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Culturally Adapted Dental Visual Aids Effect on Behavior Management during Dental Visits in Children with Autism Spectrum Disorder

J Contemp Dent Pract. 2024 Jan 1;25(1):20-28. doi: 10.5005/jp-journals-10024-3620.

ABSTRACT

AIM: Autism spectrum disorder (ASD) is a neurodevelopmental disorder characterized by unique behavioral patterns, treating children with ASD in the dental clinic has been a great challenge due to their behavior. This study aims to determine the effectiveness of culturally adapted dental visual aids in modifying behavior patterns during dental visits in children with ASD.

MATERIALS AND METHODS: A controlled, blinded, randomized, clinical trial, with 64 children diagnosed with ASD, were randomly divided into two groups. The study took place between January 2019 and January 2021. The experimental group was provided with culturally adapted dental visual aids created especially for this research and the control group was provided with universal dental visual aids. The children’s behavior patterns were evaluated before and after using the dental visual aids. SPSS v.25 was used to process all the data.

RESULTS: Behavior patterns have modified significantly in the experimental group (p < 0.001) however, it was statistically insignificant in the control group (p = 0.077). In terms of behavioral patterns, the experimental group outperformed the control group significantly (p < 0.001).

CONCLUSION: The culturally adapted dental visual aids have shown effectiveness in modifying behavior patterns in children diagnosed with ASD during dental visits.

CLINICAL SIGNIFICANCE: By evaluating the impact of culturally adapted visual aids on behavior management, the study can enhance the accessibility and effectiveness of dental care for this vulnerable population, ultimately promoting better oral health outcomes and reducing potential trauma associated with dental visits for children with ASD. How to cite this article: Aljubour AA, AbdElBaki M, El Meligy O, et al. Culturally Adapted Dental Visual Aids Effect on Behavior Management during Dental Visits in Children with Autism Spectrum Disorder. J Contemp Dent Pract 2024;25(1):20-28.

PMID:38514427 | DOI:10.5005/jp-journals-10024-3620

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Comparative Evaluation of Push-out Bond Strength of Three Different Root Canal Sealers: An In Vitro Study

J Contemp Dent Pract. 2024 Jan 1;25(1):15-19. doi: 10.5005/jp-journals-10024-3610.

ABSTRACT

AIM: The aim of this present study was to compare the dislodgement resistance of calcium silicate-based sealer, zinc oxide sealer, and a new sealer combining both zinc oxide and calcium silicate-based sealer in vitro.

MATERIALS AND METHODS: 60 single-rooted human teeth were instrumented with F3 Protaper Gold. All endodontic canals were filled using gutta percha cones using the cold lateral condensation technique in combination using one of the mentioned sealers (n = 20 per group). The teeth were divided into three groups: group A consisted of Sealite® Ultra, group B consisted of K-Sealer®, and group C consisted of BioRoot® RC. After 2 months of incubation (37°C, 100% humidity) and after cutting out 2 mm from the most apical portion of the root apex, six slices of 1 mm thickness were generated. Mechanical dislodgement resistance was examined using a universal pressure-testing machine and the push-out bond strength (POBS) was calculated. Specimens were examined under 20× magnification to define the bond failure mode. Statistical analysis was executed using ANOVA, post hoc Turkey test for pairwise comparisons and Kruskal-Wallis tests.

RESULTS: The POBS of BioRoot® was significantly higher than the POBS of the two other sealers with a mean of 10.54 MPa ± 2.10 and 5.73 MPa ± 2.34, respectively (p < 0.001). Sealite® and K-Sealer® showed similar results in the median and coronal part. K-Sealer® revealed highest POBS compared with Sealite® in the apical part (p < 0.05).

CONCLUSION: The POBS of the zinc oxide and calcium silicate-based sealer was significantly lower compared with calcium silicate. Sealite® and K-Sealer® exhibited almost same results. BioRoot showed the highest POBS of all sealers.

CLINICAL SIGNIFICANCE: The current study was needed to evaluate the bond strength of three different cements to dentinal walls, by evaluating their respective POBS in vitro. The findings of this study may provide guidance for the clinician in the selection of an adequate endodontic sealer that guarantees an enhanced adhesive seal between the Gutta-percha and the dentinal canal walls. How to cite this article: Makhlouf MP, El Helou JD, Zogheib CE, et al. Comparative Evaluation of Push-out Bond Strength of Three Different Root Canal Sealers: An In Vitro Study. J Contemp Dent Pract 2024;25(1):15-19.

PMID:38514426 | DOI:10.5005/jp-journals-10024-3610

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Comparative Evaluation of Fracture Toughness and Flexural Strength of Four Different Core Build-up Materials: An In Vitro Study

J Contemp Dent Pract. 2024 Feb 1;25(2):191-195. doi: 10.5005/jp-journals-10024-3624.

ABSTRACT

AIM: To evaluate and compare the fracture toughness and flexural strength of four different core build-up materials.

MATERIALS AND METHODS: A total of 60 samples were divided into four groups (n = 15) group I: dual cure composite resin reinforced with zirconia particles (Luxacore Z), group II: light cure composite resin (Lumiglass DeepCure), group III: zirconia reinforced glass ionomer cement (GIC) (Zirconomer Improved), and group IV: chemically cure composite resin (Self Comp) respectively. All the core build-up materials were manipulated according to the manufacturer’s instructions and poured into the mold. A universal testing machine applied a central load to the specimen in a 3-point bending mode. Fracture of the specimen was identified and the reading was recorded by the universal testing machine. The data were analyzed statistically using one-way analysis of variance (ANOVA) and then compared.

RESULTS: Group I showed the highest flexural strength (48.65 MPa) among all the groups while group IV showed the lowest flexural strength (17.90 MPa). Group I showed the highest fracture toughness (99.12 MPa) among all the groups while group IV showed the lowest fracture toughness (36.41 MPa.cm-0.5). When mean flexural strength and fracture toughness values of all four groups were compared by using one-way ANOVA, the compared data was highly significant.

CONCLUSION: Based on the findings of this study, dual cure composite resin was the material of choice in terms of flexural strength and fracture toughness for core build-up material followed by light cure composite resin.

CLINICAL SIGNIFICANCE: The core buildup material serves to strengthen the tooth structure, allowing it to withstand the forces of chewing and preventing the risk of tooth fractures. This material is essential in restoring damaged or decayed teeth, as it provides a stable foundation for further dental work. By reinforcing the tooth structure, the core buildup material ensures that the tooth can function properly and remain healthy for years to come. How to cite this article: Nakade P, Thaore S, Bangar B, et al. Comparative Evaluation of Fracture Toughness and Flexural Strength of Four Different Core Build-up Materials: An In Vitro Study. J Contemp Dent Pract 2024;25(2):191-195.

PMID:38514419 | DOI:10.5005/jp-journals-10024-3624

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Efficacy of Visual Oral Health Reinforcement in Reducing Plaque Accumulation and Gingival Bleeding: A Pilot Randomized Controlled Trial

J Contemp Dent Pract. 2024 Feb 1;25(2):186-190. doi: 10.5005/jp-journals-10024-3637.

ABSTRACT

AIM: To compare oral hygiene (OH) differences during verbal or video OH instructions with or without images displaying poor oral health consequences.

MATERIALS AND METHODS: Twenty-one healthy females (18-30 years) were randomly and equally divided into three intervention OH instruction groups: (1) verbal, (2) video-based, (3) video-based with image displaying the consequences of poor OH. Gingival bleeding on probing (BOP), gingival bleeding index (BI), and plaque score (PS) were assessed at baseline and after 4 weeks. Within- and between-group differences were assessed by non-parametric tests.

RESULTS: Plaque score only showed a statistical group difference after follow-up [H(2) = 9.214, p = 0.01]. The post hoc test revealed that group III showed a significantly lower PS than groups I and II (p = 0.04 and p = 0.017, respectively). No differences were observed in PS between groups I and II. Group I showed no follow-up reduction in PS, BI, and BOP, while group II showed a statistically significant reduction in BI only after follow-up (p = 0.028). However, group III showed a statistically significant reduction in BOP and PS (p = 0.023 and p = 0.045, respectively) but not BI.

CONCLUSIONS: Verbal and video-alone OH instructions similarly affect gingival health, while participants who were exposed to images displaying the severe OH consequences had lower PS than verbal or video-alone groups.

CLINICAL SIGNIFICANCE: The mode of OH instructions is not influential for optimum oral health. However, employing visuals highlighting the severe consequences of poor OH leads to short-term reduction of plaque accumulation. How to cite this article: Aleid AA, Alnowaiser A, AlSakakir A, et al. Efficacy of Visual Oral Health Reinforcement in Reducing Plaque Accumulation and Gingival Bleeding: A Pilot Randomized Controlled Trial. J Contemp Dent Pract 2024;25(2):186-190.

PMID:38514418 | DOI:10.5005/jp-journals-10024-3637

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Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial

J Contemp Dent Pract. 2024 Feb 1;25(2):180-185. doi: 10.5005/jp-journals-10024-3572.

ABSTRACT

AIM: To evaluate the intensity of postendodontic pain (PEP) using final irrigation with side-vented needle (SV), EndoActivator (EA), and Ultra X (UX) in single-visit endodontics (SVE) with F-One rotary files.

MATERIALS AND METHODS: A total 150 patients indicated for endodontic treatment were selected. Single-visit endodontics treatment was performed under local anesthesia. For the final irrigation protocol, they were divided into three groups: group I (SV), group II (EA), and group III (UX). The severity of PEP was assessed using visual analogue scale (VAS) score after 6, 12, 24, and 48 hours. Analgesics taken by patients, for pain, were also recorded. Finally, the data were tabulated and statistically analyzed using SPSS 20.0 software at a level of significance being 0.05.

RESULTS: Postendodontic pain was less in group III (UX) and group II (EA) compared with group I (SV) at 6 and 12 hours, which is statistically significant (p < 0.05). There was no statistically significant difference found after 24 hours and 48 hours.

CONCLUSION: The intensity of PEP was minimum in patients treated with EndoActivator and ultrasonic along with single rotary file systems. The incidence of analgesic intake was similar in all three groups. How to cite this article: Kathiria NV, Attur K, Bagda KM, et al. Postendodontic Pain Using Single File System with Different Irrigation Protocols in Single-visit Root Canal Treatment: A Randomized Control Trial. J Contemp Dent Pract 2024;25(2):180-185.

PMID:38514417 | DOI:10.5005/jp-journals-10024-3572

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Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates

J Contemp Dent Pract. 2024 Feb 1;25(2):168-173. doi: 10.5005/jp-journals-10024-3638.

ABSTRACT

AIM: To evaluate the push-out bond strength of two newly modified mineral trioxide aggregates (MTAs) with conventional MTA and biodentine.

MATERIALS AND METHODS: Material preparation: Two commercially available bioactive bioceramics: Group I: Mineral trioxide aggregate; Group II: Biodentine; and two newly formulated modified MTAs: Group III: Doxycycline incorporated MTA formulation; Group IV: Metronidazole incorporated MTA formulation was used in the present study. All the test materials were then carried using a plastic instrument to the desired experimental design. Teeth sample preparation: A total of 120 teeth samples were collected and divided into four groups of test materials with 30 teeth samples per group. Single-rooted permanent teeth, that is, incisors were collected and stored in saline until the study was performed. Sectioning of the teeth into 2.0 ± 0.05-mm thick slices was performed perpendicular to the long axis of the tooth. The canal space was instrumented using Gates Glidden burs to achieve a diameter of 1.5 mm. All four prepared materials were mixed and placed in the lumen of the slices and placed in an incubator at 37°C for 72 hours. Push-out test and bond failure pattern evaluation: The push-out test was performed using a universal testing machine. The slices were examined under a scanning electron microscope (SEM) at 40× magnification to determine the nature of bond failure. All the collected data were recorded and statistically analyzed.

RESULTS: The mean push-out bond strength was found to be the highest for group II (37.38 ± 1.94 MPa) followed by group III (28.04 ± 2.22 MPa) and group IV (27.83 ± 1.34 MPa). The lowest mean push-out bond strength was noticed with group I (22.89 ± 2.49 MPa). This difference was found to be statistically significant (p = 0.000). Group I samples had the predominantly adhesive type of failure (86.4%), while group II samples showed the cohesive type of failure (94.2%). Both the modified MTAs (groups III and IV) primarily showed mixed types of failures.

CONCLUSION: Both the antibacterial-enhanced MTAs had better pushout bond strength compared to conventional MTA but did not outperform biodentine. Hence, it could serve as a substitute for conventional MTA due to its augmented physical properties.

CLINICAL SIGNIFICANCE: Carious pulp exposure and nonvital open apices pose a critical challenge to pediatric dental practitioners. In such circumstances, maintaining the vitality of pulp and faster healing would help in a better prognosis. Novel MTAs without any cytotoxic components, and enhanced antibacterial contents with augmented physical properties can help in treating such clinical conditions. How to cite this article: Merlin ARS, Ravindran V, Jeevanandan G, et al. Comparative Evaluation of Push-out Bond Strength of Conventional Mineral Trioxide Aggregate, Biodentine, and Two Novel Antibacterial-enhanced Mineral Trioxide Aggregates. J Contemp Dent Pract 2024;25(2):168-173.

PMID:38514415 | DOI:10.5005/jp-journals-10024-3638

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Evaluation of Regenerative Efficacy of Amnion and Chorion Membrane in Treatment of Mandibular Molar Furcation Defects: A Clinico-radiographic Study

J Contemp Dent Pract. 2024 Feb 1;25(2):160-167. doi: 10.5005/jp-journals-10024-3640.

ABSTRACT

AIM: Amnion and chorion membranes possess unique inherited biological properties that enhance wound healing and may accelerate periodontal regeneration. The present study aims to evaluate and compare the efficacy of amnion and chorion membranes in the treatment of furcation defects.

MATERIALS AND METHODS: A total of 20 patients were selected and were randomly allocated to group I and group II with 10 subjects in each group. Amnion and chorion membranes are placental-derived membranes that accelerate regeneration by having natural growth factors with their antimicrobial and inflammation reduction properties. Group I was treated using bone grafting with decalcified freeze-dried bone allograft (DFDBA) and placement of amnion as a membrane for guided tissue regeneration (GTR) whereas group II was treated using bone grafting with DFDBA and placement of chorion as a membrane for GTR. The patients were followed for clinical and radiographic parameters and were evaluated between 3 and 6 months after surgery.

RESULT: In intragroup comparison, a significant difference was evident in both the groups for all the clinical and radiographic parameters within the groups. (p = 0.01) This means both amnion and chorion membranes showed statistically significant regenerative efficacy. In intergroup comparison, the results show that all the clinical parameters and radiographic parameters show no significant difference between the groups.

CONCLUSION: The amnion and chorion membranes had similar regenerative efficacy in combination with DFDBA in patients with buccal degree II furcation defects in mandibular molars.

CLINICAL SIGNIFICANCE: The amnion and chorion membranes have shown significant improvement in clinical and radiographic parameters when used for the treatment of buccal degree II furcation defects in mandibular molars. How to cite this article: Mallapragda S, Gupta R, Gupta S, et al. Evaluation of Regenerative Efficacy of Amnion and Chorion Membrane in Treatment of Mandibular Molar Furcation Defects: A Clinico-radiographic Study. J Contemp Dent Pract 2024;25(2):160-167.

PMID:38514414 | DOI:10.5005/jp-journals-10024-3640

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Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study

J Contemp Dent Pract. 2024 Feb 1;25(2):156-159. doi: 10.5005/jp-journals-10024-3618.

ABSTRACT

AIM: The purpose of the present study was to evaluate the smear layer removal efficacy of three various agents on periodontally compromised tooth.

MATERIALS AND METHODS: The current study included 75 molar teeth that were extracted due to periodontal disease. After that, 25 samples were randomly assigned using a simple random technique to the three different agent groups, group A: Scaling and root planing (SRP) and application of SofScale agent, group B: SRP and application of QMix agent, group C: SRP and application of MTAD agent. Using a diamond circular saw, the treated portions were divided into horizontal and vertical halves. All samples were viewed under Scanning Electron Microscope. Every tooth was focused at the coronal third, middle third, and apical third portion with a magnification of 1000×. Data were recorded and statistically analyzed.

RESULTS: The smear layer removal efficacy was more in the QMix agent (3.06 ± 0.04) group followed by MTAD agent (3.28 ± 0.09) and SofScale agent (4.14 ± 0.10) group on the root surface. On intra group comparison, there was a statistically significant difference found in all the intra group agents with all the three levels. On inter group evaluation, at coronal third, there was no significant difference found between the different agents. There was a significant difference found between the different agents at middle and coronal third.

CONCLUSION: On conclusion, the current investigation found that, the root surfaces treated with QMix shown a greater ability to remove smear layers compared to tooth surfaces treated with MTAD and SofScale agent.

CLINICAL SIGNIFICANCE: Conventional therapies such as SRP effectively eliminate calculus, plaque, and necrosed cementum; nevertheless, they leave behind a smear layer that could impede normal healing. In an effort to overcome this, root conditioning agents were applied on the root surface to remove the smear layer. The traditional root conditioning agents such as citric acid have certain disadvantages, though, such as an acidic pH that could harm the root surface. As a result, researchers have been looking for biocompatible root conditioning treatments that are more effective. How to cite this article: Singh DK, BS Raj H, Soans CR, et al. Assessment of the Smear Layer Removal Efficacy of Three Different Agents on Periodontally Compromised Tooth: An In Vitro Study. J Contemp Dent Pract 2024;25(2):156-159.

PMID:38514413 | DOI:10.5005/jp-journals-10024-3618

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Perceptions and Knowledge of Undergraduate Dental Students about Artificial Intelligence in Dental Schools: A Cross-sectional Study

J Contemp Dent Pract. 2024 Feb 1;25(2):148-155. doi: 10.5005/jp-journals-10024-3633.

ABSTRACT

OBJECTIVE: This study aims to assess the perceptions and knowledge of undergraduate dental students about artificial intelligence (AI) in dental schools through a cross-sectional study.

MATERIALS AND METHODS: This was a multicenter, cross-sectional study. Participant recruitment was achieved by sending an online questionnaire to the undergraduate students at the assigned universities. The questionnaire consisted of two parts. The first seven questions record general information about participants and their perceptions of AI. The remaining questions are about the knowledge of participants about the applications of AI. The data were analyzed using SPSS version 26.

RESULTS: About 165 undergraduate students from 20 universities related to the dental sciences responded to the questionnaire. And 80.6% of participants found the use of AI in dentistry exciting. I have a basic knowledge of the working principles of AI. About 80.6% of participants believe that applications of AI should be part of undergraduate dental training. And 66.6% of students are aware of the opportunities and threats that AI can create. The results show that 75% of the students indicated that they got their information about AI through social media. Regarding the association of years of studies with AI applications used in periodontics, the knowledge about AI applications in “aggressive periodontics,” “compromised teeth,” and “success in rate of dental implant” was significantly higher in senior students than junior students (p < 0.05). Concerning applications of AI used in restorative dentistry and prosthodontics, only “computer color matching,” “tooth surface losses,” and “I do not know” showed statistical significance (p < 0.05) with the year of study of participants. Senior students show significantly better knowledge in “success in retreatment” and “working length determinant.”

CONCLUSION: Although undergraduates are enthusiastic about AI and aware of its threats and benefits, their knowledge is limited. In addition, undergraduate programs must exert more effort to prepare students for the era of AI. How to cite this article: Aldowah O, Almakrami A, Alghuwaynim Y, et al. Perceptions and Knowledge of Undergraduate Dental Students about Artificial Intelligence in Dental Schools: A Cross-sectional Study. J Contemp Dent Pract 2024;25(2):148-155.

PMID:38514412 | DOI:10.5005/jp-journals-10024-3633

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Effects of an increased financial incentive on follow-up in an online, automated smoking cessation trial: A randomised controlled Study Within a Trial (SWAT)

Nicotine Tob Res. 2024 Mar 21:ntae068. doi: 10.1093/ntr/ntae068. Online ahead of print.

ABSTRACT

INTRODUCTION: Poor retention in clinical trials can impact on statistical power, reliability, validity and generalisability of findings and is a particular challenge in smoking cessation studies. In online trials with automated follow up mechanisms, poor response also increases resource-need for manual follow up. This study compared two financial incentives on response rates at 6 months follow up, in an online, automated smoking cessation feasibility trial of a cessation smartphone app (Quit Sense).

METHODS: A study within a trial (SWAT), embedded within a host randomised controlled trial. Host trial participants were randomised 1:1 to receive either a £10 or £20 voucher incentive, for completing the 6-month questionnaire. Stratification for randomisation to the SWAT was by minimisation to ensure an even split of host trial arm participants, and by 6-week response rate. Outcome measures were: questionnaire completion rate, time to completion, number of completers requiring manual follow up and completeness of responses.

RESULTS: 204 participants were randomised to the SWAT. The £20 and £10 incentives did not differ in completion rate at 6 months (79% versus 74%; p=0.362) but did reduce the proportion of participants requiring manual follow up (46% versus 62%; p=0.018) and the median completion time (7 days versus 15 days; p=0.008). Measure response completeness rates were higher among £20 incentive participants, though differences were small for the host trial’s primary smoking outcome.

CONCLUSIONS: Benefits to using relatively modest increases in incentive for online smoking cessation trials include more rapid completion of follow up questionnaires and reduced manual follow up.

IMPLICATIONS: A modest increase in incentive (from £10 to £20) to promote the completion of follow up questionnaires in online smoking cessation trials may not increase overall response rates but could lead to more rapid data collection, a reduced need for manual follow-up and reduced missing data among those who initiate completing a questionnaire. Such an improvement may help to reduce bias, increase validity and generalisability, and improve statistical power in smoking cessation trials.

PMID:38513087 | DOI:10.1093/ntr/ntae068