Knowledge, Attitude, and Practice of Teledentistry in Periodontal Diagnosis Among Dental Interns at a College in Sebha, Libya: A Cross-Sectional Questionnaire Study

Background Teledentistry, a subspecialty of telemedicine dedicated to dentistry, has shown promise in improving access to dental care, particularly in rural and isolated areas. It integrates digital and telecommunication technology with dentistry, allowing for the remote distance exchange of relevant clinical information and digital dental imaging for dental consultation and treatment planning. Periodontal disease diagnosis is crucial for effective treatment and prevention of irreversible loss of periodontal structures. Early identification of periodontal disease can be pivotal in preventing periodontal tissue destruction and tooth loss and improving the overall quality of patients' lives. Sebha is a city located in the Fezzan region of southwestern Libya. It is the capital of the Sabha District and the Sabha Governorate. The city is situated in the Libyan part of the Sahara desert and is known for its strategic location as a gateway to the Sahara desert. However, there is a lack of information on the use of teledentistry in Libya in general and the use of teleperiodontics, especially in periodontal diagnosis. Hence, the aim of this questionnaire study was to evaluate knowledge, attitudes, and practice of teledentistry among dental interns at Sebha, Libya. Materials and methods A paper-based questionnaire consisting of 28 close‑ended Likert scale questions, including sections assessing the knowledge, attitude, and practice of teledentistry and teleperiodontics, was administered to dental interns at the Faculty of Dentistry, Sebha University, Sebha, Libya. Results The study surveyed 42 dental interns of the Faculty of Sebha, Libya, in total, with an 82.35% response rate among them. The majority of participants (59.5%) felt that teledentistry is reliable in arriving at periodontal diagnosis. The majority of participants (64.3%%) also had acceptable levels of trust in teledentistry equipment. However, over 45% percent of dental practitioners voiced their worries about patient privacy. Most of the participants suggested using teledentistry in some form in their future practice. Conclusion Teledentistry and its branch teleperiodontics are recent developments and its penetration among dental healthcare workers, and their knowledge, attitude, and practice remain to be thoroughly understood. The changing trends in attitudes and practice as a consequence of changes in Internet and technological awareness and the effects of the pandemic warrant closer observation and study.

Awareness Levels About Specialty Services Offered by the Faculty of Dentistry in Sebha, Libya

BACKGROUND

Assessment of awareness levels about any hospital is critical to judge its current standings and plan for future development. Limited literature is available about dental health in Libya.

AIM

This study aimed to study the awareness and perception of the various specialty services offered by the Faculty of Dentistry (SDC), Sebha University for their quality and preference.

MATERIALS AND METHODS

It was a performance monitoring research, and the data was collected by interview using a standardized questionnaire. Non-probability judgmental sampling was used. The offered services included all specialties in dentistry and oral cancer screening. Information relating to the awareness and perception of SDC specialty services was collected with few agree/disagree questions from 450 subjects. Data was collected, tabulated, and analyzed with descriptive statistics using SPSS v23.0 (IBM, Armonk, NY, USA).

RESULTS

About 22.7% (n=102) were in the 45-54 years age group. Self-employed (n=108, 24%) and professional (n=108, 24%) were noted in occupation. Forty-eight (n=216) were graduates. Three hundred twenty-eight respondents (72.9%) were aware about the dental services. Four hundred twenty-eight respondents (95.1%) have visited SDC. Three hundred six respondents (68%) were satisfied, and 66 respondents (14.7%) were very much satisfied. Dental health checkups were predominantly known to the respondents (n=302, 67%). For all the other specialties, the awareness level was low.

CONCLUSION

The identification of weak areas is crucial for the future planning and development of oral health care rendered by SDC.

Identification, Evaluation, and Correction of Supracrestal Tissue Attachment (Previously Biologic Width) Violation: A Case Presentation With Literature Review

The supracrestal tissue attachment (SCTA) is the new terminology for biologic width. SCTA is defined as the physiologic dimension of a solitary functional unit composed of junctional epithelium and connective tissue attachment. Its preservation is critical for the well-being of periodontal health. SCTA has been widely studied and scientific literature is indicative of its significance during the placement of restoration, including prosthetic crowns. This should be taken care of in cases of anterior teeth within the smile zone, where dental crowns are regularly placed subgingivally for aesthetic reasons. In addition, any violation of SCTA while restoring the dentition will present as gingival inflammation and pain, consequently, leading to failure of the clinical procedure.

Furcation Involvement in Periodontal Disease: A Narrative Review

Furcation-involved teeth, commonly seen in dental practice, have a higher likelihood of needing extraction as the severity of periodontal furcation involvement increases. Studies consistently show that periodontitis in teeth with multiple roots significantly increases the risk of tooth loss, especially in the area where the furcation is involved. These furcation defects pose a major problem for dentists because of their location, accessibility issues, and the unpredictable healing process. The biggest hurdle in treating furcation defects is their irregular shape, which makes it hard to achieve complete debridement. While various treatments have been explored, non-surgical methods have not shown much success. This article comprehensively provides a review and discussion on the classification, assessment, and treatment options, including surgical and non-surgical management of furcation-involved molar teeth. Properly understanding the severity of the disease and its confounding factors and managing and treating the lesions appropriately have been shown to impart satisfactory survival rates for these teeth. Enhancing the understanding of managing these teeth can also lead to better outcomes for patients.

Sex determination using mandibular ramus flexure in South Indian population - A retrospective study

Sex determination or sex estimation from a single or fragment of bone is always difficult in the absence of other bones from the same individual. The current study was an attempt to estimate the sex of an individual from the posterior ramus of mandible or the mandibular ramus flexure. A retrospective study was conducted using orthopantomographs (OPGs) of 200 males and 200 females between the age group of 20 - 70 years. Each radiographic image was examined for the presence of a flexure or notching on the posterior border of the ramus in relation to occlusal plane as the method followed by Loth & Henneberg 1996.The study resulted in samples that were correctly classified as females 59.5% and males 57.5 %. The overall correct sex estimation was achieved in 58.5% of the cases. The predictive accuracy or assessment was higher for females compared to males. Consequently, the posterior ramus of mandible or mandibular ramus flexure can be considered as supplementary rather than a definitive means of sex determination. Hence, it is preferable to include as many parameters as possible to attain optimal accuracy.

Role of Resistin in Various Diseases with Special Emphasis on Periodontal and Periapical Inflammation - A Review

Resistin is a small adipocyte-specific secretory hormone molecule. It has been associated with a number of cellular and metabolic processes. It has also been essentially implicated to have a vital role in the interplay between insulin resistance, obesity, and type II diabetes. Numerous clinical studies have demonstrated an association between many pathological illnesses with elevated serum resistin levels. It has also been shown to affect and modulate various molecular processes such as atherosclerosis, cancer cell metabolism, and inflammation. Periodontitis is a widespread inflammatory disease affecting human beings. Periapical periodontitis is an inflammatory disease that manifests as a sequela of untreated dental caries. Therefore, in this article, we summarize the divergent physiological roles played by resistin and its association with the mechanism of various pathologies. Moreover, current scientific studies discussing its association and role in common dental pathologies, periodontitis, and apical periodontitis are reviewed.

The Antimicrobial Efficacy Against Selective Oral Microbes, Antioxidant Activity and Preliminary Phytochemical Screening of Zingiber officinale

Introduction

Ginger (Zingiber officinale) has been one of the most commonly consumed herbal medicines for a long time to treat several common diseases. Antibacterial activity, antioxidant properties and many bioactive compounds in ginger have been identified previously, which could be used as an alternative method to treat many infectious diseases.

Methods

The current study evaluates ginger’s biochemical profile using qualitative and quantitative analysis and its bioactive potentials using antioxidant and antimicrobial assays against Streptococcus mutans and selective oral microbes. HPLC analysis was performed for the quantitative analysis. DPPH and disc diffusion assays were used for antioxidant and antimicrobial activities. The antimicrobial activity was checked against Streptococcus mutans, Enterococcus faecalis, Staphylococcus spp., and Lactobacillus spp. All solvents were removed by rotary evaporation before testing the dried extracts.

Results

The observed IC₅₀ value showed that distilled water extract exhibited the highest antioxidant activity (43.9), followed by ethanol extract (52.4), and the lowest activity was observed in n-butanol extract (91.2) and n-hexane (90.6). Different plant extracts have shown significant antibacterial activity (p = 0.001) against each bacterium. The highest antibacterial activity against tested bacteria was observed in n-hexane, chloroform and ethanol extracts. In comparison, the ethyl acetate, n-butanol and water extracts showed low antibacterial activity.

Conclusion

This study emphasizes that Zingiber officinale (Z. officinale) against Gram-positive bacteria is an effective antimicrobial herb. Furthermore, it can be used as a potential natural source of antioxidants. Further studies on the toxicity analysis of ginger are recommended.

Root and Root Canal Configuration Characterization Using Microcomputed Tomography: A Systematic Review

This systematic review’s objective was to conduct a complete analysis of the literature on the root canal morphology using advanced micro-computed tomography. The electronic web databases PubMed, Scopus, and Cochrane were examined for research papers concerning the chosen keywords, evaluating the root canal morphology using Micro-CT, published up to 2021. The articles were searched using MeSH keywords and searched digitally on four specialty journal websites. DARE2 extended (Database of Attributes of Reviews of Effects) was used to assess bias risk. The information was gathered from 18 published studies that strictly met the criteria for inclusion. In the included studies, a total of 6696 samples were studied. The studies were conducted on either maxillary (n-2222) or mandibular teeth (n-3760), permanent anteriors (n-625), and Third molars (n-89). To scan samples, a Scanco Medical machine in was used in 10 studies, Bruker Micro-CT in 34, and seven other machines were utilized in the rest. Bruker Micro-CT software from Kontich, Belgium, VG-Studio Max 2.2 software from Volume Graphics, Heidelberg, Germany, was the most commonly used software. The minimum Voxel size (resolution) adopted in the included studies was 11.6 µm. However, 60 µm was the maximum. Most studies classified the root canal morphology using Vertucci’s classification system (n-16) and the four-digit system (n-6).

Knowledge of COVID-19 Infection Guidelines among the Dental Health Care Professionals of Jazan Region, Saudi Arabia

BACKGROUND

This study aimed to assess the knowledge about guidelines related to COVID-19 infection control procedures among dental health care professionals (DHCPs) in the Jazan region.

METHODS

A cross-sectional study involving DHCPs (dental students, interns, and dentists) of the Jazan region between January and March 2021. A questionnaire with 35 items was developed and circulated online among the DHCPs. The dimensionality of the questionnaire was assessed using exploratory factor analysis (EFA). The level of awareness (LOA) was compared across the genders, level of professional experience, and exposure to guidelines. Participants were considered to have high LOA when they responded to 26 or more items correctly.

RESULTS

A total of 363 DHCPs participated in the survey. The questionnaire was found to be valid and reliable. EFA revealed a distinct three-factor structure. Moreover, 61.2% of the respondents had high LOA related to COVID-19 infection prevention. Among those who had high LOA, dentists (65.5%) were relatively more than the students (62.5%) and interns (46.2%). Among the six guideline statements related explicitly to operative dentistry, more than 50% of the respondents were aware of 3 guideline statements, while less than 50% of the respondents were aware of the remaining statements.

CONCLUSIONS

Most DHCP had a high LOA for general COVID-19 infection prevention and control guidelines. Dentists, males, and those who read the guidelines had higher LOA than their counterparts.

Role of Pentraxin-3 in Periodontal Inflammation - A Comprehensive Review

Acute phase reactants like C-reactive protein (CRP), and pentraxin 3 (PTX3) are increased with inflammation and tissue injury. PTX3 is an acute phase protein and a member of the long pentraxin family. CRP is synthesized in the liver but PTX3 is generated locally at the inflammatory site. It is a fluid-phase pattern-recognition molecule that regulates antimicrobial immunity and inflammation by interfering with selectin-dependent neutrophil recruitment and regulating the complement cascade. Hence, PTX3 could be used as a potential biomarker to identify inflammatory response in both acute and chronic diseases. In this review, we discuss the role of PTX3 in periodontal inflammation.

Role of Serum Amyloid A Protein in Various Diseases with Special Reference to Periodontal and Periapical Inflammation- A Review

Serum Amyloid A (SAA) is an Acute-Phase Protein (APP) produced as an innate nonspecific response to any tissue damage. Hence, it plays a significant role in chronic inflammatory diseases. In particular, SAA levels increase dramatically in chronic periodontitis and chronic apical periodontitis. Recent studies suggest this role of SAA in the pathogenesis of various diseases, including chronic periodontitis and chronic apical periodontitis. Thus, the focus of this review is to sum up the current understanding of the role of SAA in health and disease and to elaborate on possible mechanisms by which SAA could play a role in the pathogenesis of chronic periodontitis and chronic apical periodontitis.

Accomplishments and challenges in tobacco control endeavors - Report from the Gulf Cooperation Council countries

Objectives

To review the tobacco governance and national responsibility for control, and existing countering measures to reduce the tobacco use among the Gulf Cooperation Council (GCC) member states.

Methods

We reviewed the data in regards to tobacco control efforts and difficulties encountered during implementation of the policies for all the GCC member states from the respective country profile in the WHO report on the global tobacco epidemic. Also, we utilized the measures outlined in the FCTC’s MPOWER package to not only assess the degree of national commitment, but also compare it against the level of significance that the legislatures give to this matter.

Results

We observed that there have been genuine advancements towards tobacco control in the GCC member states over the past few years. All the countries except Bahrain have national offices committed to tobacco control and 5 nations (excluding Oman) have dedicated support services for smoking cessation accessible to the general public. Similarly, majority of the member states have implemented a national-level ban on tobacco advertisement through national media cells as well as free dissemination of marketing material.

Conclusion

Application and implementation of measures outline in the MPOWER package, formulation and enforcement of sturdy laws on tobacco control, and development of infrastructure and trained workforce are fundamental to manage and reinforce tobacco control measures in the GCC region.

"Education level" responsible for inequities in oral practices among 15-34-year-old individuals in Jizan, Saudi Arabia

Background:

Education plays an important role and is a second major (non-medical dimensional) factor influencing the health status. Individuals demonstrate oral practices that impact the oral health positively or negatively. This study analyzes how self-reported oral practices are influenced by different educational levels among young adults in Jizan.

Materials and Methods:

The survey was conducted in four areas around University of Jizan. The survey subjects, aged between 15 and 34 years, completed the self-administered, structured questionnaire. Inter-group comparison was done using Chi-square test. Level of significance was fixed at P < 0.05.

Results:

Exactly 1597 subjects completed the survey. Of these, 644 (40.3%) had attained higher education, 884 (55.4%) had lower education, and 69 (4.3%) were illiterate. Statistical comparisons showed significant differences among the three groups with respect to the use of toothbrushes (χ² = 88.67, P < 0.001), use of interdental cleaning aids (χ² = 15.04, P < 0.001), siwak use (χ² = 16.31, P < 0.001), cigarette smoking (χ² = 14.28, P < 0.001), and khat chewing (χ² = 38.1, P < 0.001). Siwak use was more among those with low educational level and illiterates. Further, smoking and khat chewing were significantly more prevalent among illiterates.

Conclusion:

The subjects with low education and the illiterates exercise harmful oral practices. This study indicates that educational level is responsible for inequities in oral practices.

A study of lip print patterns among adults of Sebha city, Libya

Introduction:

Lip print patterns are individualistic and unique and can be used for identification of individuals.

Objectives:

The objective of this study was to find out the different types of lip patterns, know the most common one and to know whether it has any gender predilection among adults of Sebha city.

Materials and Methods:

A total of 104 adults aged 18-35 years participated in this study. Lip prints were recorded and analyzed for lip print patterns. Statistical analysis was carried out using the computer software Statistical Program for Social Sciences (SPSS) 17.0 (Chicago, Illinos, USA).

Results:

Type I lip print pattern was seen in 53.37% and 60.07% of lip quadrants in males and females, respectively. 27 (25.96%) subjects had same lip print pattern in all the four quadrants.

Conclusion:

Suzuki and Tsuchihashi's Type I lip print pattern was most common type of lip print pattern in the studied population, whereas Type I' was found to be the least common.

Association between mental well-being, depression, and periodontal attachment level among young adults of the postwar Sebha city, Libya: A pilot study

OBJECTIVES

The present study was aimed to investigate the association of mental well-being and depression with periodontal clinical attachment loss among young adults in postwar urban population of Sebha city, Libya.

MATERIALS AND METHODS

Mental well-being and depression were assessed using Arabic versions of World Health Organization (WHO) five well-being index and major depression inventory (ICD-10), respectively. Random sample of 149 subjects were studied. Degree of periodontal attachment was measured at six sites per tooth using a rigid manual periodontal probe.

RESULT AND CONCLUSION

A total of 59.11% of the studied samples had healthy mental well-being state, whereas 40.81% had poor mental well-being. The severity of depression was stronger in males than in females. In the present study mental well-being, depression, and all its categories did not have any significant effect on periodontal attachment loss. Further studies and health interventions can be planned based on this data.

Gingival pigmentation index proposal of a new index with a brief review of current indices

Cosmetic expectations have increased with time and current trends speak volumes about gingival esthetics and smile designing. Gingival pigmentation especially on the labial aspect of anterior teeth has become an important component of general esthetics. Various physiologic and pathologic factors cause gingival pigmentation. The existing indices do not deal with the etiology, extent and severity of gingival pigmentation. Hence, we propose a new classification and index for gingival pigmentation to assess the treatment needs for the patient.

Oral health in Libya: addressing the future challenges

Libya is a vast country situated in North Africa, having a relatively better functioning economy with a scanty population. This article is the first known attempt to review the current state of oral health care in Libya and to explore the present trends and future challenges. Libyan health system, oral health care, and human resources with the present status of dental education are reviewed comprehensively. A bibliographic study of oral health research and publications has been carried out. The results point toward a common indicator that oral health-related research is low. Strategies have to be developed to educate the medical and dental professionals, to update the current curriculum and enable the system to be competent in all aspects of oral health care management.

Periodontal status and its risk factors among young adults of the Sebha city (Libya)

BACKGROUND

The occurrence of periodontal diseases in humans has been a global problem. Certain risk factors affect the initiation, progression, and severity of periodontitis. The present study has been designed to assess the periodontal status in relation to risk factors such as age, gender, oral hygiene practices, and smoking among the young adults of the Sebha city in Libya.

MATERIALS AND METHODS

A cross-sectional study was carried out among 1,255 subjects aged between 18 years and 34 years. 1,006 (80.15%) subjects were females and 249 (19.84%) subjects were males. Data was generated by conducting interview and clinical examination. The periodontal status was assessed by using Community Periodontal Index of Community Periodontal Index of Treatment Needs. The Chi-square test and analysis of variance were used for statistical analysis at 5% level of significance.

RESULTS

A total of 89.08% reported the use of toothbrush and toothpaste for cleaning and 10.91% used other aids, such as finger and Siwak. Of the 1,255 subjects, 3.98% were current smokers (all males). Only 4.7% had healthy periodontium (CPI code 1), while majority of 44.30% were detected with calculus (CPI code 2). Nearly 40.63% had shallow pockets (CPI code 3), 6.29% had bleeding (CPI code 1), and 4.06% had deep pockets (CPI code 4). The overall mean CPI score was 2.33 (0.84). Age and gender showed a statistically significant difference with the CPI codes.

CONCLUSION

The result of this study provides baseline information for planning a preventive program. With preventive procedures being implemented at this young age, there is a possibility that the prevalence of periodontal disease will be lesser during adulthood.

Descriptive analysis of toothbrushing used as an aid for primary prevention: a population-based study in Sebha, Libya

This study aimed to assess toothbrushing behavior and descriptively analyze the effect of age and gender. Two thousand and six people from the city of Sebha, Libya, aged 1 to 64 years (mean age 26.9 ± 11.6 years, 1,463 females and 543 males) constituted the study sample. Data was collected using a self-administered questionnaire. Overall, 85.3% were using a toothbrush and toothpaste as a cleaning aid, whereas 6.3% never brushed their teeth. Only 36.1% brushed twice daily. Age and gender were significantly associated with use of a toothbrush and frequency of toothbrushing. This data serves as a baseline to implement a "preventive self-care instruction program."