The Use and Reprocessing of Endodontic Files in Saudi Arabia: A Cross-Sectional Study

Objectives This study aimed to assess the awareness, implementation, and compliance with the infection control policy recommended by the Saudi Ministry of Health (MOH) for the use and reprocessing of endodontic files and to examine the association between compliance and gender, experience, clinical ranks, and workplace sector. Methods This was a cross-sectional study conducted using a validated self-administered electronic questionnaire created and distributed to dentists who perform endodontic treatment in Saudi Arabia. Data were collected between June and July 2023. Descriptive statistics were reported as counts and percentages. Comparisons among the demographic groups were done using the Kruskal-Wallis and Mann-Whitney tests. Results A total of 402 dentists completed the survey. The results showed that 76.1% (n=306) of respondents claimed that they were aware of the infection control policy recommended by the Saudi MOH for the use and reprocessing of endodontic files in dental clinics. Only 13.2% (n=53) of dentists used single-use endodontic files, and 36.6% (n=147) did not use an endodontic box in their dental clinics. The most commonly reported method of tracing the number of uses of endodontic files was to write the ID of the patient or the number of uses on the sterilization pouch as reported by 37.6% of participants (n=151). The average compliance score percentage was 63.5 ± 16.7. Most of the respondents showed moderate to high levels of compliance (51.7% (n=208) and 42.0% (n=169) of dentists, respectively). Dentists with less than 5 years of experience showed significantly less compliance than dentists with more than 10 years of experience (p = 0.005). Gender, clinical rank, and workplace sector were not significantly associated with the extent of adhering to the evaluated infection control policy. Conclusions Our findings indicate a relatively high level of compliance with the Saudi MOH policy of using and reprocessing endodontic files. However, critical measures such as the single-use of endodontic files, sterilizing new endodontic files, and using the sterilized endodontic box for each patient need improvement. Hence, this study recommends enhancing awareness through continuous education and training.

Fracture Load of Mesio-Occluso-Distal Composite Restorations Performed with Different Reinforcement Techniques: An In Vitro Study

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 nanohybrid composite (Group III); polyethylene fibers called "Ribbond" placed on both axial walls and the floor of the cavity, and layered with a nanohybrid composite (Group IV); polyethylene fibers placed on both axial walls and the floor of the cavity, and layered with the ACTIVA BioACTIVE-Restorative and -Liner as a dentin substitute and nanohybrid composite (Group V); and polyethylene fibers placed on both axial walls and the floor of the cavity and layered with the everX posterior composite resin and nanohybrid composite (Group VI). All teeth were subjected to thermocycling to simulate the oral environment. The maximum load was measured using a universal testing machine.

RESULTS

The highest maximum load was exhibited by Group III with the everX posterior composite resin, followed by Group IV, Group VI, Group I, Group II, and Group V. A statistically significant difference was demonstrated between groups (p = 0.0023). When adjusting for multiple comparisons, there were statistical differences specific to comparisons between Group III versus I, Group III versus II, Group IV versus II, and Group V versus III.

CONCLUSIONS

Within the limitations of the current study, it can be concluded that a higher maximum load resistance can be achieved (statistically significant) when reinforcing nanohybrid composite resin MOD restorations with everX Posterior.

The Impact of Social Media Posts Concerning Esthetic Dentistry on Self-Esteem and Satisfaction Among Adults in Saudi Arabia

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 validity and reliability of the questionnaire, which was modified based on feedback, as well as the results of the reliability testing.

Results:

The analysis showed that the social media platforms on which information about or advertisements for esthetic dentistry are most commonly found were Snapchat (45.8%) and Instagram (44.5%). A statistically significant association was found between the sociodemographic data, including age (P=0.00), gender (P=0.000), occupation (P=0.001), monthly income (P=0.000), and the effect of the appearance of one’s smile on willingness to post personal photos on social media.

Conclusion:

The findings suggest that seeing esthetic dentistry addressed on social media sites influences social media users’ self-esteem and satisfaction. Social media platforms should be encouraged to properly discuss common concerns and available dental treatments.

Effect of grinding and polishing on roughness and strength of zirconia

STATEMENT OF PROBLEM

The clinical applications of high-translucency monolithic zirconia restorations have increased. Chairside and laboratory adjustments of these restorations are inevitable, which may lead to increased roughness and reduced strength. The influence of grinding and polishing on high-translucency zirconia has not been investigated.

PURPOSE

The purpose of this in vitro study was to compare the roughness averages (Ra) of ground and polished zirconia and investigate whether roughness influenced strength after aging.

MATERIAL AND METHODS

High-translucency zirconia disks were milled, sintered, and glazed according to the manufacturer's recommendations. Specimens were randomized to 4 equal groups. Group G received only grinding; groups GPB and GPK received grinding and polishing with different polishing systems; and group C was the (unground) control group. All specimens were subjected to hydrothermal aging in an autoclave at 134°C at 200 kPa for 3 hours. Roughness average was measured using a 3-dimensional (3D) optical interferometer at baseline (Ra1), after grinding and polishing (Ra2), and after aging (Ra3). A biaxial flexural strength test was performed at a rate of 0.5 mm/min. Statistical analyses were performed using commercial software (α=.05).

RESULTS

Group G showed a significantly higher mean value of Ra3 (1.96 ±0.32 μm) than polished and glazed groups (P<.001), which showed no statistically significant difference among them (GPB, 1.12 ±0.31 µm; GPK, 0.88 ±0.31 µm; C: 0.87 ±0.25 μm) (P>.05). Compared with baseline, the roughness of groups G and GPB increased significantly after surface treatments and after aging, whereas aging did not significantly influence the roughness of groups GPK or C. Group G showed the lowest mean value of biaxial flexural strength (879.01 ±157.99 MPa), and the highest value was achieved by group C (962.40 ±113.84 MPa); no statistically significant differences were found among groups (P>.05). Additionally, no significant correlation was detected between the Ra and flexural strength of zirconia.

CONCLUSIONS

Grinding increased the roughness of zirconia restorations, whereas proper polishing resulted in smoothness comparable with glazed surfaces. The results provide no evidence that grinding and polishing affect the flexural strength of zirconia after aging.