Dentistry

To all great people who have inspired my soul, added valuable meanings to my life and influenced my journey. iv ACKNOWLEDGMENTS • The profound thanks, first and foremost, to God "Allah" for blessing my journey of education and my whole life. • My sincere appreciation to my principle investigator Dr. R. Giordano for teaching and supporting me. • I would like to give special thanks to Dr. R. Pober for teaching me, guiding me, motivating me, supporting me and for all his valuable time and advices. • I would like also to thank Dr. Y. Fan for his dedicated support and for being always there to teach me and assist me. • I am grateful to Dr. D. Nathanson for accepting me into this program. • I would like also to extend my thanks to all staffs and colleagues at Boston University for their great collaboration and contributions. • I would like to express my gratitude to Umm Alqura University for sponsoring my postgraduate education. • Last but not least, I am thankful to my parents, my sisters, my brothers and my friends. Without their unconditional love and support, none would have been achieved successfully.

Background: Social media platforms have become credible tools for spreading awareness of dental care as well as advertisements for esthetic dentistry, which may negatively affect users by leading to dissatisfaction and low self-esteem when they compare themselves with others. Objective: To measure self-esteem and satisfaction related to esthetic dentistry by administering a validated questionnaire to adults in Saudi Arabia, which investigates how they are affected by seeing the topic addressed on social media. Methods: This study investigated 515 participants living in Saudi Arabia. A self-administered validated questionnaire was electronically developed using Google Forms 2020. A link to the questionnaire was distributed through multiple social media platforms, such as WhatsApp, Twitter, and Instagram, to assess self-esteem and satisfaction resulting from the presentation of esthetic dentistry on social media platforms among adults. A pilot study was conducted to assess the validit...

Objectives. The level of evidence (LOE) of Saudi dental research from 2000 to 2020 was evaluated, and factors associated with the LOE were determined. Methods. This study was a systematic review. PubMed, Web of Science, and Medline databases were utilized to retrieve available dental articles published in English between January 2000 and May 2020. The inclusion criteria consisted of clinical studies conducted in Saudi Arabia with at least one Saudi dental affiliation. The retrieved eligible articles were evaluated independently by two reviewers using a modified Oxford LOE scale. The LOE of the studies was compared between the last two decades. Results. Of the 7237 articles identified, 1557 articles met the inclusion criteria. Approximately 78% of the published articles reported Level IV evidence. A higher trend toward Level I, II, and III publications has occurred in recent years (i.e., 2010–2020). However, no statistically significant difference existed in LOE proportions between t...

This in vitro study aimed to compare the fracture strength of direct non-reinforced class II composite resin restorations and polyethylene fiber-reinforced restorations, and also to investigate the influence of the locations of polyethylene fibers within the cavity on the fracture strength. Sixty freshly extracted human teeth were disinfected and prepared (class II cavity design). The teeth were assigned randomly into four groups (n = 13). Group I (control) was restored with nano-hybrid composite resin. The other three experimental groups were restored with the same composite resin material reinforced by polyethylene fibers (Ribbond) at different locations. Fibers were placed either on the axial wall (Group II), on the gingival floor (Group III), or on the axial wall and pulpal/gingival floor (Group IV) of the proximal cavity. All the teeth were subjected to thermocycling to simulate the oral environment. The fracture strength was measured using a universal testing machine. Group IV...

Background: Mesio–occluso–distal (MOD) cavity preparations are often fragile due to the amount of tooth and carious structure removed. MOD cavities can often fracture if left unsupported. Aim: The study investigated the maximum fracture load of mesi–occluso–distal cavities restored using direct composite resin restorations with various reinforcement techniques. Method: Seventy-two freshly extracted, intact human posterior teeth were disinfected, checked, and prepared according to predetermined standards for mesio–occluso–distal cavity design (MOD). The teeth were assigned randomly into six groups. The first group was the control group restored conventionally with a nanohybrid composite resin (Group I). The other five groups were restored with a nanohybrid composite resin reinforced with different techniques: the ACTIVA BioACTIVE-Restorative and -Liner as a dentin substitute and layered with a nanohybrid composite (Group II); the everX Posterior composite resin layered with a nanohyb...

Introduction: The recently developed single-shade composite resin (using the concept of structural coloring) is a promising option to eliminate the process and subjectivity of shade selection. However, current evidence of its performance is still insufficient. This study aimed to evaluate the color matching, color stability, and refractive index (RI) of single-shade restorations compared with conventional composite resin. Methods: This in vitro study was conducted on 48 extracted maxillary premolars. The teeth were sorted into three tooth shade groups (B2, A3, and A3.5). Each group included two subgroups based on the materials used: Omnichroma (OM; Tokuyama Dental, Tokyo, Japan) and Filtek Z350 (FT; 3M ESPE, St. Paul, MN, USA). Buccal and lingual Class V round cavities were prepared and restored according to the randomly assigned subgroups, with the test single-shade material (OM) on one surface and the matching conventional control material (FT) of the proper shade on the other surface of each tooth. Color matching was evaluated by visual assessment and a spectrophotometer. All specimens were distributed into four staining groups and immersed in various staining beverages (black coffee, Arabic coffee, Coca-Cola, and distilled water) for four weeks. Color changes were assessed using a spectrophotometer. Four groups of disc-shaped specimens (single-shade, B2, A3, and A3.5) were fabricated to evaluate the RI using a refractometer. Statistical analyses were performed to compare the materials. Results: The mean value of the color difference (ΔE) of single-shade restorations was significantly higher than that of paired conventional restorations in all shade groups. The highest mean ΔE was in subgroup A3.5-OM (8.84 ± 2.39) and showed significantly less color matching than other OM subgroups (p=0.009). The visual assessment showed comparable and acceptable color matching in all subgroups except A3.5-OM (p=0.006). There was a significant color change after the staining test within and across staining groups, but the color change was comparable between the OM and FT subgroups. The RI of single-shade material was significantly higher than conventional material (p<0.05). Conclusion: The color matching of single-shade restorations was affected by tooth shade. Its color stability was influenced by various staining substances but was similar to conventional restorations.

Purpose: There are unfavorable opinions connected with rubber dam isolation amongst dental students during adhesive restorative treatments. The aim of this study was to investigate the various barriers to practicing rubber dam isolation during dental procedures and provide necessary insight towards implementation of rubber dam among undergraduate dental students in Jazan. Materials and methods: A pre-validated questionnaire in English entitled Rubber Dam Isolation Survey (E-RDIS) based on the Capability Opportunity Motivation-Behaviour (COM-B) model of behavioral change wheel was responded by 226 university dental students. Results: The satisfaction of training was highest among sixth year students (Mean=3.57, p<0.001). Fourth year dental students scored higher in the capability (Mean=3.18) and were more highly motivated to use rubber dams (Mean=4.21). Third year students were more likely to use rubber dams in anterior teeth (Mean=3.52) whereas fourth year students use rubber dam in posterior teeth (Mean=3.74). Lack of motivation was found to be the significant barrier influencing rubber dam usage (odds ratio (OR)=12.1; 3.74, p<0.05). Conclusion: The satisfaction with training differed among the students of different years. The rubber dam technique might be used more frequently if it were made clear to students that mastering it would be necessary for them to receive good grades.

Introduction: Informed consent is a legal process intended to protect patients' rights and ensure ethical medical practice. The aim of this cross-sectional study was to assess dentists' practice of obtaining informed consent and adherence to the recommended guidelines, and to investigate the types of consent, barriers, the process, and the quality of the information included in preoperative informed consent for endodontic treatment in Saudi Arabia. Methods: A validated self-administered online questionnaire was developed and distributed to dentists performing endodontic treatment in Saudi Arabia. Data were collected using a snowball sampling technique for three months (May to July). Results: Of the 452 participants included in the study, 79.4% (n = 359) obtained informed consent, and 63.5% of them followed the recommended guidelines. Dentists with over 10 years of experience used informed consent regularly (p < .005). The main barrier to obtaining informed consent was the lack of a standardized format (28.5%). Furthermore, only 36.3% of the participants obtained written informed consent. Most participants (75.4%, n = 341) reported that they discuss and disclose information about the treatment to patients themselves. Less than 5% of participants include all listed criteria in their consent process. Conclusion: Although obtaining informed consent prior to endodontic treatment was a broadly adopted process among the participants, their practice appears to be inadequate. Issues such as the type and quality of informed consent need to be improved through educational and awareness programs and strict implementation by responsible authorities.