Hammam Ahmed Bahammam

Background: The paediatric dentistry domain requires effective management of pain in children during invasive procedures such as the inferior alveolar nerve block (IANB). This study aimed to evaluate the effectiveness of Buzzy BEE^TM in reducing pain perception during IANB in children. Methods: This crossover study recruited 38 children aged 6–10 years scheduled for bilateral dental procedures requiring IANB. The washout period was 7 days, and two visits were scheduled for procedures on either side. Two randomly allocated groups received the study intervention, with each group receiving it alternately at each visit. Outcomes measured were pulse rate; subjective pain assessment using the Wong–Baker FACES Rating Scale (WBS); objective pain assessment using the Sound, Eyes and Motor (SEM) scale; and parental rating of observed pain on a scale of 1–10. Results: A statistically significant reduction in pulse rate after IANB was observed in the Buzzy BEE group at the first (p = 0.02) and second (p = 0.002) visits. At the second visit, the WBS scores (p < 0.001) and ‘eye’ (p = 0.004) and ‘motor’ (p = 0.002) scores on the SEM scale were significantly reduced in the Buzzy BEE group. The crossover analysis identified a significant treatment effect on pulse rate (p < 0.001) and significant carryover effects on WBS and SEM scores (p < 0.001). Conclusions: The use of Buzzy BEE reduced pulse rates during IANB, suggesting a positive impact on children’s anxiety. The carryover effects in the current study limit the consistency of improvements in subjective and objective pain perceptions. Further studies with a larger sample size and an extended washout period are recommended to evaluate the effectiveness of Buzzy BEE in reducing pain perception during IANB.

Introduction: Dental caries remain a major global health concern, emphasizing the need for durable restorative materials with reliable mechanical properties. This study aimed to compare the μTBS and Vickers hardness number (VHN) of three composite materials (3M Filtek Z250, Kerr OptiShade, and SHOFU Beautifil II LS) on sound coronal dentin using a corresponding bonding system (3M Universal Bond, Kerr OptiBond, and SHOFU BeautiBond Universal Adhesive, respectively). Methods: Dentin surfaces were exposed from twelve extracted molars. Each composite and its respective adhesive were applied and cured. The teeth were cut into 1 × 1 × 8 mm beams. Twenty beams per group were tested for μTBS. Additionally, 20 composite discs (2 x 10 mm) were prepared for each material. VHN was measured at three sites per disc, and mean values were calculated. Results: Filtek Z250 showed the highest VHN, followed by OptiShade and Beautifil II LS, with significant differences among all groups. OptiShade demonstrated the highest μTBS, followed by Filtek Z250 and Beautifil II LS. μTBS differed significantly between Beautifil II LS and both Filtek Z250 and OptiShade but not between Filtek Z250 and OptiShade. Discussion: Differences in filler composition, resin matrix characteristics, and adhesive protocols likely contributed to the variations observed in microhardness, bonding performance, and restoration longevity. Conclusions: Filtek Z250 exhibited superior microhardness, while OptiShade demonstrated superior bond strength. Beautifil II LS performed the worst in both tests. These findings support evidence-based material selection to enhance restoration longevity.

Background/Objectives: Early childhood caries (ECC) and saliva have been studied across disparate domains, including microbiome, fluoride, immune, oxidative-stress, and neuroendocrine research. However, the ECC–saliva literature has not previously been mapped as a connected system using modern natural language processing (NLP). This study treats PubMed titles and abstracts as data to identify major themes, emerging topics, and candidate neuroimmune axes in ECC–saliva research. Methods: Using the NCBI E-utilities API, we retrieved 298 PubMed records (2000–2025) matching (“early childhood caries” [Title/Abstract]) AND saliva [Title/Abstract]. Text was cleaned with spaCy and embedded using a transformer encoder; BERTopic combined UMAP dimensionality reduction and HDBSCAN clustering to derive thematic topics. We summarised topics with class-based TF–IDF, constructed keyword co-occurrence networks, defined an internal topic-level Novelty Index (semantic distance plus temporal dispersion), and mapped high-novelty topics to gene ontology and Reactome pathways using g:Profiler. Prophet was used to model temporal trends and forecast topic-level publication trajectories. Finally, we generated a fully synthetic neuroimmune salivary dataset, based on realistic ranges from the literature, to illustrate how the identified axes could be operationalised in future ECC cohorts. Results: Seven coherent ECC–saliva topics were identified, including classical microbiome and fluoride domains as well as antioxidant/redox, proteomic, peptide immunity, and Candida–biofilm themes. High-novelty topics clustered around total antioxidant capacity, glutathione peroxidase, superoxide dismutase, and peptide-based host defence. Keyword networks and ontology enrichment highlighted “Detoxification of Reactive Oxygen Species”, “cellular oxidant detoxification”, and cytokine-mediated signalling as central processes. Temporal forecasting suggested plateauing growth for classical epidemiology and fluoride topics, with steeper projected increases for antioxidant and peptide-immunity themes. A co-mention heatmap revealed a literature-level Candida–cytokine–neuroendocrine triad (e.g., Candida albicans, IL-6/TNF, cortisol), which we propose as a testable neuro-immunometabolic hypothesis rather than a confirmed mechanism. Conclusions: AI-assisted topic modelling and network analysis provide a reproducible, bibliometric map of ECC–saliva research that highlights underexplored antioxidant/redox and neuroimmune salivary axes. The synthetic neuroimmune dataset and modelling pipeline are illustrative only, but together with the literature map, they offer a structured agenda for future ECC cohorts and mechanistic studies.

Objective: To evaluate the effect of mouth breathing on sleep quality and oxygen saturation in pediatric patients aged 6-12 years. Material and Methods: A cross-sectional observational study was done on 120 children recruited from the pediatric outpatient department. Based on clinical evaluation and parental history, participants were separated into 2 groups: mouth breathers (n=60) and nasal breathers (control group, n=60). Sleep quality was assessed using a validated Pediatric Sleep Questionnaire (PSQ), and overnight oxygen saturation was recorded with pulse oximetry. Data were analyzed using SPSS version 24.0, applying independent t-tests and Pearson’s correlation coefficient, with significance set at p<0.05. Results: Children in the mouth-breathing group exhibited significantly poorer sleep quality, with mean PSQ scores of 6.8 ± 1.1 compared to 2.3 ± 0.9 in the nasal-breathing group (p<0.01). Mean overnight oxygen saturation was 93.6% ± 2.4 in mouth breathers versus 96.8% ± 1.8 in controls (p<0.01). A moderate positive correlation was observed between reduced oxygen saturation and deteriorated sleep quality (r = 0.64, p<0.01). Conclusion: Mouth breathing in children is significantly associated with decreased sleep quality and reduced oxygen saturation during sleep. These findings highlight the importance of early identification and management of mouth breathing habits to mitigate their adverse effects on pediatric sleep and respiratory health.

The purpose of this study is to assess the alteration of surface roughness and occlusal stains in zirconia crowns produced for pediatric dental applications. This study combined clinical observation and in vitro experimentation. The clinical component involved collecting data from 20 pediatric patients under the age of 6 years who received zirconia crowns in their upper teeth and stainless steel crowns (SSCs) in their lower teeth. A standardized shade guide was used to evaluate staining severity. The laboratory component analyzed surface roughness of zirconia crowns opposed with zirconia crowns compared to those opposed with SSCs using a chewing simulator machine. Zirconia crowns opposed with SSCs caused maximum surface staining and roughness changes due to metal transfer through biofilms formed on the surfaces, with significant differences (p < 0.001) and large effect sizes. The combination of zirconia crowns with SSCs may increase the chances of surface corrosion and staining. The selection of materials and their opposing counterparts determines the longevity, appearance, and overall quality of pediatric zirconia crowns. Zirconia crowns opposing SSCs have increased surface roughness and staining of the occlusal surface; so, when choosing materials, we need to be careful regarding their application to pediatric dentistry. These observations inform clinicians on how to maximize restorative modalities to increase durability and esthetics. Bahammam HA, Rady AF. Evaluation of Occlusal Stains and Surface Roughness of Prefabricated Zirconia Crowns in Pediatric Dentistry: An Observational and In Vitro Study. Int J Clin Pediatr Dent 2025;18(12):1431–1436.

Introduction: Dental radiographs play a crucial role in diagnosis. However, radiation has a cumulative effect on children and may lead to carcinogenesis. Aims: To determine the genotoxicity and cytotoxicity in buccal mucosal cells of children exposed to panoramic and bitewing radiographs or Cone Beam Computed Tomography (CBCT) at various time intervals. Methods: A cohort study was conducted involving 38 healthy children (ages 6-12), divided into two groups: one group received panoramic and bitewing radiographs, and the other underwent CBCT. Buccal mucosal cells were collected at baseline, and follow-ups occurred at 10±2 days, one month, and three months post-exposure. Cells were stained using Feulgen/fast green and analyzed microscopically for genotoxic (micronuclei) and cytotoxic (condensed chromatin, karyolysis, pyknosis, karyorrhexis) markers. Results: At the 10±2 days mark, an increase in micronuclei was observed in both groups, with no significant difference (p=0.660). However, after one month, the percentage of micronuclei was significantly lower in the CBCT group compared to the first group (p < 0.001). Cytotoxic alterations showed a comparable pattern, with transient increases in both groups that returned to baseline at three months. Discussions: The findings indicate transient and reversible genotoxic and cytotoxic effects in buccal mucosal cells due to radiographic exposure. While CBCT exhibited lower micronuclei counts after one month, both modalities showed similar patterns of cellular damage. Conclusion: These results highlight the importance of adhering to the ALARA principle in pediatric dentistry, as the observed effects of dental radiography are transient and do not indicate long-term damage. Further research is recommended to explore these effects in larger populations.

Background: Effective pain management in children is essential, particularly when administering local anaesthesia. This study was undertaken to compare pain perception in children after application of pre-cooled and plain topical anaesthetic gel during local anaesthetic administration. Methods: A randomised, single-blinded controlled trial was conducted among 51 children between the ages of 6 and 12, visiting the paediatric clinic, Jazan (REC-45/10/1070). Children were allocated into one of the following three groups using a simple randomisation having a 1:1:1 allocation ratio into Group I (n = 17): Plain topical anaesthetic gel, Group II (n = 17): Pre-Cooled topical anaesthetic gel, and Group III (n = 17). An ice pack was applied for a period of 1 min at the injection site. The intensity of pain and the behaviour of the children were assessed using Face, Leg, Activity, Cry, Consolability (FLACC), the Modified Wong–Baker Scale (WBS) and the Frankel Behaviour Rating Scale (FBRS). Results: A significant difference in FBRS scores was observed during anaesthesia, with the highest median score [3 (3,3)] in the pre-cooled topical anaesthetic gel group (p value < 0.001). FLACC scores varied significantly among groups, with the ice pack group [3 (3, 3)] and [4 (4, 5)] showing the highest median score (p value < 0.001). WBS scores also differed significantly between groups (p value < 0.001) with a lower value in the pre-cooled topical gel group [0 (0, 0), 2 (0, 2)]. Conclusions: This study concluded that, the use of a pre-cooled topical anaesthetic gel before LA administration reduced the pain better than that of plain anaesthetic gel and ice pack application at the injection site during infiltration.

Objective To explore perceptions of undergraduate dental students regarding difficulties faced during endodontic procedures. Methods An e-questionnaire was sent to 57 fourth-year and 45 fifth-year dental students. It comprised questions regarding demographic data and difficulties faced during different steps of the endodontic treatment. The responses were recorded on a 5-point Likert scale. During dichotomization, responses where one and two were chosen were considered yes whereas responses where three, four, and five were chosen were considered no. The sample size (SS) calculated using the Qualtrics SS calculator was 89. Data were analyzed using SPSS version 20. Frequencies and percentages were calculated. A p-value of less than 0.05 was considered significant. The chi-square test was applied for comparison based on the students’ academic year and genders. Results Ninety students responded with an 88.2% response rate. Most students reported not facing any difficulty in differentiating healthy pulp and periapex from conditions of pulp pathosis (78.9%) and periapical pathosis (75.6%). Most males found access opening and de-roofing of the pulp chamber (35.6%) and working length determination (31.1%) difficult. Females reported having difficulty mostly in mesial and distal shift radiograph techniques (55.6%) and access openings (51.1%). No statistical difference was found based on an academic year or gender except in the use of mesial and distal shift techniques for radiograph acquisition Conclusion Assessing difficulties encountered by students during endodontic therapy can aid in the development of teaching strategies for preclinical and clinical instruction. Mesial and distal shift techniques, access cavity preparation, and working length determination are areas requiring more focus in the training process.

Background: One of the main reasons for post endodontic pain is the polymicrobial intracanal flora that may survive the initial disinfection. A single antimicrobial agent might not provide adequate disinfection, and an antimicrobial combination such as triple antibiotic paste was tested to achieve this goal. Aim: The study aimed to assess the efficacy of three intra-canal medicaments on post root canal preparation pain. Materials and Methods: Eighty patients with single-rooted necrotic teeth and symptomatic apical periodontitis were randomly assigned to four treatment groups (n = 20). Their preoperative pain was recorded on Wong-Baker’s FACES pain rating scale. After chemo-mechanical canal preparation, intracanal medications were applied to the groups (Group 1 (20% calcium hydroxide), Group 2 (2% chlorhexidine), Group 3 (tri-antibiotic paste), Group 4 (no medication (Control group)). Patients were instructed to record pain on the Wong-Baker FACES pain rating scale at 4, 48, 72 and 96 hrs, postoperatively. Pain scores were analyzed using a one-way ANOVA test and Tukey’s post hoc test and, if significant, Dunn’s test was used for pair-wise comparisons. The significance level was set at a p-value ≤ 0.05. Results: Tukey’s post hoc test revealed significantly lower pain scores in Group 3 compared with other groups at all follow up intervals. Dunnett’s test showed significantly lower pain in Group 3 compared with the Control group at 48, 72 and 96 hrs, postoperatively. Conclusions: Triple-antibiotic paste showed effective pain control as an intracanal medication on necrotic teeth with symptomatic apical periodontitis.

Background: This study aimed to observe the impact of service learning on the attitude of senior dental students toward community service.Methods: A cross-sectional survey-based was conducted and recruited a total of 120 senior students of Dentistry Taibah University that were enrolled in a clinical service-learning course using convenience sampling. The attitude of dental college students toward community service based on the model of helping behavior by Schwartz was evaluated through Community Service Attitude Scale (CSAS). The data was collected using the same questionnairesfor the pre-test and post-test. Data were analyzed by using SPSS 25. A repeated-measures mixed-model ANOVA was used to test the changes across pre-and post-test.Results: A total of 96 students completed the first survey, making a response rate of 80%, and 78 among them completed the second survey as well, making a response rate of 81%. Significant change (P < 0.0001) in ANOVA indicated that there was an overall change in attitude. Conclusions: It can be concluded that community-based service-learning positively impacts the attitude of last year’s dental students toward understanding needs at the community level and the attitude to help in providing dental care at the community level.