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This systematic review evaluates current evidence regarding the feasibility of using needleless jet injection instead of a conventional local anesthetic needle. EBSCO, ProQuest, PubMed, and Scopus databases were used to identify relevant literature published in English from 2005 to 2020. Ten studies were selected. Five of them were randomized clinical trials, 3 case-control studies, and 2 equivalence trials. Using the Critical Appraisal Skills Program checklist, 6 studies scored between 67% and 100%, and 4 studies scored between 34% and 66%. According to Jadad's scale, 2 studies were considered strong, and 8 studies were considered moderate in quality. The results of the 10 studies showed differences in patient preference for needleless jet injection. Needleless injection technique has been found to be particularly useful in uncooperative patients with anxiety and needle phobia. Needleless jet injection is not technique sensitive. However, with needleless jet anesthesia, most treatments require additional anesthesia. Conventional needle anesthesia is less costly, has a longer duration of action, and has better pain control during dental extraction. Needleless jet anesthesia has been shown to be moderately accepted by patients with a fear of needles, has a faster onset of action, and is an efficient alternative to conventional infiltration anesthesia technique.

Background Fully guided implant surgery as a technique is gaining popularity. It has been observed that use of surgical guides improves precision and predictability for dental implant placement. However, like any other newer technology, the acceptance of fully guided dental implant technology among users is based upon its perceived usability. This study aimed at evaluating the perception about using Virtual Implant Planning Software (VIPS) among undergraduate dental students at the university of Sharjah. Methods Ninety-Six dental surgery students from the University of Sharjah were included in the study. One week after the Virtual Implant Planning Software (Planmeca Romexis version 6.2 procedure, students were asked to complete a Combined technology acceptance model and the theory of planned behaviour (C-TAM TPB) questionnaire. Sixty-six students responded to the questionnaire. Results Cronbach’s alpha surpassed 0.7 for perceived usefulness, perceived ease of use, perceived behavioral control, and subjective norm. Attitude and behavioural intention reported Cronbach’s alpha values less than 0.7. Spearman’s correlation coefficient was significant for all the constructs. Perceived ease of use explained 49%, 33%, and 42% of the variance of perceived usefulness (R2 = 0.49), attitude (R2 = 0.33), and perceived behavioral control (R2 = 0.42) respectively. Perceived usefulness explained 25%, 18%, and 23% of the variance of attitude (R2 = 0.25), behavioral intention (R2 = 0.18), and perceived behavioral control (R2 = 0.23) respectively. Attitude accounted for 25%, 33%, and 29% of the variance of behavioral intention (R2 = 0.25), perceived behavioral control (R = 0.33), and subjective norm (R = 0.29) respectively. Conclusion The fully guided VIPS was acceptable by dental students specifically because of its usability. This makes VIPS a very effective tool for teaching implantology for dental students. VIPS also allows students to perform multiple repetitions of the implant planning procedure which enhances understanding and content retention.

Background In healthcare practice, ethical challenges are inevitable and their optimal handling may potentialy improve patient care. Ethical development in medical education is critical for the transition from a medical and health sciences student to an ethical healthcare practitioner. Understanding the health professions students’ approaches towards practice-driven ethical dilemmas could harness i the effective ethical development in their medical education. This study attempts to identify the health professions students’ approaches towards practice-driven ethical dilemmas. Methods An inductive qualitative evaluation was conducted on six recorded videos of health professions students’ case-based online group discussions, followed by a one-hour online ethics workshop. The online ethics workshop was organized with students from the College of Medicine, College of Dental Medicine and College of Pharmacy at the University of Sharjah, and the College of Medicine at the United Arab Emirates University. . The recorded videos were transcribed verbatim and imported to the qualitative data analysis software of MAXQDA 2022. Data were analyzed applying four stages of review, reflect, reduce and retrieve and two different coders triangulated the findings. Results Six themes emerged from the qualitative analysis of the health professions students’ approaches to the practice-based ethical dilemmas; (1) emotions, (2) personal experiences, (3) law and legal system, (4) professional background, (5) knowledge of medical research and (6) inter-professional education. In addition, during the case-based group discussions in the ethics workshop, students efficiently applied the relevant ethical principles of autonomy, beneficence, non-maleficence and justice in their reasoning process to reach an ethical decision. Conclusion The findings of this study explained how health professions students resolve ethical dilemmas in their ethical reasoning process. This work sheds light on ethical development in medical education by gaining students’ perspectives in dealing with complex clinical scenarios. The findings from this qualitative evaluation will aid academic medical institutions in developing medical and research-based ethics curriculum to transform students to ethical leaders.

The field of dentistry has seen various technological advances regarding caries detection, some lesions still prove to be difficult to detect. A reasonably new detection method, near-infrared (NIR), has shown good results in caries detection. This systematic review aims to compare NIR with conventional methods in terms of caries detection. Online databases (PubMed, Scopus, ScienceDirect, EBSCO, and ProQuest) were used for the literature search. The search was performed from January 2015 till December-2020. A total of 770 articles were selected, of that 17 articles qualified for the final analysis as per Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The articles were assessed according to a modified Critical Appraisal Skills Programme checklist, and then synthesis of the review started. The inclusion criteria were clinical trials done in vivo on teeth with active caries of vital or nonvital teeth. This review excluded nonpeer reviewed articles, case reports, case series, opinions, abstracts, non-English written articles, studies of subjects with arrested caries, or teeth with developmental defects of tooth structure and teeth having environmental defects of tooth structure, as well as in-vitro studies. The review compared near-infrared technology with radiography, visual inspection, and laser fluorescence in terms of caries detection, sensitivity, specificity, and accuracy. The sensitivity of NIR ranged from 99.1 to 29.1%. Studies showed that NIR exhibited higher sensitivity for occlusal enamel and dentin caries. The specificity of NIR ranged from 94.1 to 20.0%. In enamel and dentinal occlusal caries, NIR demonstrated lower specificity than that of radiograph. The specificity of NIR in early proximal caries was low. Accuracy was determined in 5 out of 17 studies where the values ranged from 97.1 to 29.1%. The accuracy of NIR was the highest for dentinal occlusal caries. NIR shows promising evidence as an adjunct in caries examination due to its high sensitivity and specificity; however, more studies are required to determine its full potential in different situations.

Objective The present study aimed to analyze the salivary levels of macrophage-activating factor (MAF), macrophage-chemotactic factor (MCF), and macrophage migration inhibitory factor (MIF) in healthy and gingivitis patients, and to correlate between the concentrations of these chemo attractants with the intensity of gingival inflammation clinically. Methods Sixty saliva specimens were collected from periodontally healthy (n = 30), and gingivitis patients (n = 30). Bleeding on probing (BOP), Visible Plaque Index (VPI), and Simplified Modified Gingival Index (SMGI) were recorded through clinical examination. Salivary MAF, MCF, and MIF concentrations were assayed using enzyme-linked immunosorbent assays (ELISA). Statistical analysis was performed using SPSS (version 28). Total mean score for each biomarker was determined, and descriptive bivariate statistics were conducted to characterize the levels of biomarkers among the study groups. The difference in the biomarker levels among the study groups were analyzed by independent sample t test and one-way ANOVA. The diagnostic ability of the biomarkers was further tested by ROC curve analysis. Results Salivary levels of MAF was not significantly different between periodontally healthy individuals and gingivitis patients. The difference in MCF and MIF levels between patients with gingivitis and those with healthy periodontium was statistically significant (p 0.05 and p 0.001, respectively). When examined across the various stages of disease progression, MIF showed statistically significant difference among the three biomarkers (p 0.05). ROC curve analysis further revealed that area under the curve (AUC) for MIF has a better diagnostic capacity than MCF (AUC 0.981 vs. 0.673). Conclusions Our results suggest that MIF could be considered as a potential salivary biomarker for gingivitis.

The use of alternative tobacco products, particularly medwakh, has expanded among youth in the Middle East and around the world. The present study is conducted to investigate the biochemical and pathophysiological changes caused by medwakh smoking, and to examine the salivary metabolomics profile of medwakh smokers. Saliva samples were collected from 30 non-smokers and 30 medwakh smokers and subjected to metabolomic analysis by UHPLC-ESI-QTOF-MS. The CRP and Glutathione Peroxidase 1 activity levels in the study samples were quantified by ELISA and the total antioxidant capacity (TAC) by TAC assay kits. Statistical measurements and thorough validation of data obtained from untargeted metabolomics identified 37 uniquely and differentially abundant metabolites in saliva of medwakh smokers. The levels of phthalate, L-sorbose, cytosine, uridine, alpha-hydroxy hippurate, and L-nicotine were noticeably high in medwakh smokers. Likewise, 20 metabolic pathways were differentially altered in medwakh smokers. This study identified a distinctive saliva metabolomics profile in medwakh smokers associated with altered redox homeostasis, metabolic pathways, antioxidant system, and CRP levels. The impact of the altered metabolites in medwakh smokers and their diagnostic utility require further research in large cohorts.

Objectives The aim of this study was to determine the value of immune expression of p63 and cyclin D1 in the prediction of lymphovascular invasion (LVI) and perineural invasion (PNI) in oral squamous cell carcinoma (OSCC). Subjects and Methods Clinical and histopathologic features of 65 subjects with histologically confirmed OSCC were collected. Tissue microarray blocks representing all subjects were prepared for the immunohistochemical quantification of the nuclear expression of p63 and cyclin D1 using immune ratio plugin of image J software. Image analysis was performed by two independent pathologists. Independent samples t-test, analysis of variance, and receiver operating characteristic curve tests were used for statistical analysis. The level of significance was set at p≤ 0.05. Results The optimum cutoff value for the prediction of LVI for p63 and cyclin D1 was found to be 100 and 93.2, respectively, while the optimum cutoff value for the prediction of PNI for p63 and cyclin D1 was found to be 95.9 and 94, respectively. p63 and cyclin D1 expression correlated with several clinicopathologic features of the studied population. p63 expression was a significant predictor of moderate/poorly differentiated OSCC compared with well-differentiated OSCC. A parallel combination of positive p63 and cyclin D1 increased the specificity of predicting LVI from 89.1% and 67.4% for either p63 or cyclin D1, respectively, to 93.5% with a positive predictive value of 92.5%. Similarly, the parallel combination of the two markers raised the specificity of predicting PNI from 70% and 77.5% for either p63 or cyclin D1, respectively, to 90% with a positive predictive value of 86.3%. Conclusion Combined overexpression of nuclear markers p63 and cyclin D1 can be considered as a valuable independent predictor of LVI and PNI, and hence tumor progression, in OSCC.

Titanium particles as a product of degradation have been detected in periimplant oral tissues and it has been assumed that implants were the source of these particles. Periimplantitis sites had higher concentrations of particles in comparison to healthy implant sites. Several factors have been identified in the degradation of dental implant surface, such as mechanical wear, contact with chemical agents, and the effects of biofilm adhesion. Titanium particles silently prompt the immune-system activation and generate a pro-inflammatory response in macrophages, T lymphocytes and monocytes. During the activation, inflammatory cytokines are released including, granulocyte–macrophage colony-stimulating factor (GM-CSF), prostaglandin, and TNF-α, IL-1β, IL-6. The nanoparticles depict unique features such as high level of biological reactivity and potentially harmful compared to microparticles since they have a relatively greater surface area to volume ratio. Allergic response to titanium as a cause of implant failure has not been well documented. Evidence demonstrating biological complication due to titanium particles release includes peri-implant tissue inflammation that lead terminally to implant loss. There is a biological probability for a relation between the presence of titanium particles and ions, biological complication, and corrosion, but there is no justifiable evidence for unidirectional series of causative actions.

Background Professional competencies are integral part of the competent dental graduate that include professional attitude and behaviour, ethics and communication skills. The aim of this study was to evaluate senior students’ and dental graduates' perception of professionalism as defined by international regulatory bodies and to assess students’ ability to apply such knowledge in clinical-based scenarios mimicking their daily clinical practice. Methods Knowledge of professional competencies was conducted using a survey based on domains of professionalism for a newly qualified general dental practitioner as defined by international regulatory bodies. This survey consists of 32 items addressing participants’ perception of three domains of professionalism. Application of the perceived professional competencies was tested by asking participants to answer questions following the observation of a clinical-based scenario video where participants needed to identify issues related to professional, ethical and communication skills which were embedded in the scenarios. Results Data from 146 participants showed no significant differences in the survey scores between the participants’ professional levels, place of practice, age groups and genders. Analyses of correlation between the different domains of professionalism showed significant relationships between pair-wise comparisons of the total domain scores. Paired t-tests revealed that the mean score percentage for each of the three domains of professionalism was significantly higher than the responses reported in the relevant clinical-based scenario questions. Conclusions This indicates that all aspects of professionalism are inter-related and the three domains contributed in a similar way to the overall assessment of professionalism. Furthermore, our findings show that dental practitioners may not be able to apply their knowledge of professionalism in real-life scenarios. This suggests that teaching professionalism at the early stages of the dental curriculum should incorporate innovative approaches to mimic real-life scenarios and should be reinforced throughout clinical practice at the later stages of the curriculum.

Introduction. Dental education involves teaching and assessing the acquisition of verifiable domains that require superior psychomotor, communication, and cognitive skills. Evolving technologies and methods of assessment could enhance student’s learning environment and improve tutor assessment experience. The aim of this study was to review the current body of research and evaluate the effectiveness of various methods of assessments in improving learning and performance in preclinical and clinical dental practice. Materials and Methods. A search strategy was implemented using electronic search in major databases. The following key terms, clinical skills, preclinical, dental students, and assessment, were included in the search. Two reviewers independently screened all the articles retrieved following very specific inclusion criteria. Results. The initial search generated 5371 articles and 24 articles were selected for review and data extraction. Cohen’s kappa coefficient was used to measure interrater agreement and a score of 94.7% was obtained. Conclusion. Preclinical assessment is an effective tool for promoting skills transfer to clinical phase. Early psychomotor skills assessment is valuable. It allows early intervention in the learning process and assists in effective utilization of learning resources. Technology-enhanced assessment systems allow better patient simulation, enhance learning and self-assessment experiences, and improve performance evaluation. However, these systems serve as an adjunct to conventional assessment methods. Further research should aim at calibrating and integrating these systems to optimize students learning and performance.

Wael Talaat,1– 3 Smriti Aryal AC,1,2 Sausan Al Kawas,1,2 AB Rani Samsudin,1,2 Nadia G Kandile,4 David RK Harding,5 Mohamed M Ghoneim,6 Waleed Zeiada,7,8 Jayalakshmi Jagal,2 Ahmed Aboelnaga,9 Mohamed Haider2,10,11 1Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah 27272, United Arab Emirates; 2Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates; 3Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Suez Canal University, Ismaillia 41522, Egypt; 4Department of Chemistry, Faculty of Women, Ain Shams University, Heliopolis, Cairo 11757, Egypt; 5School of Fundamental Sciences, Massey University, Palmerston North 4442, New Zealand; 6Department of Oral and Maxillofacial Surgery, Faculty of Dentistry, Sinai University, Arish 45511, Egypt; 7Department of Civil and Environmental Engineering, College of Engineering, University of Sharjah, Sharjah 27272, United Arab Emirates; 8Public Works Engineering Department, College of Engineering, Mansoura University, Mansoura 35516, Egypt; 9Department of Surgery, Faculty of Medicine, Suez Canal University, Ismaillia 41522, Egypt; 10Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah 27272, United Arab Emirates; 11Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo 71526, EgyptCorrespondence: Wael TalaatOral and Maxillofacial Surgery, College of Dental Medicine, University of Sharjah, Sharjah, United Arab EmiratesTel +971 65057605Fax +971 65057606Email wtaha@sharjah.ac.aePurpose: Several scaffolds and cell sources are being investigated for cartilage regeneration. The aim of the study was to prepare nanocellulose-based thermosensitive injectable hydrogel scaffolds and assess their potential as 3D scaffolds allowing the chondrogenic differentiation of embedded human dental pulp stem and progenitor cells (hDPSCs).Materials and Methods: The hydrogel-forming solutions were prepared by adding β-glycerophosphate (GP) to chitosan (CS) at different ratios. Nanocellulose (NC) suspension was produced from hemp hurd then added dropwise to the CS/GP mixture. In vitro characterization of the prepared hydrogels involved optimizing gelation and degradation time, mass-swelling ratio, and rheological properties. The hydrogel with optimal characteristics, NC-CS/GP-21, was selected for further investigation including assessment of biocompatibility. The chondrogenesis ability of hDPSCs embedded in NC-CS/GP-21 hydrogel was investigated in vitro and compared to that of bone marrow-derived mesenchymal stem cells (BMSCs), then was confirmed in vivo in 12 adult Sprague Dawley rats.Results: The selected hydrogel showed stability in culture media, had a gelation time of 2.8 minutes, showed a highly porous microstructure by scanning electron microscope, and was morphologically intact in vivo for 14 days after injection. Histological and immunohistochemical analyses and real-time PCR confirmed the chondrogenesis ability of hDPSCs embedded in NC-CS/GP-21 hydrogel.Conclusion: Our results suggest that nanocellulose–chitosan thermosensitive hydrogel is a biocompatible, injectable, mechanically stable and slowly degradable scaffold. hDPSCs embedded in NC-CS/GP-21 hydrogel is a promising, minimally invasive, stem cell-based strategy for cartilage regeneration.Keywords: tissue regeneration, cartilage, scaffolds, stem cells, nanocellulose, chitosan, hydrogel

To evaluate the ability of the maxillary sinus membrane to produce bone after internal sinus lifting and implant placement without adding exogenous bone graft, and to assess the quality of bone that has been produced 6 months postoperatively.In this retrospective study, 10 subjects who underwent maxillary sinus floor lifting and met the inclusion criteria were selected and then subdivided into: Group-A underwent internal sinus elevation and placement of implants without the use of bone graft and Group-B underwent classical internal sinus lifting and placement of bovine bone particles and then placement of the implant as a control group. Radiofrequency analysis (RFA) values for measuring the Implant Stability Quotient (ISQ) of all implants were measured by Osstell device. CBCT was performed involving linear measurements of the site of sinus lifting for both groups.High RFA values demonstrating excellent biomechanical stability were observed in Group-A compared to Group-B at 6 months postoperatively. Group-A showed a median of ISQ value;78 (8), 77(12), 79(3.5) and 77(4.50). Group-A was significantly higher in ISQ values than Group-B, which showed median and interquartile range (IQR) of ISQ value of [51(12.50), 54(14.50), 55(9), and 55(7.50)]. However, the amount of bone available in group B was significantly higher than group A; [3.5 mm (0.75) and 3.8 mm (0.69)].Internal sinus lifting without bone graft has the ability of bone formation by osteogenic potential of the sinus membrane. Nevertheless, the high quality of bone being produced is of high importance for the success of an implant without the need for an exogenous bone graft. The newly formed bone was significantly of a better quality in Group-A. Thus, it is recommended to perform internal sinus lifting, without adding bone graft material and allow the osteogenic potential of the maxillary sinus membrane to produce its own osteogenic cells.

This study aimed to assess the effect of smoking different tobacco types on the supragingival microbiome and its relation to dental caries. Forty supragingival plaque samples were collected from smokers of a single tobacco type and non-smokers seeking treatment at the University Dental Hospital Sharjah, UAE. DMFT (decayed, missing and filled teeth) was determined for all participants who were divided into two groups: no-low caries (NC-LC: DMFT = 0–4; n = 18) and moderate-high caries (MC-HC: DMFT = 5–20; n = 22). 16S rRNA gene was sequenced using third-generation sequencing with Nanopore technology. Microbiome composition and diversity were compared. Caries was most common among cigarette smokers. Supragingival microbiota were significantly altered among smokers of different tobacco types. In cigarette smokers, cariogenic bacteria from genus Streptococcus (including S. mutans) were significantly more among subjects with NC-LC, while Lactobacilli (including L. fermentum) were more among subjects with MC-HC. In medwakh smokers, several periodontopathogens were significantly elevated in subjects with NC-LC, while other pathogenic bacteria (as Klebsiella pneumoniae) were more in those with MC-HC. Cigarette and alternative tobacco smoking had a significant impact on the supragingival microbiome. Indeed, further studies are required to unravel the consequences of oral dysbiosis triggered by smoking. This could pave the way for microbiota-based interventional measures for restoring a healthy oral microbiome which could be a promising strategy to prevent dental caries.

Background The association of the linear dimensions of the inferior turbinate hypertrophy with nasal septal deviation has been studied recently. However, the volumetric dimensions provide a more accurate status of the turbinate hypertrophy compared to linear measurements. The aim of this study was to analyze the association of inferior nasal turbinate volume with the degree of nasal septal deviation (NSD). Methods A retrospective evaluation of the cone beam computed tomography (CBCT) scans of 412 patients was carried out to obtain 150 scans which were included in the study. The scans were categorized into three groups. Group 1 comprised of 50 scans of patients with no inferior turbinate hypertrophy (ITH) and no nasal septal deviation. Group 2 comprised of 50 scans of patients with ITH and no NSD; whereas Group 3 included 50 scans of patients with ITH and NSD. The total turbinate volume of inferior turbinates (bilateral) were determined by using Vesalius 3D software (PS-Medtech, Amsterdam, Netherlands). Results The intraclass correlation coefficient (ICC) between the volumetric estimations performed by the two radiologists was 0.82. There were no significant age and gender related changes in the total turbinate volume. Patients in Group 3 had significantly higher (p = 0.001) total turbinate volume compared to Group 2 and Group 1. There was a positive and significant correlation (r = 0.52, p = 0.002) between the degree of septal deviation and total turbinate volume. When the total turbinate volume of the patients with different types of septal deviation was compared in Group 3, a statistically significant difference (p = 0.001) was observed. Regression analysis revealed that the septal deviation angle (SDA) (p = 0.001) had a relationship with total turbinate volume. From the results of the study we can conclude that the total turbinate volume is higher in patients with nasal septal deviation. It can also be concluded that the septal deviation angle has a positive correlation with total turbinate volume. The data obtained from the study can be useful in post-surgical follow up and evaluation of patients with nasal septal deviation and hypertrophied inferior nasal turbinate.

The volume of the inferior turbinates (IT) and the lining of the maxillary sinuses are important parameters when assessing sino-nasal diseases. However, no radiographic studies have investigated the correlation between these parameters. The present study was conducted to analyze the association between IT volumes and thickness of maxillary sinus mucosal lining.A retrospective evaluation of the cone-beam computed tomography (CBCT) scans of 100 adult subjects was carried out by two radiologists. The scans were assigned to two groups (Group 12) based on the radiographic evidence of maxillary sinus lining in the CBCT scans. Group 1 consisted of 50 CBCT scans of subjects with no evidence of maxillary sinus mucosal lining, whereas Group 2 consisted of 50 subjects with evidence of maxillary sinus mucosal lining. The scans in the Group 2 were further sub-classified into five categories, based on the thickness of the maxillary sinus mucosal lining. Vesalius 3D software was used to evaluate the total volume of inferior nasal turbinates by the two radiologists and a mean volume was obtained for each study subject.The intraclass correlation coefficient (ICC) between the volumetric estimations performed by the two radiologist was 0.87. Analysis of the results revealed that there was no significant gender-based difference (Group 1, P = 0.67 and Group 2, P = 0.95) in the total turbinate volume in either of the study groups. The total turbinate volume did not show any significant correlation (Group 1, r = 0.24 and Group 2, r = 0.12) with the age. There was a significant increase (P = 0.001) in the total turbinate volume of the subjects in Group 2 compared to Group 1. Regression analysis revealed that the thickness of sinus lining correlated significantly (P = 0.001) with the total turbinate volume.An increase in the total turbinate volume has been associated with an increase in the thickness of the maxillary sinus mucosal lining. The data from this study will be useful for post-operative follow-up of inferior turbinates and maxillary sinus lining after the turbinate volume reduction procedures.

To study the prognostic significance of E-cadherin, β-catenin, and cyclin D1 expression in oral squamous cell carcinoma.The study included 65 subjects with histologically confirmed squamous cell carcinoma. TMA blocks were prepared for immunohistochemical quantification of the expression of the three markers using IHC profiler and Immune ratio plugin of Image J.E-cadherin expression was significantly correlated with histological grades and the metastasis status (p0.05), whereas β-catenin expression was significantly correlated with smoking and tumor recurrence (P0.05). Cyclin D1 expression was significantly correlated with depth of invasion and tumor recurrence. (p0.05). Advanced tumor stage and depth of tumor invasion increases the risk of recurrence or death by 2.5 times (OR= 2.53 and 0.84 respectively).High expression of β-Catenin and Cyclin D1 are significantly correlated with tumor recurrence and old age. Depth of invasion, low histological grade and old age were a significant predictor for the risk of having tumor recurrence and cancer related death.

Background The primary aim of this prospective study is to demonstrate the technical feasibility of OCT to map real tumor margins and to monitor skin changes that occurred post- PDT. Moreover, to optimize PDT efficacy based on the relationship between measured OCT features and treatment outcome. Material and Methods A series of 12 patients with overall 18 facial skin lesions were investigated by OCT before surface illumination by PDT to determine tumor free margins. Monitoring of the healing process was undertaken at 3, 6 and 12 months post-PDT. Parameters measured by the in vivo OCT during healing phase were the organization of skin layer and the degree skin fibroses for the active center and peripheral transit zone of the treated lesion. Clinical and aesthetics assessment was carried out at 12-month post-PDT. Results Distinct microstructural differences between normal skin, pre-cancer, cancer, and the transition zone between the two tissues were observed on OCT images. In the subsequent healing phase, OCT demonstrate marked delineation and organization of skin layer at late stage of healing. Early features showing bizarre non-homogenous disorganized layering (scab) but afterwards, OCT was able to differentiate between different histological layers. One lesion demonstrated clinical healing by fibrosis (scar) without sign of recurrence. Another lesion demonstrated skin erythema. Only one lesion did not response to treatment despite margins clearance. The CR rate was 95% at the end of the study. The cosmetic effect was "excellent" in 89% of the patients. Conclusions This feasibility study lays the groundwork for using OCT as a real-time, noninvasive monitoring device for PDT in patients with skin cancer.

Online learning has become the new normal in many medical and health science schools worldwide, courtesy of COVID-19. Satisfaction with online learning is a significant aspect of promoting successful educational processes. This study aimed to identify factors affecting student and faculty satisfaction with online learning during the new normal. Online questionnaires were emailed to students (n = 370) and faculty (n = 81) involved in online learning during the pandemic. The questionnaires included closed- and open-ended questions and were organised into two parts: socio-demographic information and satisfaction with online learning. Descriptive statistics were used to analyse the responses to the satisfaction scales. Students’ and faculty responses to the open-ended questions were analysed using the thematic analysis method. The response rate was 97.8% for students and 86.4% for faculty. Overall satisfaction among students was 41.3% compared to 74.3% for faculty. The highest areas of satisfaction for students were communication and flexibility, whereas 92.9% of faculty were satisfied with students’ enthusiasm for online learning. Technical problems led to reduced student satisfaction, while faculty were hampered by the higher workload and the required time to prepare the teaching and assessment materials. Study-load and workload, enhancing engagement, and technical issues (SWEET) were the themes that emerged from the thematic analysis as affecting student and faculty satisfaction. Adopting a combination synchronous and asynchronous approach, incorporating different applications to engage students, and timely feedback are imperative to increasing student satisfaction, while institutional support and organisational policy could enhance faculty satisfaction.

Prior research has demonstrated that motor skill learning is often disrupted by self-focus and attempts to control movement. The propensity for reinvestment (i.e., self-focus and movement control) has been associated with poor motor skill learning in sport and surgery, but it has not yet been examined in dental education. Therefore, the aim of this study was to evaluate the propensity for disruptive reinvestment among dental students so as to optimize their learning needs. Volunteer dental students (210) completed three reinvestment surveys to investigate their self-reported propensity to engage in conscious self-monitoring and control of their movements and decisions. We used analysis of variance (ANOVA), with post-hoc analyses as appropriate, to assess the effect of various participant demographics on their reinvestment scores. Male participants had a lower mean reinvestment scale score than females ( p

The anxiolytic effects of music have been studied during the past twenty years in different medical therapies. The aim of this study is to evaluate the effect of music therapy on patients' dental anxiety, salivary cortisol, heart rate, blood pressure and body temperature during dental treatment.In this randomized control study, 46 patients were randomly selected from the Urgent Care dental clinic who needed urgent endodontic treatment (endodontic access and pulp extirpation). Participants were divided into two groups: intervention group (N=23) which was exposed to slow rhythm melody music and had no lyrics throughout the entire procedure and a control group (N=23) who undergoes the same dental procedure without being exposed to music. Participants' blood pressure, heart rate, body temperature and salivary cortisol were measured before and after the treatment for both groups.Patients in the intervention group showed lower salivary cortisol, blood pressure, heart rate and body temperature compared to those in the control group, however, the differences did not reach to statistical significance.-Despite the change in the dental anxiety and stress during treatment with music, the findings of this study could not establish evidence of the effect of music in reducing dental anxiety and lowering physiological stressors. Therefore, further studies with larger sample size may be needed. (www.actabiomedica.it).

Background High-quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various health professionals remains a challenge. Very few focus group discussions to determine the medical students’ readiness and positive attitudes towards IPE have been reported from the Arabian context. Methods A two-staged sequential mixed methods study was conducted among medical, dental, pharmacy, and health sciences students of the University of Sharjah United Arab Emirates. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument, Readiness for Interprofessional Learning Scale (RIPLS). This was followed by focused group discussions. A quantitative as well as a qualitative data analysis was performed. Results This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statements of the RIPLS inventory scored high median scores. All participants showed positive attitudes and readiness towards IPE. Three main domains of themes were generated from focus group discussions; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers. Conclusion This study demonstrated a substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE programs into existing curricular frameworks, which can potentially enhance collaborative learning and improve quality of patient care.

Additional file 1.

Student engagement is vital in achieving learning outcomes and improving students' motivation, involvement, and attitudes toward learning. The aim of this study was to identify the factors that affect student engagement in online learning in medical and health science colleges.A cross-sectional study was conducted among medical and health science students and faculty in May 2020. The Online Engagement Strategies Questionnaire was e-mailed to 370 students and 102 faculty members. The SPSS statistical software was used for the statistical analysis. Exploratory factor analysis was performed to identify the factors that affected the students' engagement in online learning. Composite scores were calculated for factors, separately for the student and faculty responses. Descriptive statistical analysis was performed for the student and faculty responses.The response rates of the students and faculty were 85.1% and 74.1%, respectively. The mean ages of the students and faculty were 20.6 and 44.6 years, respectively. Eighty-five percent of the faculty (n = 51) and 88.3% (n = 278) of the students found that the use of technology in proper communication was an important strategy to engage students in online learning. The factor analysis revealed agreement between the students and faculty regarding the factors that support student engagement in online learning. Techno-pedagogical skills were considered very important for faculty and important for students. For both faculty and students, self-directed learning skills were important, and peer-assisted learning (PAL) was fair symmetry. Nevertheless, collaborative learning (CL) was fairly symmetry to students and important to faculty.To enhance student engagement in online learning, faculty members should consider improving their techno-pedagogical skills. Moreover, by incorporating self-directed learning, CL and PAL will support student engagement. Finally, faculty development, updating of course design, and institutional policies are all required to support online learning.

الملخص: أهداف البحث: إن تدريب التغذية العلاجية هو مقرر أساسي يجمع بين الدراسة النظرية والمهارات العملية في المجال السريري. الهدف من التدريب هو إعداد الخريجين ليكونوا أكفاء في مستقبلهم العملي. التعلم القائم على الحالات السريرية هو مناقشة تعليمية يشارك فيها الطالب لعلاج الحالات التي يتعاملون معها خلال فترة تدريبهم. والتعليم المدمج هو طريقة تدريس تتناول الجوانب المتعددة لحالة المريض وتأثيرها على حالته التغذوية بهدف تسهيل فهم الطالب لعلاقة العلوم ببعضها. يصف هذا البحث تجربة تدريس طلبة التغذية العلاجية بطريقة التعليم المدمج القائم على الحالة وتقييم تأثيرها على أداء طلاب التغذية خلال فترة تدربيهم السريري. طرق البحث: استهدف هذا المشروع التعليمي تدريب طلاب التغذية العلاجية في جامعة الشارقة. حيث تم عقد ١٠ جلسات تعليمية بطريقة التعليم المدمج القائم على الحالة لتسعة وعشرين طالبا في أماكن تدريبهم. واستخدم الباحثون نتائج تقريرعملية الرعاية التغذوية لتقييم الأداء التعليمي للمتدربين قبل الجلسة التعليمية وبعدها. علاوة على ذلك، أجريت مقابلة مع مجموعة من الطلاب لتوضيح تأثير هذه الطريقة في التدريس على تجربة الطلاب التعليمية. النتائج: شهد جميع الطلاب (١٠٠ ٪) تحسنا في أدائهم التعليمي خلال تدريب التغذية العلاجية. وارتفعت درجات تقارير الطلاب بنسبة ٥٥٪ وقد صرحوا بأنهم اكتسبوا مهارات تعليمية مفيدة لحياتهم العملية بعد هذه الجلسة التعليمية. الاستنتاجات: أظهر تدريس طلاب التغذية العلاجية بطريقة التعليم المدمج القائم على الحالة السريرية خلال فترة تدريبهم أثرا على نتائجهم العلمية وأسهم في تحسين مهاراتهم العملية، مما أدى إلى تطور قدرتهم على وصف العلاجات التغذوية. وأوصى الطلاب باعتماد هذه الطريقة التعليمية لمقرر تدريب التغذية العلاجية لما اختبروه من تطور في قدرتهم على ربط مواد التغذية العلاجية ببعضها. Abstract: Objectives: Clinical nutrition training is an essential course for clinical nutrition and dietetics (CN&D) students. The training combines theoretical knowledge with practical skills. The goal is to prepare competent graduates for future practice. Case-based learning is an active learning method based on cases from the clinical setting. This study aimed to introduce an integrated case-based learning (ICBL) method to the clinical training of a cohort of CN&D students and to evaluate its impact on the students’ knowledge of nutrition care process. Methods: This action research project employed an ICBL-method of teaching in the clinical training of senior students in the CN&D course at the University of Sharjah, United Arab Emirates. Ten integrated case-based learning sessions were conducted with 29 students. The record of the nutrition care process was used to evaluate the learners' performance through a pretest-posttest mechanism. Furthermore, a focus group interview was conducted to determine the impact of the ICBL-based training on the students' learning experience. Results: All of the students (100%) showed improvement in their learning. There was a 55% improvement in their grades. There was also self-perceived improvement of their life-long learning skills after the ICBL sessions. Conclusion: Integraed case-based learning positively influenced learning among CN&D students. Consequently, the students were able to describe appropriate and individualized nutritional care plans. The students were satisfied with the training and considered ICBL to be an effective method of clinical training.

Background To investigate the effectiveness of technology-enhanced teaching and assessment methods of undergraduate preclinical skills in comparison to conventional methods. Methods A comprehensive search strategy was implemented using both manual and electronic search methods, including PubMed, Wiley, ScienceDirect, SCOPUS, and the Cochrane Central Register of Controlled Trials. The search and selection of articles that met the inclusion criteria were carried out in duplicates. A Cochrane data extraction form for RCTs was used to extract the relevant information from all included articles. Risk of bias of all included articles was assessed independently by two authors using the Cochrane risk of bias tool. Results A total of 19 randomized controlled clinical trials met the inclusion criteria and were included in this review. The majority of the studies included in this review have a high risk of bias mainly due to incomplete data, lack of blinding of the examiners, and due to other biases, such as small sample sizes, not accounting for additional hours of training, and the lack of calibration of examiners grading the preparations. Conflicting results were reported in the included studies with regards to whether there were differences between the intervention and control groups in the outcome measure of quality of students’ performance. A meta-analysis could not be done for this study due to the heterogeneity among the included studies. Conclusions Technology-enhanced teaching and assessment tools used in preclinical skills training of undergraduate dental students have the potential to improve students’ performance. However, due to the conflicting outcomes reported in the 19 studies included in this systematic review and their high risk of bias, better quality studies are required to find a definitive answer to the research question of this systematic review.

Background High‐quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various medical disciplines remains a challenge. Several survey-based studies have reported attitudes about IPE, but very few mixed methods studies, particularly in Arabic-speaking countries, have been conducted to determine medical students’ perspectives and readiness. Methods A two-staged sequential mixed methods study was conducted among medical and health sciences students of University of [---],[country]. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument; namely Readiness for Interprofessional Learning Scale (RIPLS). This was followed by detailed focused group discussions. Quantitative and qualitative data analysis were performed using SPSS and NVivo, respectively.Results This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statement of RIPLS survey scored high means. Highest mean of 5 was achieved for IPE elements of identifying and resolving patients’ problems and small group work. Three main themes were generated; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers. Conclusion This study demonstrates substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE program into the existing curricular framework that can potentially enhance collaborative learning and improve quality of patient care.

Objective The tongue microbiome has emerged as a non-invasive diagnostic and tracking prognostic tool in the detection of diseases mainly cancer. This scoping review aimed to identify the association between tongue microbiome and pre-cancer or cancer lesions. Design A comprehensive electronic database search including PubMed, Web of Science, and Scopus was undertaken up to March 2021, without language or date restrictions. This review was conducted following the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) guideline. All observational studies that compared microbial community on the dorsal surface of the tongue between cancer or precancerous cases and healthy controls using NGS techniques were included. Results Of 274 records identified, nine studies were eligible to be included. Despite the inconsistent observations in terms of diversity and richness, most studies reported alteration in bacterial communities between pre-cancer or cancer cases and control groups. The bacterial profile among cases was so far correlated at the phylum level with a noticeable diverse degree at the genus level. The majority of included studies reported a higher abundance of certain kinds of microorganisms as compared to healthy participants including Firmicutes, Fusobacteria and Actinobacteria at phyla level as well as Streptococcus, Actinomyces, Leptotrichia, Campylobacter, and Fusobacterium at the genus level. Conclusion The alteration of the tongue microbial community has been associated with several diseases mainly cancer. So, the tongue microbiome may serve as a promising diagnostic tool or as a long-term monitor in precancerous or cancer cases.

The aim of this study was to determine the efficacy of immediate implant placement with alveolar bone augmentation on socket preservation following atraumatic tooth extraction and comparing it with a tooth alveolar socket that was allowed to heal in a conventional way.Twenty medically fit patients (8 males and 12 females aged between 18 and 40 years) who needed noncomplicated tooth extraction of mandibular premolar teeth were divided randomly and equally into 2 groups. In Group I, the empty extraction socket was left untreated and allowed to heal in a conventional way. In Group II, the immediate implant was placed and the gap between the implant and the inner buccal plate surface of the socket wall was filled with lyophilized bovine bone granules and the wound was covered with pericardium membrane. The patients were followed up clinically and radiologically for regular reviews at 1 week, 3 months, and 9 months postoperative. Cone beam computerized tomography images of the alveolar ridge and socket were analyzed to determine the structural changes of the alveolar ridge. Resonance frequency analysis was measured at 9 months for Group II to assess the degree of secondary stability of the implants by using Osstell machine.A significant difference of bone resorption of 1.49 mm (confidence interval, CI 95%, 0.63-2.35) was observed within the control group at 3 months, and 1.84 mm (P ≤ 0.05) at 9 months intervals. No significant changes of bone resorption were observed in Group II. Comparison between groups showed a highly significant difference at 3 months; 2.56 mm (CI 95% 4.22-0.90) and at 9 months intervals; 3.2 mm (CI 95%, 4.70-1.62) P ≤ 0.001 between Group I and II. High resonance frequency analysis values were observed at 9 months postoperative in Group II.In conclusion, the insertion of immediate implants in fresh extraction sockets together with grafting the circumferential gap between the bony socket wall and the implant surface with bovine bone granules was able to preserve a greater amount of alveolar ridge volume when compared with an extraction socket that was left to heal in a conventional way.

The aim of the present study was to compare cone-beam computerized tomography (CBCT) findings and joint space measurement in temporomandibular disorder (TMD) and non-TMD joints, and to correlate these findings with the clinical diagnosis.The study was conducted on patients diagnosed with temporomandibular joint (TMJ) osteoarthritis or closed lock according to the Research Diagnostic Criteria for TMDs (Group IIb, IIc, and III). CBCT and clinical records of non-TMD patients who sought treatment for purposes other than TMD were used retrospectively as a control. The following radiographic criteria were assessed: flattening, osteophyte, Ely's cyst, condylar surface irregularities, and joints' space measurements.Osteoarthritic joints had significantly more condylar irregularities (P50.0), osteophytes (P50.0), and condylar flattening (P50.003) than non-TMD joints. Osteoarthritic joints had significantlymore superior surface irregularities (P50.0) and osteophytes (P50.006) than closed lock joints.Non-TMDjoints had significantlymore joint space (5.64+1.88) compared with osteoarthritic joints (4.57+1.97), (P50.025). The correlation among TMD, osteophytes, and flattening of the condylar surface was statistically significant (r50.331, Pv0.000).Cone-beam computerized tomography findings are significantly associated with the clinical diagnosis of TMD. Osteophytes and flattening of the condylar surface are common features of TMD.

Introduction Dentists are at a very high risk of developing work-related musculoskeletal pain. The present study aimed at studying the prevalence of musculoskeletal pain among different dental specialists in the United Arab Emirates (UAE), and correlating the region of pain with the type of clinical work done by the specialists. Materials and methods A sample of more than 100 dentists was chosen randomly from different emirates in UAE. An interview questionnaire was administered regarding the number of years of experience and the presence, region, duration, and type of musculoskeletal pain they experienced. Results Musculoskeletal pain is experienced by 83.3% of periodontists, 80% of conservative dentists, 77.8% of endodontists, 72.7% of orthodontists, 70% of oral surgeons, 63.6% of prosthodontists, 63% of general dental practitioners, and 50% of pedodontists. The results have also indicated that the region of experienced musculoskeletal pain does vary according to the specialty. From those dentists who experience work-related musculoskeletal pain, 80% of conservative dentists experience pain in neck and shoulders, 66.7% of periodontists, and 54.5% of orthodontists experience pain in the lower back region. More than 50% of endodontists experience pain in the neck and shoulders regions, and 39% of general dental practitioners who experience pain in the neck region. Conclusion Preventive measures need to be taken to decrease the risk of dentists and dental specialists developing workrelated musculoskeletal pain. Clinical significance The prevalence and distribution of musculoskeletal disorders (MSDs) among registered general dental practitioners and dental specialists in UAE was not clearly documented. The study results indicated that the region that experienced musculoskeletal pain does vary according to the specialty. How to cite this article Al-Rawi NH, El Khatib H, Rajoub L, El-Sayed M, Naji R, Youssef R, Al Kawas S. Work-related Musculoskeletal Pain among Different Dental Specialists in United Arab Emirates. J Contemp Dent Pract 2016;17(8): 639-644.

Objectives: We aim to assess the antibacterial effectiveness of probiotic cleaning in a dental clinic at the University Dental Hospital Sharjah (UDHS), UAE. Materials and Methods: The current cleaning protocol of UDHS was evaluated by the surface swabbing of three dental clinics routinely cleaned using regular chemical disinfectants. Then, a new probiotic cleaning solution containing Bacillus subtilis was applied for 3 weeks in a selected clinic. Bacteria were grown onto selective culture media for colony counting from surfaces cleaned with probiotic solution compared to those obtained from the same surfaces cleaned with the regular chemical solutions. Isolates identity was confirmed by biochemical tests or polymerase chain reaction. Results: There was a significant reduction of the bacterial counts of various bacterial species (Staphylococci, Streptococci, and Gram-negative rods) from almost all the surfaces in the dental clinic after the application of the probiotic solution compared to the same surfaces cleaned with the regular chemical solutions. However, the antibiotic resistance rates were not significantly reduced within the short period of 3 weeks of using the new probiotic cleaning product. Conclusions: This study demonstrated that the use of probiotic cleaning is effective in reducing microbial growth in dental settings. This approach may be tested further to examine the long-term effect and to evaluate the opportunity of applying this novel biotechnology as part of the infection control routine in dental settings instead of the chemical disinfectants which are known to cause serious health problems. This is the first study testing the application of probiotic-based solution in dental settings.

Introduction Alveolar bone is critical in supporting natural teeth, dental implants as well as a removable and fixed prosthesis. Alveolar bone volume diminishes when its associated natural tooth is lost. Objective The aim of this study is to evaluate the effectiveness of bovine bone granules on alveolar bone socket augmentation for ridge preservation following atraumatic tooth extraction. Materials and methods Twenty medically fit patients (12 males and 8 females aged between 18 and 40 years) who needed noncomplicated tooth extraction of 1 mandibular premolar tooth were divided randomly and equally into 2 groups. In control group I, the empty extraction socket was left untreated and allowed to heal in a conventional way. In group II, the empty extraction socket wound was filled with lyophilized bovine bone xenograft granules 0.25 to 1 mm of size, 1 mL/vial. A resorbable pericardium membrane was placed to cover the defect. Clinical and 3-dimensional radiological assessments were performed at day 0, 3 months, and 9 months postoperative. Results There were no clinical differences in general wound healing between the groups. Comparisons within the groups showed a significant difference of bone resorption of 1.49 mm (95% confidence interval, 0.63-2.35) at 3 months, and further resorption of 1.84 mm (P ≤ 0.05) at 9 months in the control group. No significant changes of bone resorption were observed in group II during the same time interval. Comparison between groups showed a significant difference of bone resorption at 3 and 9 months (2.40 and 2.88 mm, respectively). Conclusion The use of lyophilized demineralized bovine bone granules in socket preservation to fill in the extraction socket seems essential in preserving the alveolar bone dimension as it showed excellent soft and hard tissue healing. This study concludes that the alveolar bone socket exhibited a dynamic process of resorption from the first day of tooth extraction. Evidence shows the possibility of using bovine bone granules routinely in socket volume preservation techniques following tooth extraction.

Background: Dental injuries in children and adolescents living across the globe are a serious public health problem. There are no data on dental injuries in United Arab Emirates (UAE). For the development of effective preventive measures, the present study was conducted to investigate the etiology and environment where dental injuries occurred, and to assess the relationship between traumatic dental injuries and socioeconomic status. Material and Methods: This study was undertaken in different colleges of University of Sharjah, UAE. 412 participants aged 18-22 years were screened using Dental Trauma Index (DTI), following the questionnaire phase of the study. Results: Prevalence of dental injury was 25.9%, mostly (46.9%) with restored teeth; followed by 42.3% of minor injury (untreated enamel fracture), affecting one upper central incisor (53%). The mean age at the time of dental injury was 10.5 years (SD = 1.52; range 8-13 years) in females vs 14 years (SD = 1.71; range 12-16 years) in males. Dental injuries among males mostly occurred at public places such as on streets (27%) with (19%) of injuries were related to motor bike/micro scooters followed by bicycles (17%) and traffic accidents (9%). Socioeconomic indicators chosen were not statistically significant with the exception of family income (P = 0.01). Conclusion: The findings of this study show that dental traumas are prevalent among middle and high socioeconomic groups. There is a need for potential interventions like educating parents, caretakers, and older siblings on how to reduce the risk factors related to dental injuries. Language: en

Background: The aim of this study was to evaluate the stability of immediate implant placement for alveolar bone augmentation and preservation with bovine bone graft following atraumatic tooth extraction. Materials and Methods: This was a prospective interventional study with convenient sampling (n = 10). Thirty patients aged between 18 and 40 years, who needed noncomplicated tooth extraction of mandibular premolar tooth, were sequentially divided equally into three groups. In Group I, simple extraction was done and the empty extraction socket left to heal conventionally. In Group II, extraction sockets were filled with lyophilized bovine granules only. In Group III, immediate implants were placed into extraction sockets, and the buccal gap was also filled with bovine granules. All groups were subjected to cone beam computed tomography scan for radiological evaluation. Assessment of biomechanical stability (radiofrequency analysis [RFA] was performed at 9 months postoperative for Group III to assess the degree of secondary stability of the implants using Osstell. Repeated measure analysis of variance (ANOVA) test was applied when comparing within each group at three different time intervals, whereas one‑way ANOVA was applied followed by post hoc‑tukey test when comparing between groups. P < 0.05 was considered statistically significant. Results: Radiological assessment reveals a significant difference of bone resorption in alveolar dimension within Group I; 1.49 mm (P = 0.002), and 0.82 mm (P = 0.005), respectively, between day 0 and 3 months. Comparison between Group I and III showed a highly significant difference of bone resorption in ridge width at 3 months 2.56 mm (P = 0.001) and at 9 months interval 3.2 mm (P < 0.001). High RFA values demonstrating an excellent biomechanical stability were observed in Group III at 9 months postoperatively. Conclusion: The insertion of immediate implants in extraction sockets with bovine bone augmentation of the buccal gap was able to preserve a greater amount of alveolar ridge volume. Key Words: Cone beam computed tomography, Immediate Dental Implant Loading, ridge, preservation

J Oral Pathol Med (2010) 39: 48–55 Background: Salivary glands tumors are relatively uncommon neoplasm with widely variable histopathologic and biologic characteristics. Alteration in some proto-oncogenes and tumor suppressor genes may lead to the development and progression of these tumors. Aims: The purpose of this study was to analyze the immunohistochemical expression of P53 and bcl-2 in some salivary gland tumors in relation to tumor size, histologic grade, and extent of invasion. Setting and design: The sample consisted of 22 formalin-fixed paraffin embedded blocks of benign and malignant salivary glands tumors. Material and method: P53 and bcl-2 immunoreactivity was semi-quantitatively evaluated in at least 1000 cells examined under the microscope at 40× magnification and recorded as percentage of P53 or bcl-2 positive tumor cells over the total number of cells examined in the same area. Percentage scores were subsequently categorized using the 5% cut-off point for positive staining. Results and conclusion: Pleomorphic adenoma (PA) showed negative expression of P53 and bcl-2 in 70% of cases, whereas all malignant salivary glands tumors were positive for P53 and bcl-2. P53 positive/bcl-2 positive immunostaining reaction was week in small size PA and was totally absent in larger lesions. However, all malignant tumors expressed P53, with the highest record in low-grade adenocarcinoma (76%) and the lowest score was observed in both low-grade carcinoma in PA and adenocystic carcinoma. bcl-2 immunostaining was also assessed, the highest recorded score was in high-grade adeno cystic carcinoma (90%) and the lowest in both low-grade carcinoma ex-PA and low-grade cystic mucoepidermoid carcinoma (3%). P53/bcl-2 immunostaining reactivity could be helpful in demonstrating salivary glands tumor behavior in terms of progression and extent of invasion.

The aim of this study was to assess the undergraduate dental education in sleep medicine in Middle East universities as well as the students' knowledge in this field.A cross-sectional observational study was carried out during the period from September 2013 to April 2014.Two different questionnaires were used. A self-administered questionnaire and a cover letter were emailed and distributed to 51 randomly selected Middle East dental schools to gather information about their undergraduate sleep medicine education offered in the academic year 2012-2013.The second questionnaire was distributed to the fifth-year dental students in the 2nd Sharjah International Dental Student Conference in April 2014, to assess their knowledge on sleep medicine. A survey to assess knowledge of sleep medicine in medical education (Modified ASKME Survey) was used.Thirty-nine out of 51 (76%) responded to the first questionnaire. Out of the responding schools, only nine schools (23%) reported the inclusion of sleep medicine in their undergraduate curriculum. The total average hours dedicated to teaching sleep medicine in the responding dental schools was 1.2 hours. In the second questionnaire, 29.2% of the respondents were in the high score group, whereas 70.8% scored low in knowledge of sleep-related breathing disorders.Dental students in Middle East universities receive a weak level of sleep medicine education resulting in poor knowledge in this field.

The murine homologue of the 25-hydroxyvitamin D [25(OH)D] 1alpha-hydroxylase gene [1alpha(OH)ase; Cyp27bl], which is mutated in humans with vitamin D-dependent rickets type I (VDDR-I; also known as pseudovitamin D-deficiency rickets [PDDR]) was cloned and characterized. Like the human, the mouse gene has nine exons, and the exon-intron organization is well conserved. By interspecific backcross analysis, the Cyp27bl gene was mapped to 70.5 cM on mouse Chr 10. This is in a region syntenic with human Chr 12q13.1-q13.3 to which the human 1alpha(OH)ase gene was previously mapped. Kidney expression of the 1alpha(OH)ase was localized to cortical tubules and was higher in the adult mouse than in the fetus, consistent with the increased role of its product as a circulating hormone postnatally. Prenatally, the 1alpha(OH)ase gene, together with the vitamin D receptor (VDR) gene, was expressed in embryonic stem cells, and expression of 1alpha(OH)ase in bone and intestine was higher in the fetus than in the adult. These observations suggest that 1,25-dihydroxyvitamin D [1,25(OH)2D] plays a role in fetal development. In view of the fact that humans lacking 1alpha(OH)ase have apparently normal prenatal development, this may point to functional redundancy in the fetal vitamin D system, which now can be explored further in mouse models in which the 1alpha(OH)ase gene has been deleted.

Objective: The purpose of this study is to assess the impact of knowledge acquired in preventive aspects of dental education on dental students’ own health attitudes, oral hygiene and gingival status in the United Arab Emirates.Methods: To compare the self-reported oral health behavior of first year dental students in the University of Sharjah with their actual oral hygiene and gingival conditions, 93 volunteers who participated in the study completed the Hiroshima University-Dental Behavioral Inventory (HU-DBI) questionnaire. Subsequently a clinical examination for their Plaque Scores (Modified Quigley Hein Plaque Index) and Gingival Bleeding Index was performed by a calibrated dentist.Results: 29% of the participants reported bleeding gums; 83% were concerned by the color of their gums while 63% reported that it was impossible to prevent gum disease with brushing alone; and only 10% noticed some sticky white deposits on their teeth. However, approximately 92% were not in agreement that they would have false teeth when they grew older. 56% mentioned that they used dental floss regularly and 86% brushed twice daily or more. Male students had higher bleeding and plaque scores than female students. There appeared to be a significant relationship between plaque scores and HU-DBI responses; in addition to the significant relationship noted between recorded bleeding percentages and HU-DBI responses.Conclusion: Female students have shown better dental care behavior than male students. The dental students with better self-reported oral health attitudes were expected to have lower plaque scores but instead had moderate plaque and gingival bleeding scores. This indicates the need for more emphasis on preventive measures in oral health education. (Eur J Dent 2013;7:22-27)

Saliva is an important body fluid containing a complex mixture of proteins, peptides and other substances. These are not only important in maintaining the health of the oral cavity but also may yield information about oral and systemic disease. Comprehensive analysis and identification of the proteomic content of human saliva may contribute to the understanding of oral pathophysiology and provide a foundation for the recognition of potential biomarkers of human disease. The collection of saliva samples is non-invasive, safe, and inexpensive. It seems likely that testing methods can be developed which can be used in general medical or dental practice. However, it is important to realize that the collection of saliva must be carefully controlled. In this paper we review the progress in the analysis of the human salivary proteome and summarise the diagnostic possibilities that have been explored. The precautions in collecting saliva, and some of the factors which would have to be considered if a diagnostic test were to be generally adopted are discussed.

Dental injuries in children and adolescents living across the globe are a serious public health problem. There are no data on dental injuries in United Arab Emirates (UAE). For the development of effective preventive measures, the present study was conducted to investigate the etiology and environment where dental injuries occurred, and to assess the relationship between traumatic dental injuries and socioeconomic status.This study was undertaken in different colleges of University of Sharjah, UAE. 412 participants aged 18-22 years were screened using Dental Trauma Index (DTI), following the questionnaire phase of the study.Prevalence of dental injury was 25.9%, mostly (46.9%) with restored teeth; followed by 42.3% of minor injury (untreated enamel fracture), affecting one upper central incisor (53%). The mean age at the time of dental injury was 10.5 years (SD = 1.52; range 8-13 years) in females vs 14 years (SD = 1.71; range 12-16 years) in males. Dental injuries among males mostly occurred at public places such as on streets (27%) with (19%) of injuries were related to motor bike/micro scooters followed by bicycles (17%) and traffic accidents (9%). Socioeconomic indicators chosen were not statistically significant with the exception of family income (P = 0.01).The findings of this study show that dental traumas are prevalent among middle and high socioeconomic groups. There is a need for potential interventions like educating parents, caretakers, and older siblings on how to reduce the risk factors related to dental injuries.

At a late stage of amelogenesis, a basement-membrane-like (BML) structure appears between mature ameloblasts and the enamel surface. Although this BML structure is known to contain certain basement membrane components, its detailed nature and role were not well defined. As such, this study examined the BML structure using high-resolution electron microscopy combined with immunohistochemical staining. Mandibular rat incisors were processed for the preparation of Epon sections for ultrastructural observations, and frozen sections were used for immunostaining laminin, heparan sulphate proteoglycan (HSPG) and type IV collagen. The BML structure was characterized by the presence of abundant ribbon-like ‘double tracks’, 4.5–5.0 nm wide; the form known to be taken by HSPG in basal laminae. The main ultrastructural component of basal laminae, known as ‘cords’, was replaced by fine filaments of type IV collagen. Immunohistochemical staining of the BML structure showed an intense reaction for HSPG, moderate staining for type IV collagen and negligible staining for laminin. These observations indicate that this structure is an atypical basement membrane in which the cord network is replaced by type IV collagen filaments. However, the BML structure was found to be unusually rich in HSPG, similar to kidney glomerular basement membrane. It is likely that this specialized basement membrane mediates firm attachment of mature ameloblasts to the enamel surface, and filters the influx and efflux of materials to and from enamel during maturation.

Amalgam waste from dental clinics is a significant source of mercury released into the environment when it is washed down a drain or disposed of improperly. Mercury is of particular concern because of its potential adverse effects on humans and the environment. As a consequence, several measures have been adopted by dental clinics worldwide to reduce mercury discharge into the environment. The aim of this study was to quantitatively asses the mercury burden in the wastewater discharged from some dental clinics in the United Arab Emirates using a cold-vapour atomic absorption spectrometry technique. Wastewater samples were collected from 28 public clinics at Sharjah and Abu Dhabi over a period of 10–14 days. The average concentration of mercury in all samples was 317.7 μg/l, with a standard deviation of 379.7 μg/l and a range from below the method detection limit (MDL) to 1535.2 μg/l. The results show some variation in mercury concentrations between samples, depending on the type and nature of dental operations undertaken at the specific clinic from which each sample originated. Most of the wastewater released from dental clinics in the study area contains concentrations of mercury which, although lower than levels reported elsewhere in the literature, are unacceptable according to local and international environmental standards. This implies that such wastewater should not be discharged without adequate pretreatment in order to reduce mercury pollution in the environment.