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OBJECTIVE: To evaluate the bond efficacy and failure rates of rebonded metallic brackets after enamel reconditioning with chemical 37% phosphoric acid (PA) and natural and synthetic photosensitizers activated by PDT. MATERIALS AND METHODS: A total of 50 non-cavitated, and cautiously extracted human premolars were congregated after sample size calculation. The enamel exterior was etched, washed, dried for adhesive application, and cured. Metallic brackets were then oriented and adapted to enamel surface using composite. Later, brackets were debonded from the surface via a Weingart plier. Enamel was finished for ensuing surface reconditioning. Ultimately, specimens were randomly distributed into five groups (n=10). Enamel surface before rebonding was reconditioned with curcumin photosensitizer (CP), riboflavin photosensitizer (RP), rose bengal photosensitizer (RBP), methylene blue photosensitizer (MBP), and 37% PA (control) respectively. After following reconditioning protocol, brackets were rebonded to the enamel exterior employing a composite adhesive system. Then, specimens were subjected to the universal testing machine for analyzing shear bond strength (SBS), and bond failures were predicted using an ARI index. One-way ANOVA and Tukey multiple comparison tests were used for statistical analysis at a variance value of p < 0.05. RESULTS: Enamel reconditioned with 37% PA demonstrated the highest SBS for bracket rebonding, and the lowest SBS was presented by CP actuated by PDT. Enamel reconditioned with RP and RBP corroborated the analogous SBS outcome to 37% PA. Likewise, enamel surface treatment with MBP revealed a statistically significant result to CP for metallic bracket rebonding. The most prevalent failure scores anticipated among groups were 0 and 1 indicating an adhesive failure with the exemption of group 5 (control) that encountered more score 2 cohesive failure on debonding metallic brackets from enamel exterior. CONCLUSIONS: Rose bengal and riboflavin photosensitizers activated by photodynamic therapy with low ARI scores have the potential to be used as viable enamel reconditioning alternatives to 37% phosphoric acid for rebonding metallic brackets. [ABSTRACT FROM AUTHOR]

Background/Aim. Dentists and particularly general dental practitioners (GDPs) should be able to identify problems such as malocclusions and refer patients with such problems to orthodontics. The aim of the study was to evaluate the awareness of orthodontic problems and referral practices among GDPs and non-orthodontic specialists practicing in the Kingdom of Saudi Arabia. Methods. A cross-sectional prospective study included GDP and specialists/consultants of both genders, aged between 22–60 years, practicing general dentistry and specialists other than orthodontics who had worked in their field for two or more years. Non-practicing dentists and nonregistered dentists were excluded. Data was analyzed on SPSS version 21.00. Results. Among the respondents, 55.5% were men, and 44% were GDPs. Out of the total number of respondents, 107 (53.5%) GDPs and 66 (33%) non-orthodontic specialists practiced orthodontic referral in their practices. By using the χ2 test, statistical analysis of different variables depending on the participants’ gender and specialty was performed. It revealed that variables with significant p-value were: orthodontist referral, the recommendation of orthodontic treatment only after the eruption of all permanent teeth, awareness of tooth extraction for alignment of irregular teeth, and awareness regarding worsening of temporomandibular joint problems by orthodontic treatment. Conclusion. The referral practices of dentists practicing in the Kingdom of Saudi Arabia concerning orthodontic patients were satisfactory, although awareness regarding orthodontic problems requires continuous learning and considerate positive progression toward basic orthodontics.

Aim: To acquire a thorough comprehension of the photoactivated Cur-doped ZnONPs at different concentrations 0%, 2.5%, and 5% on the physical qualities, antibacterial efficacy, degree of conversion, and μshear bond strength between orthodontic brackets and the enamel surface., Material and Methods: An extensive investigation was carried out utilizing a range of analytical methods, scanning electron microscopy (SEM) combined with energy-dispersive X-ray spectroscopy (EDX), Fourier-transform infrared (FTIR) spectroscopy, micro tensile bond strength (μTBS) testing, and evaluation of antibacterial effectiveness. Cur-doped ZnONPs at concentrations of 2.5% and 5% were blended with Transbond XT, a light-curable orthodontic adhesive. A control group without the addition of Cur-doped ZnONPs was also prepared. The tooth samples were categorized into three groups based on the weight percentage of NPs: Group 1 (control) with 0% Cur-doped ZnONPs, Group 2 with 2.5 wt% Cur-doped ZnONPs, and Group 3 with 5 wt% Cur-doped ZnONPs. The SEM technique was employed to analyze the morphological characteristics of Cur-doped ZnONPs and ZnONPs. The composition and elemental distribution of the modified Cur-doped ZnONPs were assessed using energy-dispersive X-ray spectroscopy. The effectiveness of NPs at various concentrations against S.Mutans was gauged through the pour plate method. DC of Cur-doped ZnONPs at a region of 1608 cm -1 to 1636 cm -1 for the cured area, whereas the uncured area spanned the same range of 1608 cm -1 to 1636 cm -1 was assessed. The Adhesive Remnant Index (ARI) approach was utilized to investigate the bond failure of orthodontic brackets, while a Universal Testing Machine (UTM) was utilized to test μTBS. The Kruskal-Wallis test was employed to investigate variations in S.mutans survival rates. To determine the μTBS values, analysis of variance (ANOVA) and the post hoc Tukey multiple comparisons test were used., Results: The maximum μTBS was given and documented in group 3: 5 wt% Cur-doped ZnONPs (21.21 ± 1.53 MPa). The lowest μTBS was given in group 2: 2.5 wt% Cur-doped ZnONPs (19.58 ± 1.27 MPa). The highest efficacy against S.mutans was documented in group 3 in which 5 wt% Cur-doped ZnONPs (0.39 ± 0.15). The lowest efficacy was seen in group 1 in which no Cur-doped ZnONPs were used (6.47 ± 1.23). The ARI analysis indicated that the predominant failure was between scores 0 and 1 among all experimental groups. Control group 1 which was not modified showed the highest DC (73.11 ± 4.19)., Conclusion: Orthodontic adhesive, containing 5% Cur-doped ZnONPs photoactivated with visible light exhibited a favorable impact on μTBS and indicated enhanced antibacterial efficacy against S.mutans. Nevertheless, it was observed that the addition of Cur-doped ZnONPs at different concentrations (2.5%,5%) resulted in a decrease in the monomer-to-polymer ratio compromising DC., Competing Interests: Declaration of competing interest The authors declare no conflict of Interest in the present study., (Copyright © 2023. Published by Elsevier B.V.)

Background and Objectives : To investigate the antiplaque properties of two plant-based mouthwashes, Morinda citrifolia (MC) and Ocimum sanctum (OS), and their effect on TNF-α, IL-α, IL-β, IL-2, and IL-6 in gingival crevicular fluid (GCF) of patients undergoing fixed orthodontic treatment. Materials and Methods : Seventy-five individuals were recruited according to defined inclusion and exclusion criteria. This study was structured into two distinct phases. Phase I was a combination of toothbrushing using toothpaste containing fluoride (Protocol A), while Phase II toothbrushing included fluoride toothpaste and use of a mouthwash (Protocol B). For Phase II, individuals participating in this study were allocated into different groups through a randomization process: Group 1-0.12% CHX, Group 2-5% MC, and Group 3-4% OS. Each individual's Phase I and Phase II scores were assessed. GCF was measured in three phases to determine the level of inflammatory biomarkers. The paired t -test evaluated the disparities between the pre- and post-plaque index. Categorical data were subjected to crosstab analysis to assess qualitative variables. The mean values of cytokine levels were presented. An unpaired t -test was employed to assess the levels of cytokines between individuals in Phase I and Phase II. Results : Toothbrushing, fluoride toothpaste, and the supplementary use of mouthwash (Phase II) resulted in mean plaque scores significantly lower than group A ( p < 0.001). Cytokines TNF-α, IL-α, and IL-β demonstrated a significant downward trend in herbal mouthwash users. Conclusions : In conjunction with fluoridated toothpaste and brushing, OS and MC can serve as a viable alternative to conventional synthetic mouthwash CHX. This combination demonstrates reducing mean plaque scores and diminishing the levels of cytokines TNF-α, IL-α, and IL-β.

Despite the effectiveness of warfarin in extended anticoagulation, its narrow therapeutic index requires frequent dose adjustments and careful patient monitoring. Thus, we aimed to evaluate the outcomes of clinical pharmacists' intervention in warfarin therapy management in terms of International Normalized Ratio (INR) control, reduction of bleeding, and hospitalization in a tertiary care hospital. An observational retrospective cohort study was conducted on 96 patients taking warfarin therapy in a clinical pharmacist-led anticoagulation clinic. We observed that 39.6% of patients required dose adjustments at their first and second visits. However, dose adjustments during the third, fourth, and fifth weeks were required at 31.1%, 20.8%, and 4.2%, respectively, to achieve INR levels. We also observed that 36.46% of the patients attained the target INR at baseline, which was increased over the first week to the fifth week to 57.29%, 61.46%, 61.46%, 68.75%, and 85.42%, respectively. No one reported the ADR between the third and fifth weeks. Based on our findings, the study strongly suggests that pharmacists' interventions can improve the health-related quality of life of patients undergoing warfarin therapy. Thus, competent pharmacy personnel must be a priority in both usual patient care and critical care among primary care networks.

Objectives: The objective of this study was to assess bone biomarkers and cytokines in patients with conventional labial appliances (CLAs) and aligners., Materials and Methods: Participants were recruited to undergo orthodontic treatment with CLAs and aligners according to predefined inclusion and exclusion criteria. Periodontal examination was accomplished at baseline and 4 weeks using the plaque index (PI), gingival index (GI), and bleeding on probing (BoP). Samples of gingival crevicular fluid (GCF) were collected at baseline (T0) before the start of treatment and at the 1-month follow-up (T1) to assess bone metabolic and inflammatory biomarkers. GCF from participants with CLAs and aligners was evaluated with enzyme-linked immunosorbent assay. Comparison between labial conventional orthodontic treatment and aligners were assessed using an unpaired t-test. The difference between T0 and T1 was measured using a paired t-test., Results: BoP, PI, and GI demonstrated no significant difference between participants treated with aligners and subjects with CLAs at baseline and at 4 weeks (P > .05). Bone markers and other biomarkers (tumor necrosis factor α, interleukin [IL]-α, IL-2, IL-6, and IL-8) showed significant differences (P < .05). Also, a significant difference between CLAs and aligners was noted among all biomarkers (P < .05) except IL-β., Conclusions: Aligners and CLAs increase the level of inflammatory and bone metabolic biomarkers after 1 month., (© 0000 by The EH Angle Education and Research Foundation, Inc.)

Background: Few studies have studied burnout among dental students worldwide, and no such study is available from Saudi Arabia. In addition, an Arabic version of the Maslach Burnout Inventory-Student Survey (MBI-SS) has not yet been validated for use among students., Objectives: This study aimed to translate and validate an Arabic version of the MBI-SS questionnaire and to examine the psychometric properties of burnout among dental college students at a university in Saudi Arabia., Materials and Methods: This cross-sectional questionnaire study included all dental students at King Khalid University, Saudi Arabia, and was conducted between December 2019 and January 2020. After the MBI-SS questionnaire was translated, its face validity was determined and the test-retest reliability was assessed. Confirmatory factor analysis and reliability analysis were performed following the full-scale study to validate the Arabic MBI-SS., Results: A total of 433 dental students responded in the full-scale study (mean age: 21.9 ± 1.6 years). Emotional exhaustion was present in 32.3% (95% confidence interval: 28%-36.9%), cynicism in 33.7% (29.3%-38.4%), and poor academic efficacy in 34.2% (29.8%-38.9%) of the dental students. Emotional exhaustion and cynicism were significantly associated with academic level, a history of medication due to academic stress, and thoughts of quitting the course (for all, P < 0.05). The reliability of MBI-SS was found to be adequate for all three subscales: Emotional exhaustion, Cronbach's α = 0.827; cynicism, α = 0.855; academic efficacy, α = 0.704., Conclusions: All three subscales of burnout were highly prevalent in the study cohort. The Arabic version of the MBI-SS inventory was shown to be a valid and reliable tool for assessing the psychometric properties of burnout among dental students, and its use may aid in identifying burnout in the early stages., Competing Interests: There are no conflicts of interest., (Copyright: © 2022 Saudi Journal of Medicine & Medical Sciences.)

This study aims to evaluate the feasibility of chlorhexidine (CHX)-loaded poly-L-glycolic acid (PLGA) nanoparticles as a modifier of a commercial orthodontic adhesive via the assessment of physicochemical, biological, and mechanical properties at tooth-bracket interface. CHX-loaded PLGA nanoparticles were synthesized using double emulsion-solvent evaporation method and characterized using transmission electron microscopy and Raman analysis. CHX-loaded PLGA nanoparticles in Transbond XT orthodontic adhesive were prepared using two different concentrations of the CHX (25 and 50%) and characterized for degree of conversion (DC), antimicrobial, and cytotoxicity testing. Bonded specimens were tested for shear bond strength (SBS) and adhesive remnant index (ARI) at tooth-bracket interface. The synthesized PLGA nanoparticles averaged between 60 and 80 nm in size. After loading CHX inside PLGA nanoparticles, the morphology of the PLGA nanoparticles was considerably changed. Orthodontic bracket bonded with 25% CHX-loaded PLGA-modified adhesive demonstrated DC scores similar to control group. Both 25 and 50% CHX-loaded PLGA-modified adhesive specimens showed higher antibacterial activity against S. mutans compared to control group. The least mean SBS values were exhibited by 50% CHX-loaded PLGA-modified adhesive samples, while a statistically significant difference was observed in the mean ARI values among all study groups at all-time points (p = .018). This study indicates that the addition of CHX-loaded PLGA nanoparticles in Transbond XT achieved stable bonds with enhanced antimicrobial and mechanical properties., (© 2021 Wiley Periodicals LLC.)

Aim: To assess bond integrity and failure mode after enamel pretreated with conventional and contemporary conditioning methods were bonded to metallic brackets (MB)., Material and Methods: Forty maxillary central incisors were selected and disinfected. All specimens were mounted up to the cement-o-enamel junction and divided into four experimental groups randomly based on the enamel conditioning technique. Photodynamic therapy (PDT) was used to condition enamel in group 1, Total-etch and rinse (TER) was used to treat samples in group 2, Specimens in group 3 were conditioned with ECL, and samples in group 4 surface pretreated with SEP. Bonding of MB was performed on the surfaces of all the specimens with a Transbond XT. Specimens from all investigated groups were positioned on a universal testing machine maintaining buccal surfaces similar to the direction of the force. After bracket debonding bond failure was assessed using ARI. The bond integrity of all four groups was compared using analysis of variance (ANOVA). Post hoc Tukey test was used for pairwise comparison among different groups., Results: Group 2, TER+MB (15.38±0.14 MPa) displayed the highest bond value whereas the lowest values of SBS were exhibited by group 1, PDT+MB (10.11±0.17 MPa). The inter-group comparison revealed that specimens of group 2 and group 3, ECL+MB (14.61±0.55 MPa) demonstrated comparable bond strength (p>0.05)., Conclusion: Enamel conditioned with TER and ECL demonstrated comparable SBS. However, bond integrity after PDT and SEP (self-etch primer) surface treatment of enamel bonded with MB significantly lowered bond values., (Copyright © 2021. Published by Elsevier B.V.)

Background: The aim of the present clinical trial was to evaluate the effect of methylene blue-mediated antimicrobial photodynamic therapy (aPDT) on the gingival and immunological parameters in diabetic adolescent patients undergoing fixed orthodontic treatment., Methods: The selected 40 participants were randomized equally into two groups; Group I (ultrasonic scaling + oral hygiene instructions) and Group II (ultrasonic scaling/oral hygiene instructions + aPDT). Serum HbA1c levels was assessed for all the participants at chairside. Plaque index (Pi), and bleeding on probing (BOP) were analyzed. Moreover, the assessment of crevicular fluid matrix metalloproteinase 8 (MMP-8) and macrophage inflammatory protein 1 alpha (MIP-1α) was performed using enzyme-linked immunosorbent assay technique. All measurements were recorded at baseline, 6 weeks, and 12 weeks follow-up periods, respectively. Intergroup comparisons for p-value were computed using Mann-Whitney test and Wilcoxon singed ranks test to compute p-value for intra-group comparisons. Stepwise logistic regression analysis was used to identify explanatory variables for reduction in plaque scores and bleeding on probing, after controlling for the effects of other covariates. Odds ratios and 95% confidence intervals were used to assess the direction and strength for associations. Significance level was set at 5% for all analyses., Results: All 40 individuals completed the clinical trial. There was a statistically significant reduction in Pi and BOP in both Group I and Group II from baseline to 12 weeks of follow up (P<0.05). However, there was slight reduction in the plaque scores in Group-II as compared to Group-I at 12 weeks visit (P<0.05). There was also a statistically significant difference for BOP when Group-I was compared with Group-II on 12 weeks follow up assessment (P<0.05). HbA1c assessment indicated no statistically significant difference either within or between groups at any time point (P>0.05). Both MMP-8 and MIP-1α reported a significant decrease for both Groups I and II at 6 weeks and 12 weeks follow-up periods in comparison to baseline (P<0.05). Inter-group comparison indicated a statistically significant difference noted at both 6 weeks follow up that was maintained at 12 weeks follow up (P<0.05). The logistic regression analysis revealed that even after controlling the mean BMI as a predictor, the change of biomarker levels along with the improvement in plaque scores and bleeding on probing was not significant (p> 0.05)., Conclusion: aPDT significantly improved bleeding on probing and proinflammatory biomarkers among diabetic adolescent patients undergoing fixed orthodontic therapy., (Copyright © 2021. Published by Elsevier B.V.)

Background: Dental caries is the localized destruction of dental hard tissues (enamel and dentine). Decayed, Missing, and Filled Teeth (DMFT) index is the most commonly used dental caries index. Thickness of the outermost part of the tooth called the enamel is determined by the rate of deposition of enamel proteins. Relative enamel thickness (RET) gives a measure of enamel thickness with respect to dentine. Dental caries is influenced by a genetically determined factor called dermatoglyphics (DG). As the genes responsible for RET and DG lie on the same chromosome and develop during the same time of intrauterine life, it is biologically plausible to correlate RET and DG., Aims: This study consists of two primary aims: (1) to assess RET using cone beam computed tomography images and correlate it with caries and (2) to correlate RET with DG., Materials and Methods: 148 dental subjects were assessed for DMFT caries score and were categorized as Group 1 with DMFT = 0 and Group 2 with DMFT ≥ 1. Following this, their DG pattern was recorded digitally. The CBCT images of these subjects were assessed for RET, and the data were analyzed statistically., Results: Mean RET in our sample population is 18.45 (SD 3.79) while mean DMFT is 5.34 (SD 5.13). Mean RET in Group 1 subjects was 19.82 (SD 4.05) while that in the Group 2 was 17.68 (SD 3.43). RET and DMFT showed a statistically significant negative correlation ( p = 0.007). The "Single Loop" DG characteristic showed a statistically significant difference between males and females ( p = 0.031). The "Simple Arch" type of DG was positively correlated with RET., Conclusion: This is the first in vivo study to assess RET using CBCT images and correlate with DMFT and DG. RET is inversely related to DMFT while directly proportional to the "Simple arch" DG pattern. Males and females differed in their "Single Loop" DG characteristic., Competing Interests: The authors declare that there is no conflict of interest regarding the publication of this paper., (Copyright © 2021 A. A. Dawasaz et al.)

Coronavirus disease 2019 (COVID-19), a mystified cryptic virus has challenged the mankind that has brought life to a standstill. Catastrophic loss of life, perplexed healthcare system and the downfall of global economy are some of the outcomes of this pandemic. Humans are raging a war with an unknown enemy. Infections, irrespective of age and gender, and more so in comorbidities are escalating at an alarming rate. Cardiovascular diseases, are the leading cause of death globally with an estimate of 31% of deaths worldwide out of which nearly 85% are due to heart attacks and stroke. Theoretically and practically, researchers have observed that persons with pre-existing cardiovascular conditions are comparatively more vulnerable to the COVID-19 infection. Moreover, they have studied the data between less severe and more severe cases, survivors and non survivors, intensive care unit (ICU) patients and non ICU patients, to analyse the relationship and the influence of COVID-19 on cardiovascular health of an individual, further the risk of susceptibility to submit to the virus. This review aims to provide a comprehensive particular on the possible effects, either direct or indirect, of COVID-19 on the cardiovascular heath of an individual., Competing Interests: The authors declare no conflict of interest., (© 2021 The Author(s). Published by IMR Press.)

Purpose: The aim of this laboratory study was to investigate the amount of bacterial destruction through riboflavin mediated photodynamic therapy (PDT) around fixed orthodontic devices by using the two strains of bacteria Streptococcus mutans and Streptococcus sanguinis., Materials and Methods: A total of 80 metallic brackets were divided into four groups consisting of 20 brackets each. Group-I: riboflavin + LED irradiation; Group-II: riboflavin alone; Group-III: immersion in 0.2 % chlorhexidine gluconate solution and Group-IV: not submitted to any treatment. All metallic brackets were immersed in the standard bacterial solutions and incubated at 48 h. All samples were subjected to MTT assay for microbial cell viability testing after treatment. After 24 h of incubation, biofilms adhered on the mesh of metallic brackets after treatment were assessed by confocal laser microscopy. The total CFU/mL was estimated, and the results were log-transformed (log 10 ) and analyzed using one-way analysis of variance and Tukey-Kramer test. P-value was set to <0.05 that indicated statistical significance., Results: The samples from group-IV showed the highest amount of relative biofilm viability compared to any other group while group-I (PDT) showed the least viability of the two bacterial strains studied (p < 0.05). Group-I showed no significant difference when compared with group-III (chlorhexidine) (p > 0.05). The biofilms on the samples from group-II and group-IV were largely viable indicating thick green staining across the mesh of the brackets. Among the group-III samples, there were predominantly dead cells as compared to the live cell staining. A considerable amount of red staining was observed with noticeable less green staining in group-I samples., Conclusion: This laboratory investigation revealed that riboflavin mediated PDT significantly reduced the amounts of S. mutans and S. sanguinis around the orthodontic brackets., (Copyright © 2021 Elsevier B.V. All rights reserved.)

Background: The aim of the present study was to evaluate the effectiveness of photodynamic therapy (PDT) on clinical gingival inflammatory parameters, bacterial load, proinflammatory cytokine status, and pain scores in adolescent patients undergoing fixed orthodontic treatment with gingivitis., Methods: Thirty adolescent undergoing fixed orthodontic treatment with gingivitis were randomly divided into two groups: Group A - patients undergoing dental scaling (DS) with adjunctive photodynamic therapy (PDT) and Group BDS alone. Clinical gingival parameters including plaque scores, (PS), bleeding on probing (BOP) and probing depth (PD) were assessed. Visual analogue scale (VAS) and McGill Pain Questionnaire (MPQ) were used to report the values of present pain intensity. Crevicular fluid was sampled to quantify the levels of interleukin (IL)-6 and tumor necrosis factor (TNF)-α using enzyme-linked immunosorbent assay. The total bacterial counts for Porphyromonas gingivalis (P. gingivalis) and Tannerella forsythia (T. forsythia) were assessed. All examinations were performed at baseline, 1 week and 4 weeks., Results: Both the treatment regimens reported statistically significant reduction in PS and BOP (p < 0.05). However, no significant difference was observed in PS and PD values when Group B was compared with Group A (p > 0.05). There was a statistically significant reduction noted for BOP in Group B when compared to Group A (p < 0.05). There was a statistically significant reduction in the microbial counts of T. forsythia in Group A when compared to Group B at week-1 (p < 0.05). During the 4-week follow-up, the counts for T. forsythia significantly increased. No significant changes could be seen in either of the pain scores in both the groups (p > 0.05). Both groups showed statistically significant reduction in the IL-6 and TNF-α levels. However, IL-6 was significantly reduced at 1 week, while TNF-a significantly reduced at 4 weeks of follow up among the participants in Group B., Conclusion: PDT has a positive effect in significantly reducing the periodontal microbial load in established gingivitis in adolescent patients undergoing fixed orthodontic treatment., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Purpose: The aim of the present randomized controlled clinical trial was to evaluate the efficacy of photodynamic therapy (PDT) on halitosis in adolescent patients undergoing fixed orthodontic treatment., Materials and Methods: Forty-five adolescents with halitosis undergoing orthodontic treatment were equally randomized into three groups: Group - I: provision of treatment through PDT on dorsum of tongue; Group - II: provision of treatment with the help of tongue scrappers (TS); Group - III: provision of treatment with the help of TS and adjunctive PDT. Presence of halitosis confirmed on the basis of gas chromatography and estimation of oral malodour with a cysteine challenge and H 2 S values recorded ≥112 parts per billion (ppb). A portable device Oral Chroma™ was used for performing breath analysis. A total of 5 bacterial species including P. gingivalis, F. nucleatum, P. intermedia, T. forsythia and T. denticola were studied as the proportion of sites defined as having ≥1.0 × 10 5 bacterial cells., Results: The mean age of the participants in Group-I, II and III were 15.4 years, 13.8 years, and 14.2 years, respectively. The median values for Group-I, II and III at initial breath analysis were 874 ppb, 613 ppb and 1089 ppb, respectively. After treatment with the respective therapeutic modalities, a statistically significant difference was seen among groups after 2-weeks (p < 0.0001) (Table 3). After applying Kruskal-Wallis test, group-III showed the highest amount of reduction in H 2 S concentration (100 %) at final 2-weeks breath analysis compared to group-I and group-II (p = 0.0001). Descriptive statistics for all bacteria showed that group-III (TS + PDT) statistically significantly reduced the proportional distribution of all bacteria at 2-week follow-up (p < 0.0001) compared to group-I or group-II., Conclusion: PDT along with tongue scrapping showed effective immediate reduction of H 2 S concentration and reduction of oral pathogens in adolescent patients undergoing fixed orthodontic treatment with short-term follow up. Long-term evaluation and complete eradication of halitosis needs to be explored in further clinical trials. In addition, the cost of PDT and its potential side effects should not be disregarded., (Copyright © 2020 Elsevier B.V. All rights reserved.)

This within subject clinical experiment assessed oral health impacts before and after Invisalign orthodontic treatment and their relationships with personality characteristics. 50 patients (26 females and 24 males; mean age = 27.62 ± 8.25 years, SE = 1.17, 95% CI = 24.71-29.89 years) were assessed before and after treatment with Invisalign orthodontic treatment. Treatment clinical success was evaluated according defined clinical guidelines. Oral health impacts before and after Invisalign orthodontic treatment were measured via the Oral Health Impact Profile (OHIP). Personality features were measured via the NEO Five-Factor Inventory (NEO-FFI). Probability of α = .05 was utilized to identify significant findings. Females scored less OHIP scores after treatment (had less negative impacts) in comparison to baseline OHIP scores (t = 3.782, df = 25, P = .001, 95% CI of mean difference = 2.750-9.327). Among males, openness scores (R 2  = .911, B = 5.235, 95% CI for B = 0.062-10.407, t = 2.601, P = .048) were able to predict OHIP scores before treatment; meanwhile, extraversion (R 2  = .959, B = - 8.224, 95% CI for B = - 14.605-1.843, t = - 3.313, P = .021), openness (R 2  = .959, B = 21.795, 95% CI for B = 10.737-32.853, t = 5.067, P = .004), and conscientiousness (R 2  = .959, B = 10.293, 95% CI for B = 4.796-15.790, t = 4.813, P = .005) scores were useful to predict OHIP scores after treatment (R 2  = .959, P < .05). NEO-FFI scores were not useful to predict OHIP scores before or after treatment among females (P > .05). These findings demonstrate that oral health impacts of Invisalign orthodontic treatment and personality profiles contribution to oral health impacts were different between genders.

Background: External stressors such as high altitude and low oxygen are known to affect the human microbiome, and in light of the increased occurrence of dental caries and periodontitis in orthodontic patients, the effect of high altitude and the altered oral environment in orthodontic patients on the oral salivary microbiome was researched., Materials & Methods: 31 orthodontic patients from high altitude, Aseer region and 25 orthodontic patients, residing at sea level, as controls were included. DNA isolation was done from the saliva collected from the study participants. V3 area of 16s RNA was targeted by universal primers through PCR to decipher the salivary microbiome in both the groups., Results: A total of 11 genera belonging to 4 phyla of bacteria were identified in both groups. The most abundant microbiome at the phylum level was: Firmicutes, Bacteroidetes Proteobacteria, and Cyanobacteria. The salivary microbiome was more diverse in sea level controls compared to that of the orthodontic patients at high altitude wherein the presence of only two main phyla: Firmicutes and Proteobacteria were seen. The controls revealed Firmicutes, Proteobacteria, Bacteroidetes and Cyanobacteria., Conclusions: The findings of the study suggest that the biodiversity of the salivary microbiome is severely perturbed under the cumulative influences of high altitude and presence of fixed orthodontic appliance. Under these circumstances, a strict and meticulous oral hygiene regimen should be recommended and followed to avoid harmful effects on the periodontal tissues., (Copyright © 2020 Elsevier Ltd. All rights reserved.)

Background: The aim of this 4 week follow up randomized controlled clinical trial is to evaluate the effectiveness of photodynamic therapy (PDT) as an adjunct to ultrasonic scaling (US) in the reduction of gingival inflammatory parameters and periodontal pathogens in established gingival inflammation in adolescent patients undergoing fixed orthodontic treatment., Materials and Methods: A total of 22 adolescent patients (mean age: 17.5 years) undergoing fixed orthodontic treatment and presenting with persistent local gingival inflammation were randomized into two groups: Group-US: patients receiving ultrasonic scaling (US) with usual oral hygiene instructions and Group-PDT: in which patients received adjunctive PDT with US. Dichotomous recording for plaque scores (PS) and bleeding on probing (BOP) was used to assess the clinical inflammatory status. The total bacterial counts of P. gingivalis and T. forsythia were estimated and were expressed as log CFU/mL. All assessments were performed at baseline, 1 week and 4 weeks. For intergroup comparisons, student's t-test was computed along with Bonferroni correction for post hoc multiple comparisons. To identify differences between repeated follow-ups, ANOVA multiple rank test was used., Results: Both treatment modalities reported statistically significant reduction in PS and BOP in patients undergoing fixed orthodontic treatment (p < 0.05). However, there was no significant difference in PS and BOP when US was compared with PDT (p > 0.05). Group-US showed statistically significant reduction in T. forsythia at 1 week only (p < 0.05). Group-PDT showed statistically significant reduction in P. gingivalis and T. forsythia from baseline to 1 week and 4 weeks (p < 0.05). This was also significant when compared with US on both the time points (p < 0.05)., Conclusion: PDT was effective in significantly reducing periodontal pathogens in established gingivitis lesions in adolescent patients undergoing fixed orthodontic treatment in short term., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Competing Interests: The authors have no conflicts of interest that are relevant to this article.

Aim: The aim of the present clinical trial is to evaluate the clinical, bacterial, and immunological outcomes of photodynamic therapy (PDT) in adolescent patients with orthodontic treatment-induced gingival enlargement (OTGE)., Materials and Methods: A total of 26 adolescent patients, 16 girls and 10 boys, of mean age 16.8 years, undergoing fixed orthodontic treatment for at least 6 months (mean duration in months, 8.3 ± 1.9) and presenting with GE were included in the clinical trial. All patients undergoing fixed orthodontic treatment with clinical diagnosis of OTGE were divided into two groups: Patients receiving full-mouth periodontal debridement (FMPD) 'Group-FMPD' and 'Group-PDT' included participants receiving methylene blue-assisted PDT in the selected area along with FMPD. Clinical periodontal assessments included the evaluation of plaque scores (PS), bleeding on probing (BOP), probing depth (PD) and hyperplastic index (HI). The total bacterial counts of Porphyromonas gingivalis (P. gingivalis), Treponema denticola (T. denticola), and Tannerella forsythia (T. forsythia) were estimated and expressed as log CFU/mL of each bacteria. Cytokines including interleukin (IL)-1β and IL-6 were analyzed using enzyme-linked immunosorbent assay (ELISA) kit., Results: The mean percentage of PS and BOP statistically significantly reduced with both FMPD and PDT from baseline to 4 weeks (p < 0.05). Although mean PD significantly reduced in both the groups at all time points, there was significantly higher reduction with PDT as compared to FMPD at 2 weeks post treatment (p < 0.05). Inter-group comparison showed PDT demonstrated significantly higher HI at 2- and 4-weeks post treatment (p < 0.05). The mean log CFU/mL of P. gingivalis and T. forsythia showed statistically significantly higher reduction with PDT than FMPD (p < 0.05) at both 2-and 4-weeks follow-up. T. denticola reported significantly reduced levels at 2 weeks follow-up period only with PDT (p < 0.05). No statistically significant difference appeared when both treatment modalities were compared with one another (p > 0.05). Four weeks after periodontal treatment, IL-6 significantly reduced with PDT compared to FMPD (p < 0.05)., Conclusion: PDT assisted in reducing bacterial counts and improving hyperplastic index in OTGE., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Purpose: In the early stages, osteoporosis is relatively a silent disease characterised by low bone density with microarchitectural deterioration of the bone tissue leading to enhanced bone fragility. The objective of this study was to evaluate the relationship between age, body mass index, oral signs, and osteoporosis among postmenopausal women., Materials and Methods: The study included postmenopausal women who were divided into two groups of subjects. The osteoporotic group comprised 30 patients with osteoporosis who were diagnosed using dual-energy X-ray absorptiometry, and the non-osteoporotic group (control group) comprised 30 subjects with no evidence of osteoporosis. Panoramic radiography was performed, followed by the acquisition of two direct digital intraoral periapical radiographs from the mandibular premolar-molar region., Results: Chi-square test revealed a statistically significant difference (p = 0.001) in the mandibular cortical shape index between the two groups. However, a statistically non-significant difference in cortical width, the panoramic mandibular index, mandibular alveolar bone resorption degree, fractal dimension, and mean number of teeth was found between the two groups. A statistically significant difference was observed in the mean age between the osteoporotic and non-osteoporotic groups., Conclusion: The mandibular cortical index findings (MCI) on panoramic radiograph are effective indicators of osseous changes in postmenopausal osteoporosis, thereby determining early prediction of osteoporotic fracture risk and reducing its related morbidity.

Background/purpose: Tooth size discrepancy is one of the causative factors of malocclusion. This study aimed to establish the TDS among various malocclusion classes and normal occlusion subjects in a Southern Saudi population., Materials and Methods: The study casts of orthodontic patients from Southern Saudi Arabia (mean age: 19.6 years ± 2.45; n = 120) were randomly selected and grouped into eight equal classes based on Angle's classification and gender. An additional 30 study casts, devoid of malocclusion, having excellent intercuspation and class I occlusion, were grouped into two controls ( n = 15) based on gender. The study casts were three-dimensional scanned to measure mesiodistal widths of all the teeth. The calculated anterior ratios (AR) and overall ratio (OR) were statistically analyzed with analysis of variance and t -tests., Results: There were no significant differences in "OR" and "AR" between the genders ( P > 0.05) and among the malocclusion and control subgroups ( P > 0.05). The mean "OR" (92.01 ± 0.18) and "AR" (78.60 ± 0.27) of the malocclusion group were significantly higher than that of Bolton's ratios ( P > 0.05). The "AR" of the control group was significantly higher than Bolton's standards ( P = 0.048). However, "OR" was no different ( P = 0.105). Malocclusion patients displayed a discrepancy (±2 standard deviation) in "AR" of 22.5% and 'OR' of 6.7% from Bolton's mean (BM). Similarly, the control group displayed a discrepancy in "AR" of 20% and "OR" of 10% from BM., Conclusion: The mean "OR" and "AR" of the Southern Saudi population showed no sexual dimorphism and no significant difference among various malocclusion and control subgroups. The "AR" of the malocclusion and control subgroups did not comply with Bolton's standards., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Contemporary Clinical Dentistry.)

Aim: To evaluate the effect of simulated intraoral hydraulic, thermal, and mechanical stresses on the debonding characteristics of orthodontic brackets under different adhesive regimes., Materials and Methods: Groups of pre-coated (G1) and non-coated (G2) orthodontic metal brackets were bonded onto the buccal surfaces of 96 premolars using etch-and-rinse (SG1, n = 24) and self-etch (SG2, n = 24) primers. Twelve specimens (C1) from each subgroup were subjected to early debonding resistance tests, while the other twelve (C2) were used to test delayed debonding resistance after exposure to conditions simulating intraoral hydraulic, thermal, and mechanical stresses. The debonding resistance of the brackets was evaluated using a universal testing machine and the debonding patterns were micro-visualized to determine the adhesive remnant indexes of subgroups of specimens., Results: Within each group, the etch-and-rinse primer (SG1) resulted in higher debonding resistance than self-etch primers (SG2) ( p < 0.05), while there was no difference between non-stressed and stressed specimens ( p > 0.05). Within each category of test specimens, there was no difference between pre-coated (G1) and non-coated (G2) brackets ( p > 0.05). The tested specimens in all categories showed comparable adhesive remnant indexes. However, higher percentages of favorable scores (0 and 1) were obtained for all stressed specimens., Conclusions: Short-term cumulative intraoral stresses have no adverse effect on the debonding values of either pre-coated or non-coated brackets when either etch-and-rinse or self-etch primer is used for bonding. Exposure of the bonded brackets to different types of stress reflects favorable debonding patterns.

This cross-sectional study was done to evaluate linear and angular measurement of lip morphology in Saudi adults and their comparison with the norms. After taking their history and physical examination, the patients were referred for a lateral Cephalograph using Dolphin Imaging Software. Linear and angular measurements related to lip morphology were recorded. Significant differences were found in the lower lip to E line, upper and lower lip protrusion, upper and lower lip to S line and upper and lower lip thickness, nasolabial angle, Z angle, with Saudi males having more prominent, thicker lips than the Saudi females. Comparison with the norms revealed that both lips are prominent among Saudi males, while in females there is an increased prominence of the lower lip. Value of the lower lip to H line is increased in both genders, males have prominent and thicker upper lips compared to the females and the lower lip in both genders is more prominent compared to the norms.

The study aimed to evaluate differences in tooth size between patients with hypodontia and those with normal complement of permanent teeth using three-dimensional geometric morphometric analysis. The number of anatomical landmarks was recorded on the clinical crown of the permanent teeth on three-dimensional scanned study models of hypodontia and in control subjects. The study sample comprised 120 patients with hypodontia (mild, moderate, severe) and 40 controls matched for age and sex. Tooth size differences were tested statistically using multivariate statistics. Size variation was for the most part found to be significant, especially when the control subjects were compared with the hypodontia groups. The explained variance among group membership was generally larger in the anterior and premolar region than in the molar region Sexual dimorphism was found less in the anterior region than in the posterior region; therefore, the sexes were pooled more often for teeth in the anterior region. Quantitative measurement of tooth size in patients with hypodontia may enhance the multidisciplinary management of these patients.

Background: Photobiomodulation therapy, a non invasive method with no adverse effects, has been used to accelerate tooth movement in orthodontia. However, the specific characteristics of laser settings used in studies documented have reported varied inconsistent conflicting results., Objectives: We decided to undertake a systematic review to eliminate this inconsistency by quantifying the literature studies that indicated the link between photobiomodulation and acceleration of tooth movement and to assess if there is any association of photobiomodulation therapy in accelerating tooth movement., Search Strategy: We systematically searched for articles of existing literatures on Photobiomodulation therapy and acceleration of tooth movement over Cochrane library, Pubmed central, EMBASE, Scopus and Web of sciences from 2000 to 2017. Mesh search terms using various descriptors were used to identify the studies., Search Criteria: We included randomized control trial and clinical control trail studies that used Ga-Al-As diode laser and Oseeopulse laser with specific characteristics and company specifications, addressing relevant efficiency and safety outcomes., Data Collection and Analysis: Eligible studies were reviewed and data was extracted on a standard from. We used Cochrane review manager software (Revman version 5.3) to assess the qualities of each included trials. Data were analyzed using an inverse variance method with random effects model effect., Results: We observed a statistical significant difference between the photobiomodulation therapy compared to non laser group in the acceleration of tooth movement (Mean difference 0.59 (95%CI- 0.24 to 0.95) I 2 95%). However, these results need caution while generalizing in clinical practice due to the large amount of heterogeneity across the studies., Conclusion: Findings of the current systematic review suggest a possible benefit with photobiomodulation therapy and tooth movement in orthodontia. However these findings need to be further validated in larger trials using specific standardized characteristics of laser settings to uniform the methodological design that can be used in routine clinical practice., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Aim: To evaluate the shear bond strength (SBS) and modes of lithium disilicate ceramics (LDC) photosensitized by Er,Cr:YSGG (ECL) and fractional carbon dioxide (CO 2 ) laser bonded to metallic bracket compared to traditional conditioning methods., Material and Method: Fifty LDC discs were polished and randomly allocated into 5 groups (n = 10) each. Group 1 were photosensitized with ECL + Silane (S). Group 2 were irradiated using CO 2 laser + S. In group 3 LDC discs were treated with aluminium trioxide (Al 2 O 3 ) air abrasion (AA). Moreover, samples in group 4 and 5 were conditioned with Hydrofluoric acid (HFA)+ S (Control) and Self-Etch Glass Ceramic Primer (SEGCP). Following conditioning regimen fifty maxillary central incisor brackets were pasted on LDC using adhesive material. SBS testing was performed by mounting the specimens on a universal testing machine. After debonding, sheared surface was examined under stereomicroscope to classify failure mode using adhesive remnant index (ARI). Mean and standard deviation (SD) were compared by analysis of variance (ANOVA) and Tukey multiple comparison test at a significance level of p = 0.05., Results: Among the conditioning groups the highest SBS values were presented by HFA + S (21.08 ± 1.06). The lowest SBS values were displayed by AA Al 2 O 3 (12.61 ± 0.45). SBS of samples conditioned with SEGCP showed significant difference amongst all experimental groups (16.76 ± 0.81)., Conclusion: LDC photosensitized with CO 2 and ECL has a potential to be recommended in clinical settings alternate to HFA + S when bonded to metallic bracket., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objectives: To assess correlation of dermatoglyphic (DG) pattern with quantitative palatal anatomic parameters measured using three-dimensional (3D) scanning of dental casts and to explore the possibility of utilizing these to predict future occurrence of malocclusion., Materials and Methods: Pretreatment casts of 477 Saudi Arabian patients were divided into Class I, II, and III malocclusion groups. Fingerprints were recorded for all hand digits using a digital biometric device. Maxillary arch analysis was accomplished including intercanine, intermolar distance, palatal height, and palatal area. The results were statistically analyzed., Results: The mean surface area of the palate was highest in Class II malocclusion. The DG pattern was not significantly associated with the type of malocclusion, except in the instance of the double loop characteristic ( P = .05). There was a strong correlation, however, between DG characteristics like simple arch, loop, and double loop and palatal dimensions (intercanine, intermolar distance, and palatal height). Heterogeneity of DG pattern could be reliably used to predict palatal dimensions. Logistic regression revealed that only tented arch, symmetrical, spiral DG patterns and palatal area were significant but weak predictors of Angle malocclusion ( P < .05)., Conclusions: A novel correlation of DG pattern with 3D palatal anatomic characteristics was assessed in different Angle malocclusion classes. Few of the DG characteristics and palatal dimensions showed significant correlations. However, only some of these were significant predictors of Angle malocclusion.

The mechanical of the tricalcium phosphate matrix sintered with different amounts of the magnesium oxide have been investigated. The tricalcium phosphate - magnesium oxide composites were characterized by using the mechanical properties such as rupture strength, Vickers hardness and elastic modulus. The effects of the sintering process on the structural changes of the composites were investigated. At 1300 °C, the highest performance was obtained for the tricalcium phosphate containing 5 wt% MgO. The maximum mechanical strength and Young's modulus of the composites reached 9 MPa and 38 GPa, respectively. The result can be explained by the formation of both, liquid phase, which helps to fill the pores in the microstructure, and a new phase relative to the calcium magnesium phosphate. At 1400 °C and beyond 5 wt% MgO, the performances of the composites are hindered by the intragranular porosity formation and by the exaggerated grain growth. The addition of the magnesium oxide to the tricalcium phosphate matrix promotes the reduction of the wear rate and the friction coefficient. The composites performances are close to the enamel., (Copyright © 2018 Elsevier B.V. All rights reserved.)

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., (Copyright © 2019 Elsevier B.V. All rights reserved.)

Objective: To evaluate the status of occlusion among school children in city of Abha, Saudi Arabia., Materials and Methods: The current study was based on the clinical examination of 1998 Saudis (mean age 14.13 ± 0.99 years) who were randomly selected by a multi-stage random sampling technique from the city of Abha. The occlusal parameters recorded in this study were molar and canine relationships, overbite, overjet, crowding, spacing, anterior open bite, anterior crossbite, posterior crossbite, and scissors bite using gloves, light source, mouth mirror, and ruler., Results: Class I molar relationship was observed in 1219 (61%) of the total sample, while Class II and III molar relationships were observed in 326 (16.3%) and 154 (7.7%), respectively. Class I-III canine relationships were seen in 1255 (62.8%), 231 (11.6%), and 112 (5.6%) of the sample, respectively. Normal overbite was found in 1490 (74.6%) of cases, while 1515 (75.8%) had normal overjet. The most prevalent malocclusion trait was crowding (26.6%), followed by spacing (20.6%), increased overjet (19.5%), increased overbite (19.4%), posterior crossbite (8.5%), and anterior open bite (6.1%)., Conclusions: Crowding was the highest occlusal trait in frequency followed by spacing, increased overjet, and increased overbite. Class I molar and canine relationships, normal overjet, and normal overbite were frequent findings among Saudi adolescents in Abha city., Competing Interests: There are no conflicts of interest.

The objective of this study was to evaluate the association between salivary 1,5-anhydroglucitol (AG), vitamins A (VA), C (VC), and E (VE), and caries risk in children. 100 healthy children aged between 6 and 13 years were divided into two equal groups of caries-free (DMFS/dmfs=0) and caries active (DMFS/dmfs>3). Unstimulated midmorning saliva was collected from all the children and the levels of salivary AG and vitamins A, C, and E were measured. Caries risk assessment was done using American Academy of Pediatric Dentistry Caries Assessment Tool. Analysis of salivary AG and vitamins was performed using a commercially available ELISA kit. Low levels of AG were present in caries active and high caries risk groups compared to caries-free and low/medium caries risk groups. This difference is statistically significant (p < 0.05). A strong negative correlation between AG and caries activity was observed in the caries active group. VA was not related to caries activity, while VC and VE displayed a statistically significant correlation (p < 0.05). Similarly, a strong negative correlation was observed between the levels of AG and high caries risk group. Salivary AG, VC, and VE together are related to caries risk in caries active children. These salivary parameters can act as indicator of caries status in children.

The aim of this study was to verify Cameriere's regression formula to predict chronologic age in Saudi Population and if proven to be inaccurate, develop a new algorithm specific for Saudi children. A total of 788 Orthopantamographs(495 boys and 293 girls) were analyzed. The tooth measurement parameters were: number of teeth with closed apex (N 0 ), open apex width (a), crown length (l), A/L ratio for each tooth (x 1 to x 7 ) and summation of all open apex width (s). The radiographic measurements were substituted in the formula: Age = 8.971 + 0.375g + 1.631 x 5 + 0.674 N 0 - 1.034s-0.176s * N 0 The mean dental age assessed by Cameriere's method was significantly lower than chronologic age in Saudi population and with both genders and total study population (p < 0.05). A stepwise linear regression showed all parameters gender, N 0 , x 1 to x 7 except x 2 significantly associated with age (R 2  = 0.6334, F (6,779) = 168.28, p < 0.05). There was no statistically significant difference between predicted and actual chronologic age for 788 children using regression equation for Saudi population (p = 1). Cameriere's formula verified in Saudi children was found to underestimate the chronologic age in both genders. A prediction formula based on Cameriere's method specific to Saudi children has been developed for estimating chronologic age. The new regression formula developed will be more accurate for age assessment in Saudi children., (Copyright © 2019. Published by Elsevier Ltd.)

Our study evaluated the adhesion strength and antibacterial effect of a conventional orthodontic composite resin blended with yttrium fluoride (YF₃) nanoparticles. Yttrium fluoride nanoparticles (NP) were added to the conventional orthodontic composite resin (Transbond XT) at concentrations of 1%, 2%, and 3% (w/w), and the blended composite resins were labeled as NP1, NP2, and NP3, respectively. A total of 60 extracted human premolars was randomly allocated to four groups of 15 samples ( n = 15). Orthodontic brackets were bonded using the conventional (control) and experimental composite resins (NP1, NP2, and NP3). The adhesion strengths of the composite resins were determined using a universal testing machine. The debonding sites were assessed and scored using the adhesive remnant index (ARI). The antibacterial effect of YF₃ nanoparticles against Streptococcus mutans was assessed by the viable cell counting method. For the same, 40 composite disc specimens were prepared using the control and experimental composite resins ( n = 10). The data was analyzed by one-way ANOVA and Tukey's post hoc analysis. In all the tests, the significance level was determined to be 0.05. The highest adhesion strength values were found in the control group (11.61±0.23) and the lowest values were found in the NP3 group (10.49±0.17). A significant difference was observed between the control and experimental groups, NP2 and NP3 ( P < 0.05). NP1 group showed insignificant ( P = 0.388) adhesion strength values compared with the control group. There was no significant difference between the ARI scores of the conventional and experimental groups ( P > 0.05). The highest colony forming units (CFU) were found in the control group (75.85±1.15) and the lowest CFU were found in the NP1 group (2.24±1.14). A significant difference between the mean CFU of the conventional and experimental composite groups was observed ( P < 0.05). Despite higher antibacterial activity in the NP1 group compared with NP2 ( P = 0.146) and NP3 ( P = 0.117), the difference was not significant. Similarly, no significant difference was observed between NP2 and NP3 groups ( P = 0.97). Our results suggested that yttrium fluoride nanoparticles, blended with a conventional resin at 1% concentration, demonstrated significant antibacterial effect and did not compromise adhesion strength.

Objective: To determine the shear bond strength of orthodontic brackets after anti-oxidant treatment on previously bleached teeth.., Methods: The experimental in-vitro study was conducted in Saudi Arabiaat Qassim University, Al-Qassim, and King Saud University, Riyadh, from December 2016 to March 2017, and comprised extracted maxillary and mandibular premolars which were divided randomly into three groups. In Group A, which was the control group, the teeth were etched and bonded, while those in Group B were bleached, etched and bonded. Group C was subjected to bleaching, followed by treatment with anti-oxidant 10% sodium ascorbate solution, then etched and bonded. All three groups were then tested and analysed for bond strength using the Instron, Universal testing machine. SPSS 23 was used for data analysis.., Results: There were 60 teeth with 20(33.3%) in each of the three groups. Group C had the maximum mean shear bond strength of 12.231}2.1Mpa, followed by Group A with 10.948+/-2.1Mpa and Group B with 7.621}1.8Mpa., Conclusions: Anti-oxidant treatment had a positive effect on the shear bond strength of orthodontic brackets after tooth bleaching. Keywords: Anti-oxidant. Bleaching, Brackets, Extracted premolars, Shear bond strength.

Background: Adhesion strength of orthodontic attachments to enamel should be within optimal range to resist occlusal forces and to allow debonding without enamel damage., Objective: The present study compared the effect of non-thermal plasma (NTP) and conventional surface treatment on the adhesion strength of orthodontic bracket to enamel., Methods: A total of 100 premolar teeth were allocated into 5 groups according to the bonding procedure followed: Group 1 (Etch, prime and composite adhesive); Group 2 (Prime and composite adhesive); Group 3 (Glass ionomer cement); Group 4 (NTP, prime and composite adhesive) and Group 5 (NTP and glass ionomer cement). Ten specimens in each group were subjected to artificial aging and the remaining ten specimens served as baseline specimens. Adhesion strength values were recorded after debonding and bond failure types were scored. Water contact angles of the NTP treated and untreated enamel surface were measured., Results: Group 1 specimen demonstrated highest bond strength at baseline (21.5 ± 3.01) and thermocycling (15.8 ± 2.87) and the least values were in Group 2 specimens at baseline (3.9 ± 1.01) and thermocycling (1.6 ± 0.7). Among the experimental (NTP) groups, Group 4 specimens exhibited high adhesion strength at baseline (10.2 ± 1.76) and after thermocycling (9.8 ± 2.15) compared to Group 5 specimens at baseline (10.1 ± 1.05) and thermocycling (6.5 ± 2.19). The water contact angle on untreated enamel surface was 53.1° ± 2.1° as compared to 1.4° ± 0.7° in treated surface., Conclusion: Non-thermal plasma (NTP) treatment in conjunction with composite adhesives demonstrated clinically acceptable adhesion strength and was well within the optimal range (7-14 MPa) for enamel bonding.

Transverse palatal distraction is a biological process of regenerating new bone and enveloping soft tissues in the maxillary palate region. This technique is similar to Osteo-distraction (OD) procedure for bone lengthening in which gradual and controlled traction forces are applied on the osteotomy gaps to produce new bone in between the surgically separated bone segments. This review describes the different phases after osteotomy and the biological process involved during the new bone and soft tissue formation. The mechanical environment formed in the distraction area is due to the traction forces by the distractor appliance. This environment stimulates differentiation of pluripotent cells, neovascularization, osteogenesis and remodeling of newly formed bone. The role of different pro-inflammatory cytokines, interleukins, bone morphogenic proteins, transforming growth factors, fibroblast growth factors-2) and extracellular matrix proteins (osteonectin, osteopontin) during the distraction phases has been described in detail. Also, an important note on the nutritional aspect during Osteo-distraction will benefit the clinicians to guide their patients after osteotomy throughout the distraction process.