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An outbreak of novel coronavirus disease (COVID-19) in China has influenced every aspect of life. Healthcare professionals, especially dentists, are exposed to a higher risk of getting infected due to close contact with infected patients. The current study was conducted to assess anxiety and fear of getting infected among dentists while working during the current novel coronavirus diseases (COVID-19) outbreak. In addition, dentists’ knowledge about various practice modifications to combat COVID-19 has been evaluated. A cross-sectional study was conducted using an online survey from 10th to 17th March 2020. The well-constructed questionnaire was designed and registered at online website (Kwiksurveys) and validated. A total of 669 participants from 30 different countries across the world responded. After scrutiny, completed questionnaires (n = 650) were included in the study. Statistical analysis was performed using SPSS version 25. Chi-Square and Spearman correlation tests were applied to control confounders and assess the relation of dentists’ response with respect to gender and educational level. More than two-thirds of the general dental practitioners (78%) from 30 countries questioned were anxious and scared by the devastating effects of COVID-19. A large number of dentists (90%) were aware of recent changes in the treatment protocols. However, execution of amended treatment protocol was recorded as 61%. The majority of the dentists (76%) were working in the hospital setting out of which 74% were from private, and 20% were from government setups. Individually we received a large number of responses from Pakistan and Saudi Arabia, but collectively more than 50% of the responses were from other parts of the world. Despite having a high standard of knowledge and practice, dental practitioners around the globe are in a state of anxiety and fear while working in their respective fields due to the COVID-19 pandemic impact on humanity. A number of dental practices have either modified their services according to the recommended guidelines to emergency treatment only or closed down practices for an uncertain period.

This in vitro study aimed to examine the effects of popular Saudi Arabian beverages on tooth shade after home bleaching. A total of 60 extracted single-rooted teeth were used, of which 45 teeth were bleached using a 35% carbamide peroxide gel and an LED light. After bleaching, the teeth were immersed in three different beverages—Cola, Arabic Qahwa, and Black Coffee—for 14 days, while a control group of unbleached teeth ( n  = 15) was also exposed to the same beverages (5 teeth/ beverage). Tooth color changes were assessed using a spectrophotometer before and after immersion. Statistical analysis was conducted using Mann-Whitney and t-tests, with significance set at p  < 0.05. Results showed that after bleaching, the Cola group had a slightly higher mean E1 value compared to the control, but the difference was not statistically significant ( p  = 0.087). After 14 days of immersion, both the Cola and control groups exhibited increased changes in tooth shade, with no significant difference in ΔE values. In contrast, the Arabian Qahwa group showed significantly ( p  = 0.001) greater discoloration than the control group, indicating a stronger staining effect. For the Black Coffee group, the mean E2 value was 16.04 ± 2.97, while the control group had a higher mean of 19.2 ± 2.09, with a statistically significant difference ( p  = 0.044). The study concluded that beverages such as Cola, Arabic Qahwa, and Black Coffee can influence tooth shade over time. Black Coffee caused significant discoloration, whereas Cola showed statistically insignificant changes. However, Arabic Qahwa led to significant differences in ΔE values compared to the controls, indicating a notable effect on tooth shade.

Objectives: To evaluate the shade selection accuracy of male dental students according to the three dimensions of color: value, hue, and chroma, using visual and instrumental shade selection methods under different lighting conditions. Methods: This comparative cross-sectional study was instigated amongst 70 male 4th, 5th, and 6th years BDS students of the Dental Clinics Complex at King Faisal University, Saudi Arabia for a duration of two months. First, the principal investigator determined the shade of tooth 11 and 46 on patient utilizing the spectrophotometer after calibration. In the next step, students were asked to select the shade of same tooth 11 and 46 using VITA 3D-Master shade guide under clinic lightening condition and corrected light. The characteristics of the color such as hue, chroma and value were recorded. The Kruskal-Wallis test was applied to find the significant difference in shade selection between visual and instrumental methods with respect to academic years. Results: The mean of the value of instrumental shade selection of tooth # 46 was slightly higher among 4th year students (4.41±0.73), than that of 5th year (3.72±1.02), and 6th year students (3.83±0.83), with a statistically significant difference among them (p= 0.024), indicating 6th year students selected darker shades. Additionally, a statistically significant relationship was noticed among 4th, 5th, and 6th year students with respect to the means of the chroma of 2.18 ±1.29, 2.92±1.11, and 3.13±1.10, respectively (p= 0.025). Conclusion: The selection of posterior teeth shades was notably influenced by academic years, employing both instrumental and visual methods, while considering color parameters. doi: https://doi.org/10.12669/pjms.40.8.9491 How to cite this: Ahmed MA. Assessing the shade matching accuracy among dental students through visual and instrumental methods. Pak J Med Sci. 2024;40(8):---. doi: https://doi.org/10.12669/pjms.40.8.9491 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Objective: To compare the removal efficacy of propolis and calcium hydroxide medicaments from the root canal using manual irrigation with sodium hypochlorite. Methods: A randomized controlled trial was conducted at the Department of Restorative Dentistry and Endodontics, College of Dentistry, King Faisal University for two months. Thirty single-rooted upper or lower permanent anterior teeth with sound root and closed apex were selected. After cleaning and shaping of canal by protaper rotary, teeth were randomly divided into two groups. In group “A,” propolis paste was placed while calcium hydroxide was placed inside root canals in group “B,” followed by temporary restoration. After seven days, intracanal medicament was removed using 25 # K file and irrigated canal by 5 ml of 3.0% sodium hypochlorite. A final irrigation of 2-ml of 17% EDTA for three minutes followed by 1-ml of normal saline was performed. A diamond disc was used to cut the crowns of the teeth from cemento-enamel junction and divide the roots into two halves. These sectioned halves were then observed under a stereomicroscope at 7X magnification and analyzed using Adobe Photoshop. Magnetic lasso tool was used to calculate the percentage of residual medicament in the canals by comparing the pixel proportion of the medicament with the total pixel proportion of the canal. Paired t-test was used to see the difference in the number of remaining remnants between propolis and calcium hydroxide. A p-value of less than 0.5 was considered statistically significant. Results: A statistically significant difference (p-value < 0.001) was observed in the percentage of remaining remnants between propolis (23.22%) and calcium hydroxide (38.58%) after thorough irrigation with sodium hypochlorite. Conclusion: Propolis is superior to calcium hydroxide in terms of their removal potency from the root canal after thorough irrigation with sodium hypochlorite. doi: https://doi.org/10.12669/pjms.37.7.4241 How to cite this:Ahmed MA. Removal efficacy of propolis/calcium hydroxide medicaments from the root canal. Pak J Med Sci. 2021;37(7):---. doi: https://doi.org/10.12669/pjms.37.7.4241 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The selection of an accurate tooth shade has always been a challenging task for dental practitioners in restoring the natural appearance of teeth. Various factors can influence shade selection, such as different lighting conditions, clearness and opaqueness of teeth, eye fatigue, aging and color vision problems. It is imperative to have a sound knowledge about the concept of shades and its selection protocol for obtaining good esthetics outcomes. To attain the best esthetics, four elementary contributing factors are essential: exact position, shape, surface texture and shade. The current analysis focuses on several features of shade, sensitivity of shades, optical properties of the teeth, visual and innovative instrumental techniques for shade selection, protocols for shade selection and factors affecting dental shade selection.

Over the previous years of the 20th and 21st centuries, there has been a progression in the field of bonded esthetic restorations. At the present time, the inclination of dentists toward the smart monochromatic shade of composite is flourishing owing to the fact that it decreases the requirement of a range of composite shades, curtails the waste of unconsumed composite shades, lessens chair side interval, abolishes the shade selection, and decreases dependency on shade-selecting methods. Smart monochromatic composite is known to obtain the color of the adjacent tooth structure in which it is placed. Therefore, the current literature elucidates the several features of innovative and revolutionary monochromatic composites including color stability, mechanical and optical properties, and shade-matching capability that could have a positive impact potentially over other resin composites.

Introduction. Dental anxiety is a common occurrence in patients undergoing dental treatments, especially in children. The success in paedriatric dental treatments and patient comfort depends on controlling the level of patient’s anxiety in clinical settings. This study is aimed at evaluating the efficacy of different techniques applied for the reduction of dental anxiety in paediatric patients. Material and Methods. One hundred and sixty participants were divided into 4 groups; each group having 40 patients as follows: group I: mobile application “little lovely dentist,” group II: YouTube® “dental video songs,” group III “tell-show-do,” and group IV “control.” Dental prophylaxis treatments were provided to all the participants. Initial anxiety levels were noted during the patient’s education phase by measuring heart rate with pulse oximeter and distress level with facial image scale, at the same time in each group, respectively. The postoperative anxiety was noted later with the same methods, after the application of anxiety reduction techniques. The data obtained were entered in the statistical package for the social sciences software, version 25. One-way ANOVA and paired t-test for matched groups were used to compare mean values of the 4 groups, in this study to determine their effectiveness. A p value of ≤0.05 was considered as statistically significant. Results. The mean age of patients in group 1 was 6.8±2.1 years, group 2: 8.15±2.27 years, group 3: 7.5±2.3 years, and group 4: 7.27±1.68 years. The intragroup comparisons of heart rate and facial image scores have shown a significant difference in before and after dental treatment procedures. Marked reduction in heart rate and facial image scale scores were found in patients belonging to group 1 (mobile applications) and group 2 (dental video songs). An increase in heart rate and facial image scale scores was seen in group 3 (tell-show-do) and the control group. Conclusion. The paediatric dental anxiety is a common finding in dental clinics. Behavior modification techniques like smartphone applications, “little lovely dentist,” and “dental songs” can alleviate dental anxiety experienced by paediatric patients. The “tell-show-do” technique although most commonly used did not prove to be beneficial in the reduction of the anxiety levels.

Omnichroma is a smart monochromatic material and is believed to attain the shade of the surrounding tooth structure in which it is placed. However, the color stability of this material is unknown. Therefore, this study was conducted to evaluate the effect of different pH beverages on the color stability of the Omnichroma composite and its comparison with micro-hybrid composite resin. Sixty extracted human maxillary premolars of different shades, viz. A2, A3, B2 and B3, were selected in equal numbers. A Class V cavity was prepared on the buccal and palatal sides of each tooth. After the cavity preparation, etching of the cavity was performed with 35% phosphoric acid followed by bonding. The prepared cavities were then filled with Omnichroma composite resin on the buccal side and Filtek Z250 composite on the palatal side. The baseline color measurements of all tooth samples were performed by a spectrophotometer. The teeth were then divided into three groups, the Pepsi group, coffee group and milk tea group. Five teeth from each shade, viz. A2, A3, B2 and B3, were immersed in 10-mL of Pepsi, coffee, and milk tea for 14 days. After the completion of the 14 days, the teeth were rinsed and kept in distilled water for 24 h. Finally, a spectrophotometer was used to calculate the color alteration value ΔE. Mean difference in ΔE values of the samples before and after immersion in different beverages was calculated and analysed by SPSS 25. One-way ANOVA test was applied to compare groups. Further stratification was performed using the Post-Hoc Tukeys test. Samples immersed in milk tea showed a statistically significant difference (p < 0.05) in A2, A3, and B2 shades of the OM-milk tea group in comparison with the FT-milk tea group. In summary, the immersion of teeth in beverages with a different pH and colorants showed an apparent alteration in the color of both the smart monochromatic and micro-hybrid composites. Hence, the type of resin composite material should be selected wisely depending on the patient’s drinking and social habits.

Dental anxiety is one of the most common conditions present amongst the masses globally. It is this fear that makes individuals avoid seeking dental treatment which results in a deteriorated oral health-related quality of life (OHRQoL). Discrepancies exist in the prevalence of dental anxiety based on gender, education levels, level of deprivation of a society and its socioeconomic status. In this study, a sample size of 522 respondents was collected. Kuppuswamy’s socioeconomic status scale and modified dental anxiety scales were used to collect the necessary data. These data were analyzed by cross tabbing and chi-square test of significance was applied to assess the association between dental anxiety and other factors. Female gender was significantly associated with dental anxiety with p-value = 0.03. Higher education levels and dental anxiety also displayed significant associations with each other, with a p-value of 0.048. Seventy-six percent of the individuals of lower socioeconomic status were prone to be more dentally anxious. Dental anxiety was more significant in individuals with higher levels of education in our study. Respondents who were part of a lower socioeconomic class were also more prone to being anxious while receiving dental treatment. Knowing the factors that cause dental anxiety can help dentists effectively manage and treat their patients.

Objective This study evaluated the effects of sonic activation and graphene-functionalized methylene blue on the push-out bond strength of two endodontic sealers, AH Plus and Bio C, following Photodynamic therapy (PDT). Methods Sixty extracted single-rooted human teeth were divided into six groups ( n  = 10), treated with either 5% NaOCl (Groups 1 & 2), MB-based PDT (Groups 3 & 4), or MB-rGO-based PDT (Groups 5 & 6). In Groups 2, 4, and 6, sonic activation was applied prior to laser irradiation. Each group was further divided based on the sealer used: AH Plus or Bio-C. One mm-thick root slices from the coronal and middle thirds were subjected to push-out bond strength testing. Statistical analysis included one-way ANOVA, Tukey’s post-hoc, and independent t-tests. Results Group 6 (MB-rGO + Sonic Activation + PDT) showed the highest bond strength for both AH Plus (6.07 ± 0.99 MPa) and Bio-C (5.54 ± 0.76 MPa), while Group 3 (MB + PDT) showed the lowest. Significant differences were observed between groups for both sealers ( p  < 0.05). Sonic activation significantly enhanced bond strength in Bio-C Sealer ( p  = 0.026) but not in AH Plus ( p  = 0.124). AH Plus showed predominantly cohesive failures, whereas Bio-C exhibited more adhesive failures. Conclusion Sonic activation and graphene functionalization significantly enhanced the bond strength of both sealers, with the highest values in the MB-rGO with activation group. AH Plus showed superior adhesion, attributed to its chemical interaction with dentin collagen, while Bio-C Sealer benefited from hydroxyapatite bonding and improved mechanical retention. These findings suggest that optimizing photodynamic therapy with nanotechnology and activation techniques can improve the adhesion and clinical performance of endodontic sealers.