Research Articles

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Consumption frequency of ultra‐processed foods andbeverages among 6‐ to 36‐month‐olds in Kampala, Uganda
(John Wiley & Sons Ltd, 2025) Naidoo, Sudeshni; Mwesigwa, Catherine Lutalo
The nutrition transition in sub‐saharan africa has led to increased consumption of ultra‐processed foods in infancy, especially sweet foods. this has heightened the risk for nutrition‐related non‐communicable diseases, including dental caries and overweight/obesity, and promotes poor food choices later in life. the present study used a cross‐sectional design to investigate the consumption frequency of ultra‐processed foods and beverages among urban 6‐ to 36‐month‐olds attending four selected health facilities in kampala using a standardised questionnaire and 24‐h diet recall record. the primary outcome was the consumption of at least one ultra‐processed food or beverage (upfb) the previous day, and frequency of upfb consumption of the week before was the secondary outcome. four hundred and ten caregiver–child pairs were randomly recruited, 94% of caregivers being mothers with a mean age of 30.7 (±5.3) years. fifty‐nine per cent of mothers and 73% of fathers had attained a college education. the median age of children was 18 months and 51% were female. most children (57%) consumed at least one upfb the previous day. in the week before, 69% had consumed upfb frequently (4–7 days) which was significantly positively associated with maternal education (odds ratio [or] = 2.85, 95% confidence interval [ci]: 1.02–7.96, p = 0.045) and child's age ([or = 2.87, 95% ci: 1.62–5.08, p < 0.001], [or = 3.68, 95% ci: 1.88–7.20, p < 0.001]). in conclusion, the dietary habits of the surveyed ugandan population were unhealthy, characterised by the frequent consumption of upfb with added sugar. there is an urgent need to re‐enforce existing ugandan food regulation guidelines and policies and to build strong nutritional education programmes to enhance health‐promoting environments in early childhood.
A methodological assessment of randomization integrity in alteplase for acute ischemic stroke individual patient data meta-analyses
(Public Library of Science, 2025) Mickenautsch, Steffen; Garg, Ravi; Torrealba-Acosta, Gabriel
Objectives Little is known about the integrity of randomization for randomized controlled trials (RCT) included in alteplase for stroke meta-analyses. If the RCTs were not properly randomized, the results could not be accepted at face value. The objective was to assess the integrity of randomization in individual patient data (IPD) meta-analyses supporting alteplase for acute ischemic stroke. Methods We assessed randomization reporting, performed qualitative risk of bias assessments arising from the randomization process, and performed fixed effects meta-analyses of baseline variables for which zero heterogeneity is expected if all included RCTs have unbiased randomization. Fixed-effects meta-analyses of baseline age, weight, and National Institute of Health Stroke Scale (NIHSS) score were performed. If heterogeneity was present (I2 > 0%), trials were systematically removed, starting with the RCT with the largest t-statistic until the I2 value was 0%. Results The NINDS rt-PA Stroke Study had a high risk of bias, the ECASS-3 RCT had some concerns, and all other trials were graded as low risk according to the Cochrane Risk of Bias (ROB-2) tool. The NINDS rt-PA Stroke Study contributed to heterogeneity in age and weight meta-analyses, and the ECASS-3 RCT contributed to heterogeneity in the NIHSS score meta-analysis. Removal of suspect trials resulted in the expected I2 value of 0%. Conclusions: The NINDS rt-PA Stroke Study and ECASS-3 trials contributed to heterogeneity in fixed effects meta-analyses of baseline variables while there should have been none. These RCTs are likely a source of selection bias in IPD meta-analyses due to suspect randomization.
A comparison of conventional root canal sealers with ones that use green synthesized nanoparticles for antimicrobial activity: protocol for a systematic review
(JMIR Publications Inc., 2024) Mohamed, Abubaker; Ismail, Enas; Adam, Razia Z
Background: Root canal failure and secondary endodontic infection are frequent clinical scenarios in dentistry. The main microorganisms implicated in root canal therapy failure are persistent Enterococcus faecalis, Candida albicans, and Staphylococcus aureus. To combat the impact of disease resistance, scientists are concentrating on alternative antimicrobial root canal sealers. Nanomaterials are a recent development in endodontic materials that exhibit great antimicrobial properties, making them an ideal material choice for root canal sealers. Objective: This systematic review aims to compare the antimicrobial properties of conventional root canal sealers to those incorporating green synthesized nanoparticles between 2010 and 2024. Methods: A well-constructed protocol was established and registered with PROSPERO (CRD42021286373). Ethics approval was obtained from the Biomedical Research and Ethics Committee from the University of the Western Cape (UWC; BM22/1/4). PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) reporting guidelines were followed. The included criteria demonstrate the green synthesized nanoparticles studies where the nanoparticles (NPs) are incorporated in root canal sealers. MeSH (Medical Subject Headings) terms were used for the search strategy of the systematic electronic databases for articles published in English between 2010 and 2024. The selected databases included Scopus, PubMed, Web of Science, Science Direct, EBSCOhost, SpringerLink, and Wiley Online.
Determining the ability of senior dental students to detect interproximal caries using different radiographic techniques
(John Wiley and Sons Ltd, 2024) Abdalla, Muzan; Khan, Saadika B
Objective: To evaluate the diagnostic capability of 5th-year students using digital imaging, conventional bitewing (BW) radiographs, and printed film on paper to detect interproximal caries lesions. Methods: A cross-sectional study was conducted with senior dental students. Three different radiographs: digital, BW, and printed films on paper were used; thus, nine radiographs, each with a 2-min viewing time, were considered by students along with a questionnaire. A control group of specialists from Prosthodontics and Radiology had finalized the answers prior to conducting the study. The appropriate responses were divided into five categories: R0: Intact surface, R1: Radiolucency in the outer half of enamel, R2: Radiolucency in the inner half of enamel, R3: Radiolucency in the outer half of dentin, and R4: Radiolucency in the inner half of dentin. Students' responses were analyzed using a one-way analysis of variance (ANOVA) test and a t-test. Results: Ethics for the study was obtained from the institutional committee (Reg No: BM19/9/8). When compared with the control group using ANOVA testing, the results showed good detection accuracy with a success rate of 64 accuracy. There was a significant difference in the outcomes when detecting the presence of the caries lesion between the three diagnostic techniques (p >0.001). In detecting the size of the carious lesion, the students' ability was recorded as poor. The highest average for detecting the presence of the carious lesion was correspondent to the printed film on paper method.
Comparative Study of Callistemon citrinus (Bottlebrush) and Punica granatum (Pomegranate) Extracts for Sustainable Synthesis of Silver Nanoparticles and Their Oral Antimicrobial Efficacy
(MDPI, 2024) Ismail, Enas; Mohamed, Abubaker; Elzwawy, Amir
A comparative study was applied to investigate the potential of Callistemon citrinus (bottlebrush) flower extract (BBE) and Punica granatum (pomegranate) peel extracts (PPE) for the sustainable synthesis of the silver nanoparticles, Ag-BBE and Ag-PPE, respectively. The synthesis process of Ag NPs using the selected extracts was applied under optimized conditions. Hence, the effect of the selected plant’s type on the different characteristics of the synthesized green Ag NPs was investigated. The UV-Vis spectroscopy revealed the presence of the characteristic silver peaks at 419 and 433 nm of the Ag-BBE and Ag-PPE, respectively. The XRD spectra reported the fcc phase formation of Ag NPs. The TEM results highlighted the morphological features of the synthesized Ag NPs. with a size range of 20–70 nm, and with 10–30 nm for Ag-BBE and Ag-PPE, correspondingly. The Raman spectra revealed characteristic silver bands in the Ag-PPE and reflected some bands related to the natural extract in the Ag-BBE sample. The antimicrobial activity and statistical analysis investigation were conducted against four selected oral pathogens (Staphylococcus aureus (SA), Candida albicans (CA), Staphylococcus epidermidis (S. epi), and Enterococcus faecalis (EF)). Both tested extracts, BBE, and PPE, revealed potential effectivity as reducing and capping agents for Ag NP green synthesis. However, the synthesized NPs demonstrated different features, depending on the used extract, reflecting the influence of the plant’s biomolecules on the nanoparticles’ properties.
The use and ethics of dental photography and social media at an oral healthcare training centre in South Africa
(AOSIS (Pty) Ltd, 2024) Kimmie-Dhansay, Faheema; Potgieter, Nicoline; Mprah, Nanayaa
Background: The ethics surrounding the use and sharing of photographs on social media has come under the spotlight as the Protection of Personal Information Act (POPI Act) has come into play. Aim: The aim is to determine the use, ethical practice and sharing of dental photography on social media among qualified and undergraduate oral health practitioners at a dental school in South Africa. Methods: A cross-sectional study design was used on staff and students at the University of the Western Cape’s Dental Faculty in 2022. Chi-squared and Fisher’s exact tests were used to determine associations between the different graduation statuses and various demographic factors. Results: From the 80 undergraduate students and 46 qualified oral healthcare practitioners, the majority were aware that photography could be used in dentistry, and 87.3% (n = 110) took photographs of the dental treatments performed on their patients. Only 60.3% of the participants attended an ethical course that addressed issues with social media and digital photography. Almost 80% (n = 100) of the participants did not feel that they needed to mention all the social media platforms that they would use with their patients’ photographs before sharing. Conclusion: Dental photography is being used and sometimes shared on social media platforms by some students and staff at university level. Not all participants have attended an ethical course on clinical photography. Dental training needs to include an ethical course on dental photography and the use of sharing photographs on social media. Contribution: Good ethical practice regarding clinical photographs in all undergraduate and postgraduate curriculums, to eliminate any uncertainty.
Extension of the composite quality score (cqs) as an appraisal tool for prospective, controlled clinical therapy trials–A systematic review of meta-epidemiological evidence
(Public Library of Science, 2022) Mickenautsch, Steffen; Rupf, Stefan; Miletić, Ivana
To conduct a survey of current meta-epidemiological studies to identify additional trial design characteristics that may be associated with significant over- or underestimation of the treatment effect and to use such identified characteristics as a basis for the formulation of new CQS appraisal criteria. We retrieved eligible studies from two systematic reviews on this topic (latest search May 2015) and searched the databases PubMed and Embase for further studies from June 2015 –March 2022. All data were extracted by one author and verified by another. Sufficiently homogeneous estimates from single studies were pooled using random-effects meta-analysis. Trial design characteristics associated with statistically significant estimates from single datasets (which could not be pooled) and meta-analyses were used as a basis to formulate new or amend existing CQS criteria.
The role of traditional healers in tooth extractions in Lekie Division, Cameroon
(BMC, 2011) Agbor, Ashu M; Naidoo, Sudeshni; Mbia, Awono M
The extraction of the teeth by traditional healers in Cameroon is an established cultural practice in the central region of the Cameroon. Traditional healers (TH) use herbs and crude un-sterilized instruments and tools for the tooth extraction procedure. The present study investigates the knowledge and practices of traditional healers regarding tooth extraction and the management of its complications. A cross sectional design utilizing semi-structured questionnaires was used to collect the data from traditional healers and their patients.
A green synthesis of zinc oxide nanoparticles using Musa paradisiaca and Rooibos extracts
(Elsevier, 2022) Lyimo, G. V.; Ajayi, Rachel Fanelwa; Adam, R. Z.
This study describes the single pot synthesis of zinc oxide nanoparticles (ZnO NPs) using a mixture of Aspalathus linearis and Musa paradisiaca for use against the fungi Candida albicans. These nanoparticles are known to be one of the most multifunctional inorganic nanoparticles with effective antifungal and antibacterial activity. The synthesized ZnONPs were characterized by a peak at 290 nm in the UV–vis spectrum while HRSEM confirmed rod-shaped nanoparticles. The FTIR data clearly revealed that the extracts contained -OH functional groups whose role was capping agents during the nanoparticle synthesis. This study also found that the purity of the green synthesised ZnO NPs (GZnO NPs) was 94.4 %, 91.5 %, and 82.1 %, respectively, using XRD, HRTEM, and HRSEM-EDS. The antifungal activity of ZnONPs was tested against Candida albicans using the Kirby Bauer method. The maximum inhibition zone observed in the ZnO NPs against Candida albicans was confirmed to be 24 mm, a clear indication that the synthesized ZnO NPs have great potential to act as effective antifungal agents.
Nanobiotechnology in regenerative dental medicine
(Nanomaterials in Dental Medicine, 2023) Adeola, Henry A
Nanotechnology harnesses the phenomenal atomic and molecular behaviour of materials at a nanoscale size (1–100 nm) to provide solutions to a vast array of scientific applications. Although nanomaterials are commonly classified as carbon-based, organic-based, inorganic-based and composite-based, there are several other classification systems (based on chemical composition, shape, origin, dimensionality and crystallinity). The use of nanobiomaterials finds crucial use in all domains of regenerative tissue engineering, including cellular therapies (mostly stem cells), hybrid biomimetic organic–inorganic materials, as well as artificial/purely inorganic prosthetic devices. Although the field of regenerative nanomedicine has gained significant popularity, regenerative nanodentistry and its potential manifold applications in the era of precision medicine still needs to be promoted, to bring much desired advancement to the field of individualized/precision dentistry. Dental tissues like the rest of human tissues are made up of molecules, and the application of nanotechnology to molecular science will foster remarkable progress in regenerative nano-dental science problem management, leveraging molecular knowledge to improve and maintain “molecular-scale” dental health. Despite the invaluable promise of regenerative nanodentistry, ethicolegal, regulatory, privacy, metaphysical, equity, safety, social security and public acceptance issues, viz-a-viz its use, persists. Hence, this review focuses on discussing the current and potential applications of note in the field of nanobiotechnology in regenerative dental medicine.
Sexual dimorphism in odontometric parameters using cone beam CT: A systematic review
(BMC, 2023) Ajmal, M. A.; Roberts, Tina Sharon; Beshtawi, Khaled R.
To determine whether odontometric parameters using cone beam computed tomography (CBCT) would aid in sex estimation by assessing sexual dimorphism of odontometric parameters. The focused question was whether there is sexual dimorphism in linear and volumetric odontometric parameters when assessed using CBCT. The preferred reporting items for systematic reviews and metaanalysis (PRISMA) guidelines were followed to conduct a systematic search until June 2022 in all major databases. Data were extracted regarding the population, size of the sample, age range, teeth analyzed, linear or volumetric measurements, accuracy, and conclusion. The quality of included studies was assessed using (Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool.
Prevalence of dental caries and associated risk factors among people living with HIV/AIDS and HIV uninfected adults at an HIV clinic in Kigali, Rwanda
(Public Library of Science, 2023) Murererehe, Julienne; Malele-Kolisa, Yolanda; Yengopal, Veerasamy
Dental caries is among the most frequent oral conditions in People Living with HIV/AIDS (PLWHA). There is a lack of baseline information on dental caries prevalence and associated risk factors among PLWHA in comparison to HIV uninfected people in Rwanda. This study was conducted to determine the prevalence of dental caries and associated risk factors among PLWHA and HIV uninfected adults at an HIV clinic of Kigali Teaching Hospital (CHUK) in Kigali, Rwanda.
Evaluation of innovative polyvinyl alcohol/ alginate/ green palladium nanoparticles composite scaffolds: Effect on differentiated human dental pulp stem cells into osteoblasts
(Journal of the Mechanical Behavior of Biomedical Materials, 2023) Ismail, Enas; Mabrouk, Mostafa; Salem, Zeinab. A; AbuBakr, Nermeen; Beherei, Hanan
Three-dimensional (3D) scaffolds are attracting great concern for bone tissue engineering applications. However, selecting an appropriate material with optimal physical, chemical, and mechanical properties is considered a great challenge. The green synthesis approach is essential to avoid the production of harmful by-products through textured construction, sustainable, and eco-friendly procedures. This work aimed at the implementation of natural green synthesized metallic nanoparticles for the development of composite scaffolds for dental applications
Attrition of dental therapists in South Africa—A 42-year review
(John Wiley & Sons, Ltd, 2022) Yengopal, Veerasamy; Sodo, Pumla Pamella; Jewett, Sar
Introduction: Dental therapists are mid-level oral healthcare providers introduced in 1977 to the South African health system to improve access to oral health services. There has, however, been anecdotal evidence of their unusually high rate of attrition that is cause for concern. Aim and Objectives: This study aimed to determine the demographic profile and attrition rate among members of the South African Dental Therapy profession. Methods: A retrospective time series review of records of all dental therapists who were previously registered and who are still registered with the Health Professions Council of South Africa (HPCSA) between 1977 and 2019 was conducted. Results: A total of 1232 dental therapists were registered from 1977 to 2019. The majority (64%) were Africans. Most practicing dental therapists were based in KwaZuluNatal (44%) and Gauteng (27%), which are the provinces where dental therapists are trained. The overall attrition rate between 1977 and 2019 was 40%, with a figure of 9% for the last 10 years of the study (2010 to 2019). Conclusion: This study has provided the first evidence of the high attrition rate of dental therapists in South Africa. The high attrition warrants further investigation to address the loss of valuable human resources from an already overburdened and under-resourced public oral health sector
Antimicrobial effects of gum Arabic-silver nanoparticles against oral pathogens
(Hindawi, 2022) Ahmed, Omnia; Sibuyi, Nicole R. S.; Fadaka, Adewale O.
Dental caries is considered one of the most prevalent oral diseases worldwide, with a high rate of morbidity among populations. It is a chronic infectious disease with a multifactorial etiology that leads to the destruction of the dental tissues. Due to their antimicrobial, anti-inflammatory, antifungal, and antioxidant properties; silver nanoparticles (AgNPs) are incorporated in dental products to help prevent infectious oral diseases. In this study, the antimicrobial efects of AgNPs synthesized using Gum Arabic extracts (GAE) were examined. Te GA-AgNPs were synthesized and characterized using ultraviolet-visible (UV-Vis) spectrophotometer, dynamic light scattering (DLS), transmission electron microscopy (TEM), and Fourier transform infrared (FTIR) spectroscopy. Te antimicrobial activity of the GA-AgNPs was evaluated on Streptococcus sanguinis (S. sanguinis), Streptococcus mutans (S. mutans), Lactobacillus acidophilus (L. acidophilus), and Candida albicans (C. albicans) using agar disc diffusion and microdilution assays.
Why patients visit dentists a study in all world health organization regions
(journal of evidence based dental practice, 2020) Oluwafemi, Ikeoluwa
Objective: The dimensions of oral health–related quality of life (OHRQoL) Oral Function, Orofacial Pain, Orofacial Appearance, and Psychosocial Impact are the major areas where patients are impacted by oral diseases and dental interventions. The aim of this study was to evaluate whether dental patients' reasons to visit the dentist fit the 4 OHRQoL dimensions. Methods: Dentists (N = 1580) from 32 countries participated in a web-based survey. For their patients with current oral health problems, dentists were asked whether these problems were related to teeth, mouth, and jaws' function, pain, appearance, or psychosocial impact or whether they do not fit the aforementioned 4 categories. Dentists were also asked about their patients who intended to prevent future oral health problems. For both patient groups, the proportions of oral health problems falling into the 4 OHRQoL dimensions were calculated.
The influence of horizontal glass fiber posts on fracture strength and fracture pattern of endodontically treated teeth: A systematic review and meta-analysis of in vitro studies
(Wiley, 2022) Abdulrab, Saleem; Geerts, Greta; Al-Maweri, Sadeq Ali
This systematic review and meta-analysis aimed to summarize available evi-dence regarding the effect of horizontal glass fiber posts (HGFPs) on fracture strengthand fracture pattern of endodontically treated teeth (ETT) compared to controls withoutHGFP. The review protocol was registered on the OSF registries.Literature searches were conducted in MEDLINE/PubMed, Scopus, Web ofScience, Embase, Google Scholar, and ProQuest for all relevant studies published upto February 2022. All in vitro studies that assessed the influence of HGFPs on fracturestrength and fracture pattern of ETT whether mesio-occluso-distal or mesio-occlusalor DO cavities were considered eligible. Review Manager (RevMan) was used forthe meta-analysis. Subgroup and funnel plot analyses were also performed. Qualityassessment was conducted by two independent reviewers.
Osteoma of the mandibular condyle: A rare case report and review of the literature
(ScienceDirect, 2019) Ostrofsky, M
Osteoma is a rare slow-growing benign neoplasm which is often asymptomatic and composed of mature bone. Only 21 cases were previously reported in the mandibular condyle. Observation: A 60 year old male presented with gross asymmetry of the lower jaw and reduced function. He mentioned that he was involved in an accident to the head about 16 years ago. Upon examination, it was noticed that the chin deviated to the left with some discomfort during function. Computed tomography revealed a radiopaque mass medial to the left condylar pole.
Barriers and facilitators of and strategies for successful community engagement in infectious disease clinical trials in low- and middle-income countries
(John Wiley and Sons Ltd, 2022) Späth, chmidt, B.-M. C
Objectives: This is a protocol for a Cochrane Review (qualitative). The objectives are as follows:. 1. To identify and synthesise barriers and facilitators of successful community engagement in infectious disease clinical trials (e.g. HIV, tuberculosis, and malaria) in low- and middle-income countries; and. 2. To identify and synthesise strategies for engaging community stakeholders in infectious disease clinical trials in low- and middle-income countries. Copyright © 2022 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.
Mucoepidermoid carcinoma ex pleomorphic adenoma: A rare diagnostically challenging entity
(Elsevier, 2022) Titinchi, Fadi; Sallies, Moegamat; Wu, Hue-Tsi
Mucoepidermoid carcinoma (MEC) arising in pleomorphic adenoma (PA) is an extremely rare entity. Involvement of minor salivary glands by this entity has only being described twice previously. We report on a diagnostically challenging case in an 18 year old male with a large mass in the junction of the hard and soft palates that has been present for 12 months. Both cytology and incisional biopsy were inconclusive and indicated benign mixed tumour. Upon excision of the tumour with a 5 mm clear margin, histology demonstrated PA that has been replaced by small nests and cribriform islands of high-grade MEC with 13 mm of invasion beyond the original PA capsule. The tumour was composed of mostly intermediate-type cells with up to 7 mitoses per 10 high power fields. The tumour cells were positive for cytokeratin (CAM 5.2) and S100. Due to the high-grade nature and focal positive posterior margin of the resected specimen, adjuvant radiotherapy was administered. In conclusion, this case highlights the need to consider rare entities such as mucoepidermoid carcinoma ex pleomorphic adenoma in atypical cytological and histological findings. Moreover, it underlines the need to manage lesions with unconfirmed histological diagnosis with wide excision margins to avoid having involved margins post resection.

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