Mahmoud K. AL-Omiri

Antibiotic prescribing practices by dentists: a review

Antibiotics are prescribed by dentists for treatment as well as prevention of infection. Indications for the use of systemic antibiotics in dentistry are limited, since most dental and periodontal diseases are best managed by operative intervention and oral hygiene measures. However, the literature provides evidence of inadequate prescribing practices by dentists, due to a number of factors ranging from inadequate knowledge to social factors. Here we review studies that investigated the pattern of antibiotic use by dentists worldwide. The main defects in the knowledge of antibiotic prescribing are outlined. The main conclusion is that, unfortunately, the prescribing practices of dentists are inadequate and this is manifested by over-prescribing. Recommendations to improve antibiotic prescribing practices are presented in an attempt to curb the increasing incidence of antibiotic resistance and other side effects of antibiotic abuse.

Fracture resistance of teeth restored with post-retained restorations: an overview.

INTRODUCTION Posts have been used efficiently to retain restorations for badly destructed teeth. This article critically analyzes the concerned topics related to the fracture resistance of teeth restored with dowel-retained restorations. METHODS A systematic review of PubMed/MEDLINE, Cochrane, and Scopus databases was completed (from 1960 to 2010). Single or combined key words were used to obtain the most possible comprehensive list of articles. Checking the references of the relevant obtained sources completed the review along with a manual search to locate related articles on the topic. In vivo and ex vivo (laboratory, computer-based finite element, and photoelastic stress analysis studies) investigations related to the topic were included. RESULTS Many factors have been proposed to influence the fracture resistance of post-restored teeth. Recognizing the significance of these factors on the fracture resistance of teeth would aid in choosing the suitable treatment modality for every individual case. Fracture resistance was improved if tooth structure loss was limited, a ferrule was obtained, a post with similar physical properties to natural dentine was used, and adhesive techniques for post luting and coronal restoration were used. Adhesively luted resin/fiber posts with composite cores appear to be the best currently available option in terms of tooth fracture and biomechanical behaviour. CONCLUSIONS Most guidelines were based mainly on ex vivo studies and to a lesser extent on limited in vivo studies. The lack of long-term controlled randomized clinical studies was the main hindrance to reaching a conclusive and undisputable opinion regarding endodontic posts in terms of tooth fracture and biomechanical behaviour.

Satisfaction with dental implants: a literature review.

Recent years have witnessed a consistent trend toward the introduction of patient assessment of different treatment outcomes in dental practice. Patient satisfaction with dental implants was considered among these treatment modalities. Few literature reviews have been published on this topic. This article critically analyzes the concerned topics related to patient satisfaction with dental implant. A MEDLINE search was completed from 1983 to 2004, along with a manual search, to locate related articles on the topic. Dental implants provided promising and predictable results regarding patient satisfaction and various aspects of life assessment.

Fracture resistance of teeth restored with different post systems: in vitro study

OBJECTIVES The objective of this study was to investigate fracture resistance and mode of failure of teeth restored with different prefabricated post systems. STUDY DESIGN Thirty teeth were collected, sectioned 15 mm from the apex, root canal prepared, and randomly allocated into 3 groups as follows: glass fiber posts (group 1), carbon fiber posts (group 2), and Radix-Anchor titanium posts (group 3). Teeth were then restored with a composite core and tested using a universal testing machine at 10 mm/min cross-head speed. Mode of failure was identified as either reparable or irreparable (catastrophic). RESULTS Mean values of fracture forces (N) for teeth restored with Radix posts (571.6) were statistically significantly higher than teeth restored with either carbon fiber (420.6) or glass fiber posts (393.9). There were 86.67% of fractures that were catastrophic in nature. CONCLUSIONS Teeth restored with Radix-titanium posts were more resistant to fracture than those restored with either carbon or glass fiber posts. Most of the fracture modes were catastrophic in nature.

Risk indicators of postoperative complications following surgical extraction of lower third molars.

Objective: The aim of this prospective clinical trial was to evaluate the incidence of postoperative complications following surgical extraction of lower third molars (L8) and the risk factors and clinical variables associated with these complications. Subjects and Methods: Three-hundred and twenty-seven consecutive patients (128 men and 199 women, mean age = 23.1 ± 3.9 years, range: 18–40) were recruited to this study. The L8 of all the patients were surgically extracted. Immediate and late complications like pain, swelling, trismus, paresthesia, bleeding, dry socket, infection and fracture were assessed 3 and 7–14 days, respectively, following the surgery. Results: The most frequent immediate and late complications were slight pain, swelling, and trismus. Thirty-nine (11.9%) patients reported dry socket and 10 (0.3%) reversible sensory nerve complications. More immediate and late complications were experienced by females (p = 0.000 and 0.016, respectively). Older subjects reported more late complications. Frequent immediate and late complications were associated with preexisting pericoronitis, longer duration of operation, extraction of two molars, flaps with vertical incision, extractions with bone removal, extractions without tooth sectioning and distoangular impactions (p ≤ 0.05). Linear regression analysis showed that the above factors were able to predict postoperative complications. Conclusion: The most frequent immediate and late complications were slight pain, swelling, and trismus. Preoperative complaints, angulation of the impacted molars, duration of surgery, type of surgical flap, the need for bone removal and tooth sectioning could predict and had an impact on the incidence of postoperative complications following L8 removal. Females and older patients were likely to have more postoperative complications following surgical extraction of L8.

Quantification of tooth wear: Conventional vs new method using toolmakers microscope and a three-dimensional measuring technique

OBJECTIVES This study aimed to evaluate the reliability of a new CAD-CAM Laser scanning machine in detection of incisal tooth wear through a 6-month period and to compare the accuracy of using this new machine against measuring tooth wear using tool maker microscope and conventional tooth wear index. METHODS Twenty participants (11 males and 9 females, mean age=22.7 years, SD=2.0) were assessed for incisal tooth wear of lower anterior teeth using Smith and Knight clinical tooth wear index (TWI) on two occasions, the study baseline and 6 months later. Stone dies for each tooth were prepared and scanned using the CAD-CAM Laser Cercon System (Cercon Smart Ceramics, DeguDent, Germany). Scanned images were printed and examined under a toolmaker microscope (Stedall-Dowding Machine Tool Company, Optique et Mecanique de Precision, Marcel Aubert SA, Switzerland) to quantify tooth wear and then the dies were directly assessed under the microscope to measure tooth wear. The Wilcoxon Signed Ranks Test was used to analyse the data. RESULTS TWI scores for incisal edges were 0, 1, and 2 and were similar at both occasions. Scores 3 and 4 were not detected. Wear values measured by directly assessing the dies under the tool maker microscope (range=517-656microm, mean=582microm, and SD=50) were significantly more than those measured from the Cercon digital machine images (range=132-193microm, mean =165microm, and SD=27) and both showed significant differences between the two occasions. CONCLUSIONS Measuring images obtained with Cercon digital machine under tool maker microscope allowed detection of wear progression over the 6-month period. However, measuring the dies of worn dentition directly under the tool maker microscope enabled detection of wear progression more accurately. Conventional method was the least sensitive for tooth wear quantification and was unable to identify wear progression in most cases.

Anxiety due to Dental Treatment and Procedures among University Students and Its Correlation with Their Gender and Field of Study

Aim of Study. To investigate dental anxiety levels among university students and its relation with their specialty and gender. Materials and Methods. 850 undergraduate university students were recruited into the study. The Modified Corah Dental Anxiety Scale (MDAS) was used to measure the levels of their dental anxiety. 700 questionnaires were returned, 390 females and 310 males (response rate of 0.92% among females, 0.73% among males). The MDAS score ranged from 5 to 25. Patients were considered to suffer from high dental anxiety if they scored 13 to 20 points. Statistical analysis significance was set at P ≤ 0.05. Results. Seven hundred students participated in this study including 13% of medical students, 10% of dental students, 58% of arts students, and 18% of computer science students. Medical and dental students were less anxious than arts and computer science students (P < 0.05). Local anesthesia injection was the most fearful dental procedure (P < 0.05). Females were more anxious than males (P < 0.05). Conclusion. Male students were less anxious than female students. Students from medical background faculties were less anxious than students from nonmedical faculties. Lack of adequate dental health education may result in a higher level of dental anxiety among nonmedical students in Saudi Arabia.

Smoking‐cessation practice guidelines: awareness and implementation among medical teams

Objectives The aim was to evaluate the awareness and implementation of the Smoking Cessation Clinical Practice (SCCP) guidelines.

A Survey of Standard Protocols for Endodontic Treatment in North of KSA

The objective of this study was to collect information regarding methods, materials, and attitudes employed during the endodontic treatment by dentists in north of Saudi Arabia. A questionnaire was designed and distributed among 300 dentists in north of Saudi Arabia to collect the data about the standard protocols of endodontic treatment. The collected data was analyzed by using the SPSS 10 computer software. Out of a total of 300 surveyed dentists, the 66% response rate showed that this study was true representation of the endodontic treatment performed by the dentists in north of Saudi Arabia. 152 (76%) were general dentists and 48 (24%) were endodontists. 18 (9%) were using rubber dam as the method of isolation during endodontic treatment. 173 (86.5%) were using only measurement radiographs for working length determination and 27 (13.5%) were using both electronic apex locator and measurement radiographs. 95 (47.5%) of the respondents were using standardized technique and 25 (12.5%) were using step-down as a root canal preparation technique. 127 (63.5%) of the respondents were using lateral condensation technique, with gutta percha points for root canal obturation.

Ozone treatment of recurrent aphthous stomatitis: a double blinded study.

This study aimed to evaluate the use of ozone to treat recurrent aphthous stomatitis (RAS). Consecutive sixty-nine participants with RAS were recruited into this non-randomized double blind, controlled cohort observational study (test group). A control group of 69 RAS patients who matched test group with age and gender was recruited. RAS lesions in test group were exposed to ozone in air for 60 seconds while controls received only air. Ulcer size and pain were recorded for each participant at baseline and daily for 15 days. Ulcer duration was determined by recording the time taken for ulcers to disappear. The main outcome measures were pain due to the ulcer, ulcer size and ulcer duration. 138 RAS participants (69 participants and 69 controls) were analyzed. Ulcer size was reduced starting from the second day in test group and from the fourth day in controls (p ≤ 0.004). Pain levels were reduced starting from the first day in the test group and from the third day in controls (p ≤ 0.001). Ulcer duration, ulcer size after day 2 and pain levels were more reduced in the test group. In conclusion, application of ozone on RAS lesions for 60 seconds reduced pain levels and enhanced ulcers’ healing by reducing ulcers’ size and duration.