013. Five investigators were trained and calibrated with 20 subjects for two successive days (Cronbachs Alpha = 0.91). Data was analyzed for descriptive statistics and Mann-Whitney U test was applied to compare the DMFT scores. Results Prevalence of dental caries among the study population was found to be 72.9%. The DMFT scores were found to be highest in the posteriors (90.7%). First permanent molar was the most common tooth affected by dental caries in all quadrants. Conclusion The present study revealed that there is a high prevalence of dental caries among students aged 15–17 years in Abha, Saudi Arabia. Caries prevalence was highest in mandibular posterior segments, however, it was lowest in mandibular anterior segments. There is an urgent need for both preventive and curative dental health services in the region. It is recommended that a coordinated school dental program may be initiated in the area.

Biomolecular phases in transverse palatal distraction: A review

Transverse palatal distraction is a biological process of regenerating new bone and enveloping soft tissues in the maxillary palate region. This technique is similar to Osteo-distraction (OD) procedure for bone lengthening in which gradual and controlled traction forces are applied on the osteotomy gaps to produce new bone in between the surgically separated bone segments. This review describes the different phases after osteotomy and the biological process involved during the new bone and soft tissue formation. The mechanical environment formed in the distraction area is due to the traction forces by the distractor appliance. This environment stimulates differentiation of pluripotent cells, neovascularization, osteogenesis and remodeling of newly formed bone. The role of different pro-inflammatory cytokines, interleukins, bone morphogenic proteins, transforming growth factors, fibroblast growth factors-2) and extracellular matrix proteins (osteonectin, osteopontin) during the distraction phases has been described in detail. Also, an important note on the nutritional aspect during Osteo-distraction will benefit the clinicians to guide their patients after osteotomy throughout the distraction process.

Knowledge, attitude, and behavior related to use of miswak (Chewing Stick): A cross-sectional study from aseer region, Saudi Arabia

Aim: The aim of this study was to assess the oral health knowledge, behavior, and practices related to use of miswak (chewing stick) in population of Aseer Region, Saudi Arabia. Subjects and Methods: Of the 2023 participants, 1666 (83.3%) were females and 334 (16.7%) were males. The questionnaires having 10 online questions were used to assess the knowledge of oral hygiene methods, including frequency, reason, and methods for miswak use. Statistical Analysis Used: The survey data were collected and organized into Microsoft Excel spreadsheets (Microsoft Inc., USA) and were statistically analyzed utilizing the Statistical Package for the Social Sciences version 20.0 software (IBM Inc., USA). The statistical test used here was the Chi-square test, and P < 0.05 was considered to be statistically significant (P < 0.05). Results: Participants responded regarding the primary oral hygiene methods; 46.5% respondents used toothbrushes, 44.5% used both toothbrushing and miswak, and 8% used only miswak as their primary tooth cleaning method. 28.2% respondents cleaned their teeth with tooth brush or miswak at least once a day, 37.6% twice, 28.4% whenever required, and 5.9% infrequently. Majority of the participants, i.e. 70.2% were using miswak with taper and as a brush to clean all tooth surfaces. About 84.7% feel fresh, and teeth are whiter after the use of miswak. Nearly, 84.7% prefer to continue using miswak in combination with other teeth cleaning methods, which may have more benefits. Conclusions: In our study, most common type of oral hygiene method employed is toothbrush and in combination with miswak. Chewing stick use was common among participants with religious advice being the dominant reason for usage.

Ellis-van Creveld Syndrome: A Rare Clinical Report of Oral Rehabilitation by Interdisciplinary Approach

Ellis-van Creveld syndrome (EVC) is a very rare genetic disorder that affects various tissues of ectodermal and mesodermal origin; patients with EVC present with typical oral deficiencies. The affected individuals are quite young at the time of oral evaluation. It is, therefore, important that these individuals are diagnosed and receive dental treatment at an early age for their physiologic and psychosocial well-being. Albeit there are numerous articles penned on the EVC, the treatise from an oral perspective is inadequate, covering only oral exhibitions and the preventive treatments. This article reviews the literature and serves as the first disquisition for oral rehabilitation of an EVC patient utilizing surgical, orthodontic, restorative, and prosthodontic management.

Perception of professional female college students towards smile arc types and outlook about their appearance

Aims and Objectives: The aim of this study is to assess the perception of female students about the type of smile arc as well as their outlook about different parameters of esthetics. Materials and Methods: A study was conducted among female students of King Khalid University, Abha, Saudi Arabia. One section of the questionnaire contained pictures having three types of smile arc wherein the respondents had to select any response ranging from 1 to 4 (1 for beautiful, 2 for good, 3 for average, and 4 for poor); besides it included 12 questions regarding the viewpoints of respondents about their smile and dental esthetics. The collected data were analyzed using the statistical package for social services version 16.0 (SPSS Inc., Chicago, IL, USA, 2001). Results: The dental students accounted for least mean score of 1.807 ± 0.8174 for consonant smile arc while it was 2.692 ± 0.8053 and 2.235 ± 0.9074 for information technology (IT) and medical students, respectively. When the individuals were asked whether they had a pleasant smile or not; only 53.8% of the dental students, 76.9% of the IT students, and 66.7% of the medical students responded positively. Conclusion: It was concluded that most of the female dental students were able to identify the consonant smile arc as being more beautiful than the flat and reverse smile arcs whereas lesser medical and IT students could perceive the smile arcs in the same manner. It was also observed that almost all the study participants were quite conscious about their smile attractiveness and dental esthetics.

Study cast measurements in the assessment of incisor crowding among patients attending dental clinics in Abha city, Saudi Arabia

Introduction: Demand for orthodontic treatment is increasing in Saudi Arabia. An observational study was planned to assess the incisor crowding in maxillary and mandibular arch among Saudi males and females reporting to different dental clinics in Abha city, Kingdom of Saudi Arabia (KSA). Materials and Methods: A cross-sectional study was conducted. Five hundred and thirty-two study casts of males and females aged between 16 and 35 years without a previous history of extraction of permanent teeth were included in the study. Labiolingual linear displacement of anatomic contact points of each maxillary and mandibular incisor from the adjacent tooth was measured. Right canine mesial aspect to the left canine mesial aspect was examined for five displacements. Results: There was a high prevalence of incisor crowding observed in the study population. Sixty-four percent (342 out of 532) casts showed bi-maxillary crowding, 14% (75 out of 352) showed mandibular, and 8.1% (43 out of 532) showed maxillary crowding. About 13.6% (72 out of 532) of the study population had well-aligned maxillary and mandibular incisors while 86.4% (460 out of 532) had some degree of incisor crowding. Females had more incisor crowding (48.5%-258 out of 532) than males (37.9%-202 out of 532). Conclusion: High prevalence of incisor crowding in Abha region reported in this study necessitates long-term planning and preventive measures for the adolescent population and treatment of the adult population of the Abha city, KSA.