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Empathetic communication of dentists with their patients is a primary characteristic of their health care. This study aims to evaluate dental students' empathy levels during the transitional period of internship and postgraduate studies of different specialties at one of the oldest dental schools in Saudi Arabia and explore how this empathy was affected by gender, age, and study duration.In this study, the self-reported empathy level among the participants was assessed using the Jefferson scale of empathy-student version (JSE-HPS). This survey includes a 20-question Likert scale formulated to measure clinical empathy in health care professionals. The JSE-HPS was distributed to all registered dental interns and postgraduate students during the academic year 2019-20 in King Abdulaziz University Faculty of Dentistry (KAUFD), Jeddah, Saudi Arabia.Mean total score of empathy of the participants was (101.07 ± 14.8) with a response rate of 89%. A statistically significant higher empathy score appeared among dental postgraduate students in general (p = 0.04) and specifically among the females (p = 0.04) and those with postgraduate programs for more than four years, (p = 0.02). Dental postgraduate students scored significantly higher in the parameters of standing in patients' shoes (p = 0.02).Gender, academic level, and duration of postgraduates' studies influenced empathy more than the age of the dental graduates in KAUFD. Our recommendation is to integrate empathy into the dental curriculum emphasizing interactive communication skills and early patient contact.

Ghada H Naguib,1,2 Gamal S Abd El-Aziz,3 Hisham A Mously,4 Wafaa A Alhazmi,5 Abeer M Alnowaiser,6 Ali H Hassan,7 Mohamed T Hamed4,8 1Department of Restorative Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 2Department of Oral Biology, Faculty of Dentistry, Cairo University, Cairo, Egypt; 3Department of Anatomy, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia; 4Department of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 5Department of Medical Laboratory Sciences, Faculty of Applied Medical Sciences, King Abdulaziz University, Jeddah, Saudi Arabia; 6Department of Pediatric Dentistry, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 7Department of Orthodontics, Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia; 8Department of Fixed Prosthodontics, Faculty of Dentistry, Cairo University, Cairo, EgyptCorrespondence: Mohamed T HamedDepartment of Oral and Maxillofacial Prosthodontics, Faculty of Dentistry, King Abdulaziz University, P.O.Box 80209, Jeddah, 21589, Saudi ArabiaEmail mthamed@kau.edu.saPurpose: This in vitro study was undertaken to investigate the antimicrobial effect of distinctive oral mouth washes after the addition of zein-coated (Magnesium oxide) MgO nanoparticles on exemplary of some oral microorganisms.Materials and Methods: Three hundred and twelve samples were used in this study. A set of five concentrations of MgO nanoparticles with zein and without zein-coating were incorporated into three oral mouth washes: Listerine zero, Listerine total control and Oral B in the mass percentages of 0.3%, 0.5%, 1%, 2%, 5% and 10%, in addition to controls with no MgO nanoparticles. The antimicrobial effect of three mouth washes with variable concentrations of MgO was tested against the following organisms: Staphylococcus aureus, Streptococcus mutans, Enterococcus faecalis and Candida albicans using the disc diffusion test (DDT) and direct contact test (DCT). Data were analyzed using one-way ANOVA statistical test.Results: The tested mouthwashes with zein-coated MgO nanoparticles showed significant differences of antimicrobial activity on S. mutans, S. aureus, E. faecalis, and C. albicans in the disc diffusion test. While in the DCT, all tested mouthwashes with MgO nanoparticles with and without zein coating showed antimicrobial activity on all tested microorganisms.Conclusion: Zein-coated MgO nanoparticles may be considered as a potential antimicrobial agent when added to oral mouthwashes. Future analysis, including in vivo studies, is required in order to incorporate zein/MgO nanoparticles into oral mouthwashes that may improve its antibacterial property.Keywords: MgO, nanoparticles, zein polymer, antibacterial, mouthwash

The aim of this study was to test the antimicrobial properties of dental cements modified with magnesium oxide (MgO) nanoparticles. Zein-modified MgO nanoparticles (zMgO) in concentrations (0.0, 0.3, 0.5, and 1.0%) were mixed with dental cements (Fuji II, Rely X Temp E, Ionoglass Cem, Es Temp NE, and System P link). Eight discs were fabricated from each zMgO-cement pair for a total of 32 specimens for each cement. Characterization of the dental cements incorporating zMgO was done by X-ray Diffraction (XRD) and Field Emission Scanning Electron Microscopy (FESEM). The antimicrobial properties of the mixtures were tested using direct contact and agar diffusion assays against Streptococcus mutans, Staphylococcus aureus, Enterococcus faecalis, and Candida albicans. Data was analyzed using two-way analysis of variance and LSD post hoc test at 0.05 significance level. XRD spectra showed sharp peaks of zMgO indicating its high crystalline nature, while the amorphous dental cements with zMgO had broad peaks. FESEM analysis showed a uniform distribution of the zMgO nanoparticles in the cement. There were significant inhibition zone values associated with all concentrations of zMgO-cement mixtures tested compared to controls (p < 0.001) with a dose-response recorded only with Fuji II. Optical density values were significantly lower in zMgO groups compared to controls for all microorganisms. The effect was most prominent with Rely X against C. albicans and S. aureus. Dental cements containing zMgO showed significant antimicrobial properties that were dependent on the specific initial cement substrate., Graphical abstract Image 1, Highlights • Antimicrobial nanoparticles (NPs) are widely used in dental materials to improve their biological properties. • Magnesium Oxide (MgO) NPs are novel antimicrobial agents. • Incorporation of MgO NPs in dental cements aids in minimizing bacterial colonization at the restoration margin. • Zein polymer facilitates the dispersion of MgO NPs and avoid its agglomeration. • Zein polymer effectively enhances the performance of MgO NPs.

The aim of this research was to assess the effect of incorporating zein-coated magnesium oxide (zMgO) nanofillers to resin-based composite on the internal adaptation of the restorations using cross-polarisation optical coherence tomography (CP-OCT).Thirty noncarious human molar teeth were used. Class V cavities (3 × 5 mm) were prepared on the buccal and lingual surfaces of each tooth. Clearfil SE Bond 2 was applied to all the cavities and then the teeth were divided into 3 groups (n = 10) as follows: group 1-restored with N-Flow composite; group 2 and group 3-restored with N-Flow composite mixed with different zMgO nanoparticle concentrations (0.3% and 0.5% by weight, respectively) and then light cured using an LED curing device. Specimens were examined for interfacial adaptation examination under CP-OCT. Characterisation of the dental composite incorporating zMgO was done by Fourier-transform infrared spectroscopy (FTIR), x-ray diffraction (XRD), and field emission scanning electron microscopy (FESEM). Results were analysed with Kruskall-Wallis test followed by Mann-Whitney U test, at a significance level of P.05.XRD spectra exhibited the sharp peaks of zMgO in the composite enhanced with zMgO nanoparticles. FESEM analysis showed a uniform distribution of the zMgO nanoparticles in the composite and FTIR illustrated no change in the spectra. The gap percentage along the cavity floor was significantly lower in groups 2 and 3 in comparison to group 1 (P.05). Also there was a significant difference in gap percentages between groups 2 and 3 (P.05), with group 3 showing the lowest gap percentage.The incorporation of 0.3% and 0.5% zMgO nanoparticles in flowable composite assists in improving the internal adaptation of the composite to the tooth surface.

Objective: The present study explains the success and failure of dental implant diameter on the efficiency of fatigue by conducting a systematic review analysis. Methods: An extensive literature search was conducted to carry out systematic review using different scholarly platforms and libraries. A total of 12 studies published within the past 20-year time (1999-2019) were included following the inclusion and exclusion criteria based on the PRISMA guidelines. Additionally, the study outcomes were evaluated to determine their perceptions regarding the role of dental implant diameter in influencing the implant’s fatigue performance. Results: The implant diameter can be categorized into wide diameter (5-6 mm), regular diameter (3.75-4 mm), and small/narrow diameter (3-3.4 mm). The narrow diameter implants are indicated through thin alveolar ridges and mesiodistal spaces (less than 7 mm). The implants with narrow diameter would offer greater risk of fatigue failure for clinical situations with significant functional loading. No significant differences were found either in success or failure of dental implant diameter on fatigue efficiency after 1-year and 3-year follow-up. Conclusion: The technical complication of dental implant include abutment screw loosening or fracture, abutment and superstructure fracture, and implant body fracture. The study has study has mainly focused on the impact of dental implant diameter on the efficiency of fatigue and reviewed a significant impact of dental implant diameter on the fatigue efficiency. Keywords: Dental Implants, Efficiency, Perception. Continuous...

Introduction: Recently, zein-coated MgO nanowires were synthesized, which could be promising as an effective antimicrobial compounds that can be combined in the preparation of a diversity of new dental formulations. However, there is a deficiency of information concerning their toxicological profile regarding the human health. Objective: This in vivo study aimed to explore the hepato- and nephrotoxicity of low versus high doses of zein-coated MgO nanowires in rats. Materials and Methods: A 21-day recurrent dose toxicity research was carried out. Wistar rats were divided into 2 main groups, males and females (n = 18). Each group was further subdivided into 3 subgroups: control, MgO-zein nanowires low dose, MgO-zein nanowires high dose. The low dose used was 100 mg/kg while the high dose used was 200 mg/kg. Results: The results showed that MgO-zein nanowires at both doses did not affect the electrolytes levels compared to the control levels. Also, they did not produce any significant alteration in liver function markers in both rats' genders. MgO-zein nanowires at both doses did not produce any effective alteration in serum creatinine in treated rats of both genders. Moreover, very minimal histological alterations were observed in both doses of MgO-zein nanowires in liver and kidney of both genders. Conclusion: Based on the observed safety of zein-coated MgO nanowires, it can be utilized as an effective antimicrobial compound that can be combined in the preparation of a diversity of new dental formulations.KEY MESSAGESMgO NPs are globally used in multiple fields including the therapeutic field.Zein has wide pharmaceutical applications especially coating the tablet over sugar.There are no cytotoxic studies that investigate MgO-zein nanowires safety until now.

Purpose Dental implant is an effective and standardized treatment procedure in the healthcare setting. This study presents a comparison of dental implant reconstruction using screw and cement. It explicitly reviews the studies concerning cement and screws dental implants to determine the efficiency of the two. Patients and methods A systematic review was conducted by comprehensively searching electronic literature. The keywords, such as "Screw versus Cement Retained Fixed Implant Supported Reconstructions," "Screw Retained Fixed Implant." "Cement Implant" and "Dental Implant" were used for article searching. Twelve studies were included based on the determined inclusion and exclusion criteria. Results No significant difference was found between the screw-retained and cemented retained implant supported reconstructions. Dental implants are associated with complications leading to implant failure based on the type of restoration that is being used; cement-retained restoration and screw-retained restoration. The treatment selection must be based on the significance criteria and the tooth condition. Conclusion Screw-retained implant-supported reconstructions were found to pose less biological and technological complications. Retention of the tooth is more stable and functional when implantation is selected based on the efficiency of a treatment procedure.

Aim The utilization of fixed partial dentures (FPD) ceramic frameworks for replacing the missing posterior teeth is observed to have reported high failure rates. For this reason, 3-units FPD are designed and used extensively in the clinical practices, particularly for posterior mandibular region. The current study however, aims to carry out an evaluation of different stress patterns that are induced in a 3-units FPD within posterior part of mandible using finite element analysis (FEA). Materials and methods Different modalities of the implant-supported FPDs such as type of connector, length and diameter of implants were taken into account. A three-dimensional (3D) model simulation of a mandibular Kennedy class II removal partial denture (RPD) was designed from a computerized tomography (CT) input with digital imaging communication on medicine (DICOM) format. In addition, occlusal load of 100 N was also used for central fossae of first premolar, first molar and second molar of the 3-units' reconstruction for each model. The magnitude of von Mises stress including minimum stress, maximum stress and average stress were also evaluated for each loading condition. Results The findings of the current study showed evidence that tooth-implant design with a nonrigid connector has significantly increased the average stress. Furthermore, it was observed that rigid connector has considerably minimized the stress within the tooth-implant-supported FPD. Conclusion The study concluded that stress designs significantly influence the stress distribution around the bone. Clinical significance This study gives some guidance and criteria for the selection of the type of fixed implant prosthesis in the posterior mandibular region.

Issues associated with missing teeth can be found in almost all age groups. For edentulous patients, osseointegration is a highly efficient treatment. However, certain biochemical challenges are presented when osseointegrated implants are taken into consideration due to the periodontal ligament. Therefore, the current study focuses on clinical concerns that can occur with the use of dental implants and examines different trends of implant restoration and treatment of partial edentulous patients. Data were collected from ten research articles and analyzed by means of a qualitative secondary approach. The findings of the current study indicate that restoration and preservation of natural teeth are significant in the development of dental practices. Moreover, the determinant of endodontic treatment is considered to be a key factor in the retention and reconstruction of tooth functioning that is influenced by necrosis of dental pulp. We conclude that the osseointegration method is significant and highly effective for treating edentulous patients.

Mefenamic acid (MA) is a non-steroidal anti-inflammatory drug with analgesic activity. Marketed MA tablets or capsules often result in gastrointestinal disorders, such as upset and bleeding. MA also has poor solubility and short half-life (2 h), which requires frequent dosing, leading to higher incidence of side effects. The objective was to develop a statistically optimized nanoethosome (NE) formulation of MA loaded into transdermal films, as an alternative to oral delivery, to offer an extended release behavior. Box-Behnken design was used to analyze the effect of phospholipid concentration, ethanol concentration, and ultrasonication time. On three variables, particle size, entrapment efficiency, and steady state flux. Optimized MA-loaded nanoethosome formulation was prepared using a thin layer evaporation technique. Further, the nanoethosomal-loaded transdermal film was evaluated for in-vitro release, ex-vivo permeation, and in-vivo pharmacokinetics studies. The optimized formula indicated particle size of 97 nm with 80% of entrapment efficiency. Enhanced skin permeation of MA was more than 3.4 folds higher for nanoethosomes loaded films in comparison to pure drug transdermal films The estimated steady state flux was 2 and 15 mcg/cm2 min. The bioavailability studies indicated that mean AUC0-48 increased by 4-folds after transdermal delivery of optimized nanoethosomal film with no side effects.

The utilization of fixed partial dentures (FPD) ceramic frameworks for replacing the missing posterior teeth is observed to have reported high failure rates. For this reason, 3-units FPD are designed and used extensively in the clinical practices, particularly for posterior mandibular region. The current study however, aims to carry out an evaluation of different stress patterns that are induced in a 3-units FPD within posterior part of mandible using finite element analysis (FEA).Different modalities of the implant-supported FPDs such as type of connector, length and diameter of implants were taken into account. A three-dimensional (3D) model simulation of a mandibular Kennedy class II removal partial denture (RPD) was designed from a computerized tomography (CT) input with digital imaging communication on medicine (DICOM) format. In addition, occlusal load of 100 N was also used for central fossae of first premolar, first molar and second molar of the 3-units' reconstruction for each model. The magnitude of von Mises stress including minimum stress, maximum stress and average stress were also evaluated for each loading condition.The findings of the current study showed evidence that tooth-implant design with a nonrigid connector has significantly increased the average stress. Furthermore, it was observed that rigid connector has considerably minimized the stress within the tooth-implant-supported FPD.The study concluded that stress designs significantly influence the stress distribution around the bone.This study gives some guidance and criteria for the selection of the type of fixed implant prosthesis in the posterior mandibular region.

Empathy is the fundamental substructure of moral behavior. Skillful clinicians may not necessarily be successful dentists if they do not have sufficient empathy. The aim of this study was to assess the level of empathy among dental students at King Abdulaziz University with an emphasis on the effect of gender and study level. A cross-sectional study was carried out among third- to sixth-year dental students of King Abdulaziz University in Jeddah, Saudi Arabia. A validated, self-administered Jefferson Scale of Empathy-Health Care Provider Student Version was distributed in academic year 2016-17 to all 380 students in the third to sixth years. A total of 300 students responded, for a response rate of 78.9%. The results showed that the students' mean empathy score was 84.84±11.28 on a range from 20 to 140. The fifth- and sixth-year students had higher scores than the third- and fourth-year students although the differences were not statistically significant. The mean empathy score of women students was significantly higher (p

OBJECTIVES: To assess the knowledge level and attitude of the Saudi population about the use of a dental implant as a treatment option for replacing the missing teeth. MATERIALS AND METHODS: This cross-sectional study adopted a quantitative approach and used an online questionnaire to collect data. Nine hundred and five participants were recruited as per the inclusion criteria (above 18 years of age, know how to read and write, and technology literate). The collected data were analyzed statistically using IBM Statistical Package for Social Sciences (SPSS) software. RESULTS: A low level of knowledge about teeth replacement methods (56%) was recorded among the participant, while 44.4% of them had heard about implant, bridges, and dentures. The oral hygiene of the participants was considered good (59.3%). The main source of information, reported by the participants, was the dentist (53.4%). The knowledge about dental implants was found to be significantly the highest (P = 0.02) among the highly educated participant who had completed postgraduate studies. CONCLUSION: There is a need for introducing comprehensive orientation programs, conducted by dentists, to communicate knowledge about dental implants. The social campaigns and official information programs should be instigated for improving the knowledge of the patients. Structured programs should be also introduced at an academic level, for enhancing the knowledge related to replacing missing teeth and dental implants.

Background: Facebook and other social media are attractive to those in the field of medical education. It can affect human being as some researches show that it has positive effect while others revealed the opposite. This study aimed to describe the pattern of Facebook use among the dental students at king Abdulaziz University and to assess its effect on behavior, social interactions, academic performance and study as well as health status. Methods: This is a cross sectional study targeted the undergraduate dental students in the academic year 2016-2017. A self-administered questionnaire was distributed online to all target students. It included 4 sections asked about the pattern of Facebook use and its purpose, the effect of Facebook use on behavior, study, academic performance and health of the target students. Data was analyzed using the Statistical Package for the Social Sciences (SPSS) version 16. Results: Whatsapp (82%) and Facebook (62%) were the most common types of social media used by the students and about 50% of them used Facebook for only 30 minutes per day. Considerable number of the students were using Facebook for educational purposes (66%) and felt that it made the social life better and believed it affected the time they spend with their friends and family (38%). They perceived Facebook as a source of inspiration and motivation (40%) about one third of them felt lonely despite of their many Facebook friends. Feeling less active (58%), having affected eyesight (33%) and headache (45 %) was reported after using Facebook by the students. About 31 % of them decided that Facebook had a negative effect on their study and 33.6 % of them believed that Facebook affected their grade point average (GPA). Conclusion: Although having some positive impact, use of Facebook has also negative impact on the students social interactions, behavior, health, study and academic performance as perceived by the dental students. Keywords: FACEBOOK, SOCIAL MEDIA, DENTISTRY, HEALTH BEHAVIOUR, GPA

MgO nanoparticles have been recently discovered as an antibacterial, however, they limited by property degradation due to agglomeration. The addition of a coating agent, such as a zein polymer, is effective in preventing agglomeration without affecting nanosized properties. The aim of this study was to assess the antimicrobial property of MgO nanoparticles when coated with a zein polymer against several oral bacteria and fungi. This was done by utilizing various assessment techniques. The ultimate aim is to use these nanoparticles in dental preparations. The antimicrobial activity of zein-coated MgO nanoparticles at different concentrations of 0.5, 1 and 2% were tested against four different microorganisms: Staphylococcus aureus, Streptococcus mutans and Enterococcus faecalis (gram positive bacteria), and Candida albicans (as oral fungus). Two different techniques were utilized: the Kirby-Bauer test, and a modified direct contact test. The results indicated that the antibacterial effect of 1% or 2% zein-coated MgO nanowires were statistically significant (p0.05) against the four organisms studied: S. mutans, S. aureus, E. faecalis and C. albicans. Zein-coated MgO nanoparticles are a new human friendly and potent antimicrobial agent that can be incorporated in the formulation of a variety of new dental materials and products that should provide improvements in dental care and oral health.

The pathophysiology of restless legs syndrome (RLS) may be related to abnormalities in central dopamine pathways. Vitamin D may play a role in the pathophysiology of RLS by modulating the dopaminergic system. The aim of our study is to examine the possible link between RLS and vitamin D deficiency.The total number of subjects enrolled was 201, including 78 patients with RLS based on the International RLS Study Group (IRLSSG) diagnostic criteria and 123 controls. Serum 25-hydroxy vitamin D levels were measured in both groups. RLS severity was assessed in all cases using the IRLSSG symptom severity rating scale.Fifty-nine patients with RLS (75.6%) and 52 controls (42.3%) had a diagnosis of vitamin D deficiency,Our study identified an association between vitamin D deficiency and RLS. Consequently, vitamin D deficiency should be considered in the management of RLS. However, further studies are needed to evaluate the causality relationship between vitamin D level and RLS.

Purpose: This study compares the stress distribution in the structure of a loaded endodontically treated maxillary extracted canine restored with either custom-made zirconia (Cercon) or cast gold dowel and core. Materials and Methods: Standard treatments were implemented to prepare the gutta-percha-filled root canal and dowel space. The tooth along with the dowel and core fabricated pattern resin were prepared to receive an all-ceramic (Cercon) crown. An impression was made for the tooth preparation with the zirconia milled dowel and core in place to fabricate the Cercon crown using CAD/CAM. The restored canine was scanned, and from the scan two models were constructed with the surrounding ligament and bone. Three-dimensional finite element elastic analysis was then carried out for the stress distribution within the different regions of the two models due to a concentrated force of 100 N applied at the mid-lingual area. Analyses were made for three load angulations, vertical, buccolingual horizontal, and an in-between oblique force at 45o. Each region of the models was assumed isotropic and homogeneous. The two restored canines with zirconia and gold were compared in terms of the resulting maximum tensile, compressive, and Von Mises stresses. Results: Generally, there were no significant differences in the maximum stresses in most regions for both models. Von Mises stresses for zirconia dowel and core was 8.966 MPa and for cast gold dowel and core was 8.752 MPa. The maximum tensile stress for zirconia dowel and core was 9.326 MPa, and for cast gold dowel and core was 8.166 MPa. Conclusions: The present work validates the use of CAD/CAM zirconia material for ceramic dowel and cores. Clinical implications: CAD/CAM Zirconia can be used for a custom-made dowel and core in an esthetically demanding zone as an esthetic replacement for a metal cast dowel and core when restoring endodontically treated teeth.

Background Calls for incorporating Facebook into the academic process to achieve educational purposes were done since more than 10 years. Objectives This study was designed to assess the perception of the dental students towards the use of Facebook in learning of the Biomaterials course and to determine if there is a gender-based difference in the students' perception. Subjects and methods This cross sectional study was conducted on the 3rd year undergraduate dental students, at one of Saudi universities during the academic year 2016-2017 using a self-administered questionnaire that was distributed to all students with a response rate 100%. Data was analyzed using the SPSS version 16. Results The female students were significantly more satisfied with the course than the male as they wanted to use Facebook to study the other topics of the Biomaterials course (p=0.01) as well as to study the other subjects (p=0.012) and they thought that Facebook can be used for scientific discussion (p=0.01).The willing to use Facebook in future learning was high among the female students but with no significant difference between both males and females. It was unexpected to find low agreement score among the participants on their preference to have assignments, movies, feedback or even reminders on Facebook with no significant difference between males and females. Conclusion Integrating learning through Facebook groups into the dental courses was generally well-perceived among the dental students and specifically accepted for the Biomaterials course. Students were willing to apply such model in other dentistry subjects. Further investigation of the impact of the approach on students' performance is recommended.