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   Table of Contents - Current issue
May-August 2022
Volume 9 | Issue 2
Page Nos. 79-144

Online since Wednesday, August 31, 2022

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Health sector transformation program 2030 in Saudi Arabia and implications in dentistry p. 79
Cristalle Soman
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Potential influence of COVID-19 on periodontal and peri-implant health – A review of literature p. 81
Rakan S Shaheen, Layan S Alolayan, Rayan J Al-Otaibi, Khalid M Abu Nakha, Abdulrahman K Alhazmi, Meelaf S Alshahrani, Kholood K Al-Huthali
Introduction: Coronavirus disease of 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) which manifests with severe respiratory symptoms. The plaque biofilm was shown to harbor SARS-CoV-2 virus and that it could be transmitted via droplets. It has been hypothesized that COVID-19 could have an influence on periodontal and peri-implant health. Aim: This review was done to theoretically study the literature for reports that link COVID-19 to periodontal and peri-implant health. Materials and Methods: The review was done on articles published on the Medline and Saudi Digital Library databases, and included case reports, original papers, reviews, and any other reports that link COVID-19 to periodontal and peri-implant health. Results and Discussion: Commonly shared by COVID-19 and periodontal/peri-implant inflammation, is the increase in the pro-inflammatory mediators such as cytokines, which contribute toward exacerbating the immunological response and elevating the severity of the conditions. Furthermore, the reduced immunity due to COVID-19 can allow the periodontal/peri-implant pathogens to flourish and grow, especially when associated with poor oral hygiene owing to fatigue or bed confinement, and the negligence of maintaining routine periodontal visits due to fear of contracting COVID-19. Nevertheless, no direct cause-and-effect relationship between the SARS-CoV-2 virus and periodontal/peri-implant conditions has been ascertained, which warrants the need for further clinical studies on this topic to achieve a better understanding of it. Conclusion: There is no direct cause-and-effect relationship between the SARS-CoV-2 virus and periodontal diseases, but the similarity of the pro-inflammatory expressions in both diseases poses an indirect risk on periodontal health.
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Challenges and opportunities for oral health care professionals in COVID-19 pandemic p. 87
Amit Tirth, Naved Alam, TL Ravishankar, Vaibhav Tandon
Introduction: The World Health Organization announced a pandemic crisis when the virus was isolated in all of its worldwide regions. Being highly transmissible, this novel coronavirus disease-2019, also known as COVID-19, has spread fast all over the world. The outbreak was declared a Public Health Emergency of International Concern. Human-to-human transmission happens mainly through the respiratory tract of droplets and close contact transmission. Dental practitioners are at higher risk of transmission as severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has the potential to spread through droplets and aerosols from infected individuals in dental clinics and hospitals. Aim: The aim of the study is to highlight the potential sources of COVID-19 infection in oral health-care services. Materials and Methods: An electronic search was made of the PubMed (MEDLINE), ScienceDirect, and Google Scholar databases. Articles were identified by the searches which were checked based on title first, then by abstract or keywords with “COVID-19,” “SARS-CoV-2,” “Dentist,” and “health-care workers,” for articles involving studies and review articles published in English language only and relevant to the objectives of our review article. Results and Discussion: The majority of the emergency cases required endodontic treatment during the COVID-19 pandemic. Atraumatic restorative treatment and interim therapeutic restoration are alternative approaches to prevent infectious aerosol during dental procedures in dental, community, or hospital settings. Conclusion: Oral healthcare professionals are at higher risk of contracting COVID-19 infection. Risk of COVID-19 can be reduced by appropriate techniques and practice in dental settings.
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Active learning by means of team-based versus traditional learning methods in undergraduate dental students: A cross-sectional pilot study p. 92
Md Zahid Hossain, Saeed Ali Alsareii, Khaled Mashoor Hyderah, M M Iqbal Hossain, Abdulrahman Aseri, Siraz D. A. A. Khan
Introduction: Team-based learning (TBL) is gaining popularity because it allows students to achieve desired intellectual tasks through teamwork, discussion, and professionalism, in contrast to traditional (Trad) learning, which fails to keep the students' continued attention throughout the teaching session, resulting in low grades and retention rates. Aims: Comparing the outcomes between TBL and Trad learning sessions. Materials and Methods: A cross-sectional pilot study was carried out. Seventy-two undergraduate dental students were grouped as TBL and Trad. Each group consisted of 36 students and was made up of good, average, and below-average achievers based on their most recent exam results. The control group (Trad) received lecture-based teaching on a topic, while the case group (TBL) received discussion-based teaching on the same topic using the TBL approach. Allocated time slot for each method was equal. Following the completion of the teaching, a test was taken in the same session, consisting of 20 well-constructed multiple-choice questions (MCQs). The outcomes of the MCQ tests were subjected to item analysis. Chi-squared test was used to compare test parameters between the control and case groups using SPSS (v. 23). Results and Discussion: Overall, the TBL groups yielded significantly higher (58.33%) learning outcomes than the Trad groups (44.4%) (P = 0.01). In general, the TBL approach showed highly significant performance results (P = 0.000) compared to Trad approach. The Cronbach's alpha for TBL and trad learning was 0.967 and 0.949, respectively, indicating an excellent reliability of our findings. Conclusion: TBL approach has a potential to improve learning outcome by increasing knowledge and encouraging self-directed learning.
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Assessment of oral health problems, dietary, and lifestyle changes among pediatric dental patients during the COVID 19 pandemic – A cross sectional pilot study p. 99
Padma Yangdol, Namita Kalra, Rishi Tyagi, Amit Khatri, Drishti Kaushal, Puja Sabherwal
Introduction: The COVID-19 pandemic has affected the routine lives of people worldwide because of lockdowns/restrictions. Children have been largely confined to home due to the suspension of schools, which may lead to potential behavioral changes. Routine dental services have been nonfunctional, and oral health problems have been frequently neglected. Aims: The present study aimed to assess oral health problems, dietary, and lifestyle changes among pediatric dental patients during the COVID-19 pandemic. Materials and Methods: This is a cross-sectional study that employed a structured 38-item questionnaire through teledentistry to 121 children who previously visited the dental department of a tertiary hospital in Delhi. The Dental Problems and Treatment Needs (DPTN-COVID-19) Questionnaire and Dietary Habits Lifestyle Changes (DHLC-COVID19) Questionnaire, customized and validated for the study, were administered for the assessment of oral needs of children and how they were managed during the pandemic. We also evaluated their dietary/lifestyle changes. Results and Discussion: Participants were interviewed telephonically; as a general trend, oral health was observed to be significantly affected among children. A majority of the children (83.47%) suffered from toothache, 34.71% had tooth-related swelling, and 18.1% experienced dental trauma. More than half of the parents of the participants (54.5%) preferred the management of dental problems with self-medication. Oral hygiene of the children was affected primarily due to decreased brushing frequency during the COVID-19 pandemic (43.8%). A considerable proportion of parents (44.6%) believed that the COVID-19 infection could spread by dental treatment and perceived the dental environment to be more dangerous than other places. A significant number of parents (59.5%) observed the changes in their children's dietary habits, with a drastic reduction in the consumption of high-carbohydrate snacks in children during the COVID-19 pandemic. Many parents (67.8%) observed a change in their children's hunger and satiety levels during the COVID-19 lockdown, with decreased appetite in 38.8% of the children. Moreover, a significant increase in screen time and changes in sleeping patterns was also observed during the pandemic. Multivariate logistic regression analysis was found to be significant predictors for brushing frequency, carbohydrates intake, and lifestyle changes before and during COVID-19. It was a good fit as analyzed on Pearson goodness-of-fit Chi-square test. The likelihood ratio of during COVID-19 model was statistically significant. The model was able to explain variance in the outcome measure before and during COVID-19, respectively, as analyzed on Nagelkerke pseudo R2. Conclusion: In the present pandemic situation, amid the burden of increased biological and financial needs, oral health needs of children may have been neglected. This has been accompanied by associated dietary and lifestyle changes, leading to a vicious cycle demonstrating a need for appropriate strategies to address the issue.
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Oral cancer awareness and attitude toward its screening among health-care practitioners in Saudi Arabia p. 115
Hattan A Zaki, Rahaf S Almukhlifi, Somaya S Alrowaithi, Mahir A Mirah, Roqia Abdoh, Muhannad M Kaaki, Ismail Abdouh
Introduction: Oral cancer (OC) is a major health problem globally; it is the sixth-most common cancer worldwide, affecting anywhere in the oral cavity and associated with multiple risk factors, including the awareness and practices from medical and dental practitioners regarding OC. Aim: This study aims to explore the level of awareness of medical and dental practitioners regarding OC and attitude toward its screening in Saudi Arabia, Madinah. Materials and Methods: A cross-sectional study was conducted between December 2020 and March 2021 among medical and dental students, interns, and practitioners in Madinah. A total of 265 participants were included in the survey. Data were collected and statistically analyzed and the significance level was set at (P < 0.05). Results and Discussion: About 86.9% of the participants were belongs to the dental field, while 13.6% were from the medical field. Half of the respondents (50.2%) were not sure if they feel confident regarding their knowledge concerning the prevention and detection of OC. About 53.8% indicated that they usually do not perform OC screening. However, 88.7% of the respondents are willing to know more information about OC. Dental practitioners were significantly feeling more confident in their knowledge concerning the prevention and detection of OC (P = 0.001). However, a higher number of medical practitioners (44.4%) indicated that they were poorly informed about OC clinical appearances (P = 0.001). Conclusion: This study highlighted the importance of improving knowledge and awareness of medical and dental practitioners regarding OC in Madinah Western Saudi Arabia. Current results demonstrate that medical and dental practitioners should be encouraged to take an active role in raising awareness about OC, its signs and symptoms and the associated risk factors; hence, this can aid in the early detection of OC among relevant population.
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Hearing impairment in patients with oral submucous fibrosis: Our experiences p. 122
Santosh Kumar Swain, Somadatta Das
Introduction: Oral submucous fibrosis (OSMF) is a premalignant condition of the oral cavity. The pathological changes in OSMF often affect mucosa, submucosa, and underlying muscles in the oral cavity and pharynx. The pathological changes of the tubal and para-tubal muscles can affect the function of the Eustachian tube. The Eustachian tube dysfunction in OSMF often may result in hearing impairment. Aim: This study aims to evaluate the effect of OSMF on Eustachian tube function resulting in hearing impairment. Materials and Methods: This prospective study was carried out at a tertiary care teaching hospital of Eastern India from June 2019 to July 2021. There were 68 patients with OSMF enrolled in this study by simple random sampling. In this study, 68 patients (136 ears) suffering from OSMF with hearing impairment or fullness/blockage feeling in the ear who participated in this study. The clinical profile of these patients was worked out by taking a detailed history and clinical examination. All the patients underwent audiological evaluation with pure-tone audiometry and tympanometry. Results and Discussion: Out of 68 patients, 42 (61.76%) were male and 26 (38.23%) were female with a male-to-female ratio of 1.61:1. The age ranges of the patients who participated in this study were between 18 years and 65 years. Pure-tone audiometry showed normal hearing in 86 (63.24%) ears, mild conductive hearing loss in 31 (22.79%) ears, moderate conductive hearing loss in 14 (10.29%) ears, and sensorineural hearing loss in 5 (3.68%) ears. Conclusion: The Eustachian tube may be blocked by the effect of the OSMF and result in hearing loss. Hence, while treating OSMF, hearing impairment in OSMF has to be kept in mind.
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Endodontic management of maxillary second molar with two separated palatal roots: A report of two cases p. 128
Abdulrahman Abdullah AlDhbaan, Omar Abdulaziz Aldhaban, Abdullah Al-Hawwas
Awareness of root canal morphology and variations is a crucial factor in successful root canal therapy. The prevalence of two palatal roots in a maxillary second molar is very rare. This study aimed to describe a case report of root canals treatment of a maxillary second molar with two palatal roots. Careful digital radiograph also cone-beam computed tomography examination seems necessary for the detection of variations.
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Prosthetic rehabilitation of acquired maxillary defect secondary to mucormycosis with magnet-retained two-part prosthesis p. 131
Manu Rathee, Poonam Wakure, Sanju Malik, Sandeep Singh, Sujata Chahal, S Divakar
Mucormycosis has recently become more common in India, with COVID-19 patients being the most affected. Pulmonary, gastrointestinal, disseminated, or rhinocerebral infections have various forms of mucormycosis. The most prevalent type is rhinocerebral, which affects the maxilla, nose, sinuses, and brain. A total or partial maxillectomy has an impact on a patient's cosmetic, functional, and psychological well-being. To replace not only missing teeth but also lost soft tissues and bone, such as the hard palate and alveolar ridges, a maxillofacial prosthodontist must overcome numerous obstacles. For the rehabilitation of such deformities, prosthetic rehabilitation has become the preferred option. Magnets are an efficient technique to provide retention, quality, and consistency in a system. This clinical report describes the prosthetic rehabilitation of an acquired maxillary defect secondary to mucormycosis with a magnet-retained two-part prosthesis.
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Successful rehabilitation of a child patient with ankyloglossia using the diode laser of wavelength 808 nm and speech therapy p. 135
Mohammad Kamran Khan, Mahendra Kumar Jindal
Ankyloglossia is an abnormal congenital condition of the tongue characterized by abnormal attachment of lingual frenum or shorter lingual frenulum. Although various conventional surgical modalities and lasers for frenectomy has been described in literature, only few articles have been reported in the existing literature regarding the diode laser of 808 nm wavelength for frenectomy procedure in pediatric patient. Hence, the current article describes the clinical case report of successful and effective treatment of ankyloglossia using soft-tissue diode laser of 808 nm wavelength with minimally invasive dentistry approach in a 10-year-old male pediatric patient. In addition, the tongue-tie was clinically evaluated using the Hazelbaker Assessment Tool for Lingual Frenulum Function. Diode lasers can be used as a safe alternative surgical tool for managing tongue-tie with minimally invasive dentistry approach and also for alleviating the dental anxiety in pediatric patients.
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Brown's tumor of mandible as a manifestation of primary hyperparathyroidism: A case report and review of literature p. 141
Samia Seraj, Ashish Aggarwal, Nitin Upadhyay, Nupur Agarwal, Sowmya Gujjar Vishnurao, Ankit Singh Rathore
Hypercalcemia and increased or abnormal serum levels of parathyroid hormone are indicators of primary hyperparathyroidism (HPT). Brown tumor of bone is a rare nonneoplastic lesion that arises due to abnormal bone metabolism caused by HPT. The reported prevalence of brown tumor is 0.1%. In today's world, however, skeletal illness caused by primary HPT is quite rare. Patient consent was obtained. Here, we present a rare case of bony lytic lesion in the mandible that raised suspicion of giant cell lesion, compelling further investigations. The patient underwent blood investigations which revealed hypercalcemia. Ultrasonography revealed a hypoechoic mass on the left inferior thyroid lobe. An incisional biopsy was done which revealed hemorrhagic fibrovascular connective tissue in a background of multinucleated giant cells; the mandibular lesion was classified as a giant cell lesion. A final diagnosis of Brown tumor of the mandible was made based on the investigations. The left parathyroidectomy was done. Curettage of the mandibular lesion was done surgically. The patient was on follow-up for 6 months and showed no signs of recurrence. Although Brown tumor of mandible is a rare lesion, it should be considered a differential diagnosis for osteolytic lesions of the jaw. Early diagnosis can help to prevent late outcomes of the disease.
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