Sahar F. Albarakati

The reliability and reproducibility of cephalometric measurements: a comparison of conventional and digital methods

OBJECTIVE The aim of this study was to assess the reliability and reproducibility of angular and linear measurements of conventional and digital cephalometric methods. METHODS A total of 13 landmarks and 16 skeletal and dental parameters were defined and measured on pre-treatment cephalometric radiographs of 30 patients. The conventional and digital tracings and measurements were performed twice by the same examiner with a 6 week interval between measurements. The reliability within the method was determined using Pearsons correlation coefficient (r²). The reproducibility between methods was calculated by paired t-test. The level of statistical significance was set at p < 0.05. RESULTS All measurements for each method were above 0.90 r² (strong correlation) except maxillary length, which had a correlation of 0.82 for conventional tracing. Significant differences between the two methods were observed in most angular and linear measurements except for ANB angle (p = 0.5), angle of convexity (p = 0.09), anterior cranial base (p = 0.3) and the lower anterior facial height (p = 0.6). CONCLUSION In general, both methods of conventional and digital cephalometric analysis are highly reliable. Although the reproducibility of the two methods showed some statistically significant differences, most differences were not clinically significant.

Career characteristics and postgraduate education of female dentist graduates of the College of Dentistry at King Saud University, Saudi Arabia

OBJECTIVES The aims of this study were to investigate the number of female bachelor of dental surgery graduates who earned postgraduate education degrees from King Saud University, their specialties, degrees of qualification, and countries of graduation. METHODS A questionnaire survey was conducted through face-to-face or phone interview among 677 female dentists who graduated from the College of Dentistry at King Saud University between 1984 and 2006. RESULTS Five hundred forty-five (81%) graduate female dentists responded, of whom 54% had completed postgraduate dental education. In the Saudi Board, 17% had obtained degrees in advanced restorative dentistry, 15% in pediatric dentistry, 14% in advanced general dentistry, 11% in orthodontics, 10% in prosthodontics, 8% in operative dentistry, 5% in endodontics, 5% in periodontics, 3% in oral and maxillofacial surgery, and 11% in other specialties. Fifty-nine percent had masters degrees, 7% had doctorates, 32% had board certificates, and 2% had fellowship certificates. CONCLUSION More than half (54%) the female dentists surveyed had pursued postgraduate education. This investigation highlighted the different specialties enrolled by female dentists. Orthodontic post graduate program displayed the highest percentage of interest. Understanding the unavoidable social family needs and the demand for higher education by female dentists provides ideas as more programs should be planned to accommodate the needs of Saudi female dentists. This type of study should be repeated due to the increasing interest of female dentists in higher education.

Computational fluid dynamics analysis of the upper airway after rapid maxillary expansion: a case report.

BackgroundAssessment of the upper airway volume, morphology, and mechanics is of great importance for the orthodontic patient. We hypothesize that upper airway dimensions have significant effects on the dynamics of the airway flow and that both the dimensions and mechanics of the upper airway are greatly affected by orthodontic and orthopedic procedures such as rapid maxillary expansion (RME). The aim of the current study was to assess the effect of RME on the airway flow rate and pattern by comparing the fluid dynamics results of pre- and post-treatment finite element models.MethodsCustomized pre- and post-treatment computational fluid dynamics models of the patient’s upper airway were built for comparison based on three-dimensional computed tomogram. The inhalation process was simulated using a constant volume flow rate for both models, and the wall was set to be rigid and stationary. Laminar and turbulent analyses were applied.ResultsComparisons between before and after RME airway volume measurements showed that increases were only detected in nasal cavity volume, nasopharynx volume, and the most constricted area of the airway. Pressure, velocity, and turbulent kinetic energy decreased after dental expansion for laminar and turbulent flow. Turbulent flow shows relatively larger velocity and pressure than laminar flow.ConclusionsRME showed positive effects that may help understand the key reasons behind relieving the symptom of breathing disorders in this patient. Turbulence occurs at both nasal and oropharynx areas, and it showed relatively larger pressure and velocity compared to laminar flow.

Live demonstration versus procedural video: a comparison of two methods for teaching an orthodontic laboratory procedure

BackgroundTo measure the effectiveness of procedural video compared to live demonstration in transferring skills for fabricating orthodontic Adam’s Clasp.Materials and MethodsForty-nine fourth-year undergraduate male dental students were randomly assigned to two groups. The students in group A (n = 26) attended a live demonstration performed by one faculty, while students in group B (n = 23) watched a procedural video. Both the procedural video and live demonstration described identical steps involved in fabricating the Adam’s Clasp. Students in both groups were asked to fabricate an Adam’s Clasp in addition to completing a questionnaire, to measure their perceptions and satisfaction with the two teaching methods and lab exercise. Blind assessment was performed by one faculty for both groups.ResultsThe mean students’ scores in the fabrication of the Adam’s clasp were 6.69 and 6.78 for the live demonstration (group A) and the procedural video (group B), respectively. No significant difference was detected between the two groups (P = 0.864). Statistically significant difference was found in the mean response between the two groups for statement 6 on the questionnaire, “The steps in the teaching method were presented in a clear fashion and were easy to understand”. A higher mean response for group B was found compared to group A (P = 0.049). No significant differences were found between the two groups for the other statements (P > 0.05).ConclusionProcedural video is equally as effective as a live demonstration. Both methods should be considered in teaching undergraduate orthodontic courses in order to improve the learning experience and to match different learning preferences of students.

Retention practices and factors affecting retainer choice among orthodontists in Saudi Arabia.

Objectives: To identify the retention protocols practiced by orthodontists in Saudi Arabia, and the factors affecting retainer choice. Methods: This cross-sectional study took place between February and March of 2015 at the College of Dentistry, University of Dammam, Dammam, Saudi Arabia. A previously tested electronic survey of 34 items was sent to all 1,200 orthodontic members of the Saudi Orthodontic Society. The questionnaire elicited data on the subjects’ demographics, orthodontic treatment practices, retention, and post-retention protocols. Results: One hundred and sixty-seven (13.9%) responses were received during the study period. The results showed predominant use of Hawley in the maxillary arch (61.3%), and fixed lingual in the mandibular arch (58.5%). Approximately 90.3% recommended full-time maxillary removable retainer wear. Overall, orthodontists who performed fewer extractions tended to use fixed retainers, and those who performed more extractions used removable retainers (p=0.018). Interproximal enamel reduction was used by 28% of the respondents as an adjunct procedure to enhance retention. Approximately 64% practiced a post-retention phase of retainer wear. Participants who used removable retainers most commonly prescribed lifetime retention. Conclusion: Hawley in the maxilla, and fixed lingual in the mandible were the most common retention protocols prescribed. Lifetime retention was the most common choice for participants who used removable retainers, especially when extractions were carried out.

Influence of bimaxillary protrusion on the perception of smile esthetics.

Objectives: To evaluate the impact of bimaxillary protrusion on smile esthetics as perceived by dental professionals and laypersons. Methods: One hundred and fifty evaluators, equally distributed into their respective panels (orthodontists, general dentists, and laypersons), participated in this cross-sectional study conducted in April to December 2012 in Riyadh, Saudi Arabia. The patient sample consisted of 14 female patients divided equally into 2 groups: bimaxillary protrusion patients, and patients who have had 4-premolar extraction treatment. Two standardized photographs (frontal and three-quarter close-up smile views), and a lateral cephalogram were taken for each patient. The evaluators were asked to rate the attractiveness of each photo according to a 100-mm visual analog scale. These esthetic ratings were correlated with the patients’ cephalometric measurements. Results: The bimaxillary protrusion group was rated significantly as less attractive than the treatment group by each evaluator panel. Panel comparison showed that laypeople were less receptive of bimaxillary protrusion than dental professionals. Frontal and three-quarter views of the same smiles were not similarly rated for esthetic perceptions. Correlational analysis revealed that the dentoalveolar measurement with the highest significant negative correlation to the smile esthetics was the upper incisors to palatal plane (U1-PP) angle. Conclusion: Patients with bimaxillary protrusion were found to be less attractive than patients who were treated for the condition. This was especially evident among the laypersons. An increase in the upper incisor inclination, as well as a decrease in the interincisal angle compounds the bimaxillary effect.

Evaluation of the fit of preformed nickel titanium arch wires on normal occlusion dental arches

Aim To determine the fits of preformed nickel titanium (NiTi) archwires on dental arches with normal occlusion. Methods Forty sets of upper and lower plaster models were obtained from men and women with Class I occlusions. Preformed 0.016″ × 0.022″ NiTi archwires from Rocky Mountain Orthodontics (RMO), 3 M Unitek, Ormco, and Dentaurum were evaluated in terms of their fits on dental arches from male, female, and combined cases. Data were analyzed by using fourth- and sixth-order polynomial equations, analysis of variance (ANOVA), and the Duncan post hoc test. Results In the upper arches, the best fit and least error were obtained with RMO Ovoid and Ormco Orthos Large archwires for male cases, but with 3 M Orthoform LA archwires for female and combined cases. In the lower arches, the best fit and least error were obtained with Ormco Orthos Large for male cases, with 3 M Orthoform LA and RMO Normal for female cases, and with 3 M Orthoform LA, RMO Normal, Ormco Orthos Large, and Ormco Orthos Small for combined cases. When both dental arches were matched, Ormco Orthos Large was the best wire for male cases. 3 M Orthoform LA was the best wire for female and combined cases. Conclusions Using an archwire form with the best fit to the dental arch should produce minimal changes in the dental arch form when NiTi wires are used and require less customization when stainless-steel wires are used.

The characteristics of dental occlusion in patients with moderate to severe obstructive sleep apnea in Saudi Arabia

Objectives: To evaluate characteristics of dental occlusion among non-obese Saudi adult patients suffering from moderate to severe obstructive sleep apnea(OSA). Methods: Following ethical approval, a cross-sectional study was conducted at Sleep Disorders Center, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January and March 2017. Non-obese adult Saudi patients with moderate/severe OSA (apnea-hypopnea index>15) and without history of malocclusion or edentulism were included with an estimated sample size of 50. Demographic details and severity of OSA as diagnosed by polysomnography were recorded. Characteristics of dental occlusion, namely molar, canine and incisor relationship, overjet, overbite, crossbite and arch form were obtained through calibrated examiners (kappa 0.81). Descriptive statistical analysis and Chi-square test, with 95% significance level (p<0.05), were used to identify relationships between the severity of OSA and characteristics of dental occlusion. Results: A total of 51 patients (31 males, 20 females; mean age 49.45±10.35 years), were enrolled in the study. Severity of OSA was moderate in 17 patients and severe in 34 patients. Severe form of OSA was more among males (64.7%) and in patients with Class-II division-1 incisor relationship (94.1%). Neither the demographic characteristics, nor characteristics of dental occlusion showed statistically significant relationship with the severity of OSA. Conclusion: The results of the present cross-sectional study indicate that the characteristics of dental occlusion are not related to the severity of OSA among non-obese adult Saudi patients.

Knowledge on management of traumatic dental injuries among Saudi mothers

Objective This study investigated the knowledge of Saudi mothers regarding the management of traumatic dental injuries (TDIs) in children. Materials and methods A cross-sectional study using structured questionnaires was employed for mothers chosen by stratified-cluster random sampling technique from primary health care centers in Riyadh, Saudi Arabia, over a period of 12 months (July 2016–June 2017). The questionnaire surveyed mothers’ background and knowledge on management of tooth fracture and avulsion using photographs of TDI cases. Results The sample consisted of 3,367 Saudi mothers. More than half of the mothers (55.3%) gave the correct response, which was to send the child with tooth fracture immediately to the dentist (p<0.01). The majority of mothers (41.6%) gave the correct response for the immediate mode of action, which was to save the avulsed tooth in storage medium and send the child to the dentist immediately (p<0.001). However, they prioritized the immediate management of TDIs, and most reported saline as a suitable storage medium (p<0.001). The mothers expressed a positive interest in further education. Conclusion Educational programs and TDI protocols must be implemented to increase mothers’ awareness and improve the prognosis of children with TDIs.

Elementary school staff knowledge about management of traumatic dental injuries

Aim This study investigated the knowledge of elementary school staff regarding the management of traumatic dental injuries (TDIs) in children. Methods The present cross-sectional study analyzed data collected between September 2016 and April 2017. The sample consisted of 2,027 elementary school staff members in Riyadh, Saudi Arabia. A stratified cluster random sampling technique was used to select the required sample. Those who agreed to participate in the study completed a 4-part self-administered questionnaire comprising questions regarding demographic data, knowledge on management of tooth fracture, and avulsion using photographs of TDI cases. Results The majority of the school staff showed inadequate basic knowledge regarding the importance of saving the broken piece of the tooth and identifying the tooth involved in the trauma (67% and 66.3%, respectively), P<0.05. However, they had a significantly high number of correct responses regarding the immediate management of TDIs for the 2 case scenarios presented in the questionnaire (P<0.05), and the majority (41%) reported normal saline as a suitable storage medium (P<0.01). Conclusion This study revealed a lack of knowledge in certain aspects of TDIs among elementary school staff.