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Background: Dental implants are considered the first option to replace missing teeth. Alveolar bone resorption gradually progresses following tooth extraction leading to loss of vertical bone dimension for implant placement. The lateral window approach is the most commonly used procedure to treat vertical bone loss. Objectives: The aim of the present study is to evaluate the lateral wall thickness (LWT) of the maxillary sinus and determine the influence of gender and side on maxillary LWT. Methods: This study involved a cross sectional retrospective study. Cone- beam computed tomography data were collected from 99 patients with a total of 198 maxillary sinuses that met the inclusion criteria. The patient age ranged between 18 to 35 years. On the selected sagittal section, the points of measurement are determined by a perpendicular line at 5 mm from the lowest point of the sinus floor. Measurements were taken at four different areas; first premolar (P1), second premolar (P2), first molar (M1), and second molar (M2). Descriptive statistics were used to calculate mean lateral wall thickness for each tooth, and student’s t-test was used to test the effect of gender and side on maxillary LWT. Results: The greatest mean LWT was observed around the left first maxillary molar (2.43±0.82), while the lowest mean LWT was observed around the right second maxillary premolar (1.62±0.61). There was no significant difference in the LWT around any tooth (M1 p=0.56, M2 p=0.92, P1 p=0.14, P2 p=0.19). Conclusion: There was no significant difference in both males and females of the lateral wall thickness in the left and right side of maxillary sinus.

Objectives Peri-implantitis is a destructive inflammatory process that affects the soft and hard tissues around dental implants. porphyromonas gingivalis, an anaerobic gram-negative bacterium, appears to be the main culprit. Since there is no efficient and specific vaccine to treat peri-implantitis, the goal of our research has been to develop a multi-epitope vaccination utilizing an immunoinformatics approach that targeted P. gingivalis type I fim A. Materials and methods P. gingivalis peptides 6JKZ and 6KMF are suitable for vaccine development. B- and T-cell epitopes from 6KMF and 6JKZ were detected and evaluated based on critical factors to produce a multi-epitope vaccine construct. It was assessed based on allergenicity, antigenicity, stability. The vaccine's dual major histocompatibility complex (MHC-I and MHC-II) binding epitopes allowed it to reach a larger population. P. gingivalis fimbriae induce immune subversion through TLR -CXCR4 receptor complex pathway. The ClusPro 2.0 server was used to do the molecular docking using TLR2 - CXCR4 and vaccine epitopes as receptor and ligand respectively. Results The designed vaccine was non-allergenic and had a high antigenicity, solubility, and stability. The 3D structure of the vaccine revealed strong interaction with CXCR4(TLR2) using molecular docking. The vaccine-CXCR4 interface was more consistent, possibly because the vaccination has a higher affinity for the CXCR4-TLR2 complex. Conclusion This study details the vaccine's distinct and sustained interaction with the CXCR4(TLR2) immunological receptor and its consistent and effective utterance in the bacterial system. As a result, our vaccine formulation will evoke a significant memory response and induce an adaptive immune response against P. gingivalis.

Aim: To assess the relations between the divergence angle of the maxillary molar roots and their proximity to the maxillary sinus floor using CBCT. Method: This study comprised CBCT scans of the maxilla, including at least the inferior one-third of the maxillary sinus and at least one molar present in any quadrant with complete eruption and root formation. Evaluation included the vertical relations between the maxillary molar root apices and the maxillary sinus floor (MSF), and the root divergence was measured from the root apices to the floor of the pulp chamber. The chi-square test was used for the associations between the study parameters. For the correlation between root divergence angles and MSF vertical relationship types, the Spearman test was used. A P-value 45⁰ angle groups, and a higher prevalence of the Type I relationship was found in the 21-45⁰ angle group. For the distobuccal-palatal angle groups, higher percentages of the MSF Type II relationship were found in the three angle groups. For all teeth, there was a significant positive correlation between the MSF vertical relationship and the mesiobuccal-palatal angle (r = 0.116; P = 0.039). Conclusion: There was a positive correlation between the divergence angle of the roots and their vertical relationship with the MSF. Clinicians should assess the divergence between the roots before performing extraction or endodontic treatments.

Background: Recently, implants have been widely considered as an option for replacing missing teeth. There are several biological conditions that must be considered for the success of an implant. Failure to satisfy any of these factors may result in complications, such as peri-implantitis or failure of the implant. Aim: The aim of this study was to evaluate the general dentist's attitude towards the management of peri-implant diseases in Saudi Arabia. Methods: A multicenter cross-sectional electronic-based questionnaire was formulated based on the validated questionnaire from a previous study. It was targeted towards the general dental practitioners in Saudi Arabia. The study sample consisted of 721 general dental practitioners. The questionnaire consisted of 17 questions divided into five sections. Pearson's chi-square test was used for inferential statistical analysis with Holm's correction, for adjusted p-value, the alpha at 95% confidence interval was 0.05, and all values below alpha were considered statistically significant. Results: The majority of participants had attended an implant training course (51.2%) while the rest had not (48.7%). The majority of the participants (67.3%) thought they need special instruments for the detection of peri-implantitis but only 29.5% thought they do not need any special instruments for the intended purpose. Most participants (79.3%) said they can identify and differentiate between normal and abnormal soft tissue around an implant, while 6.5% of the respondents could not. More than half of the participants (54.8%) could differentiate between peri-implant mucositis and peri-implantitis, and 19.4% had no idea about this. Amoxicillin & metronidazole was considered as the best and most effective antibiotic by the majority of respondents (76%), while only (5%) of dentists selected ciprofloxacin. Conclusion: This study concludes by suggesting that most of the participants have adequate knowledge about peri-implant soft tissue assessment, mechanism of periodontitis and peri-implantitis, its initiation and progression along with its management. Most of the participants found the training courses on peri-implantitis to be efficient. It is recommended to conduct more courses and studies that would aim at understanding the pathogenesis, etiology, diagnosis, and treatment of peri-implant diseases so as to increase awareness among general dentists.

An area of growing attention is the justification of the environmental effects of clean energy technologies. For many years, photovoltaic modules have been employed extensively in both small- and large-scale applications. They are still not cost-effective compared to other power generation technologies, particularly in an industrial city and the harsh environmental conditions of the coastal desert areas. This study is directed to examine the effects of dust, sand grains, and soiling characterization on the efficiency of PV modules under different environmental conditions. PV modules of two technologies (Mono-Si and poly-Si), two different inclination angles (10° and 24°), and two different surface conditions (clean and soiled) are experimentally tested for concluding and comparing the performance change of PV modules. The main findings imply that, the overall losses of generated power due to soiling effect reached 24%. Mono-Si PV modules were found better than the Poly-Si PV modules under normal conditions, but Poly-Si PV modules were found better in handling the soiling impact. The 10° Inclination angle allows higher performance and better resistance to environmental conditions. Dust characterization study confirmed the effect of the geographical area on the quality and adhesion strength of the accumulated dust particles on the PV modules' surfaces.

To assess and equate the efficacy of different disinfection protocols autoclave, chlorhexidine (CHX), PDT utilizing Rose Bengal (RB), chitosan, and Er, Yag laser and their effect on fracture strength of PMMA denture-based polymer (DBP) colonized with C. Albicans, S. aureus, S.mutans, and E.coli.A total of 50 (n = 10) PMMA DBP were manufactured and adulterated with the American Type Culture Collection (ATCC) of diverse microbial colonies inhabited by C. Albicans, S. aureus, S.mutans, and E.coli. The specimens were subjected to different denture disinfection approaches by randomly distributing in into five groups i.e., Er, Yag laser, RB, autoclave, CHX, and Chitosan, respectively for appraising antimicrobial effectiveness. PMMA fracture load was also assessed and statistical analysis was performed for CFU/mL (log10) of exposed C. Albicans, S. aureus, S.mutans, and E.coli by one-way ANOVA and Tukey's multiple comparison test at a significance level of p 0.05.Intergroup comparison disclosed that denture disinfection with Er, Yag laser, autoclave, Chitosan, and CHX (control) validated comparable antimicrobial efficacy to denture against all inspected CFU/mL (log10) (p0.05). The intragroup comparison revealed that DBP sanitization with Er, Yag laser, autoclave, Chitosan, RB, and CHX substantiated equivalent effective antimicrobial efficacy in plummeting CFU/mL (log10) of S. mutans and E. coli (p0.05) but in consideration to S.aureus and C.albicans, all groups resulted in declining their count except 5µm RB activated by PDT(p 0.05). No significant difference was perceived in fracture load of PMMA denture base among Er, Yag laser, RB, chitosan, and CHX (control) (p 0.05) except autoclave decontamination procedure that indicated the least fracture strength of DBP when disinfected (p 0.05).Er, Yag laser, and Chitosan activated by PDT have the potential to be used as an alternative to chlorhexidine for disinfecting Polymethyl methacrylate denture base as they demonstrated the highest antimicrobial efficacy against E. coli, C. Albicans, S aureus, and S. mutans with optimal fracture load.

الملخص: التشنج الفكي أو ما يعرف بالضزز هو أحد مضاعفات العلاج الإشعاعي التي تصيب الناجين من أورام الرأس والعنق. يُعرّف الضزز بأنه انخفاض في القدرة على فتح الفم إلى أقل من ٣٥ ملم بسبب التهاب العضلات الرافعة للفك السفلي نتيجة للعلاج الإشعاعي المؤين. بسبب الطبيعة التقدمية للضزز، يُعد التدخل المبكر أمرا بالغ الأهمية لمنع المزيد من الضرر وضعف العضلات الرافعة للفك السفلي. تناقش هذه الورقة العلمية حالة مريضة تبلغ من العمر ٤٠ عاما، تم تشخيصها بورم الخلايا الحرشفية في الجزء الأيمن من الفك العلوي. حيث تمت عملية استئصال جراحية للجزء الأيمن من الفك العلوي متبوعة ب ٣٣ دورة من العلاج الإشعاعي. بعد خمسة أشهر من العلاج الإشعاعي، أبدت المريضة اهتماما باستبدال أسنانها المفقودة لاستعادة وظائفها الفموية وتحسين الشكل الجمالي للوجه. خلال زيارتها بعد العلاج الإشعاعي في العيادة التخصصية للأسنان، وُجد أن فتحة الفم محدودة بمقدار ١٢ ملم. واشتملت الخطة العلاجية على استخدام جهاز خاص لزيادة قدرة المريضة على فتح الفم تدريجيا بالتناوب مع مثبطات اللسان الخشبية. بعد مرور ستة أسابيع من العلاج تحسن مقدار فتحة الفم إلى ٢٠ ملم. ونتيجة لذلك، أمكن علاجها بتركيبة تعويضية صناعية للجزء المفقود من الفك والأسنان وذلك باستخدام تقنيات التصميم والتصنيع بمساعدة الحاسوب. تشير هذه الحالة إلى أن استخدام الجهاز الخاص لزيادة ارتفاع فتحة الفم ومثبطات اللسان الخشبية يسهمان في تحسين قدرة المريض على فتح الفم بشكل ملحوظ إذا استخدما بالتناوب. Abstract: Trismus is a post-radiotherapy complication that affects survivors of head and neck cancers. It is described as the reduction of mouth opening to less than 35 mm. The condition is a progressive process; hence early intervention is crucial to prevent further damage and weakness to the elevator muscles of the mandible. Here, we report a 40-year-old woman with known squamous cell carcinoma of the maxillary sinus in stage T3N0M0 who had undergone upper right partial maxillectomy with subsequent 33 fractions of radiotherapy (66 Gy; intensity-modulating radiotherapy). Five months post-radiotherapy, the patient showed interest in replacing her missing teeth to restore her oral functions and facial appearance. At her post-radiotherapy visit in the dental assessment clinic, she showed a mouth opening of 12 mm. The TheraBite® Jaw Motion Rehabilitation System™ and wooden tongue depressors were alternatively used for 6 weeks (4–5 stretches/day; each stretch held for 15 s). Mouth opening gradually increased to 20 mm. Consequently, a definitive obturator prosthesis was fabricated using computer-aided design and computer-aided manufacturing technologies with the 3Shape D900 model scanner. These were challenging and time-consuming steps, but acceptable facial appearance and mouth opening were restored for the patient. This case suggests that Therabite® Jaw Motion Rehabilitation SystemTM and wooden tongue depressors help to increase mouth opening significantly if used together and alternatively.

The aim of present study was to investigate the effect of pharmaceutical excipients and other active substances on antimicrobial efficacy of standard antibiotic against resistant and susceptible microorganisms. Pharmaceutical excipients (sodium lauryl sulfate [SLS], Tween-80, citric acid, NaOH, NaCl) and active substances (fusidic acid, sorbic acid) were investigated to check in-vitro efficacy and their effect on the efficacy of standard antibiotic. Clindamycin was selected as standard antibiotic. Clindamycin was found to be ineffective against methicillin-resistant Staphylococcus aureus (MRSA). Fusidic acid and SLS showed concentration dependent effect against MRSA. Other tested substances were also ineffective against MRSA, and also failed to improve the susceptibility of MRSA towards clindamycin. The clindamycin + fusidic acid (0.05 µg, 0.1 µg), and clindamycin + SLS (0.5 mg, 1 mg) showed concentration dependent effect on Staphylococcus epidermidis (S. epidermidis). Clindamycin combinations with fusidic acid or SLS showed better inhibition of S. epidermidis, than individual substance. At lower concentration of clindamycin (2 µg), the sorbic acid (25 µg) improves its effectiveness. SLS (0.5 mg, 1 mg) and clindamycin (4 µg, 10 µg) showed almost equal zone of inhibition against S. epidermidis, respectively. Present findings showed that certain pharmaceutical excipients (e.g. SLS) are effective against resistant and susceptible microbes, and suggested that more excipients should be screened for their antimicrobial potential and their ability to improve the efficacy of standard antibiotics.

Objective: The aim of the study is to assess knowledge, attitude and practices of dental implants among dental interns in Saudi Arabia Materials and Methods: A self-designed, close-ended questionnaire was distributed among 205 interns chosen by stratified random sampling technique. The questionnaire consisted of 28 items pertaining to demographic characteristics, knowledge and practices of dental implants. Responses were coded and entered into spreadsheet software (Microsoft Excel 16.0.) and analyzed using Statistical Package for Social Sciences (SPSS, IBM Version 22.0) and contingency tables and chi-square test (χ2). Results: The majority of the participants were males (64.4%), between 24-26 years of age (64%) and had a GPA between 4-5 (63.4%). The majority of the participants gained knowledge of dental implants through theoretical lectures (98.5%), and most of them (80%) knew, what material, an implant was made up of. Almost all participants (91.7%) knew that dental implants had surface modifications. Most (64.4%) believed that case selection is the most important criteria for the success of dental implant therapy, and this differed significantly among participants with respect to GPA (p=0.03). Many participants (60%) believed that the most important advantage of dental implants over fixed prosthesis is that reduction of adjacent tooth is not needed, and this differed significantly between males and females (p=0.026). There was a significant difference (p Conclusion: Knowledge of dental implants among dental interns is satisfactory, but this study reveals that participants lack practical experience and would like to acquire more clinical skills. Limitations: The response rate of participants from each university was low, which made comparisons between different universities difficult because sample size from some universities was very small, which could not produce statistically accurate results.

Background: Preventive oral health of a child is dependent on the parental knowledge toward caries control, care of deciduous tooth, use of space maintainers for malocclusion, and utilization of various procedures available for preventing oral diseases by oral health professionals. This study was aimed to assess the attitude and awareness of preventive dentistry among parents residing in Kingdom of Saudi Arabia. Methodology: A cross-sectional, questionnaire study was conducted among 941 parents. Questionnaire was sent through the use of social media, and responses were collected. Results: The study included 941 participants. Among them there were 692 mothers (73.5%) and 249 fathers (26.5%). The educational level of most of participants was college (n= 576, 61.2%). It is noticed from table one that most of participants agreed with the symptoms listed in the study questionnaire. They strongly agreed on black or brown spots on the teeth is the main symptom of tooth decay. The most prevalent preventive measure was limiting sugary drinks followed by proper teeth brushing. There was statistically significant relationship between proper teeth brushing and level of education (P= 0.001). Conclusion: Awareness about preventive dentistry was more among Saudi parents, but utilization rate was directly correlated to their education and income. After The utilization of preventive procedures was significant according to education (P< 0.05). Keywords:Dental services,malocclusion,preventive procedures,primary teeth

The periodontal pocket and likely caries lesions may act as a reservoir and source of dissemination and development of systemic infections. While periodontal pockets have been found to harbor several viral species, there is no information on its ability to serve as a reservoir for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We have used a real-time polymerase chain reaction (RT-PCR) approach to evaluate SARS-CoV-2 in periodontal pockets and cavitated caries lesions in a cross-sectional study of 72 participants who were divided into six groups: symptomatic positive COVID-19 cases with periodontal pockets, symptomatic positive with cavitated caries lesions, asymptomatic positive with periodontal pockets, asymptomatic positive with cavitated caries lesions, positive control, and negative control. A total of 180 samples were interrogated by RT-PCR to amplify the SARS-CoV-2 E and S genes. SARS-CoV-2 was present in 41.7% of symptomatic positive COVID-19 cases with periodontal pockets and 16.7% of symptomatic positive with cavitated caries lesions. The mean Ct value of E and S genes in periodontal pockets patients were 36.06±0.46 and 30.06±6.73, respectively, and the mean Ct value for both genes in caries lesions patients were 35.73±4.14, and 34.78±1.93, respectively. The sensitivity, specificity, and accuracy to detect SARS-CoV-2 among periodontal pockets were 20.8% (95% CI 7.13-42.15), 100% (95% CI 73.54-100.0), and 47.2% (95% CI 30.22-64.51), respectively. Among cavitated caries lesions patients, they were 8.3% (95% CI 1.03-27.0), 100% (95% CI 73.54-100.0), and 38.9% (95% CI 23.14-56.54), respectively. SARS-CoV-2 can be detected in periodontal pockets and caries lesions, and these sites may act as reservoirs for the virus. However, the sensitivity of SARS-CoV-2 detection is low compared with other methods. To our knowledge, this report is the first to investigate the relationship between SARS-CoV-2 and periodontal pockets and caries.

Improving the design of Proton Exchange Membrane Fuel Cells (PEMFC) is crucial but requires a deep understanding of the basic science surrounding the technology. In this study, the membrane electrolyte assembly (MEA), catalyst layers channels, and gas diffusion layers are modelled using the commercial PEMFC simulation package built into ANSYS FLUENT 12.1. With various mesh sizes of 20,40 and 80 cells, a mesh sensitivity study of a cross-section of the fuel cell membrane, anode, and cathode, was carried out while 16000 data iterations were collected. The simulation results showed that all data points of membrane and anode layers converged before or at 10,000 iterations, while varying cathode needs more time to converge. A study of iterations and convergence, resulting in the comparison of various meshes at different data points, is discussed while a comprehensive description of the simulation’s parameters is provided, and the emphasis is placed on determining the convergence criteria that are necessary for delivering consistent results. One of the purposes of this experiment is to demonstrate that high-quality computer modelling and simulation of fuel cells can accelerate the discovery of fuel cell components that are optimally designed. As a result, the study confirmed that computer modelling can contribute to a better understanding the mechanics and reactions occurring within the fuel cell and its layers in order to improve its performance and lifecycle in the future.

Conventional osteotomy techniques can, in some cases, induce higher stress on bone during implant insertion as a result of higher torque. The aim of the present study was to evaluate and compare the stress exerted on the underlying osseous tissues during the insertion of a tapered implant using different osteotomy techniques through a dynamic finite element analysis which has been widely applied to study biomedical problems through computer-aided software. In three different types of osteotomy techniques, namely conventional (B1), bone tap (B2), and countersink (B3), five models and implants designed per technique were prepared, implant insertion was simulated, and stress exerted by the implant during each was evaluated. Comparison of stress scores on the cortical and cancellous bone at different time points and time intervals from initiation of insertion to the final placement of the implant was made. There was a highly statistically significant difference between B1 and B2 (p = 0.0001) and B2 and B3 (p = 0.0001) groups. In contrast, there was no statistically significant difference in the stress scores between B1 and B3 (p = 0.3080) groups at all time points of implant placement. Overall, a highly significant difference was observed between the stresses exerted in each technique. Within the limitations of our study, bone tap significantly exerted lesser stresses on the entire bone than conventional and countersink type of osteotomy procedures. Considering the stress distribution at the crestal region, the countersink showed lower values in comparison to others.

The aim of the study was to assess the color matching ability and color stability of a single-shade resin-based composite (Omnichroma—OM) in comparison to a conventional dental composite. One hundred and sixty lower molar acrylic teeth in four different shades (B1, B2, A3, and C3) were prepared with class I cavities. Eighty teeth were divided into two groups based on the two resin composite materials (OM and Filtek Z-350 (FT)) for cavity restoration. Three groups were included in the color matching assessment, namely Gp 1-FT, Gp 2-OM-light cured (C), and Gp 3-OM-uncured (UC) groups. The color assessment was performed prior to cavity restoration and after cavity filling and before and after light curing to detect color matching. The 80 remaining teeth were restored with OM (n = 40) and FT (n = 40), half (n = 40) were submerged in coffee and the other half (n = 40) were submerged in cola for 2 weeks. The color stability was assessed by calculating material color (spectrophotometry) changes (∆E) before and after staining in immersion medium. The means and standard deviations of the ∆E values relating to color matching and color stability (stain resistance) among the study groups were analyzed using ANOVA and Tukey’s post hoc test. FT showed significantly better color matching (lower ΔE) in comparison to OM-UC specimens for shades B1, B2, and A3 (p &lt, 0.01). Regarding the color stability in cola, the FT samples showed significantly lower ΔE values (indicating better color stability) compared to OM samples for all four shades (p &lt, 0.01). The ΔE values of OM and FT samples in coffee were comparable (p &gt, 0.01), showing comparable color stability. The color matching ability of the single-shade resin composite (OM) was influenced by the tooth color. The conventional resin composite showed better color matching than the single-shade composite (OM). The color stability of the single-shade resin composite (OM) was dependent on the staining medium. The OM composite showed more compromised color stability than the conventional resin composite in cola and comparable color stability to conventional resin composite in coffee.

The study aimed to assess the effect of in-vitro chlorhexidine and antimicrobial photodynamic therapy (aPDT) disinfection protocols against acrylic resin specimens colonized with S. mutans, S. aureus, E. coli, and C. albicans.Reference strains of S. mutans, S. aureus, E. coli, and C. albicans were tested. Sixteen blocks of acrylic specimens were prepared by heat-cure acrylic resin and contaminated by in-vitro biofilm growth. Specimens in group 1, group 2 and group 3 were treated with Rose Bengal (RB), methylene blue (MB) 500 mg/L and porphyrin derivative (PD) 5 ml respectively, for the sensitization of biofilms. All photosensitizers (PS) were activated by LED at different wavelength. CHX was prepared in sterile distilled water and applied for 60 s. Each contaminated specimen was sprayed on all its surfaces with the aforementioned photosensitizers and control CHX. One-way analysis of variance (ANOVA) model was used to test the effect of the treatments and Tukey multiple comparison tests to compare means OF CFU/mL (log10) for exposed E. coli, C. albicans, S aureus, and S. mutans RESULTS: Specimens treated with 0.12% CHX (control) demonstrated a significant reduction in CFU/mL (log10) for exposed E. coli; 2.04±0.07 CFU/mL, C. albicans; 2.09±0.85 CFU/mL, S aureus; 3.04±0.11 CFU/mL, and S. mutans; 2.54±0.91 CFU/mL. The intragroup comparison revealed E.coli did not exhibit a decrease in reduction CFU/mL (log10) when acrylic resin irradiated with RB 5 µm. Whereas, CFU/mL (log10) values of S.aureus; 3.62±0.68 and S.mutans; 3.41±0.13 plummeted (p0.05). Intergroup comparison showed E.coli values to display comparable reduction when disinfected with MB 500 mg/L and 0.12% CHX; 3.16±0.34 and 2.04±0.07 CFU/mL (log10) (p0.05).Photosensitizers (RB, MB, PD) are selective in reducing bacterial count on acrylic resin blocks. CHX was found to be effective against all bacteria E.coli, C.albicans, S.aureus, and S.mutans at a concentration of 0.12%.

Objective The aim was to compare Photodynamic therapy (PDT) as an adjunct to NaOCl and EDTA on the extrusion bond strength (EBS) of AH Plus (AH), Sealapex (SA) and MTA Fillapex (MF) root canal sealers. Materials and method Root canal treatment for human teeth (n = 60) using protaper universal system was performed followed by irrigation with NaOCl/ EDTA. Samples were divided (n = 30) based on disinfection technique, NaOCl/EDTA and NaOCl/EDTA with PDT (Curcumin-PS-CP) as an adjunct. Specimens were divided in three subgroups (n = 10) based on sealers used (Gp 1-Na-E-AH, Gp 2-Na-E-PDT-AH, Gp 3-Na-E-SA, Gp 4-Na-E-PDT-SA, Gp 5-Na-E-MF & Gp 6-Na-E-PDT-MF). Canals were dried and obturated followed by sectioning at coronal and middle third. EBS testing was performed using a universal testing machine (UTM) and modes of failure were assessed. Analysis of variance (ANOVA) and Tukey multiple comparison tests were used to compare the means of EBS. (p Results Sealers showed a significant influence on EBS, as Gp 1 (Co: 9.21 ± 0.62, Mid: 8.54 ± 0.55) and Gp 2 (Co: 7.11 ± 0.68, Mid: 7.30 ± 0.37) showed higher EBS than Gp 3 (Co: 5.21 ± 0.63, Mid: 4.36 ± 0.83) and Gp 4 (Co: 5.39 ± 0.72, Mid: 4.46 ± 0.74). Gp 5 (Co: 9.04 ± 0.13, Mid: 8.14 ± 0.91) and Gp 6 (Co: 8.67 ± 0.42, Mid: 8.07 ± 0.07) exhibited higher EBS than Gp 3 and Gp 4 specimens. Adjunctive use of PDT for AH sealer (Gp 2) showed decreased EBS compared to Gp 1 specimens. EBS remained comparable for both MTA-Fillapex and Sealapex with and without PDT. Conclusion AH Plus (Gp 1 and 2) and MTA-Fillapex (Gp 5 and 6) sealers displayed better EBS compared to Sealapex (Group 3 and 4). Adjunctive Application of PDT (CP) did not show a significant improvement in bond strength of sealers to root dentin.

Aim: This study aimed to investigate an association between dental caries status and anthropometric measures in primary school children. Methods and Materials: An analytical cross-sectional study (n = 376) was conducted among primary school children (age range = 6–9 years) registered in private schools. Non-clinical data was gathered from parents of participating children through a self-administered structured questionnaire as well as from the children through an interviewer-administered questionnaire. Clinical data included the examination of dental caries using dmft/DMFT index and anthropometric measures including calculated z-scores of height-for-age (HAZ), weight-for-age (WAZ), BMI-for-age (BAZ), and physical examination. Inferential statistics included Kruskal Wallis and linear regression for univariate and multivariate analysis respectively. Results: The proportion of dental caries in primary and secondary dentition was 67.6 % and 8.2% respectively. A significant association was observed between dental caries status and HAZ, WAZ, and BAZ (p &lt, 0.001). An inverse relation was found between low, medium, and high dental caries categories and anthropometric measures. Conclusions: In the primary dentition, dental caries were significantly and inversely related to weight-for-age, height-for-age, and BMI-for-age. Hence, it can be concluded that among the low-income population dental caries is associated with lower anthropometric outcomes in children and therefore caries management should be considered an approach impacting overall health and quality of life.

Dental laboratories (LABs) are integral to the performance of a dentist in providing successful oral rehabilitation. The aim of this study was to compare the adaptation, contour, contacts, and shade matching of different government and commercial dental LABs in the fabrication of porcelain fused to metal (PFM) crowns. Thirty-two dental LABs were selected to fabricate PFM crowns (one PFM crown each). Marginal adaptation, contour, proximal contacts, and shade matching were evaluated. Evaluation of the crowns’ quality was performed following modified USPHS/FDI criteria. Visual and colorimeter assessments were employed to evaluate shade matching. Differences between groups were examined by Pearson’s Chi-square and Fisher’s exact test. The quality of marginal adaptation of crowns was good in 81.25%, however the quality of contours, contacts, and shade matching was compromised in 43.75%, 59.38%, and 39% of all LABs, respectively. Visual and colorimeter shade matching was acceptable in 62.5% and 80% of LABs in the cervical third and middle third regions of crowns, respectively, however in the incisal third the shade matching was unacceptable in nearly 60% of LABs. Commercial laboratories showed significantly better contours and shade matching, but not marginal adaptation. However, no significant differences were found in comparison of proximal contacts between the groups.

To assess the effectiveness of chemical, ultrasonic and photodynamic therapy (PDT) mediated disinfection against in-vitro biofilms colonized with C. albicans, S. oralis, and S. aureus on surfaces of PMMA (polymethylmethacrylate) denture base material.Fifty plates of PMMA were prepared with two different surface topography (rough and polished) analyzed by profilometry. Provenance culture (ATCC) of C. albicans, S. oralis, and S. aureus were inoculated on specimens and exposed to disinfection. The disinfection included Rosebengal (RB) 5 μM activated by a red LED, 2% glutaraldehyde, 70% Isopropyl alcohol, ultrasonic disinfection, and saline solution as a control. The antimicrobial efficacy was assessed by subsequently calculating viable counts after disinfection. The data were analyzed using analysis of variance (ANOVA) and Tukey's Post Hoc test.The unpolished surface demonstrated the highest average surface roughness As 5.32±0.36 (μm) and root mean square roughness Rr 7.22±0.81 (μm) compared to the polished surface. Intergroup comparison demonstrated polished and rough PMMA plate disinfected with rose bengal, glutaraldehyde and alcohol-based disinfection exhibited comparable reduction against C. albicans and S. oralis CFU/mL (log10) (p0.05). Whereas, this reduction was significantly higher on the rough and polished surface of PMMA when disinfected using ultrasounds for 30 sec (p0.05). Rose Bengal was the most effective method of disinfection against S. aureus both on polished (0.17±0.13) and rough (0.44±0.22) denture plates (p0.05).The ultrasonic disinfection was most effective in reducing viable microbial counts. RB mediated PDT exhibited a more substantial reduction of the colonies of S.aureus.

Contamination of zirconia restorations before cementation can impair the resin–zirconia bonding durability. The objective of this study was to evaluate the effect of human saliva or blood decontamination with 10-methacryloyloxydecyl dihydrogen phosphate (10-MDP)-containing cleaner on the resin–zirconia shear bond strength (SBS). Methods: A total of 220 zirconia specimens were prepared and air-abraded and randomly distributed into 11 groups (n = 20 per group). Except for the control group (no contamination), zirconia specimens were contaminated with either human saliva (five groups) or blood (five groups), and then subjected to one of five cleaning methods: water rinsing, 38% phosphoric acid etchant (Pulpdent Corp., Watertown, MA, USA), 70% isopropanol alcohol (Avalon Pharma, Riyadh, Saudi Arabia), Ivoclean (Ivoclar Vivadent, Schaan, Lichtenstein) and Katana Cleaner (Kuraray Noritake, Tokyo, Japan). The resin–zirconia SBS was tested at 24 h and after thermocycling (10 k cycles). Three-way ANOVA followed by Tukey’s multiple comparisons test were utilized to analyze the SBS data. Failure modes were evaluated using a scanning electron microscope. Results: Both blood and saliva significantly affected resin–zirconia SBS as contaminants. After thermocycling, there was no statistically significant difference between SBS obtained after decontamination with the Katana Cleaner (blood, 6.026 ± 2.805 MPa; saliva, 5.206 ± 2.212 MPa) or Ivoclean (blood, 7.08 ± 3.309 MPa; saliva, 6.297 ± 3.083 MPa), and the control group (no contamination, 7.479 ± 3.64 MPa). Adhesive and mixed failures were the most frequent among the tested groups. Conclusion: Both 10-MDP-containing cleaner (Katana Cleaner) and zirconium oxide-containing cleaner (Ivoclean) could eliminate the negative effect of saliva and blood contamination on resin–zirconia SBS.

Hernias are abnormal protrusions of a viscus (or part of it) through a normal or abnormal opening in a cavity (usually the abdomen). They are most commonly seen in the groin; a minority are para-umbilical or incisional. In the groin, inguinal hernias are more common than femoral hernias. Inguinal hernias occur in about 15% of the adult population, and inguinal hernia repair is one of the most commonly performed surgical procedures in the world. Although open, mesh-based, tension-free repair remains the criterion standard, laparoscopic herniorrhaphy, in the hands of adequately trained surgeons, produces excellent results comparable to those of open repair. We conducted this review using a comprehensive search of MEDLINE, PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Cochrane Central Register of Controlled Trials from January 1, 1985, through June 15, 2017.

Aim The present study aimed to evaluate the effect of different cleansers and photodynamic therapy (PDT) on disinfection of Co/Cr removable partial denture colonized with C. albicans, S.aureus and S.mutans. Material and Methods Twenty-five Co/Cr removable partial dentures were constructed. and inoculated by American Type Culture Collection (ATCC) of Candida albicans, S.aureus, and S.mutans in an in-vitro setup. Co/Cr removable partial dentures were randomly allocated into five groups and framework was immersed in 15 mL of contaminated culture medium broth. Based on the cleansing method, disinfected dentures in group 1 were cleansed with porphyrin derivative; group 2 was exposed to 0.12% chlorhexidine digluconate; samples in group 3 and group 4 were subjected to sodium perborate enzyme and citric acid respectively. Through a surface analyzer, the surface roughness of Co/Cr and methacrylate resin was measured in 3 different zones in micrometers before and after disinfection. Two-way ANOVA and Tukey's test was used to analyze the data. Levene test was used to assess the normal distribution of data. Significance level p Results The results of metal roughness displayed that Co/Cr used as an alloy did not exhibit significant difference when exposed to different chemical disinfectants and photosensitizer (p > 0.05). Similarly, surface roughness (Ra) of heat polymerized acrylic resin using cleansers and PDT demonstrated no significant difference. Intergroup comparison showed that, hematoporphyrin derivative displayed comparable cleansing property against S. aureus, C.albicans, and S. mutans compared to to 0.12% CHX digluconate (p>0.05). The intragroup comparison showed hematoporphyrin derivative and CHX were equally effective against all bacteria (p>0.05). Conclusion CHX digluconate and hematoporphyrin derivative demonstrated high antimicrobial activity against S.aureus, S.mutans, and C.albicans with minimum Ra of an acrylic denture and Co/Cr metallic framework.

Background: Type 2 diabetes (DM) mellitus and Hypertension (HT) are among the most common chronic non-communicable diseases affecting at a higher prevalence in the older age group. The presence of hypertension in diabetic patients substantially increases the risks of coronary heart disease, stroke, nephropathy and retinopathy. The objective of this study is to determine the prevalence rate and risk factor associated with co-existence of hypertension and diabetes mellitus in elderly population in Arar city, Northern Saudi Arabia. Methods: A cross sectional study, included 181 elderly attending seven randomly selected primary healthcare centers in Arar city during the period from 1st January to 30th June 2017. Participants selected using a systemic random sampling procedure as we take every second elderly attending the PHC during the study period. Data collected by means of personal interview using a predesigned questionnaire covering the required items. Results: The prevalence of coexistence of diabetes and hypertension was 16.6% while coexistence of diabetes, hypertension and obesity were found in 9.9%. Two-thirds (66.66%) of cases of coexisting diabetes and hypertension were females (P value>0.05). The relation between coexisting diabetes and hypertension with smoking status was significant (P value 0.05). Conclusion: Coexistence of diabetes and hypertension were found in 16.6% of elderly population of Arar, Northern KSA. This association leads to several cardiovascular complications, so it is mandatory to adopt more strategies for the control of DM and HT in Arar elderly population by appropriate methods.

Topical microemulsions comprising clotrimazole (CTZ) (1%) or ketoconazole (KTZ) (2%), clove oil (6%), tween-20 (25–30%) and aqueous phase (water/buffers) were prepared. Microemulsions were characterized for droplet size, polydispersity, pH value and tested for physical stress and thermodynamic stability. Effective mean diameter of CTZ and KTZ microemulsion droplets ranges between 30 and 50 nm. It was observed that, acidic external phase (pH 1.2, 3.0 and 4.1) for CTZ and KTZ microemulsion requires less emulsifier than the external phase of higher pH (5, 6). Microemulsions were physically stable and there was no substantial change in droplet size or polydispersity under stress condition of centrifugation, freeze-thaw cycle and high temperature. In-vitro efficacy of CTZ and KTZ microemulsions was tested against Candida albicans (ATCC 10231), and was found better than corresponding marketed creams. Microemulsions were found safe and non-irritant when investigated using female Wistar albino rats. In-vivo antifungal efficacy of CTZ microemulsion was studied in rats and compared with its cream. After three days of treatment the scabbing of skin lesion was started, and after five days the scabs became hard and started to erode from the skin. In-vivo observations suggested that CTZ microemulsion can be a successful approach for treatment of topical fungal infection.

A set of copper(I) complexes with the general formula [CuBr(PPh3)(N^N)] (N^N = 2,2’-bipyridine (1), 1,10-phenanthroline (2), 4,4’-dimethyl-2,2’-bipyridine (3), 4,4’-dimethoxy-2,2’-bipyridine (4), 3-(2-pyridyl)-4,5-diphenyl-1,2,4-triaine (5), 4,7-diphenyl-1,10-phenanthroline (6), 5-nitro-1,10-phenanthroline (7), dipyrido[3,2-a:2',3'-c]phenazine(8)) have been synthesized and characterized by elemental analysis, 31P-NMR spectroscopy and mass spectrometry. The structure of complexes 5 and 7 were confirmed by X-ray crystallography. Complex 5 is the second example to be reported with an unusual 4N-triazine-ligated coordination mode of the 3-(2-pyridyl)-4,5-diphenyl-1,2,4-triazine. Calculated energies of the two possible bidentate modes of the ligand (2N- and 4N-triazine) at the copper center showed no significant difference, rationalizing that with the absence of the steric hindrance effect around the metal center. Preliminary biological studies were conducted, highlighting the effect of the diimine ligands. Complexes 5 and 8 exhibited good cytotoxicity against prostate (PC-3), leukemia (MOLT-4) and breast (MCF-7) cancer cell lines, consistent with the presence of nitrogen heteroatoms and extended delocalized systems correlating with strong cytotoxic performance. Binding affinity studies against ct-DNA and docking studies with B-DNA and MDM2 protein highlighted the strong p interactions of 5 and 8, with the planarity of the diimine ligand of the latter contributing to its better binding and cytotoxicity. The current results afford structural requirements for the design of new copper(I) complexes with enhanced biological/physiochemical properties.

The copper(I) coordination compounds of general formula [CuBr(PPh3)(N^N)] (N^N = 2,2′-bipyridine (1), 1,10-phenanthroline (2), 4,4′-dimethyl-2,2′-bipyridine (3), 4,4′-dimethoxy-2,2′-bipyridine (4), 3-(2-pyridyl)-4,5-diphenyl-1,2,4-triazine (5), 4,7-diphenyl-1,10-phenanthroline (6), 5-nitro-1,10-phenanthroline (7), dipyrido[3,2-a:2′,3′-c]phenazine(8)) have been synthesized and characterized by elemental analysis, 31P NMR spectroscopy and mass spectrometry. The structure of 5 and 7 were confirmed by X-ray crystallography. 5 is the second example to be reported with an unusual 4 N-triazine-ligated coordination mode of the 3-(2-pyridyl)-4,5-diphenyl-1,2,4-triazine. Calculated energies of the two possible bidentate modes of the ligand (2 N- and 4 N-triazine) at the copper center showed no significant difference, consistent with the absence of the steric hindrance at the metal center. Preliminary biological studies were conducted, highlighting the effect of the diimine ligands. 5 and 8 exhibited good cytotoxicity against prostate (PC-3), leukemia (MOLT-4) and breast (MCF-7) cancer cell lines, consistent with the presence of nitrogen heteroatoms and extended delocalized systems correlating with strong cytotoxic performance. Binding affinity studies against ct-DNA and docking studies with B-DNA and MDM2 protein highlighted the strong π interactions of 5 and 8, with the planarity of the diimine ligand of the latter contributing to its better binding and cytotoxicity. The present results afford structural design requirements for new copper(I) coordination compounds with enhanced biological/physiochemical properties.

We are reporting a case with rare side effect of propylthiouracil. Thirty-two years old Saudi female diagnosed to have graves disease and treated by propylthiouracil for more than 4 years. She started to complain of fever, joint pain and weight loss for 8 months. Clinically, she was found to be pale, generalized lymphoadenopathy and having moderate splenomegaly. Investigation revealed pancytopenia, high ESR, and multiple small cystic nodules in the liver, spleen, and both kidneys. We thought of propylthiouracil as a cause of her problem and advised to discontinue it before doing invasive investigation. Tqo weeks later she had better appetite, less joint pain, and no more fever. Complete blood count and ESR became improved and normalized in subsequent visits. We are reporting a case of generalized lymphoadenopathy, splenomegaly and fever caused by propylthiouracil. Keywords: propylthiouracil, vasculitis, Antithyroid drugs, lymphoadenopathy.

Background: Epistaxis is considered as the most common otolaryngologic emergency, it’s difficult to determine an accurate number for the incidence of epistaxis but it has been reported to be as high as 60%. Generally, most of the time epistaxis does not require a specialist to manage, according to the published data only about 6% of the cases require medical treatment. The management of epistaxis have been evolved over the last 20 years, a lot of literatures were done evaluating different management approaches. Reviewing the recent published articles is important in order to provide a better outcome for the patients. Objective: In our study we aims to discuss the recent updates related to epistaxis management and develop a comprehensive yet simplified management approach algorithm. Method: PubMed database were used for articles selection. All relevant articles related to our review were chosen to cover the following topics: Epistaxis, Evaluation of Epistaxis, and Management. We excluded other articles, which are not related to our objectives. The data have been extracted according to specific form to be reviewed by the authors. Conclusion: Epistaxis can be dramatic and can be a life-threatening problem although in most cases it is relatively minor and usually manageable at home. Health authorities should work to the general knowledge of the population on the first aid management of epistaxis. The treatment should be with a crescendo sequence. Applying direct pressure by pinching the lower part of the nose for at least 10 minutes is the first way of treatment. Chemical cauterization and nasal packing are the most commonly used methods of treatment worldwide due to their wide availability and they are easy to perform. In severe uncontrollable cases of Epistaxis, surgical intervention such as ligation or embolization should be suggested. Surgery is associated with higher success rate, lower recurrence rate and shorter length of stay.

Oral microbiota is a vital part of human microbiota, including bacterial, protozoa, viral and fungal species. Beneficial microbes form biofilms to form a first-line defense against harmful microorganisms. Tobacco smoking is considered a major environmental factor affecting the orodental microbiota. Smokers harbor more pathogenic microbes than non-smokers. In fact, cigarette smoking exposes the oral cavity to a large number of toxicants, perturbing the oral microbial ecology through various mechanisms. In Saudi Arabia, research on the impact of tobacco smoking on oral microbiota is still lacking. Therefore, this case-control study is an important addition to the literature in terms of tobacco use and its effects on oral microbiota and oral hygiene. 130 men were recruited for this study, including 65 smokers and 65 non-smokers. The following parameters were recorded for all 130 participants – age, weight, height and education. The aim of this study was to investigate and compare the effect of tobacco smoking on the oral microbiome of smokers and non-smokers. The majority of the smokers were young adults between the ages of 21 and 30 inclusive (n=27). The results show that excessive microorganism growth was seen in smokers to a greater degree than non-smokers (38.5% of smokers vs. 8.8% of non-smokers). Not surprisingly, a significant majority (85.3%) of non-smokers had moderate microorganism growth compared to only 53.8% of smokers. cigarette smoking facilitates excessive growth of oral microorganisms, predisposing smokers to various periodontal diseases. In fact, smoking perturbs the balance of oral microbiota, producing a viable environment for microbes to cause diseases. Further large scale prospective studies are required to determine the exact mechanism that causes tobacco to affect oral microbiota.

Background Surgical site infections (SSIs) are one of the leading causes of death, and its prevention is a key element of applying the concept of patient safety and quality care. Objective This study aimed to assess the level of knowledge about SSIs and risks of wound infection among medical physicians in King Abdulaziz University Hospital. Methods All surgical and medical consultants, specialists, residents, and medical interns were invited to participate in the study. A 20-Item multiple-choice questionnaire was developed by reviewing the previous literature and with the help of a group of certified surgeons to assess the level of knowledge in all participants. Results A total of 119 doctors were included in this study. Among all respondents, 92 (77.3%) were intern doctors, 16 (13.4%) were resident doctors, and 11 (9.2%) were specialist doctors. Moreover, 66 (55.5%) doctors knew the definition of SSI. Only one-quarter, that is, 30 (25.2%) doctors knew about the incidence of SSI. In addition, 8 doctors (6.7%) had good knowledge, 75 (63.0%) had fair knowledge, and 36 (30.2%) had poor knowledge regarding SSI according to this study. Conclusions Level of knowledge about SSIs and risks of wound infections among medical physicians should be improved to ensure better wound care and quality care for the patients.