Comparative Analysis of Manual Dexterity of Dental Students at Ajman University following One Academic Year of Preclinical Training Sessions: A Longitudinal Cohort Study

OBJECTIVES

 Dental students must complete two stages of training, namely, preclinical training on phantom head models and clinical training on actual patients to acquire the practical skills required by their Bachelor of Dental Surgery program.Our objectives are to evaluate the level of improvement of the manual skills obtained by third-year dental students after one full academic year of preclinical training courses using dexterity tests under direct and indirect vision and to compare the improvement among male and female dental students under the same conditions.

MATERIALS AND METHODS

 A total of 72 preclinical students participated in our cohort trial, each of whom was assigned a random identification number that was only known to the researchers. After the beginning of the academic year, the experiment was performed under identical conditions for both the O'Connor Tweezer Dexterity Test and the Purdue Pegboard Test. The examinations were conducted at two distinct times: T0 before phantom laboratory training (the beginning of preclinical sessions) and T1 after phantom laboratory training (9 months after T0).

STATISTICAL ANALYSIS

 Signed-rank test of Wilcoxon over two separate periods (T0 and T1), comparisons were made between the direct and indirect visual dexterity test scores. In addition, the Mann-Whitney U test was used to compare results across gender. The statistical significance (p-value) was set at below 0.05 with a confidence level of 95%.

RESULTS

 A statistically significant difference was detected between the T0 and T1 assessments on the Purdue Pegboard Test and the O'Connor Tweezer Dexterity Test for all selected dentistry students in both direct and indirect conditions (p < 0.001).

CONCLUSION

 Further investigation in other dental departments or schools, particularly those with different entry standards, is required prior to making a definitive conclusion about the use of these dexterity assessments as predictors of prospective dental students' performance.

Novel Coronavirus (COVID-19) Knowledge, Attitude, and Practice among Dental Sciences and Internship Students in Ajman University, United Arab Emirates: A Cross-Sectional Study

Background

The aim of this study was to assess the COVID-19-related knowledge, attitudes, and practice among dental students (DS) and internship students at Ajman University (AU).

Methods

A cross-sectional, web-based study was conducted among Ajman dental college students registered in the academic year 2019/2020, about COVID-19 during the first week of April 2020. A questionnaire was developed and distributed to all DS to examine their knowledge and attitudes toward the COVID-19 pandemic. Chi-square (χ²) test was used to investigate the level of association among categorical variables at the significance level of p < 0.05.

Results

Out of 769 students in the dental college, majority (75%) had adequate knowledge of COVID-19, but only 40.6% of the participants projected a positive attitude. A positive behavior was reported by an overwhelming 94.5% of the participants. Participants above 25 years of age had significantly higher (p < 0.001) adequate knowledge (88.2%), positive attitude (56.9%), and positive behavior (100%) compared to those below 25 years of age. Study participants reported social media (71.1%), government websites (63.7%), and family and friends (41.0%) as top three sources of information regarding COVID-19 related information.

Conclusion

The results of this study show that AU dental and internship students have adequate knowledge and positive attitude of the COVID-19 pandemic but the majority are not eager to adopt effective strategies to avoid the spread of COVID-19 (practice). Further education should be offered to encourage efficient infection management practices to protect students, faculty, and other university staff.

Effect of a Novel Betel Leaf Dentifrice on Commonly Seen Oral Hygiene Parameters-A Randomized Clinical Crossover Study

The use of herbal medicine in dentistry has grown exponentially over time. Currently, herbal medicine is considered an effective oral hygiene aid. The objective of the current study is to assess the anti-plaque efficiency and reduction of gingival bleeding of betel leaf and miswak (Salvadora persica) toothpaste. This randomized clinical cross-over pilot study enrolled 60 individuals with mild gingivitis. They were segregated into two groups by drawing lots. The study lasted 20 days and included a two-week washout period between miswak and betel leaf toothpaste. The gingival and plaque index were measured at specific time intervals during the research period. The results revealed that betel leaf and miswak herbal toothpaste significantly decreased plaque index. Nevertheless, betel leaf toothpaste caused a more significant reduction in gingival bleeding scores (p < 0.001) when compared to miswak (p = 0.007). No significant decrease in gingival and plaque index was seen when subjects were asked to return to their conventional chemical toothpaste. The current study concluded that betel leaf toothpaste displayed a more substantial decrease in gingival bleeding when compared to miswak toothpaste. Additionally, more studies should be done on the therapeutic benefits of betel leaf toothpaste.

Comparison of Surface Equivalent Dose in CBCT, Digital Panoramic and Intra-Oral X-Ray Generators Using InstadoseTM Device: An In-Vitro Study

Background:

Radiation protection in the dental examination is often overlooked because the doses delivered are negligible. However, the volume of dental radiological examinations will constitute almost 15% of all the radiological examinations carried out in the medical field.

Aim:

This study aims to evaluate and compare the surface equivalent dose on various target organs from various radiology devices on the RINN phantom, and the effect of numerous scanning protocols on said dose using dosimetry badge (Instadose).

Objectives:

The main objective is to study surface equivalent doses delivered in various critical organ regions in the facial region with the help of an Instadose device and to compare the doses delivered between 2D programs against 3D programs.

Materials and Methods:

RINN phantom was mounted on a dental chair for use against Planmeca ProMax 3D Classic and Planmeca intraoral ProX. Models. An Instadose badge was placed on various anatomical landmarks, and radiographic exposure protocols were applied to vary the parameters. The equivalent dose was calculated by connecting the dosimeter to a laptop and performing an instant reading output on the Instadose software.

Results:

The Thyroid showed a mean of 0.350, 0.0000, 0.0133, and 0.0000 in response to exposure by intraoral machine ProX, Panoramic, CBCT, and CBCT in ULD mode respectively. The dose absorbed by the left salivary glands was found to be significantly lower than the right salivary glands in panoramic exposures.

Conclusion:

It was revealed that a significant reduction in the dose when applying the Ultra-Low Dose protocol was noticed, and it reached up to 100% in the thyroid. It was also noted that there is no need for a thyroid collar in CBCT and Panoramic exposures. Maintaining the KVp at a constant and the exposure time as a variant caused a change in the dose equivalent received by the floor of the mouth and the right salivary gland.

Validity and reliability of new instruments for measuring patient satisfaction with removable dentures, Arabic Version

BACKGROUND

The psychometric properties of self-administered instruments for measuring patient satisfaction with removable dentures should be tested before inviting patients to express their opinions. This study aimed to evaluate the validity and reliability of new instruments in the Arabic language that measure patient satisfaction with all types of removable dentures.

METHODS

A three-step methodology was used to translate and test the instruments. In step one, the instruments were translated from tested German instruments to develop the pilot questionnaires. In step two, the face validity of the pilot questionnaires was tested through three rounds of interviews. There were 15, 13, and 15 participants per round, respectively. At the end of every round, the results of the interviews were discussed with an expert panel. The expert panel confirmed the form and the type of questionnaires' adjustments before a new round of interviews began. At the end of step two, the final form of the questionnaires was reached. In step three, 235 questionnaires were distributed to 133 participants to estimate the construct validity of the upper jaw and the lower jaw questionnaires. After one week, the participants were asked to complete the questionnaires again. A total of 102 questionnaires were returned and used to assess the instruments' reliability. Factor analysis was used to assess the construct validity. The intraclass correlation coefficient and Cronbach's alpha were used to estimate the reliability and suitability of the items in the indexes.

RESULTS

The result of step one was two pilot questionnaires. The pilot questionnaires were adjusted in step two. At the end of step two, the questionnaires proved to have good face validity. Factor analyses in step three revealed that only one factor could be retained. The one-factor model explained 60.95% and 63.06 of the total variance of the upper jaw and lower jaw questionnaires, respectively. The items in every questionnaire shared the same cluster and could be summed to form an upper jaw index and lower jaw index that reflected patient satisfaction with removable dentures. Cronbach's alpha values indicated excellent internal consistency and reliability for the upper jaw questionnaire (α = 0.91) and the lower jaw questionnaire (α = 0.92). Intraclass correlation coefficient values ranged from 0.72 to 0.95, which can be considered "moderate" to "excellent".

CONCLUSIONS

The Arabic version of questionnaires and indexes assessing patient satisfaction with upper and lower removable dentures are reliable and valid self-administered instruments.

The prevalence of novel periodontal pathogens and bacterial complexes in Stage II generalized periodontitis based on 16S rRNA next generation sequencing

Objective:

To define the subgingival microbial profile associated with Stage II generalized periodontitis using next-generation sequencing and to determine the relative abundance of novel periodontal pathogens and bacterial complexes.

Methodology:

Subgingival biofilm samples were collected from 80 subjects diagnosed with Stage II generalized periodontitis. Bacterial DNA was extracted, and 16S rRNA-based bacterial profiling via next-generation sequencing was carried out. The bacterial composition and diversity of microbial communities based on the age and sex of the patients were analyzed. The bacterial species were organized into groups: bacterial complexes (red, orange, purple, yellow, and green), novel periodontal pathogens, periodontal health-related species, and unclassified periodontal species. The results were analyzed and statistically evaluated.

Results:

The highest number of bacteria belonged to the phylum Bacteroidetes and Firmicutes. In terms of relative abundance, the orange complex represented 18.99%, novel bacterial species (Fretibacterium spp. and Saccharibacteria spp.) comprised 17.34%, periodontal health-related species accounted for 16.75% and unclassified periodontal species represented (Leptotrichia spp. and Selenomonas spp.) 15.61%. Novel periodontal pathogens had outweighed the periodontal disease-related red complex (5.3%). The one-sample z-test performed was statistically significant at p<0.05. The Beta diversity based on the unweighted UniFrac distance at the species level demonstrated a total variance of 15.77% based on age and 39.19% on sex, which was not statistically significant.

Conclusion:

The bacterial species corresponding to the disease-related orange complex and novel periodontal pathogens are predominant in Stage II generalized periodontitis.

Pathogen Reduction Technology: A Novel Possibility for Inactivation of Blood Products Used in Oral and Periodontal Surgeries

Emergency surgical treatment has been challenging and the risk of blood contamination has been high, which is a concern among the medical and dental fraternity. The risk outweighs the benefits in these unprecedented times if proper screening and inactivation of blood products are not performed. Pathogen reduction technologies incorporate various modalities for the inactivation of blood products mainly related to blood transfusion. Oral surgical procedures and periodontal surgeries use platelet-rich fibrin for various regenerative procedures that amplify the prognosis positively. The use of blood products for various treatments could result in contamination, a factor which should be significant attention. The objective of this study was to review the role of pathogen reduction technology in inactivating pathogens in blood products and its use in oral and periodontal surgical procedures. The literature presented in the study is from original studies from a period of 2000 to 2020 which was sourced from Medline, PubMed, and Cochrane central databases. Relevant published papers and in-press papers that provided information were identified and selected. The studies presented have shown data related to implementation of pathogen reduction technologies in relation to the severe acute respiratory syndrome, Middle East respiratory syndrome, and its possible implementation in coronavirus disease-2019 (COVID-19). The paper reviews the various technologies offered and the possibility to eradicate pathogens found in routine blood products, used in oral and periodontal surgical procedures. In all probability, the use of pathogen reduction technology might offer a ray of light to contain the spread among dental treatment procedures.

Molecular Characterization of Staphylococcus aureus Isolates Associated with Nasal Colonization and Environmental Contamination in Academic Dental Clinics

Aim: To determine the genetic makeup of methicillin-sensitive/methicillin-resistant Staphylococcus aureus (MSSA/MRSA) from nasal colonization and environmental contamination in dental clinics. Materials and Methods: Nasal swabs from students and health care workers and environmental swabs were obtained at two academic dental clinics in the United Arab Emirates. The StaphyType DNA microarray-based assay was used for molecular characterization. Results: Forty-eight S. aureus isolates were identified phenotypically (nasal: n = 43; environmental: n = 5), but 6 of these were assigned to S. argenteus by genotyping. These were CC_(argenteus)2596, CC_(arg)2250-MSSA, CC_(arg)2250-MSSA-(Panton Valentine leukocidin [PVL]+) (n = 2), and CC_(arg)2198-MSSA (n = 2). MRSA nasal colonization rate was 5.4% (n/N = 8/146) with the following strain affiliations: CC5-MRSA-[IV+fus+ccrAB], "Maltese Clone"; CC6-MRSA-IV, "WA MRSA-51"; CC22-MRSA-IV (PVL+/tst+); CC22-MRSA-[IV+fus+ccrAA/(C)]; and two each of CC5-MRSA-[VI+fus] and CC97-MRSA-[V/VT+fus]. The SCC-borne fusidic acid resistance (fusC) gene was detected in MRSA (n = 5) and MSSA (n = 1). Some MSSA strains, CC1-MSSA-[fus+ccrAB1] and ST1278-MSSA-[ccrA1], harbored recombinase genes. A CC30-MSSA harbored ACME locus/arc-genes, while ST1278-MSSA-[ccrA1] had an ACME-III element. Enterotoxin genes were commonly carried, but tst-1 gene was found in only CC22, CC30, and CC34 strains, while pvl genes were identified in CC_(arg)2250 and CC22-MRSA-IV. Of the 51 noncoagulase staphylococci (CoNS) identified, 18 were mecA positive. Conclusion: The findings demonstrate the first report of rare strains (ST1278 MSSA, CC_(arg)2198, CC_(arg)2596, and PVL+CC_(arg)2250) in our region. Detection of MSSA with recombinase genes and ACME loci alongside mecA-positive CoNS is of clinical significance as this could provide a milieu for acquisition and transfer of SCC-elements, either with different ACME types, with fusC or the mecA gene resulting in conversion of MSSA into MRSA.

Estimation of fluoride concentration in drinking water and common beverages in United Arab Emirates (UAE)

Objective

To assess fluoride concentration in drinking water which include tap water of 4 emirates - Abu Dhabi, Dubai, Sharjah and Ajman plus bottled water, commonly available soft drinks & juices in United Arab Emirates.

Methods

Five different samples of tap water collected from each of the four emirates of UAE: Ajman, Sharjah, Abu Dhabi and Dubai; twenty-two brands of bottled water and fifteen brands of popular cold beverages, purchased from different supermarkets in U.A.E were tested using ion selective electrode method and the fluoride concentration was determined.

Results

The mean fluoride content of tap water samples was 0.14 mg F/L with a range of 0.04–0.3 mg F/L; with Ajman tap water samples showing the highest mean fluoride content of 0.3 mg F/L. The mean fluoride content for both bottled drinking water and beverages was 0.07 mg F/L with a range of 0.02–0.50 mg F/L and 0.04–0.1 mg F/L respectively. Majority (68.2%) of the bottled water are produced locally within U.A.E while a few (31.8%) are imported.

Conclusions

The tap water, bottled water and beverages available in U.A.E show varying concentrations of fluoride, however none showed the optimal level necessary to prevent dental caries. Dental professionals in U.A.E should be aware of the fluoride concentrations before prescribing fluoride supplements to children.