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Purpose: To evaluate the effects of post length, post material, and substance loss on the fracture resistance of endodontically treated mandibular premolars. Materials and Methods: A total of 96 extracted human mandibular first premolars were endodontically treated and divided into 12 test groups (n = 8 each) based on the number of residual walls (one/two), post material (glass-fiber/titanium), and post length (5 mm, 7.5 mm, and 10 mm). After luting the posts, specimens received a composite resin core and a crown preparation with a 1.5-mm ferrule. Cast cobalt-chromium crowns were cemented using glass-ionomer cement. After 1,200,000 chewing cycles with a load of 49 N and simultaneous thermocycling (5°C to 55°C), specimens were quasi-statically loaded at 30 degrees to the longitudinal axis of the tooth until fracture. Fracture loads were analyzed using three-way, two-way, and one-way ANOVA (a = .05). Fracture modes were examined under a stereomicroscope (×25 magnification) and recorded. Results: The mean ± SD fracture loads ranged from 642 ± 190 N (one wall, glass fiber, 5 mm) to 1,170 ± 130 N (two walls, titanium, 7.5 mm). The mean fracture load of titanium posts was significantly higher than that of glass-fiber posts (P < .001), and the 7.5-mm post length exhibited significantly higher fracture loads than groups with 5-mm and 10-mm post length (P = .008). Conclusions: Teeth restored with titanium posts revealed considerably higher fracture resistance than teeth restored with glass-fiber posts, especially if 7.5-mm-length posts were used. [ABSTRACT FROM AUTHOR]

To incorporate different concentrations of Al2O9Zr3 (1%, 5%, and 10%) nanoparticles (NP) into the ER adhesive and subsequently assess the impact of this addition on the degree of conversion, μTBS, and antimicrobial efficacy. The current research involved a wide‐ranging examination that merged various investigative techniques, including the application of scanning electron microscopy (SEM) for surface characterization of NP coupled with energy‐dispersive x‐ray spectroscopy (EDX), Fourier‐transform infrared (FTIR) spectroscopy, μTBS testing, and microbial analysis. Teeth were divided into four groups based on the application of modified and unmodified three‐step ER adhesive primer. Group 1 (0% Al2O9Zr3 NPs) Control, Group 2 (1% Al2O9Zr3 NPs), Group 3 (5% Al2O9Zr3 NPs), and Group 4 (10% Al2O9Zr3 NPs). EDX analysis of Al2O9Zr3 NPs was performed showing elemental distribution in synthesized NPs. Zirconium (Zr), Aluminum (Al), and Oxides (O2). After primer application, an assessment of the survival rate of Streptococcus mutans was completed. The FTIR spectra were analyzed to observe the characteristic peaks indicating the conversion of double bonds, both before and after the curing process, for the adhesive Etch and rinse containing 1,5,10 wt% Al2O9Zr3 NPs. μTBS and failure mode assessment were performed using a Universal Testing Machine (UTM) and stereomicroscope respectively. The μTBS and S.mutans survival rates comparison among different groups was performed using one‐way ANOVA and Tukey post hoc (p =.05). Group 4 (10 wt% Al2O9Zr3 NPs + ER adhesive) specimens exhibited the minimum survival of S.mutans (0.11 ± 0.02 CFU/mL). Nonetheless, Group 1 (0 wt% Al2O9Zr3 NPs + ER adhesive) displayed the maximum surviving S.mutans (0.52 ± 0.08 CFU/mL). Moreover, Group 2 (1 wt% Al2O9Zr3 NPs + ER adhesive) (21.22 ± 0.73 MPa) samples displayed highest μTBS. However, the bond strength was weakest in Group 1 (0 wt% Al2O9Zr3 NPs + ER adhesive) (14.13 ± 0.32 MPa) study samples. The etch‐and‐rinse adhesive exhibited enhanced antibacterial activity and micro‐tensile bond strength (μTBS) when 1% Al2O9Zr3 NPs was incorporated, as opposed to the control group. Nevertheless, the incorporation of Al2O9Zr3 NPs led to a decrease in DC. Research Highlights: 10 wt% Al2O9Zr3 NPs + ER adhesive specimens exhibited the minimum survival of S.mutans.1 wt% Al2O9Zr3 NPs + ER adhesive samples displayed the most strong composite/CAD bond.The highest DC was observed in Group 1: 0 wt% Al2O9Zr3 NPs + ER adhesive. [ABSTRACT FROM AUTHOR]

This research aimed to assess the stress distribution in lower premolars that were obturated with BioRoot RCS or AH Plus, with or without gutta percha (GP), and subjected to vertical and oblique forces. One 3D geometric model of a mandibular second premolar was created using SolidWorks software. Eight different scenarios representing different root canal filling techniques, single cone technique with GP and bulk technique with sealer only with occlusal load directions were simulated as follows: Model 1 (BioRoot RCS sealer and GP under vertical load [VL]), Model 2 (BioRoot RCS sealer and GP under oblique load [OL]), Model 3 (AH Plus sealer with GP under VL), Model 4 (AH Plus sealer with GP under OL), Model 5 (BioRoot RCS sealer in bulk under VL), Model 6 (BioRoot RCS in bulk under OL), Model 7 (AH Plus sealer in bulk under VL), and Model 8 (AH Plus sealer in bulk under OL). A static load of 200 N was applied at three occlusal contact points, with a 45° angle from lingual to buccal. The von Mises stresses in root dentin were higher in cases where AH Plus was used compared to BioRoot RCS. Furthermore, shifting the load to an oblique direction resulted in increased stress levels. Replacing GP with sealer material had no effect on the dentin maximum von Mises stress in BioRoot RCS cases. Presence of a core material resulted in lower stress in dentin for AH Plus cases, however, it did not affect the stress levels in dentin for cases filled with BioRoot RCS. Stress distribution in the dentin under oblique direction was higher regardless of sealer or technique used. [ABSTRACT FROM AUTHOR]

The study aimed to evaluate knowledge, awareness, and perception of tooth-supported and implant-supported prostheses among an adult sample in Sana'a city in Yemen. A cross-sectional descriptive–analytical study was conducted on a convenient sample of 509 participants. All participants were aged 18 years and above with at least 1 missing tooth. The participants visited the public or private hospitals or their outpatient clinics in the municipality of the capital, Sana'a, Yemen. Their chief complaints when visiting the hospitals were not related to dental problems but to general healthcare. The participants who agreed and signed the consent form were interviewed and examined. The data were then recorded and statistically analyzed. The levels of awareness and knowledge of implant-supported prostheses among the 509 participants were low (58.0%, 33.6%, respectively). A significant positive correlation was found between genders (p = 0.003 for males, p = 0.000 for females), but no significant differences were detected between genders related to the awareness and knowledge of tooth-supported prostheses (p = 0.690). Most of the respondents had a low level of awareness, knowledge, and perception of treatment options for tooth replacement modalities. [ABSTRACT FROM AUTHOR]

Objectives: This laboratory study compared the effects of various post systems on the fracture resistance of endodontically treated mandibular premolars. Method and materials: Thirty-two extracted mandibular first premolars were collected, endodontically treated, and assigned into four test groups (n = 8). The classification was based on the post material as follows: traditional glass-fiber posts (TFP), traditional titanium posts (TTP), coated glass-fiber posts (CFP), and coated titanium posts (CTP). The posts were cemented with a dual-curing luting composite resin. Each specimen, which was prepared with a 2-mm ferrule height, received a composite resin core. All specimens were restored with cast CoCr crowns, which were cemented with glass-ionomer cement. All specimens were submitted to dynamic loading in a dual-axis chewing simulator for 1,200,000 cycles with a nominal load of 5 kg and simultaneous thermal cycling (5 to 55°C). Each specimen was secured in place and loaded at 30 degrees using a universal testing machine until fracture occurred. The results obtained were analyzed using one-way ANOVA and the fracture modes were investigated under stereomagnification (25x). Results: Fracture loads were as follows: 858 ± 216 N for CTP, 953 ±134 N for TFP, 979 ± 219 N for CFP, and 1,130 ± 286 N for TTP group. One-way ANOVA revealed no statistically significant differences among the test groups (P = .112). Conclusions: Under the conditions of the current study, no significant fracture resistance differences were found between teeth with the different prefabricated post systems. [ABSTRACT FROM AUTHOR]

Objective: Restoration of fractured root canal-treated maxillary incisors based on recent advances in adhesive dentistry and minimal invasive principles, which are topics of great importance. In particular, the aim of the present study was to evaluate the fracture resistance of a coronoradicular direct composite restoration compared with fibre post composite restorations and direct conventional composite restorations. Materials and methods: A total of 45 freshly extracted sound maxillary central incisors were used in the study. The teeth were randomly divided into three groups of 15 each. The groups were: group I (CDC), conventional direct composite postendodontic restoration; group II (FPC), fibre post placement and direct composite postendodontic restoration; group III (CRC), coronoradicular composite postendodontic restoration. The fracture resistance was measured using a universal testing machine and a 130 degrees angle of loading. Results: One-way ANOVA depicted a significant difference (P = 0.028) among the three groups with the mean fracture load of group CRC being the highest, at 1045.2 ± 355.7 N. The FPC group had the significantly least fracture resistance load, with 426.7 ± 245.3 N. Conclusions: Within the parameters of this study, the corono-radicular composite restorations had significantly higher fracture resistance than conventional direct composite and fibre post restor- r ations when 50% of the crown structure was lost in fractured root canal-treated maxillary incisors. [ABSTRACT FROM AUTHOR]

The aim of this study was to evaluate the aging effect of thermomechanical cyclic load on fracture resistance of lower premolars obturated with AH Plus and BioRoot RCS root canal sealers. Forty-eight single-rooted premolars teeth were instrumented with REVO-S files up to SU/0.06 taper. The teeth were randomly assigned into 2 main groups (n = 24) according to the selected two root canal sealers (AH Plus or BioRoot RCS). All teeth were obturated using matching gutta-percha. Each main group were further divided into 3 subgroups (A, B and C) (n = 8). Group A acted as the negative control group (non-Thermomechanical aging). Whereas Group B and C were subjected first to thermal variations in a thermal cycling machine (7500 and 15,000 thermal cycles), then two different dynamic loading periods namely 3 × 105 and 6 × 105 in a masticatory simulator with a nominal load of 5 kg at 1.2 Hz which simulate approximately 1 ½ and 3 years of clinical function respectively. The roots were decoronated and fracture resistance were measured using a universal testing machine. After thermal-mechanical aging, BioRoot RCS showed significantly higher fracture resistance (p < 0.05) than AH Plus. As the thermal-mechanical cycles increased both AH Plus and BioRoot RCS exhibited a significant decrease in fracture resistance (p < 0.05). It could be concluded that thermomechanical aging had a significant impact on the outcome of the fracture resistance of AH Plus and BioRoot RCS. [ABSTRACT FROM AUTHOR]

The aim of this in vitro study was to assess the effect of the type of orthodontic brackets and adhesive systems on enamel discoloration. The baseline color of the buccal surfaces of 50 extracted human premolars was recorded using a spectrophotometer according to the CIE Lab system. The teeth were randomly divided into five groups according to the bracket type and adhesive system used: Group A: metal brackets + a Three-step etch and rinse adhesive (E&R); Group B: metal brackets + a two-step self-adhesive adhesive (SE); Group C: ceramic brackets + (E&R); Group D: ceramic brackets + (SE); Group E: no bracket bonding, serving as a control. All teeth were thermocycled, the brackets were debonded, and the enamel surfaces were finished and polished. The tooth color was then re-assessed, and the change in color (∆E*) was calculated. Pairwise comparisons revealed significant differences in favor of ceramic brackets (ΔE = 3.77 ± 3.60; p = 0.009) and (E&R) (ΔE= 3.52 ± 2.45; p = 0.008). A significant difference was found among the different groups, with group C having the least change in color (ΔE = 2.00 ± 0.89) and group B having the highest (ΔE = 8.42 ± 5.66). Both the type of orthodontic bracket and adhesive system influenced tooth color change. The teeth bonded with ceramic and E&R had the least effect on color changes, whereas teeth bonded with metal and SE showed the highest color changes after debonding. [ABSTRACT FROM AUTHOR]

This clinical report demonstrates the treatment of a healthy adult patient referred for prosthodontic treatment after orthodontic treatment with a resin-bonded inlay-retained cantilever fixed dental prosthesis (IRCFDP). The purpose of this report was to demonstrate the esthetic, functional, and conservative properties of a resin-bonded IRCFDP fabricated from monolithic zirconia which can be placed in posterior area in certain situations. Acceptable esthetics with a conservative and functional result were achieved by using a resin-bonded inlay-retained cantilever fixed dental prosthesis (IRCFDP). All laboratory and clinical procedures of this case report are described. [ABSTRACT FROM AUTHOR]

Noncarious cervical lesions (NCCLs) are a common clinical finding often linked with dentin hypersensitivity (DH). Aim. The aim of the study was to evaluate the influence of diode laser for the treatment of DH on microleakage of subsequent NCCL restorations. Materials and Methods. Forty-eight extracted human premolars were collected. All teeth received standardized cervical preparation on both the buccal and palatal surfaces and were randomly divided into three groups (n = 16) according to the restorative material used: nanohybrid composite resin (CR), resin-modified glass ionomer (RMGI), and conventional glass ionomer (GIC). The prepared cavities on the palatal surfaces were treated by diode laser using SIROlaser Blue (Sirona Dental Systems, Bensheim, Germany) prior to restoration, while preparations on the buccal surfaces were directly restored. After thermocycling, the teeth were immersed in methylene blue dye for microleakage evaluation under 40x magnification at both occlusal and cervical margins. The Kruskal-Wallis test followed by the Bonferroni tests was conducted to determine inter- and intragroup differences (P < 0.05). Results. All restorative materials tested showed some degree of microleakage with no statistically significantly different scores with or without the use of laser desensitization prior to restorative treatment. Group CR showed the least microleakage, followed by group RMGI, while group GIC showed the highest. Cervical margins showed greater microleakage than the occlusal margins where the difference was statistically significant in the RMGI group without laser pretreatment (P = 0.006) and in both groups CR (P = 0.02) and RMGI (P = 0.006) with the laser pretreatment. Conclusion. Application of diode laser for the treatment of DH prior to the restoration of teeth with NCCL did not affect the microleakage of all the restorative materials tested. All the materials showed some degree of microleakage, which was higher in gingival margins compared to occlusal margins. The resin composite shows the least microleakage among all the tested materials. [ABSTRACT FROM AUTHOR]

Highlights • Bleached samples conditioned with phototherapy exhibited comparable bond strength to specimens conditioned with sodium ascorbate. • Highest bond strength was observed in unbleached specimen bonded with total etch adhesive • Highest microleakage scores among experimental groups were observed in bleached treated specimen in combination with self-etch bonding regime. Abstract Aim The aim of the present in-vitro study was to explore bleached enamel reversal with phototherapy (Er,Cr:YSGG) when using two dissimilar bonding system to bond brackets on microleakage and shear bond strength. Material and Methods Amongst one twenty samples, ninety samples were bleached using 35% hydrogen peroxide. After the bleaching procedure, the teeth were randomly divided into three groups according to surface conditioning treatment (n = 30 each). Group 1: treated with Er,Cr:YSGG (ECL) Group 2: 10% sodium ascorbate (SA) and Group 3: Bleached only (BO). Based on the type of adhesive, specimens were further classified into eight subgroups. In subgroup 1,2,3 and no treatment (NT) (n = 15) adhesive Transbond XT was applied on already etched surface and these subgroups were named as NT-TEP, BO-TEP, ECL-TEP and SA-TEP. Similarly, in subgroup 5,6,7 and NT specimens (n = 15) were conditioned with Transbond Plus self-etching primer and these subgroups were named as NT-SEP, BO-SEP, ECL-SEP and SA-SEP. Samples from each subgroup were exposed to increasing load for evaluation of shear bond strength. Microleakage among subgroups were tested by immersing samples in Methylene blue prior one day. Analysis of variance and Tukey multiple comparisons test was used to assess data. Results The maximum and minimum bond strength was observed in group NT-TEP [17.14(2.54)] and BO-SEP [6.14(0.215)] respectively. Samples conditioned with phototherapy ECL-TEP [16.14(1.231)] exhibited comparable bond strength to specimens conditioned with sodium ascorbate (SA-TEP) [16.72(1.298)]. Similarly, bond strength values of ECL-SEP [13.43(0.921)] and SA-SEP were comparable. The highest microleakage score was demonstrated in BO-SEP [83.21(38.21)] whereas, the lowest microleakage scores were displayed in NT-TEP [23.73(13.45)]. Conclusion Er,Cr:YSGG phototherapy reversal on bleached enamel with etch and rinse adhesives has a potential to be used in clinical settings alternate to conventional sodium ascorbate when bonding orthodontic brackets. [ABSTRACT FROM AUTHOR]

Background: It is unclear how the different core designs made of computer-aided design/computer-aided manufacturing (CAD/CAM) system and veneering techniques affect the fracture resistance of endodontically treated teeth. Aim: The aim of this in vitro study is to investigate the effect of different core designs made of CAD/CAM system and veneering techniques on the fracture resistance of zirconia ceramic crowns. Materials and Methods: Two types of zirconia copings were designed; the first one with circumferential 0.5-mm chamfer and the second one with circumferential 1-mm deep chamfer. The core specimens (in subgroups) were veneered anatomically with either a layering technique (hand-layer) or with press-on technique resulting in four test groups (n = 12). All crowns were then cemented using self-adhesive resin cement. After that, all specimens were loaded in a universal testing machine until fractured. Statistical Analysis: Data were then analyzed with two-way analysis of variance (ANOVA) (α =0.05). Results: Mean (standard deviation) failure loads for groups ranged from 2412.7 N (±624.6) to 3020.1 N (±1099.8). Two-way ANOVA revealed no statistically significant differences among groups (P > 0.05). Almost all groups showed cohesive failure in the veneering ceramic. Conclusions: Within the limitations of this laboratory study, neither the core design nor the veneering technique affected the fracture resistance of all-ceramic crowns significantly. [ABSTRACT FROM AUTHOR]

Abstract: Khat or qat (Catha edulis) is a plant that grows in East Africa and southern Arabia. The leaves and twigs of this small tree are chewed by several millions of people worldwide for their stimulating amphetamine‐like effects. The reported prevalence of khat chewing in Europe and the USA is on the rise, especially with global migration. Long‐term khat chewing has several detrimental general and oral health effects. The aim of the present study was to review the current literature regarding khat use and its association with oral and dental diseases, with particular emphasis on its link with oral keratotic white lesions and oral cancer. We searched the literature to identify all relevant articles. Studies showed that khat is associated with several oral and dental conditions, including keratotic white lesions, mucosal pigmentation, periodontal disease, tooth loss, plasma cell stomatitis, and xerostomia. There are limited data on the incidence of dental caries among khat chewers. The evidence that khat chewing is a risk factor for oral cancer is still weak, and is mainly based on anecdotal case reports and uncontrolled studies. [ABSTRACT FROM AUTHOR]

The aim of this paper is to report a clinical case with bilateral missing mandibular second premolars that were restored by metal-ceramic inlay-retained fixed dental prostheses. The first prosthesis was of a traditional design and the second was of a modified design. The suggested design is created by modifying the retainer wings of the traditional resin-bonded inlay-retained fixed dental prosthesis and covering the wings with composite resin. The modified design is relatively conservative, esthetic and provides an extra element for the retention of posterior metal-ceramic inlay-retained fixed dental prostheses. [ABSTRACT FROM AUTHOR]

The long-term solution to managing the current COVID-19 pandemic is through mass immunization of the population. However, uncertainty or unwillingness to receive the vaccine could be a barrier in attaining sufficient vaccine coverage. Therefore, understanding the psychology of the population towards the vaccines against COVID-19 is of paramount importance. Our study was aimed at determining the predictors of COVID-19 vaccine intention in the Saudi Arabian population. A structured questionnaire guided by the 'Report of the SAGE working group on vaccine hesitancy' was administered during a span of two months among the general population from all administrative regions of Saudi Arabia, proceeding the launch of the vaccination campaign. In total, 879 out of 1600 subjects responded and completed the survey (response rate 54.9%). About 56 percent of the participants intended to be vaccinated. The predictors of a higher intention to vaccinate included those 50 years of age or older, male subjects, people suffering from systemic disease/s, subjects who were not previously infected with COVID-19, those who follow the updates about COVID-19 vaccines, and adults with a higher level of anxiety about contracting coronavirus (p < 0.05). Results from our study and other similar studies can aid policy makers and stakeholders in planning effective strategies based on the changing behavior of the population. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has caused largescale morbidity and mortality and a tremendous burden on the healthcare system. Healthcare workers (HCWs) require adequate protection to avoid onward transmission and minimize burden on the healthcare system. Moreover, HCWs can also influence the general public into accepting the COVID-19 vaccine. Therefore, determining COVID-19 vaccine intention among HCWs is of paramount importance to plan tailor-made public health strategies to maximize vaccine coverage. A structured questionnaire was administered in February and March 2021 among HCWs in Saudi Arabia using convenience sampling, proceeding the launch of the vaccination campaign. HCWs from all administrative regions of Saudi Arabia were included in the study. In total, 674 out of 1124 HCWs responded and completed the survey (response rate 59.9%). About 65 percent of the HCWs intended to get vaccinated. The intention to vaccinate was significantly higher among HCWs 50 years of age or older, Saudi nationals and those who followed the updates about COVID-19 vaccines (p < 0.05). The high percentage (26 percent) of those who were undecided in getting vaccinated is a positive sign. As the vaccination campaign gathers pace, the attitude is expected to change over time. Emphasis should be on planning healthcare strategies to convince the undecided HCWs into accepting the vaccine in order to achieve the coverage required to achieve herd immunity. [ABSTRACT FROM AUTHOR]

• Dentin conditioned with PDT exhibited low bond integrity when bonded to both bioactive and calibra (C) cement. • Dentin conditioned with ECL and bonded to C displayed highest shear bond strength (SBS). • Bioactive cement (BA c) bonded with conditioned dentin displayed cohesive failure type. Whereas, C cement demonstrated mixed failure. The aim of the present study was to evaluate the bond integrity of bioactive cement (BA c) in contrast to conventional cement Calibra (C) after dentin treated with different surface conditioners (PDT, EYL, ECL) Sixty non-carious permanent mandibular molars were disinfected and embedded in acrylic resin till cement-o-enamel junction. For homogeneity the buccal surface were grounded and polished. Samples were categorized into three main groups based on conditioning technique. Samples in group 1 and 2 dentin conditioned with Er,Cr:YSGG (ECL), group 3 and 4 surface treated with Er:YAG (EYL) and group 5 and 6 treated with photodynamic therapy (PDT).On conditioned surface bonding agent was applied and light cured. Samples from group 1,3,5 were bonded to Calibra (C). Whereas, specimens in group 2,4,6 were conditioned with bioactive cement (BA c) and subjected to ageing followed by shear bond strength testing (SBS) in universal testing machine. To detect significance difference between means of different groups analysis of variance (ANOVA) was performed followed by Tukey's post-hoc tests. The maximum SBS was displayed in group 1, dentin conditioned with ECL and bonded to C (20.23 ± 0.47 MPa). Whereas, group 6, PDT of dentin to BA c demonstrated lowest bond integrity among experimental groups (12.97 ± 0.25 MPa). Bond strength of group 1, ECL-C (21.55 ± 3.08 MPa) and group 3 EYL-C (19.11 ± 0.65 MPa) were comparable (p > 0.05). Group 5 samples treated with PDT, MB-C (13.41±0.32 MPa) and group 6, MB-BA c (12.97 ± 0.25 MPa) were also comparable (p > 0.05) BAc bonded to dentin after surface conditioning with ECL, EYL and PDT presented lower SBS in comparison to conventional cement C. Further studies are required to extrapolate the current findings. [ABSTRACT FROM AUTHOR]

• This study attempted to compare two local adjunctive therapies in experimentally induced gingivitis. • Photoactivated disinfection reduced microbial counts in experimentally induced gingivitis. • Salvadora persica reduced inflammatory bleeding parameter in gingival inflammation. This clinical trial aimed to study the comparison of clinical gingival inflammatory scores and levels of pathogenic bacteria with professionally administered plaque removal (PAPR) with photoactivated disinfection (PAD) and Salvadora persica (SP) gel application in experimentally induced gingivitis. Twenty-five non-smoking patients underwent an 8-week experimental gingivitis trial that consisted of 14 days of undisturbed plaque accumulation and a 6 week of resolution phase following the three treatment modalities. The treatment protocols included PAPR with adjunctive PAD, SP gel application and PAPR alone. Clinical gingival inflammatory parameters including plaque index (PI) and bleeding on probing (BOP) were assessed. Microbiological parameters included the log count of five periodontal pathogens in the plaque from all experimental sites. No significant difference in plaque levels was observed between PAD, SP and PAPR at 2- and 6-weeks following treatment. The magnitude of the decrease was statistically significant at 6 weeks for SP (P = 0.02). The median number of residual BOP+ sites was higher at PAD and PAPR compared to SP at either 2-weeks (2.75 and 1.25, respectively; P = 0.039) or 6 weeks (2 and 1, respectively; P = 0.044) following treatment administration. Counts of all bacteria reduced until 2 weeks with significantly greatest reduction seen in the PAD group and this was maintained until 6 weeks of follow-up. The log CFU/mL values for all bacterial counts significantly reduced for SP group, however, it did not show significant reduction when compared with PAD but had greater extent when compared with PAPR group. Both PAD and SP gel application improved clinical gingival inflammatory parameters in experimental-induced gingivitis. However, PAD helped to reduce bacterial counts, while SP had significant impact on bleeding in gingival inflammation. [ABSTRACT FROM AUTHOR]

• Seropositive patients and health controls with NUP underwent APDT and SRP. • APDT showed improved clinical and microbiological outcomes in the treatment of NUP among HIV positive patients. • Clinical and microbiological improvement was not greater in seropositive compared with seronegative patients. To evaluate clinical periodontal and microbiological parameters after the treatment with adjunctive antimicrobial photodynamic therapy (APDT) among HIV seropositive and seronegative patients with necrotizing ulcerative periodontitis (NUP). Seropositive patients (Group-I) and health controls (Group-II) with NUP were randomized into two groups and further underwent APDT and scaling and root planing (SRP), respectively. Clinical periodontal parameters including full mouth plaque index (FMPI), bleeding on probing (FMBOP), probing depth (PD) and clinical attachment level (CAL) gain were assessed. Levels of bacteria including Aggregatibacter actinomycetemcomitans (Aa), Porphyromonas gingivalis (Pg) and Tannerella forsythia (Tf) were assessed using PCR technique. All assessments were done at baseline, 3 months and 6 months. All periodontal parameters including FMPI, FMBOP, PD and CAL significantly improved in both HIV seropositive and seronegative patients. The reduction in mean PD was higher only with the APDT treatment among group II patients compared to group I patients at follow-up (p < 0.05). The gain in mean CAL was higher only with the APDT treatment among group I and group II patients at follow-up (p < 0.05). All bacterial levels reduced from baseline to follow-up with both APDT and SRP treatments in both groups (p < 0.05). APDT showed significantly reduced counts of Aa and Tf at 3 months, and only Aa at 6 months among HIV seropositive patients, while the levels of Pg and Tf significantly reduced at 3 months and only Aa at 6 months in the seronegative patients, respectively (p < 0.05). Application of antimicrobial photodynamic therapy as an adjunct to scaling and root planing was effective in improving clinical periodontal parameters and bacterial levels among HIV positive patients with NUP. However, the improvement was not greater when compared with HIV seronegative patients. [ABSTRACT FROM AUTHOR]

The purpose of this study was to determine dental practitioners' opinions, techniques, and materials used for the restoration of endodontically treated teeth (ETT) in Saudi Arabia. A comprehensive nationwide survey regarding treatment strategies of ETT, on the post types and material used for core foundations were distributed either by email or by hard copies to general dentists in different parts of Saudi Arabia (North, South, West, East, and Center). Descriptive statistics were used to analyze the responses to the questions. A total of 164 participants were included in the survey: 72.6% of them were male, and 27.4% were female. 42.1% of the participants were Saudi dental practitioners, whereas 57.9% were non-Saudi dental practitioners. Out of the surveyed dentists, 52% consider post placement for almost every post-endodontic restoration of ETT. The majority of the dentists (54%) believe that a post strengthens ETT. Cast posts and cores were used by 55% of all the dentists, whereas 34% used prefabricated posts exclusively. Screw posts were the most popular prefabricated post type (47%). Composite resin (51%) was preferred for the core foundation, followed by glass ionomer cements (GICs) (26%). Amalgam was seldom used (0.5%). Posts were placed primarily with zinc phosphate cement (51%), followed by GIC (38%). Within the limitations of this survey-based investigation among dental practitioners in Saudi Arabia, it was concluded that the treatment strategies of ETT are in accordance with the current state of evidence-based knowledge. [ABSTRACT FROM AUTHOR]

Evaluation of micro tensile bond strength (μTBS) and marginal leakage of sodium fluoride (NaF) and nano-hydroxyapatite (n-HA) modified universal adhesives (UAs) bonded using etch-and-rinse (ER) and self-etch (SE) bonding technique to the carious affected dentin (CAD). One hundred and twenty primary molars were prepared for CAD on the occlusal surface. The occlusal CAD surface was flattened and underwent a polishing procedure. The specimens were divided into six groups using a random allocation method based on the UAs applied and the mode of etching used (n = 20) Group A1: UAs (ER), Group B1: UAs (SE), Group A2: UAs (NaF) + ER, Group B2: UAs (NaF) + SE, Group A3: UA (n-HA) + ER and Group B3: UAs (n-HA) + SE. Composite restoration was placed and samples were thermocycled. Microleakage, μTBS, and failure mode assessment were performed using a dye penetration test, universal testing equipment, and stereomicroscope respectively. The μTBS and microleakage results (mean ± SD) were examined using analysis of the variance (ANOVA) and Tukey post hoc tests. Group B1 (UAs + SE) demonstrated the maximum scores of microleakage (25.14 ± 9.12 nm) and minimum recorded value of μTBS (14.16 ± 0.55 MPa). In contrast, Group A3 (UAs (n-HA) + ER) displayed a minimum value of marginal leakage (12.32 ± 6.33 nm) and maximum μTBS scores (19.22 ± 0.92 MPa). The outcomes of the intergroup comparison analysis showed that Group A2 (UAs (NaF) + ER), Group B2 (UAs (NaF) + SE), Group A3 (UA (n-HA) + ER) and Group B3 (UAs (n-HA) + SE) presented comparable outcomes of marginal seal outcomes and μTBS scores ( p > 0.05). NaF and n-HA-modified UAs displayed favorable bond strength and minimum marginal leakage to the deciduous affected dentin surface., Competing Interests: The authors declare no conflict of interest., (©2024 The Author(s). Published by MRE Press.)

Background and Objective: Ageism represents an important barrier to high-quality healthcare for older adults. The present study sought to translate and validate the Arabic version of the Ageism Scale for Dental Students (ASDS-Arabic)., Materials and Methods: The 27-item ASDS tool was translated from English into Arabic following recommended cross-sectional forward and backward translation guidelines. The translated version was subjected to the content validity ratio (CVR) and sent to dental students in 21 institutes from 10 different Arab countries. Principal components analysis (PCA) was used to assess the dimensionality of the scale, and Cronbach's alpha was used to determine internal consistency reliability. The discriminant validity of the scale was assessed using the independent t-test. Confirmatory factor analysis (CFA) was also undertaken., Results: Based on CVR, three items were removed. The 24-item Arabic version was completed by 3284 dental students. PCA and CFA retained 17 items in six components, explaining 50.3% of the total variance, with acceptable reliability, validity and discrimination. The first component "Adherence of older patients with dental treatment and instructions," included four items with a Cronbach α of 0.64 and scored 4.3 ± 0.8. The second component "Feasibility of the treatment plan," included three items with a Cronbach α of 0.66 and scored from 2.6 ± 1.2 to 2.9 ± 1.1. The third component "Cost of and responsibility for the dental treatment" included four items with a Cronbach α of 0.47 and scored 4.4 ± 0.8 to 4.5 ± 0.8. The fourth component "Medical history of older patients" included two items with a Cronbach α of 0.70 and scored 4.0 ± 1.0 to 4.1 ± 1.0. The fifth Component "Feeling towards older patients" included two items with a Cronbach α of 0.672 and scored 2.6 ± 1.2 to 2.0 ± 1.4. The sixth Component "Confidence and experience in treating older patients" included two items with a Cronbach α of 0.33 and scored 4.4 ± 1 to 4.6 ± 1., Conclusion: This preliminary validation of the ASDS-Ar resulted in a new 17-item scale with six components with acceptable validity, reliability and discrimination., (© 2024 Gerodontology Association and John Wiley & Sons Ltd.)

Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Purpose: This study sought to investigate the acceptance rate and associated factors of COVID-19 vaccines among dentists and dental students in seven countries., Material and Methods: A structured questionnaire prepared and guided by the report of the SAGE Working Group on Vaccine Hesitancy was distributed among groups of dentists and dental students in seven countries across four continents., Results: A total of 1527 subjects (850 dentists and 677 dental students) participated in this survey. Although 72.5% of the respondents reported their intention to accept COVID-19 vaccines (dentists: 74.4%, dental students: 70.2%), there was a significant difference in agreement between dentists/dental students across countries; generally, respondents in upper-middle-, and high-income countries (UM-HICs) showed significantly higher acceptance rates compared to those in low- and lower-middle income countries (L-LMICs). Potential predictors of higher vaccine acceptance included being a dentist, being free of comorbidity, being well-informed about COVID-19 vaccines, having better knowledge about COVID-19 complications, having anxiety about COVID-19 infection, having no concerns about the side effects of the produced vaccines and being a resident of an UM-HIC., Conclusion: The results of our survey indicate a relatively good acceptance rate of COVID-19 among the surveyed dentists and dental students. However, dentists and dental students in L-LMICs showed significantly lower vaccine acceptance rates and trust in COVID-19 vaccines compared to their counterparts in UM-HICs. Our results provide important information to policymakers, highlighting the need for implementation of country-specific vaccine promotion strategies, with special focus on L-LMICs.

Objectives: Preventing severe disease and acquiring population immunity to COVID-19 requires global immunization coverage through mass vaccination. While high-income countries are battling vaccine hesitancy, low-income and fragile nations are facing the double dilemma of vaccine hesitancy and lack of access to vaccines. There is inadequate information on any correlation between vaccine hesitancy and access to vaccines. Our study in a low-income nation aimed to fill this gap., Methods: In the backdrop of a severe shortage of COVID-19 vaccines in Yemen, a low-income fragile nation, we conducted a nation-wide cross-sectional survey among its healthcare workers (HCWs), between 6 July and 10 August 2021. We evaluated factors influencing agreement to accept a COVID-19 vaccine and any potential correlation between vaccine acceptance and lack of access to vaccines., Results: Overall, 61.7% ( n = 975) of the 1,581 HCWs agreed to accept a COVID-19 vaccine. Only 45.4% of the participants agreed to have access to a COVID-19 vaccine, with no sex dependent variations. Although several determinants of vaccine acceptance were identified, including, having a systemic disease, following the updates about COVID-19 vaccines, complying with preventive guidelines, having greater anxiety about contracting COVID-19, previous infection with COVID-19, believing COVID-19 to be a severe disease, and lower concern about the side effects of COVID-19, the strongest was access to vaccines (OR: 3.18; 95% CI: 2.5-4.03; p -value: 0.001)., Conclusion: The immediate and more dangerous threat in Yemen toward achieving population immunity is the severe shortage and lack of access to vaccines, rather than vaccine hesitancy, meaning, improving access to vaccines could lead to greater acceptance., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Noushad, Nassani, Al-Awar, Al-Saqqaf, Mohammed, Samran, Yaroko, Barakat, Elmi, Alsalhani, Talic and Rastam.)

Objectives: Even though several effective vaccines are available to combat the COVID-19 pandemic, wide disparities in vaccine distribution, and vaccine acceptance rates between high- and low-income countries appear to be major threats toward achieving population immunity. Our global descriptive study aims to inform policymakers on factors affecting COVID-19 vaccine acceptance among healthcare workers (HCWs) in 12 countries, based on income index. We also looked for possible predictors of vaccine acceptance among the study sample., Methods: A structured questionnaire prepared after consultation with experts in the field and guided by the "Report of the SAGE working group on vaccine hesitancy" was administered among 2,953 HCWs. Upon obtaining informed consent, apart from demographic information, we collected information on trust in vaccines and health authorities, and agreement to accept a COVID-19 vaccine., Results: Although 69% of the participants agreed to accept a vaccine, there was high heterogeneity in agreement between HCWs in low and lower-middle income countries (L-LMICs) and upper-middle- and high-income countries (UM-HICs), with acceptance rates of 62 and 75%, respectively. Potential predictors of vaccine acceptance included being male, 50 years of age or older, resident of an UM-HIC, updating self about COVID-19 vaccines, greater disease severity perception, greater anxiety of contracting COVID-19 and concern about side effects of vaccines., Conclusions: COVID-19 vaccine acceptance among HCWs in L-LMICs was considerably low as compared to those from UM-HICs. The lowest vaccine acceptance rates were among HCWs from the African continent. This underlines the need for the implementation of country-specific vaccine promotion strategies, with special focus on increasing vaccine supply in L-LMICs., Competing Interests: Author AE is employed by Hamad Medical Corporation. The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2022 Noushad, Rastam, Nassani, Al-Saqqaf, Hussain, Yaroko, Arshad, Kirfi, Koppolu, Niazi, Elkandow, Darwish, Abdalla Nassar, Abuzied Mohammed, Abdalrady Hassan, Abusalim, Samran, Alsalhani, Demachkia, de Melo, Luddin, Husein, Habib, Suleyman, Osman, Al-Awar, Dimashkieh, Swapna, Barakat and Alqerban.)