Assessment of Knowledge, Attitude and Practice of Molar-Incisor Hypomineralisation among a Group of Egyptian Dentists (Observational Cross-Sectional Study)

Abstract: Introduction: Molar Incisor Hypomineralisation (MIH) is one of qualitative DED. MIH is increasing dramatically in the new generations, which is considered to be challenging for the majority of dentists. MIH was found to be prevalent in 14.2% of the world\u27s population, with the high incidence 18% in South America and the least (10.9%) in Africa. This study was carried out to assess the knowledge, attitude, and practice of graduated Egyptian dentists\u27 group regarding MIH condition and compare the outcome information among different dental specialists. Material and methods: A google based questionnaire based on previously validated published papers distributed electronically through different social media by direct message or public social media link. Eligibility criteria including Graduated Egyptian licensed dentists excluding students, interns and other medical specialties. Model answer prepared by researchers in 3 rounds based on most recent published papers. Results: 416 participants enrolled in this study with response rate reach to 16.7% for direct message and 1.4% for public share link. 79.1% of PDs, 45.8% of GPs and 45.0% of other specialties are familiar with both MIH condition and terminology. A prevalence of 10-20 % was notice by participants during their practice (21.9% PDs, 22.0% GPs and 22.2 other specialties). Most of participants believe that there is a lack of information regarding MIH between Egyptian dentists. The majority of the participant used Full coverage for posterior teeth and composite resin for anterior teeth as treatment choice. 53.1% of PDs are encountered MIH in monthly bases. Conclusion: MIH is a clinical problem that Egyptian dentists well recognize and frequently encounter in clinical practice. There is a need to include MIH in academic curriculum to increase the awareness regarding the condition and clinical management

Visual and radiographic caries detection:a tailored meta-analysis for two different settings, Egypt and Germany

Abstract\ud \ud Background\ud Diagnostic meta-analyses on caries detection methods should assist practitioners in their daily practice. However, conventional meta-analysis estimates may be inapplicable due to differences in test conduct, applied thresholds and assessed population between settings. Our aim was to demonstrate the impact of tailored meta-analysis of visual and radiographic caries detection to different settings using setting-specific routine data.\ud \ud \ud Methods\ud Published systematic reviews and meta-analyses on the accuracy of visual and radiographic caries detection were used. In two settings (a private practice in Germany and a public health clinic in Egypt), routine data of a total of 100 (n = 50/practice) consecutive 12–14 year-olds were collected. Test-positive rates of visual and radiographic detection for initial and advanced carious lesions on occlusal or proximal surfaces of molars were used to tailor meta-analyses. If prevalence data were available, these were also used for tailoring.\ud \ud \ud Results\ud From the original reviews, 210 and 100 heterogeneous studies on visual and radiographic caries detection were included in our meta-analyses. For radiographic detection, sensitivity and specificity estimates derived from conventional and tailored meta-analysis were similar. For visual detection of advanced occlusal carious lesions, the conventional meta-analysis yielded a sensitivity and specificity (95% CI) of 64.6% (57–71) and 90.9% (88–93), whereas the tailored estimates for Egypt were 75.1% (70–81) and 84.9% (82–89), respectively, and 43.7% (37–51) and 96.5% (95–97) for Germany, respectively.\ud \ud \ud Conclusion\ud Conventional test accuracy meta-analyses may yield aggregate estimates which are inapplicable to specific settings. Routine data may be used to produce a meta-analysis estimate which is tailored to the setting and thereby improving its applicability.BHW is in receipt of an Medical Research Council Clinician Scientist’s award\ud (MR/N007999/1). The funding body had no role in the design of the study and\ud collection, analysis, and interpretation of data and in writing the manuscript

Effect of dental trauma management resources on dental practitioners' confidence and knowledge: A pilot cross-sectional study

Background/Aim: The knowledge of standardized care guidelines is critical to the confidence of practitioners in managing dental trauma. Therefore, the aim of this study was to assess the awareness, use and impact of the International Association of Dental Traumatology guidelines, and the online Dental Trauma Guide on general dental practitioners' self-reported confidence and knowledge in managing traumatic dental injuries in the primary and permanent dentitions. Materials and Methods: A cross-sectional, pre-piloted, 27-item self-administered questionnaire survey was distributed electronically to general dental practitioners' working within five member states of the Gulf Cooperation Council countries (Kingdom of Bahrain, Kingdom of Saudi Arabia, Kuwait, Oman, and Qatar) between September and December 2020. Data were collected and analysed using descriptive statistics and Wilcoxon Signed Rank test analysis for relevant comparisons. Results: A total of 294 respondents completed the survey, with the majority being from the Kingdom of Saudi Arabia (47.4%) and Qatar (27.3%). A lack of evidence-based knowledge in managing traumatic dental injuries was evident among more than half of the respondents. Respondents who were cognizant of the recent International Association of Dental Traumatology guidelines (2020) and those who use the Dental Trauma Guide routinely demonstrated a higher self-reported confidence level in managing both simple and complex primary dentition trauma, as well as simple traumatic dental injuries in the permanent dentition (p <.05). Conclusion: This survey highlights critical deficiencies in the knowledge of a large number of the respondents in the management of dental trauma which is likely to cause irreversible long-term patient effects.Open Access funding provided by the Qatar National Library

Use of the Hall technique by specialist paediatric dentists: a global perspective.

Background The Hall technique (HT) is popular with UK paediatric dentists (PDs). Global PDs perception/use of HT is unknown.Aim To investigate global PDs opinions/use of HT.Materials and methods A cross-sectional questionnaire of 26 questions was sent to specialist PDs across the globe.Results Responses of 709 PDs from six continents were obtained. The majority (n = 654, 92.32%) had heard about HT but only 50.6% (n = 358) used it, with wide country variations. Respectively, 37.5%, 31.5% and 31% were neutral, against or supportive of HT when they initially heard about it. Only 17% of HT users said it was always the treatment of choice for non-pulpal asymptomatic carious primary molars (NPACPMs), 62% would take a pre-operative radiograph, 65% would consider using high speed drills before HT, 63% would never consider HT under general anaesthesia, 56% would use HT under N2O sedation. Finally, in a clinical scenario of a NPACPM in a cooperative 6-year-old, 75% of PDs would choose conventional restorative methods over the HT.Conclusion The HT is recognised, but not used, by an outright majority of PDs across the globe. Identifiable barriers such as lack of training, perception as substandard dentistry and perceived lack of evidence reduced its use

Effect of Silver Diamine Fluoride on Micro-Tensile Bond Strength of Composite to Dentin on Primary and Permanent Teeth

Aim of the Study: The aim of the current study was to investigate the effect of silver diamine fluoride on micro-tensile bond strength of composite to dentin and on the bonding mechanism of dentin surface on primary and permanent teeth. Material and methods: This study included two groups: group 1 included twenty-four primary molars and group 2 included twenty-four premolars. Each group was further subdivided equally into sub-group A and sub-group B. Sub-groups A of each group were treated with a self-etch bonding system and 4-mm thick buildups of composite were placed with increments limited to 1 mm. Subgroups B of each group were treated with 38% SDF then treated with the same self-etch bonding system used in sub-group A and composite were placed. After storage in distilled water for 24 hours at 37℃, the restored specimens were sectioned occlusogingivally into serial slabs approximately 1.0 mm thick by a slow-speed water-cooled diamond saw. Each slab was sectioned into composite/tooth structure beams measuring approximately 1.0*1.0 mm in cross-section, the beams were affixed to the test block of a micro-tensile testing machine to record maximum tensile force before failure occurred. One slab from each sub-group was evaluated under a scanning electron microscope and microphotographs were obtained. Results: Results of the study showed non-significant reduction of micro-tensile bond strength in SDF-treated subgroups and showed significant reduction of micro-tensile bond strength in primary molars when compared to premolars. Microphotographs showed significant reduction in numbers and extend of resin tags into dentin surface in SDF-treated samples. Conclusions: 1) SDF has no effect on micro-tensile bond strength of composite to dentin. 2) Micro-tensile bond strength of composite to dentin of premolars is higher than primary molars. 3) SDF has a negative effect on resin tag formation. Key words: silver diamine fluoride, dental caries, micro-tensile bond strength, composite restoration

Atrasentan and renal events in patients with type 2 diabetes and chronic kidney disease (SONAR): a double-blind, randomised, placebo-controlled trial

Background: Short-term treatment for people with type 2 diabetes using a low dose of the selective endothelin A receptor antagonist atrasentan reduces albuminuria without causing significant sodium retention. We report the long-term effects of treatment with atrasentan on major renal outcomes. Methods: We did this double-blind, randomised, placebo-controlled trial at 689 sites in 41 countries. We enrolled adults aged 18–85 years with type 2 diabetes, estimated glomerular filtration rate (eGFR)25–75 mL/min per 1·73 m 2 of body surface area, and a urine albumin-to-creatinine ratio (UACR)of 300–5000 mg/g who had received maximum labelled or tolerated renin–angiotensin system inhibition for at least 4 weeks. Participants were given atrasentan 0·75 mg orally daily during an enrichment period before random group assignment. Those with a UACR decrease of at least 30% with no substantial fluid retention during the enrichment period (responders)were included in the double-blind treatment period. Responders were randomly assigned to receive either atrasentan 0·75 mg orally daily or placebo. All patients and investigators were masked to treatment assignment. The primary endpoint was a composite of doubling of serum creatinine (sustained for ≥30 days)or end-stage kidney disease (eGFR <15 mL/min per 1·73 m 2 sustained for ≥90 days, chronic dialysis for ≥90 days, kidney transplantation, or death from kidney failure)in the intention-to-treat population of all responders. Safety was assessed in all patients who received at least one dose of their assigned study treatment. The study is registered with ClinicalTrials.gov, number NCT01858532. Findings: Between May 17, 2013, and July 13, 2017, 11 087 patients were screened; 5117 entered the enrichment period, and 4711 completed the enrichment period. Of these, 2648 patients were responders and were randomly assigned to the atrasentan group (n=1325)or placebo group (n=1323). Median follow-up was 2·2 years (IQR 1·4–2·9). 79 (6·0%)of 1325 patients in the atrasentan group and 105 (7·9%)of 1323 in the placebo group had a primary composite renal endpoint event (hazard ratio [HR]0·65 [95% CI 0·49–0·88]; p=0·0047). Fluid retention and anaemia adverse events, which have been previously attributed to endothelin receptor antagonists, were more frequent in the atrasentan group than in the placebo group. Hospital admission for heart failure occurred in 47 (3·5%)of 1325 patients in the atrasentan group and 34 (2·6%)of 1323 patients in the placebo group (HR 1·33 [95% CI 0·85–2·07]; p=0·208). 58 (4·4%)patients in the atrasentan group and 52 (3·9%)in the placebo group died (HR 1·09 [95% CI 0·75–1·59]; p=0·65). Interpretation: Atrasentan reduced the risk of renal events in patients with diabetes and chronic kidney disease who were selected to optimise efficacy and safety. These data support a potential role for selective endothelin receptor antagonists in protecting renal function in patients with type 2 diabetes at high risk of developing end-stage kidney disease. Funding: AbbVie

Assessment of Diet Quality and its Potential Cariogenicity among School Children during School Days in Cairo Governorate: A Cross-sectional Study

Introduction: Dental Caries is the most chronic infectious disease of childhood, caused by frequent acid production from the metabolism of dietary carbohydrates. Dental caries has been increasing among children due to the unlimited consumption of sugary substances. Although, dental caries is more prevalent in school children. Dental decay caries was lower in schools with sugar restriction, compared with other schools without sugar restrictions .Aim of the study: The current study aims to assess the diet consumed by primary school children aged 9 to 12 years old during school days attending public and private schools, and reveal its potential cariogenicity. Subjects and methods: The study included 456 primary schoolchildren from public and private schools. The researcher selected the age group from 9 to 12 years. Children in the current study were from both gender girls and boys. The investigator divided the food into three categories rather than the normally adopted two. The first category, highly cariogenic food that are high in sucrose, and the second category non cariogenic food. The second category medium cariogenic food is comprised of food items listed by some authors as highly cariogenic but not recognized as such by all authors and the third category non cariogenic food. Results: The results showed, statistical significant difference was found between public and private schools in relation to the mean overall intake of highly cariogenic and medium cariogenic food, where the mean overall intake of highly cariogenic and medium cariogenic in public schools and among males was found unexpected higher than those of private with mean 1.4515 for the high cariogenic index and 1.3679 for the medium cariogenic index. Private school students are more likely to eat twice during school time then public schools, private schools 68.0%and public schools 51.2% almost half of the sample eat twice. The source of food differs significantly according to the school type. More than 40% of the public school students get their food from both the school itself and home. While, more than 55% of the private school students get their food from home. Conclusions: The highest cariogenic potentially food intake was at public schools. The highest frequency of intake of cariogenic potentially food was at private schools more than public schools which might make them at the end similarly affecting children tooth. Boys tend to eat more cariogenic food than girls. The source of cariogenic food in public schools was largely attributable to the canteens food and their home snacks while the source of cariogenic food in private schools was largely attributable to food brought from home. The public schools are delivering education programs regarding dental health in the education more than private schools. Even though public schools are proving awareness but the majority of students in public schools are not following the recommendations in their food selection .Lack of Nutrition plans in both type of schools. Lack of school policies limiting candies use as incentive in both type of schools and lack of monitoring of the canteens to ensure healthy food delivery in both type of school

Additional file 1: of Visual and radiographic caries detection: a tailored meta-analysis for two different settings, Egypt and Germany

All data used the in the meta-analysis, tabulated. (ZIP 105 kb

Protective Effects of Naringin&ndash;Dextrin Nanoformula against Chemically Induced Hepatocellular Carcinoma in Wistar Rats: Roles of Oxidative Stress, Inflammation, Cell Apoptosis, and Proliferation

Nanotechnology holds great promise for the development of treatments for deadly human diseases, such as hepatocellular carcinoma (HCC). In the current study, we compared the hepatoprotective effects of naringin&ndash;dextrin nanoparticles (NDNPs) against HCC in male Wistar rats with those of pure naringin and investigated the underlying cellular and molecular mechanisms. HCC was induced by intraperitoneal injection of diethylnitrosamine (DEN, 150 mg/kg body weight (b.w.) per week) for two weeks, followed by oral administration of 2-acetylaminofluorene (2AAF, 20 mg/kg b.w.) four times per week for three weeks. DEN/2AAF-administered rats were divided into three groups that respectively received 1% carboxymethyl cellulose (as vehicle), 10 mg/kg b.w. naringin, or 10 mg/kg b.w. NDNP every other day by oral gavage for 24 weeks. Both naringin and NDNP significantly attenuated the harmful effects of DEN on liver function. Both compounds also suppressed tumorigenesis as indicated by the reduced serum concentrations of liver tumor markers, and this antitumor effect was confirmed by histopathological evaluation. Additionally, naringin and NDNP prevented DEN-induced changes in hepatic oxidative stress and antioxidant activities. In addition, naringin and NDNP suppressed inflammation induced by DEN. Moreover, naringin and NDNP significantly reduced the hepatic expression of Bcl-2 and increased Bax, p53, and PDCD5 expressions. Naringin and NDNP also reduced expression of IQGAP1, IQGAP3, Ras signaling, and Ki-67 while increasing expression of IQGAP2. Notably, NDNP more effectively mitigated oxidative stress and inflammatory signaling than free naringin and demonstrated improved antitumor efficacy, suggesting that this nanoformulation improves bioavailability within nascent tumor sites