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Introduction: There are very few scholastic studies applying a theory-driven methodology to analyse the employment of teledentistry in clinical practice by the Saudi dental community. The objective of this research was to predict the employment of teledentistry in clinical practice by the Saudi dental community using the UTAUT (Unified Theory of Acceptance and Use of Technology) model. Methods: A countrywide survey was executed from November 2022 to April 2023 among the dental community (pre-graduate students, graduates, post-graduate students, general dentists, and specialist dentists) involved in clinical practice. The survey employed the UTAUT model, which has four fundamental constructs: performance expectancy (PE), effort expectancy (EE), social influence (SI) and facilitating conditions (FC). These constructs are known to impact the user's behavioural intention (BI). The four fundamental constructs were independent, and BI was the dependent variable. A Likert scale with five scores was used to record each variable. Descriptive statistics were used to describe all the constructs. Cronbach's alpha scores were used to measure the inner consistency of the Likert scale. Simple linear regression and multiple linear regression were used to determine the correlation between all the constructs and the overall model's prediction. The Statistical Package for the Social Sciences was applied for analysis. The study had 80% power and an alpha threshold of .05. Results: The electronic survey was sent to 3000 participants, out of whom 2143 responded (response rate = 71.43%). PE (R2= 26%, p < .01) was the most significant predictor of the Saudi dental community BI to employ teledentistry in clinical practice, followed by SI (R2= 24%, p < .01), EE (R2= 19%, p < .01) and FC (R2= 6%, p < .01). With statistically significant predictive power, the UTAUT model explained 32% of the variance in the BI (R2= 0.32, p < .01). Conclusions: Each UTAUT construct and the entire model were significantly correlated with the employment of teledentistry in clinical practice by the Saudi dental community. PE had the most salient correlation, followed by SI, EE and FC. The participants have perceived the benefits of teledentistry, increasing the future likelihood of its utilisation. The Saudi government could consider the UTAUT constructs to promote teledentistry in tandem with Vision 2030.

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Context: A regular and timely first dental visit plays a cardinal role in the future oral health of the child. It is used to begin preventive and corrective interventions in dental care. Aim: To evaluate the age, chief complaint, diagnosis, and treatment done during the first dental visit among children in an academic dental institution in southern Kerala, India. Materials and Methods: A descriptive cross sectional retrospective survey was conducted between January and June 2022 among children in an academic dental institution in southern Kerala, India. The hospital records at the Pushpagiri College of Dental Sciences were examined to obtain the child's age, chief complaint, diagnosis, and treatment done during the first dental visit among children. Statistical Analysis: The data were expressed in frequencies and percentages. Results: The records of 1000 children (680 male and 320 female) were examined. Most children (40%) who came for their first dental visit were aged between 4 and 6 years. Only 16% of children aged 0-3 years came for their first dental visit. Pain and sensitivity (50%) and tooth decay (17%) were the most common chief complaints among children. Dental caries (45%) and pulpal pathology (38%) were the most common diagnoses among children. The most common treatments done were glass ionomer cement restorations (32%), followed by prescribing medications (29%). No treatment was required for 16% of the children. Only a minority (3%) of the children received preventive treatments. Conclusions: The first dental visit was delayed, and most children sought treatment only during apparent acute symptoms. There is a high prevalence of oral disease burden and underutilization of preventive dental care among children. Education of parents on the value of first dental visits and the usage of preventative dental care in children is crucial.

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Scientific evidence on the benefits of yoga among patients undergoing dental implant surgery is sparse. The objective of the present study was to evaluate the effect of performing yoga on the vital signs and salivary cortisol in patients undergoing dental implant surgery. This study was conducted in an outpatient prosthodontics clinic during June-July 2019 as a pilot outcome assessor-blinded randomized trial with parallel design. A total of 20 patients requiring dental implant surgery were divided into two groups, with 10 patients in each group. Control group patients underwent implant surgery without yoga. In the intervention group, patients were trained to perform yoga, which included breathing exercises and meditation practiced for 10 minutes, and then underwent implant surgery. Vital signs (systolic blood pressure, diastolic blood pressure, heart rate, respiratory rate, and temperature) and salivary cortisol were recorded before (baseline) and after (post-surgery) implant surgery in both groups. There was no significant difference in the baseline values between the control and intervention groups. Mean vital sign and salivary cortisol values significantly increased from baseline to post-surgery in the control group. All vital signs except salivary cortisol significantly decreased from baseline to postsurgery in the yoga intervention group. Heart rate and temperature showed significant decreases in postsurgery values between the control and intervention groups. There was no significant correlation between vital signs and salivary cortisol at baseline and postsurgery between the control and intervention groups. This study provides preliminary evidence for the beneficial effects of yoga in reducing anxiety and stress in those undergoing dental implant surgery.

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[This corrects the article DOI: 10.3389/fbioe.2022.798988.].

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Background: Finite element analysis (FEA) is one of the best methods for evaluating the stress distribution of restorations, such as fixed partial dentures. The development of resin cement has transformed prosthesis bonding and retention properties. Resin-bonded fixed partial dentures (RBFPD) have been considered minimally invasive treatment options for the prosthetic rehabilitation of single missing teeth. Objectives: The aim of this study was to evaluate the stress load and distribution in four different designs of acid-etched RBFPDs using FEA. Materials and Methods: The designs included standard tooth preparation principles and additional features. The first premolar and first molar abutments replaced the missing second premolar. Designs 1, 2, 3, and 4 included (1) lingual wings and occlusal rests; (2) wings and proximal slices; (3) wings, rests, and grooves; and (4) wings, rests, grooves, and occlusal coverage. The prepared models were restored with RBFPDs. A load of 100 N was applied to the central groove of the pontic to simulate occlusal forces. The materials used in the models were considered to be isotropic, homogeneous, and linearly elastic. FEA was used to reveal stresses acting on the abutment, bone, and connector in all prosthesis designs. Results: The stresses transmitted to the abutment and bones were lowest for design 3, using wings, rests, and grooves. The stresses acting on the connector were the weakest in design 2. The stresses transmitted to the abutment and bone were highest in designs 1 and 4. The stresses transmitted to the connector were highest in design 3. Conclusion: The wings, rests, and grooves design is possibly the ideal and conservative tooth preparation design to receive a posterior RBFPD. This design transmits less stress to the abutments and less bone resorption in the FEA. It is most likely to be successful in the clinical provision and ensures the longevity of the prosthesis.

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A woman in her 70s with vague gastrointestinal (GI) symptoms and unintentional weight loss was referred to endoscopy clinic for investigation and consideration of GI malignancy. CT of the thorax, abdomen and pelvis showed a suspicious mass in the oesophago-gastric junction with a lytic lesion on S1-S2 sacrum. A subsequent upper GI endoscopy revealed two raised, ulcerated tumours on the lesser curvature of the stomach. By the time an MRI of the whole spine was done which revealed multiple metastases involving thoracic, lumbar and sacral skeleton, she had developed leg weakness and paraesthesias, consistent with the imaging findings. A positron emission tomography/CT scan further confirmed the above findings. The initial working diagnosis was primary GI tumour with bony metastases. However, she was later referred to the haematology team after the immunohistochemistry of the tumour showed that it was of a plasma cell origin (CD138 positive) associated with lambda light chain deposits. Serum-free light chain showed a raised lambda light chain of 272 mg/L and kappa light chain of 11.3 mg/L and involved/uninvolved light chain ratio of 24. Bone marrow biopsy confirmed a plasma cell myeloma with moderate disease burden. Monoclonal lambda chains were demonstrated on immunofixation but negative on serum protein electrophoresis and hence a diagnosis of oligosecretory myeloma with GI involvement was made. Subsequent management involved physiotherapy, pain management and chemotherapy, where this woman was commenced on Velcade (generically known as bortezomib), thalidomide and dexamethasone and she continued to experience clinical and biochemical improvement.

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RESUMEN Las dilataciones quísticas congénitas de la vía biliar extrahepática son infrecuentes, principalmente en Occidente, y afectan sobre todo a niños pero son poco comunes en adultos. El diagnóstico requiere un alto índice de sospecha y suele llevarse a cabo con estudios colangiográficos de los cuales la CRMN es, en la actualidad, el de mayor utilidad. Es conocido el aumento de malignización de estas dilataciones, por lo que el tratamiento completo de la bolsa quística es obligatorio.

ABSTRACT Congenital dilatation of extrahepatic bile ducts is rare in the Western countries and is more common in children than in adults. The diagnosis requires high level of suspicion and is made by cholangiography tests, among which MRCP is the most useful nowadays. Malignant transformation of these cystic dilatations is well-known; therefore, complete resection of the cystic pouch is mandatory.

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This study investigates the behavior and intracellular changes in Escherichia coli (model organism) during electro-oxidation with Ti/Sb-SnO2/PbO2 anode in a chlorine free electrochemical system. Preliminary studies were conducted to understand the effect of initial E. coli concentration and applied current density on disinfection. At an applied current density 30 mA cm-2, 7 log reduction of E. coli was achieved in 75 min. The role of reactive oxygen species' (ROS) in E.coli disinfection was evaluated, which confirmed hydroxyl (•OH) radical as the predominant ROS in electro-oxidation. Observations were carried out at cell and molecular level to understand E.coli inactivation mechanism. Scanning electron microscopy images confirmed oxidative damage of the cell wall and irreversible cell death. Intracellular and extracellular protein quantification and genetic material release further confirmed cell component leakage due to cell wall rupture and degradation due to •OH radical interaction. Change in cell membrane potential suggests the colloidal nature of E. coli cells under applied current density. Plasmid deoxyribonucleic acid degradation study confirmed fragmentation and degradation of released genetic material. Overall, effective disinfection could be achieved by electro-oxidation, which ensures effective inactivation and prevents regrowth of E. coli. Disinfection of real wastewater was achieved in 12 min at an applied current density 30 mA cm-2. Real wastewater study further confirmed that effective disinfection is possible with a low cost electrode material such as Ti/Sb-SnO2/PbO2. Energy consumed during disinfection was determined to be 4.978 kWh m-3 for real wastewater disinfection at applied current density 30 mA cm-2. Cost of operation was estimated and stability of the electrode was studied to evaluate the feasibility of large scale operation. Relatively low energy and less disinfection time makes this technology suitable for field scale applications.

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BACKGROUND: Edentulism affects the chewing ability of a person and can engender nutritional deficiencies which can affect the overall quality of life and depression. AIM: Our aim was to evaluate the association between perceived chewing ability, oral health-related quality of life (OHRQoL) and depressive symptoms among completely edentulous patients with and without dentures. SETTINGS AND DESIGN: Institutional study and cross-sectional design. METHODS: A cross-sectional study among 207 completely edentulous persons was conducted in South India. The subjects completed a self-administered questionnaire on demographics, Beck's depression inventory, oral health impact profile-edentulous (OHIP-EDENT), age when edentate, chewing ability, and denture satisfaction. Further, denture status was clinically evaluated. STATISTICAL ANALYSIS: Data were summarised and analysed using the Chi-square test and multivariate logistic regression. P < 0.05 was considered significant. RESULTS: Persons not using complete dentures (odds ratio [OR] =3.5, P < 0.05), who reported impaired chewing ability (OR = 4.6, P < 0.05), those who became edentate before 55 years (OR = 4.6, P < 0.05) and with poor denture status (OR = 6.2, P < 0.05) were more likely to report depressive symptoms. Lesser impact in relation to OHRQoL was found to be protective against depression among completely edentulous (OR = 0.24, P < 0.05). CONCLUSION: Depressive symptoms were associated with impaired chewing ability, higher impacts on OHIP-EDENT, and edentulous persons not using complete dentures. High priority must be given to enhance awareness towards oral rehabilitation among completely edentulous to reduce the chance of depression occurring due to impaired chewing ability and poor OHRQoL.

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BACKGROUND: Regular visits to the health care providers can develop a relationship that can extend beyond the physical health alone as the patient is transiting towards older age, adapting to changes in physical health, emotional health, and social connections. Apart from limiting access to health care services, the attitudes, beliefs, comfort level of the treating doctors towards the geriatric patients can motivate or demotivate them to access dental care. AIM: To explore the Saudi Arabian undergraduate students perception of geriatric patients and identify potential barriers that prevent the utilization of their dental appointment. METHODS: A close-ended questionnaire with one question and eight reasons was administered to the fifth year clinical students. The students were requested to specify their agreement with each question on a 5-point Likert scale. Among the barriers presented, each reason's approval was expressed as the percentage of the total number of responses. In addition, the gender comparison of mean scores was made, and an independent sample t-test was used to analyze the statements agreed by the students. All analyses were performed using Statistical Package of Social Sciences (SPSS) version 21.0 (IBM, USA) with the probability of statistical significance at 0.05 level. RESULTS: Fifty-one students recorded their perceptions on the questionnaire administered during their clinical posting in the fifth year of the geriatric dental education program. It was concluded that students believed that geriatric patients give overwhelming importance to other problems with minor importance to oral health care. In addition, gender comparison was more evident as the percentage expressed was more in females. CONCLUSIONS: There is a need for more clinical exposure of geriatric patients during their clinical postings. Student's acquaintance with didactic and clinical settings appears to be a critical element towards positive knowledge and attitude towards the geriatric population.

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PURPOSE: The purpose of the study was to assess the effectiveness of erbium:yttrium-aluminum-garnet (Er:YAG) laser surface pretreatment at various pulse durations of exposure on increasing the tensile bonding strength of permanent soft relining material and acrylic resin. MATERIALS AND METHODS: Polymethyl methacrylate resin samples were fabricated and grouped as comparison group (no laser surface pretreatment) and three test groups (received Er:YAG laser surface pretreatment at various pulse durations of 10 s, 20 s, and 30 s) for bonding with the permanent soft relining material, Molloplast B. Following the surface pretreatment, the samples were tested for tensile stress using a universal testing machine. Loads at the point of failure were noted and the tensile bond strength values were obtained. Parametric tests of one-way-ANOVA and Tukey's post hoc tests were done. RESULTS: The highest tensile bonding strength was recorded in Group C, and the control group recorded the lowest bonding strength. CONCLUSION: Er:YAG laser surface pretreatment at 10 Hz, 3 W, and 300 mJ for 30 s improved the bonding strength of the permanent soft relining material to heat-processed acrylic resin material.

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BACKGROUND: The increased prevalence of fluorosis has led to a search for biomarkers of fluoride exposure. Among the biomarkers of sub-chronic exposure to fluoride, hair, fingernails, and toenails have the advantage of being noninvasively collected, easily transported, and stored. OBJECTIVE: The objective of this study was to comparatively evaluate coronal hair, fingernails, and toenails as biomarkers of fluoride exposure from drinking water; the study was designed as a population-based observational cross-sectional study. MATERIALS AND METHODS: A population-based observational cross-sectional study was conducted in 60 children (20 subjects per group) of ages 12-17 years in three villages of Nilakottai block, Dindigul district, Tamil Nadu, India (Thomaspuram, Bangalapatti, and Singampatti). The fluoride concentration in the household drinking water was analyzed and compared with the fluoride content in the coronal hair, fingernail, and toenail clippings, which was estimated by potentiometric method (fluoride-ion-selective electrode) and expressed in ppm (parts per million). A two-tailed probability value of P < 0.05 was considered significant. RESULTS: The mean fluoride concentration in drinking water was 0.63ppm in Thomaspuram, 1.63ppm in Bangalapatti, and 2.92ppm in Singampatti. The mean fluoride content in hair samples was 2.84ppm, 4.67ppm, and 6.53ppm; fingernail clippings was 2.99ppm, 4.94ppm, and 6.84ppm; and toenail clippings was estimated as 3.13ppm, 5.10ppm, and 7.24ppm in Thomaspuram, Bangalapatti, and Singampatti residents, respectively. The mean fluoride content in the hair, fingernails, and toenails was significantly higher as compared to the mean fluoride content in the drinking water (viz., toenail fluoride > fingernail fluoride > hair fluoride). CONCLUSION: Coronal hair, fingernails, and toenails are useful biomarkers for both sub-chronic and chronic fluoride exposure from drinking water. Due to ample sample availability and the highest fluoride content, toenails are the most suitable biomarkers of fluoride exposure from drinking water.

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This study mainly focuses on the efficiency of anodic oxidation process (Ti/Sb-SnO2/PbO2 as anode and stainless steel as the cathode) in treating two different streams of urban wastewater, one from the influent of sequence batch reactor (WW1) and other from the effluent of constructed wetland (WW2). The effect of different operational parameters such as current density, hydraulic retention time, exposed electrode surface area, phosphorous, ammonia-nitrogen, nitrates, and coliform bacteria was studied. For an optimized current density of 30 mA/cm2 and an electrode surface area of 30 cm2, almost complete removal of COD and ammonia-nitrogen were achieved with both wastewaters (WW1 & WW2), while in case of phosphorous, 50% and 98% removal efficiencies were observed. Electrode deposition was analyzed using SEM-EDS and XRD, which confirms the presence of calcium and magnesium phosphates on the surface on the anode, which attributes to the phosphate removal. Electrochemical disinfection studies showed that complete inactivation of bacteria takes place within 30 min for WW1 and 60 min for WW2, and the cell morphological changes were studied using SEM analysis. Degradation of different micropollutants present in the wastewaters was evaluated with the aid of GC-MS. ICP - MS analysis confirmed that there was no leaching of lead from the anode surface, and the lead which is already present in the wastewater gets reduced to a permissible level, which further increases the treatment efficiency. Hence cleaner and comprehensive treatment of real urban wastewaters through anodic oxidation process was successfully demonstrated in this work.

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Incorporation of multifunctional inorganic additives into the commercial polymers still stands as the most captivating and effective way to realize new-generation electronic components. Here, we introduce a simple, cost-effective, and environmentally benign method to covalently functionalize graphene oxide (GO) with vinyl- and aminopropyl-functionalized hybrid silica spheres with a polyhedral oligomeric silsesquioxane (POSS)-siloxane composition. The reaction has been carried out in a mixture of ethanol and water (used as a medium) at ambient conditions with silane precursors. Later, the synthesized hybrid material has been tested for its dielectric properties after blending with syndiotactic polystyrene, a commercially available insulating semicrystalline polymer. It was observed that the dielectric constant decreases with the addition of GOPOSS up to 1.85 with a dielectric loss of 0.02 at 5 GHz. Significant improvements in the thermal properties of the composites were verified with minimal filler loading.

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PURPOSE: The aim of the study was to evaluate the effect of incorporation of organically modified nanoclay in 1%, 3%, and 5% by weight on the flexural strength, surface hardness, and linear polymerization shrinkage of heat cure denture base material. MATERIALS AND METHODS: One hundred and twenty specimens of heat-polymerized acrylic resin were fabricated. The specimens were divided into four groups (n = 10) coded I to IV. Group I was the control group (unmodified acrylic resin specimens). The specimens of the remaining three groups were reinforced with nanoclay (organically modified montmorillonite) nanoparticles to achieve loadings of 1%, 3%, and 5% by weight. The resulting nanocomposites were subjected to mechanical testing and were characterized using X-ray diffraction, scanning electron microscope, and transmission electron microscope. RESULTS: The statistical analysis showed that there was no significant increase in flexural strength within and between the groups. The most significant increase in surface hardness was observed between Group I (control) and Group II (1% nanoclay). Linear polymerization shrinkage of the specimens showed a significant decrease in the control and all the experimental groups. CONCLUSION: Addition of 1 wt% nanoclay to polymethyl methacrylate heat cure denture base material could enhance the surface hardness and reduce the linear polymerization shrinkage of the resin. However, there was no significant increase in flexural strength of the resulting nanocomposite.

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To assess the implant stability during different stages of healing in an immediate loaded implant soon after extraction. A 73-year-old female came with a chief complaint of bad smell and irritation in her lower front gum region. On examination, she was found to be completely edentulous in the maxillary arch and partially edentulous in the mandibular arch with only the canines present bilaterally. The posterior mandibular ridge was severely resorbed and hence could not be treated with a conventional mandibular complete denture. Considering the age of the patient and the preference of only a single surgical visit, we decided to plan for a conventional maxillary denture against an implant supported mandibular overdenture with two implants placed immediately after extraction of canines. The stability of these implants was assessed during the early phases of healing with the help of a resonance frequency analysis method (RFA) using Osstell ISQ™. During the healing phase, implant stability quotient (ISQ) values decrease by 4-5 values after installation with the lowest values at the 1st week postplacement. Following this, the ISQ values increased steadily for all implants up to 16 weeks. No significant differences were noted over time. At placement, the mean ISQ values at 33 and 43 regions were 74 and 75.2, respectively. The mean lowest ISQ values recorded at the 1st week were 58.8 and 65.4, respectively. At 16 weeks, the mean ISQ values were 70.5 and 67.9, respectively. The survival of such immediately placed implants, which are later used as overdenture supported implants, are highly predictable when the surgical and prosthetic part is done meticulously. However, there needs future studies oriented to understand better the healing pattern of immediately placed implants in extraction sockets, which would guide the clinician with the optimal loading time.

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Complete dentures are poorly tolerated in patients with xerostomia. A salivary reservoir can be incorporated into a denture that provides slow, sustained, and continuous release of salivary substitute. This article describes a simple, cost-effective, and innovative technique of fabrication and designing of functional maxillary salivary reservoir complete denture.