Imran Farooq

Prevalence of dental caries in primary and permanent teeth and its relation with tooth brushing habits among schoolchildren in Eastern Saudi Arabia

Objectives: To determine the prevalence of dental caries in the primary and permanent teeth, and evaluate the brushing habits of school children in Dammam, Kingdom of Saudi Arabia (KSA). Methods: This study was conducted at Dammam, KSA. Oral examination of the participants was conducted from February to May 2014. The total sample size for this cross-sectional study was 711. There were 397 children between the age of 6-9 years, who were examined for primary teeth caries, and 314 between the age 10-12 years were examined for permanent teeth caries. Primary and permanent dentitions were studied for decayed, missing, and filled teeth (dmft [primary teeth], DMFT [permanent teeth]). Results: The overall prevalence of dental caries in primary and permanent teeth was almost 73% (n=711). Among the 6-9-year-old, the prevalence of caries was approximately 78% (n=397) whereas, among the 10-12-year-old children, it was approximately 68% (n=314). Mean dmft value among the 6-9-year-olds was 3.66±3.13 with decayed (d) component of 3.28±2.92, missing (m) component of 0.11±0.69, and filled (f) component of 0.26±0.9. Mean DMFT value among the 10-12-year-old children was 1.94±2.0 with decayed (D) component of 1.76±1.85, missing (M) component of 0.03±0.22, and filled (F) of component 0.15±0.73. Daily tooth brushing had a positive effect on caries prevention, and this effect was statistically significant for caries in primary teeth. Conclusion: Although the prevalence of dental caries in primary and permanent teeth was not found to be as high as other researchers reported from different cities of KSA, still the prevalence was high considering the World Health Organization future oral health goals. Awareness should be provided to students, as well as, teachers and parents regarding the importance of good brushing habits and regular dental visits.

In vitro dentin tubule occlusion and remineralization competence of various toothpastes

OBJECTIVES The purpose of this study was to evaluate dentin tubule occlusion and remineralization competence of various toothpastes containing fluoride, bioactive glass (BG), and hydroxyapatite (HAP) as active ingredients. MATERIALS AND METHODS Sixty dentin discs that were etched with ethylene-diamine-tetraacetic acid (EDTA) were randomly divided into nine groups. The first five groups containing eight dentin discs corresponded to subsequent brushing experiments: control, distilled water, fluoride toothpaste, BG toothpaste, and HAP toothpaste. Scanning electron microscopy (SEM) was used to demonstrate tubule occlusion after 7 days of simulated brushing (twice a day for 2min), which was followed by a citric acid challenge. The discs were stored in freshly prepared artificial saliva (AS) after every brushing cycle. The remaining four groups that contained five discs each received the following treatment: discs kept in distilled water (control), discs kept in a mixture of AS (pH 7.2) and 2g fluoride toothpaste, discs kept in a mixture of AS and 2g BG toothpaste, and discs kept in a mixture of AS and 2g HAP toothpaste. These discs were left in the mixture for one week at 37°C and were then examined under SEM. The pH of the leftover mixture was analyzed using a pH meter. The Wilcoxon signed-rank test was used to identify any statistically significant differences (p<0.05). RESULTS All toothpastes demonstrated tubule occlusion after simulated brushing experiments. However, after the citric acid challenge, particles of fluoride toothpaste were completely washed away from the tubules whereas HAP and BG toothpastes demonstrated tremendous resistance to the acid challenge. After immersion of the discs in the mixture of AS and toothpaste, HAP and BG toothpastes again showed superior tubule occlusion in comparison to the other groups, but the highest pH increase was observed for fluoride toothpaste after mixing the toothpastes in AS. CONCLUSION The results of this study demonstrate that the highest tubule occlusion competence (both pre-and post-citric acid challenge) was achieved by HAP toothpaste, followed by BG toothpaste. After mixing the toothpastes in AS, the highest pH increase was observed for fluoride toothpaste, showing its superior remineralization and buffering capacity.

A review of the effect of various ions on the properties and the clinical applications of novel bioactive glasses in medicine and dentistry

Bioactive glass is a novel material that dissolves and forms a bond with bone when exposed to body fluids. Bioactive glasses are silicate-based, with calcium and phosphate in identical proportions to those of natural bone; therefore, they have high biocompatibility. Bioactive glasses have wide-ranging clinical applications, including the use as bone grafts, scaffolds, and coating materials for dental implants. This review will discuss the effects of ions on the various compositions of bioactive glasses, as well as the clinical applications of bioactive glasses in medicine and dentistry.

A Micro-Computed Tomography Study of the Root Canal Morphology of Mandibular First Premolars in an Emirati Population

Objective: To investigate variations in the root canal morphology of mandibular first premolars in a population from the United Arab Emirates using micro-computed tomography (micro-CT) and conventional radiography. Materials and Methods: Three-dimensional images of 50 extracted human mandibular first premolars were produced using a micro-CT scanner, and conventional radiography was also used to record the number of roots, the root canal system configuration, the presence of a C-shaped canal system and lateral canals, intercanal communications, and the number and location of apical foramina. The interpretations of micro-CT and conventional radiography were statistically analyzed using Fishers exact test. Results: Variable root canal configurations based on Vertuccis classification were observed in the teeth (i.e., types I, III, IV, V, and VII). The examined teeth exhibited the following 2 additional root canal configurations, which did not fit Vertuccis classification: type 1-2-3 and type 1-3. A C-shaped canal configuration was present in 14 (28%) cases, and lateral canals were present in 22 (44%) cases. Apical deltas were found in 25 (50%) cases, intercanal communications were seen in 6 (12%) cases, and apical loops were seen in 2 (4%) of the samples. Micro-CT and X-ray imaging identified 39 (78%) and 34 (68%) apical foramina, respectively. A single apical foramen was detected in 33 (66%) samples, and 2 or 3 apical foramina were detected in 14 (28 %) and 3 (6%) samples, respectively. In 18.5 (37%) samples the apical foramina were located centrally, and in 31 (62%) they were located laterally. Conclusion: A complex morphology of the mandibular first premolars was observed with a high prevalence of multiple root canal systems.

Effect of software facilitated teaching on final grades of dental students in a dental morphology course

Objectives: To evaluate differences in students’ performance in a dental morphology course after the introduction of a 3D software-teaching program. Methods: This retrospective study took place at the College of Dentistry, University of Dammam, Dammam, Kingdom of Saudi Arabia, from Augst 2013 to January 2016. The study included 3 groups of students taking the course during 3 different academic years: group 1, 2013-14 control; group 2, 2014-2015; and group 3, 2015-2016. The total sample size was 294 (n = 294; group 1 = 94; group 2 = 100; and group 3 = 100). Group 1 =students did not receive teaching facilitated by a software program, but groups 2 and 3 students were provided with the program’s CDs. The final examination grades of the students were statistically analyzed, retrospectively Results: The results demonstrated that the students who received software-facilitated teaching (groups 2 and 3) performed better than the students who did not receive it (group 1). Within the same year for groups 2 and 3, the number of students achieving good grades (>80%) was significantly higher than the students who achieved average grades (<79%), with p-values of 0.012 for group 2 and 0.009 for group 3. Conclusion: There is a positive correlation between the use of a teaching software program for students and their performance in final examinations. The addition of computer-based learning, as one of the teaching methods, could demonstrably boost students’ learning.

In vitro evaluation of variances between real and declared concentration of hydrogen peroxide in various tooth-whitening products.

Abstract Objectives. The aim of this in vitro study was to analyze the real hydrogen peroxide (HP) concentration in various commercially available tooth-whitening products containing HP and/or carbamide peroxide (CP). Materials and methods. Sixteen commercially available tooth-whitening products containing various concentrations of CP or HP were investigated. The products were divided into four groups: dentist-supervised home bleaching products (Group 1, n = 5), in-office bleaching products (Group 2, n = 4), over-the-counter bleaching products (Group 3, n = 3) and whitening toothpastes and rinses (Group 4, n = 4). The peroxide concentration was determined using the oxy-reduction titration method. All the reagents used in the study were of analytic grade and freshly prepared before the experiment. Results. The HP concentration in various dentist-supervised home bleaching products and in-office bleaching products ranged from 3.02–37.08% (expected range = 3–38%). The HP concentration of over-the-counter whitening products ranged from 1.24–5.57% (expected range cannot be estimated as no concentration of active ingredient was provided). Among whitening toothpastes and rinses, Colgate Plax whitening rinse showed more than 1% HP concentration, whereas it was lower than 0.05% in other whitening toothpastes and oral rinses (expected range cannot be estimated as no active ingredient was mentioned). Conclusions. HP concentration of most of the professional tooth-whitening products was different from the expected concentrations, although the deviations were small and most of the products were close to the expected concentration. No concentration of active ingredient was provided for over-the-counter whitening products and no active ingredient was mentioned for whitening toothpastes and rinses.

Total and soluble fluoride concentration present in various commercial brands of children toothpastes available in Saudi Arabia – A pilot study

Objective The aim of this pilot study was to perform chemical analysis and investigate the total and soluble fluoride concentrations in various brands of children toothpastes. Materials and methods Three samples of five different commercial brands of children toothpastes were collected and divided into five groups; group A – Biorepair Oral Care toothpaste containing no fluoride (control), group B – Signal Kids Strawberry toothpaste having 500 ppm fluoride, group C – Aquafresh Milk Teeth toothpaste having 500 ppm fluoride, group D – Aquafresh Little Teeth toothpaste having 500 ppm fluoride, and group E – Siwak F Junior having 400 ppm F. The total fluoride (TF) and total soluble fluoride (TSF) concentration of the toothpastes was determined using fluoride ion selective electrode. Data were analysed using Paired sample t-test. Results The measured TF values were inconsistent with that of the declared concentrations by the manufacturers. Mean TF found in the toothpastes ranged between 2.37 and 515.74 ppm whereas, the mean TSF ranged between 2.00 and 503.4 ppm. For two groups, TF was more than the declared TF whereas for the other three groups, it was less than the declared concentration. All the differences between the declared and observed TF concentration were statistically significant (p < .05) except for one group. All the toothpastes demonstrated mean TSF slightly lower than their respective observed mean TF concentrations. Conclusion The analysis of TF and TSF concentrations revealed variations from the labelled claims. Therefore, some of the toothpastes may have doubtful anti-caries effectiveness owing to deficiency of total and soluble fluoride.

Cavity cutting efficiency of a BioglassTM and alumina powder combination utilized in an air abrasion system

This study investigated the attempt to replace alumina in the air abrasion system with an alternative material that is effective at cutting and also has remineralization potential. The powder samples were randomized into three groups: group 1—alumina (composed of aluminium and oxygen), group 2—45S5 (composed of 45% silica, 24.5% calcium oxide, 24.5% sodium oxide and 6% phosphorus pentoxide in weight percentage) and group 3—alumina + 45S5. Thirty human enamel blocks and microscope glass slides of 0.5 mm thickness were randomly divided into these three groups. The time taken to cut a hole through the glass slide and for the cutting of human enamel blocks was recorded, the cutting time was fixed at 15 s. The depths of the cavities were measured using a periodontal probe and the enamel blocks were then analysed by scanning electron microscope (SEM). The mean time taken to cut a hole through the microscope glass slide was 2.96, 23.01 and 3.02 s for groups 1, 2 and 3, respectively. After cutting the human enamel blocks, the mean cavity depths produced were measured to be 2.5, 1.0 and 2.0 mm for groups 1, 2 and 3, respectively. The SEM micrographs revealed that the cavities formed by 45S5 were more conical in shape, whereas cavities produced by alumina and alumina + 45S5 were more cylindrical. The combined use of alumina and 45S5 has demonstrated a promising cutting efficiency and it has the potential to achieve effective cutting with the possibility of the remineralization.

An observation of the concentration and type of fluoride compound present in "over-the-counter" adult toothpastes available in Saudi Arabia

Objectives: This study was performed to observe the type and level of fluoride compounds existent in ′over-the-counter′ (OTC) adult toothpastes available in the open market of Saudi Arabia and to compare them with local and international guidelines. Materials and Methods: More than 100 hyper stores, shops and pharmacies of Dammam and Al Khobar cities were selected randomly and searched for the availability of fluoride containing adult toothpastes. Only toothpastes in which fluoride was present as an active ingredient were included and name of the compound of fluoride and its concentration stated on the packaging of the toothpaste were noted. Results: There were 59 different commercial brands of OTC toothpastes in which sodium fluoride was found in 59.3% of the toothpaste brands (35 of 59), 32.2% of the brands (19 of 59) had sodium monofluorophosphate, 3.3% toothpaste brands (2 of 59) had a combination of sodium fluoride and sodium monofluorophoshpate as an active ingredient, and 5% of the brands (3 of 59) mentioned the fluoride concentration in parts per million (ppm) but did not indicate the type of compound of fluoride present in them. Fluoride concentration found in toothpastes ranged between 1,000-1,470 ppm. Conclusions: Types of fluoride compounds found in toothpastes were consistent with internationally published guidelines. However, majority of toothpastes had 1,450 ppm fluoride which was consistent with Gulf Cooperation Council (GCC) and European guidelines but exceeded the normal range set by United States Food and Drug Administration (US-FDA) and American Dental Association (ADA). Care should be taken when these toothpastes are being used to prevent possible side-effects of fluoride over-exposure.

Should Surgical Burs Be Used as Single-Use Devices to Avoid Cross Infection? A Case-Control Study

Objective: The purpose of this study was to evaluate and compare the rate of bacterial contamination of reused and new unused burs after different sterilization sessions. Materials and Methods: The test group consisted of 40 used fissure burs, and the control group of 40 unused new fissure burs (total n = 80). The burs from both groups were precleaned according to standard protocols and then subjected to two sterilization sessions (high- and low-steam pressure autoclaving). After each sterilization session, the burs were transferred into incubation tubes which contained thioglycollate culture medium and were monitored daily for a period of 48 h to detect any bacterial growth. Data were collected and statistical analysis was done using Fishers exact test. Results: Of the 40 burs of the test group, 2 burs (5%) showed positive bacterial growth, whereas no bur from the control group showed any sign of bacterial growth after high-pressure autoclaving. The colony structure and Gram staining were compatible with the growth of Staphylococcus epidermis. After a second sterilization session at low-pressure steam autoclaving, no bacterial growth was observed for the test group, but 1 bur (2.5%) from the control group showed bacterial growth and Gram-positive staining matched well with the growth of Brevibacterium species. Conclusions: The new and unused burs were 100% sterile after high-pressure steam autoclaving, whereas 5% of the reused burs appeared positive with bacterial contamination. After low-pressure steam autoclaving, reused burs were 100% sterile, but 1 new bur demonstrated bacterial contamination.