Zeyad H. Al-Sowygh

Foreign-Trained Dentists in Advanced Education in Prosthodontics Programs in the United States: Demographics, Perspectives on Current Training, and Future Goals

PURPOSE This study investigated the perspectives of foreign-trained dentists (FTDs) in comparison with US-trained Dentists (USTDs) in Advanced Education in Prosthodontics (AEP) programs on their current clinical training and future goals. MATERIALS AND METHODS This study was conducted by analyzing data from previously published literature. When appropriate, Chi-square statistical analysis was conducted to determine the influence of where the AEP residents earned their DMD/DDS degree (FTDs/USTDs) on all variables. Only results that yielded significant differences were discussed. RESULTS A majority of both FTDs and USTDs were male. Most USTDs were married, while most FTDs were single. Most FTDs were not US citizens and most originated from Asia, followed by the Middle East, South America, and Europe. Significantly more FTDs had higher ranks in their dental schools, had more advanced degrees, and spent more time practicing before entering the AEP programs. In selecting AEP programs, FTDs placed significantly higher values on a programs reputation and research opportunities. During their AEP training, FTDs paid significantly higher tuition and received lower stipends, but obtained more financial support from families. On the other hand, USTDs received significantly more financial aid and earned income from part-time work, but had significantly higher total educational debts. USTDs showed a significantly higher interest in becoming a student member of the American College of Prosthodontists and participated actively in prosthodontics organizations. USTDs were more interested in becoming maxillofacial prosthodontists, while FTDs were more interested in pursuing academic careers. CONCLUSION FTDs differed from USTDs in several ways. Because of their interests in academics and research, FTDs may potentially have a positive impact on the development of the prosthodontics discipline. This information may be beneficial for AEP program directors in accommodating the needs of FTDs, and for FTDs in better preparing for their AEP training.

Peri-implant conditions and levels of advanced glycation end products among patients with different glycemic control

BACKGROUND A close relationship between poor glycemic control and peri-implant break down has been demonstrated. It is hypothesized that levels of advanced glycation end products (AGEs) in peri-implant sulcular fluid (PISF) are higher with increased glycemic levels in type 2 diabetes mellitus patients. PURPOSE In the present study, we examined the clinical and radiographic peri-implant parameters and levels of AGEs among different glycemic levels in diabetic patients and assessed whether the levels of AGEs correlate with clinical peri-implant parameters. MATERIALS AND METHODS Ninety-three patients who participated in this study were divided into four groups; Group-1: HbA1c 6.1%-8%; Group-2: HbA1c 8.1%-10%; Group-3: HbA1c > 10%; Group-4: non-diabetic individuals with HbA1c < 6%. Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD) and crestal bone loss (CBL) were recorded. Levels of AGEs in PISF were quantified using enzyme-linked immunosorbent assay. Between-group comparison of means was verified with Kruskal-Wallis test and Pearson correlation coefficient for correlations of AGE levels with peri-implant parameters. RESULTS Peri-implant PI, BOP, PD, and CBL were significantly higher in group-1, -2, and -3 as compared to non-diabetic patients (P < .05). These parameters were significantly higher in group-2 and group-3 versus group-1 (P < .01). Mean PI, BOP, PD, and CBL were comparable between group-2 and group-3 patients (P > .05). Mean levels of AGEs in PISF were significantly higher in relation to higher levels of HbA1c levels. Significant positive correlations were found between AGEs and PD (P = .0221) and CBL (P = .0425); and significant negative correlation was found for PI (P = .0376) in patients with HbA1c levels >10%, respectively. CONCLUSIONS Clinical and radiographic peri-implant parameters were poor and levels of AGEs were significantly high in patients with high glycemic levels. These findings suggest that AGEs may be considered as potential marker of inflammation in diabetic individuals with peri-implantitis.

The effect of various interim fixed prosthodontic materials on the polymerization of elastomeric impression materials

STATEMENT OF PROBLEM After tooth preparation, interim fixed prosthodontic materials are used to fabricate interim restorations until the definitive restoration can be delivered. The polymerization of elastomeric impression materials may be inhibited when in indirect contact with interim fixed prosthodontic materials. PURPOSE The purpose of this study was to detect whether the polymerization of 6 commonly used types of elastomeric impression materials was affected by direct contact with 6 commonly used interim fixed prosthodontic materials and to further evaluate the efficacy of several decontamination methods to eliminate the indirect effect of the interim fixed prosthodontic materials on the setting of elastomeric impression materials. MATERIAL AND METHODS Six brands of elastomeric impression material (Virtual, Aquasil, Genie, Correct Plus, Express, Impregum) were evaluated in vitro after direct contact with various interim fixed prosthodontic materials (Trim Plus, Unifast, Integrity, Systemp C&B, Tuff-Temp, Protemp IV) by 3 general practitioners. The setting of the impression materials was visually scored as either inhibited or noninhibited. Latex was used as a positive control. The decontamination part of the study was done indirectly on the dentin of prepared natural teeth after they had been relined with the interim fixed prosthodontic material. The decontamination methods were air-water rinse, mouthwash (chlorhexidine 0.12%), 3% hydrogen peroxide, and pumice. A Kruskal-Wallis nonparametric analysis was used to evaluate the results. RESULTS Statistically significant setting inhibition was found with 5 brands of polyvinyl siloxane impression materials with all tested types of interim fixed prosthodontic material (P<.001) except Trim Plus. No tested interim fixed prosthodontic material caused inhibition with the polyether impression material, except for minimal inhibition with Protemp IV. The decontamination method performed with 3% H2O2 alone proved adequate in preventing impression material inhibition. Interexaminer reliability data were analyzed with the kappa correlation analysis. The examiners were in complete agreement (kappa +1). CONCLUSION Under these in vitro conditions, the direct contact of polyvinyl siloxane impression materials to some brands of interim fixed prosthodontic materials resulted in polymerization inhibition. Of the decontamination methods tested, only 3% H2O2 showed efficacy in preventing the inhibitory effect of the interim fixed prosthodontic material. For optimal results, definitive impressions should be made before the prepared tooth is exposed to an interim fixed prosthodontic material.

Efficacy of photodynamic therapy in the inactivation of oral fungal colonization among cigarette smokers and non-smokers with denture stomatitis.

OBJECTIVE The aim was to assess the efficacy of antimicrobial photodynamic therapy (aPDT) in the inactivation of oral fungal colonization among cigarette smokers and non-smokers with denture stomatitis (DS). METHODS A questionnaire was used to gather demographic information. Clinical oral examination was performed to determine location of denture in the jaws and oral erythematous lesions. Presence of fungal hyphae in smokers and non-smokers was confirmed using exfoliative cytology. In both groups, aPDT was performed and colony forming units per milliliter (CFU/ml) were assessed im both groups at 3-months follow-up. Level of significance was et at P<0.05. RESULTS Twenty-two males with DS (12 smokers and 10 non-smokers) were included. The mean ages of smokers and non-smokers was 73.8±2.5 and 70.5±1.2years, respectively. The duration and daily frequency of cigarette smoking was 20.6±4.5years and 12.3±1.5 cigarettes daily, respectively. Smokers and non-smokers had been wearing complete dentures since 6.2±0.8 and 5.8±0.4years, respectively. At 3-months follow-up, there was a statistically significant decrease in the mean fungal CFU/ml among smokers (25.5±8.3 CFU/ml) compared with their respective baseline values 106.7±6.3 CFU/ml (P<0.01). Among non-smokers, the mean CFU/ml values were 12.7±0.8 CFU/ml compared with their respective baseline values (93.6±8.4 CFU/ml) (P<0.01). At 3-months follow-up, fungal CFU/ml levels were statistically significantly higher among smokers (25.5±8.3 CFU/ml) compared with non-smokers (12.7±0.8 CFU/ml) (P<0.05). CONCLUSION aPDT is effective in the inactivation of oral fungal colonization among cigarette smokers and non-smokers with. The role of denture is also emphasized.

Comparison of periodontal inflammatory parameters among habitual gutka-chewers and naswar-dippers: a split-mouth retrospective clinical study

Abstract Objective: The aim of the present split-mouth retrospective study was to compare the clinical periodontal parameters among gutka-chewers and naswar-dippers. Methods: A structured questionnaire was used to record demographic information. Jaw quadrant in which, gutka or naswar were placed were defined as “test-sites”. The remaining jaw quadrants were designated as “control-sites”. Clinical [plaque index (PI), bleeding on probing (BOP), probing pocket depth (PPD) and clinical attachment loss (CAL)] and radiographic [alveolar bone loss (ABL)] parameters were compared among gutka-chewers and naswar-dippers in the test- and control sites. Data were analysed using non-parametric Wilcoxon signed rank test followed by post hoc analyses with the Bonferroni correction. p < .05 were considered statistically significant. Results: Seventy-five gutka-chewers and 72 naswar-dippers with mean ages of 45.2 ± 0.8 years and 47.3 ± 2.8 years, respectively were included. Gutka-chewers and naswar-dippers were consuming their respective smokeless tobacco product 10.2 times and 8.5 times daily for 15.1 ± 2.7 and 12.3 ± 3.4 years, respectively. Among gutka-chewers and naswar-dippers, scores of PI, BOP, PPD ≥4 mm, CAL and ABL were significantly higher in the test-sites compared with their respective control-sites (p < .01). Conclusions: Periodontal inflammatory parameters were poorer in the test-sites among gutka-chewers and naswar-dippers compared with the control-sites.

Assessment of matrix metalloproteinase-8 and -9 levels in the peri-implant sulcular fluid among waterpipe (narghile) smokers and never-smokers with peri-implantitis

Abstract Objectives: It is hypothesized that levels of matrix metalloproteinase (MMP)-8 and MMP-9 are significantly higher in the peri-implant sulcular fluid (PISF) of waterpipe-smokers (WS) compared with never-smokers with peri-implantitis. The aim of the present convenience sample case-control study was to compare the levels of MMP-8 and MMP-9 in the PISF of WS and never-smokers with peri-implantitis. Material and Methods: Individuals smoking waterpipe (Group 1) and never-smokers (Group 2) were included. Demographic data was collected using a questionnaire. Peri-implant probing depth (PPD) was measured and crestal bone loss (CBL) was measured on digital bitewing radiographs. PISF samples were collected using paper strips and the collected PISF volume was determined. Levels of MMP-8 and MMP-9 were measured using enzyme-linked immunosorbent assay. Study sample-size was estimated and statistical analysis was performed. p values < .05 were considered statistically significant. Results: Sixty-six individuals (33 individuals in Group 1 and 33 in Group 2) were included. In Groups 1 and 2, 41 and 44 implants, respectively were placed. The mean total PPD (p < .001) and peri-implant CBL (p < .001) was statistically significantly higher around implants affected by peri-implantitis in Group 1 compared with Group 2. The PISF volume (p < .05) collected and levels of MMP-8 (p < .01) and MMP-9 (p < .01) were statistically significantly higher among individuals in Group 1 compared with Group 2. Conclusion: PISF levels of MMP-8 and MMP-9 are significantly higher among WS compared with never-smokers with peri-implantitis.

Effectiveness of adjunctive antimicrobial photodynamic therapy in reducing peri-implant inflammatory response in individuals vaping electronic cigarettes: A randomized controlled clinical trial

BACKGROUND There are no studies that have assessed the effectiveness of antimicrobial photodynamic therapy (aPDT) in reducing peri-implant inflammatory response in individuals vaping electronic cigarettes (e-cigs). This study explored the effectiveness of aPDT as an adjunct to mechanical debridement (MD) in the treatment of peri-implant mucositis (p-iM) in individuals vaping e-cigs. METHODS Vaping individuals with p-iM were divided into 2 groups: (a) Group-I: receiving MD with aPDT (test group); and (b) Group-II: MD only (control group). Peri-implant inflammatory parameters including plaque index (PI), bleeding on probing (BoP), and pocket depth (PD) were assessed at baseline and 12-weeks follow-up. Inter- and intra-group comparisons were made using Mann-Whitney U test and Wilcoxon signed ranks test. P-value < 0.05 was considered significant. RESULTS Thirty-eight male patients (20 in Group-I and 18 in Group-II) were included. The mean age of vaping individuals in groups I and II were 33.6 ± 2.8 and 35.4 ± 2.1 years, respectively. Mean daily frequency of vaping e-cigs in groups I and II was 7.3 ± 0.9 and 5.9 ± 1.0 whereas mean duration of vaping e-cigs was 4.8 ± 1.5 and 4.1 ± 1.3 years respectively. There was no significant difference between groups at baseline. There was significant improvement in PI (p < 0.001) and PD (p < 0.001) at 12-weeks follow-up with respect to the baseline visit in both groups. There was a significant reduction in PI (p < 0.001) and PD (p < 0.001) for group-I as compared to group-II at follow-up. There was no statistically significant difference for BoP between groups at follow-up. CONCLUSION Antimicrobial PDT is more effective compared to MD alone in the treatment of p-iM in individuals vaping e-cigs. The findings of the present study should be considered preliminary and interpreted with caution. Further randomized clinical trials should be performed in order to obtain strong conclusions.

Influence of silicoating, etching and heated glaze treatment on the surface of Y-TZP and its impact on bonding with veneering ceramic

Abstract The study aimed to investigate the influence of surface treatments of Y-TZP on its topography and their impact on shear bond strength (SBS) of Y-TZP to veneering porcelain. Thirty-four zirconia cubes (Cercon) (10 × 10 × 10 mm3) were divided randomly into 3 groups (n = 11) according to the different surface treatments, Silica Coating (SC); Hot Solution Etching (HE); and Heat Treatment after porcelain glaze and powder application (GP). Porcelain application (IPs e.max) was performed after surface treatment using a standardized technique. Porcelain application (Ceramco-3) was also performed on 10 metal cubes (I BOND 2) as controls (MC). Specimens were subjected to thermocycling (5–55 °C, 20,000 cycles) followed by SBS testing in a universal testing machine. Surface topography was assessed by scanning electron microscopy and surface roughness (Image J). SC developed significantly higher SBS (42.10 ± 5.84 MPa) of Y-TZP to veneering ceramics compared to treatment by HE (24.0 ± 6.4 MPa), GP (23.30 ± 4.72), and the MC (29.3 ± 5.4 MPa) control (p < 0.05). SBS among HE, GP and MC specimens was comparable (p > 0.05). Y-TZP specimens treated with SC and HE showed high surface roughness compared to GP. Silicoating of Y-TZP prior to veneering can potentially reduce the high failure rates of zirconia-based restorations by enhancing the chemical bond between the core and the veneer materials.

Association of advanced glycation end products with peri-implant inflammation in prediabetes and type 2 diabetes mellitus patients

BACKGROUND It is postulated that peri-implant sulcular fluid (PISF) levels of advanced glycation end products (AGEs) are higher with high glycemic levels. PURPOSE In the present clinico-biochemical study, we explored the clinical and radiographic peri-implant parameters and levels of AGEs among prediabetic, type 2 diabetic (T2DM), and non-diabetic patients and to evaluate the correlation of AGEs with clinical peri-implant parameters. MATERIALS AND METHODS Ninety patients were divided into three groups of 30 patients each; group 1: patients with prediabetes; group 2: patients with T2DM; and group 3: non-diabetic individuals. Clinical and radiographic peri-implant parameters assessed included plaque index (PI), bleeding on probing (BOP), probing depth (PD), and marginal bone loss (MBL). PISF was collected and analyzed for AGEs levels using enzyme-linked immunosorbent assay. Between-group comparison of means was verified with Kruskal-Wallis test and Pearson correlation coefficient for correlations of AGE levels with peri-implant parameters. RESULTS Mean peri-implant PI, BOP, PD, and MBL was significantly higher in group 1 and 2 as compared with non-diabetic patients (P < .05). Mean PI, BOP, PD, and MBL were comparable between group 1 and group 2 patients (P > .05). Mean levels of AGEs in PISF were significantly higher among prediabetic and T2DM patients as compared with non-diabetic patients (P < .05). Between group 1 and group 2, mean levels of AGEs was significantly higher in group 2 (P < .05). A significant positive correlations were found between levels of AGEs and PD (P = .0371) and MBL (P = .0117) in T2DM patients, respectively. CONCLUSION Clinical and radiographic peri-implant parameters were worse and levels of AGEs in PISF were increased in individuals with prediabetes and T2DM. AGEs may play an important role in peri-implant inflammation in prediabetes and T2DM.

Comparison of peri-implant clinical and radiographic status around short (6 mm in length) dental implants placed in cigarette-smokers and never-smokers: Six-year follow-up results

BACKGROUND It is hypothesized that peri-implant clinical and radiographic inflammatory parameters (probing depth [PD], bleeding on probing [BOP] and plaque index [PI]; and radiographic (crestal bone loss [CBL]) are worse among cigarette-smokers (CS) compared with never-smokers (NS) with short implants. PURPOSE The present 6-year follow-up retrospective study compared the peri-implant clinical and radiographic parameters in CS and NS with short dental implants (6 mm in length). MATERIALS AND METHODS Fifty-six male individuals were included. These individuals divided into 2 groups as follows: (a) Group-1: 29 self-reported systemically healthy CS with 48 short-implants; and (b) Group-2: 27 self-reported systemically healthy NS with 43 short implants. Peri-implant PD, PI, BOP, and CBL were measured. Group comparisons were done using the Kruskal-Wallis test and sample size was estimated. Level of significance was set at P values < .05. RESULTS In groups 1 and 2, the follow-up durations were 6.2 ± 0.1 years and 6.1 ± 0.3 years, respectively. A cigarette smoking history of 8.9 ± 3.6 pack years was reported by individuals in Group-1. At follow-up, scores of peri-implant PD, BOP, PI, and mesial and distal CBL were comparable around short implants in both groups. CONCLUSION Under strict oral hygiene maintenance protocols, short dental implants can remain functionally stable in CS in a manner similar to NS.