Publications by authors named "Sausan Al Kawas"

30 Publications

  • Page 1 of 1

Satisfaction with online learning in the new normal: perspective of students and faculty at medical and health sciences colleges.

Med Educ Online 2021 Dec;26(1):1920090

School of Medicine, University of Limerick, Limerick, Ireland.

Online learning has become the new normal in many medical and health science schools worldwide, courtesy of COVID-19. Satisfaction with online learning is a significant aspect of promoting successful educational processes. This study aimed to identify factors affecting student and faculty satisfaction with online learning during the new normal. Online questionnaires were emailed to students (n = 370) and faculty (n = 81) involved in online learning during the pandemic. The questionnaires included closed- and open-ended questions and were organised into two parts: socio-demographic information and satisfaction with online learning. Descriptive statistics were used to analyse the responses to the satisfaction scales. Students' and faculty responses to the open-ended questions were analysed using the thematic analysis method. The response rate was 97.8% for students and 86.4% for faculty. Overall satisfaction among students was 41.3% compared to 74.3% for faculty. The highest areas of satisfaction for students were communication and flexibility, whereas 92.9% of faculty were satisfied with students' enthusiasm for online learning. Technical problems led to reduced student satisfaction, while faculty were hampered by the higher workload and the required time to prepare the teaching and assessment materials. Study-load and workload, enhancing engagement, and technical issues (SWEET) were the themes that emerged from the thematic analysis as affecting student and faculty satisfaction. Adopting a combination synchronous and asynchronous approach, incorporating different applications to engage students, and timely feedback are imperative to increasing student satisfaction, while institutional support and organisational policy could enhance faculty satisfaction.
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http://dx.doi.org/10.1080/10872981.2021.1920090DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8118529PMC
December 2021

Evaluation of Conscious Monitoring and Movement Control Efforts Among Dental Students.

Percept Mot Skills 2021 May 3:315125211014869. Epub 2021 May 3.

Preventive and Restorative Dentistry Department, College of Dental Medicine, University of Sharjah, UAE.

Prior research has demonstrated that motor skill learning is often disrupted by self-focus and attempts to control movement. The propensity for reinvestment (i.e., self-focus and movement control) has been associated with poor motor skill learning in sport and surgery, but it has not yet been examined in dental education. Therefore, the aim of this study was to evaluate the propensity for disruptive reinvestment among dental students so as to optimize their learning needs. Volunteer dental students (210) completed three reinvestment surveys to investigate their self-reported propensity to engage in conscious self-monitoring and control of their movements and decisions. We used analysis of variance (ANOVA), with post-hoc analyses as appropriate, to assess the effect of various participant demographics on their reinvestment scores. Male participants had a lower mean reinvestment scale score than females ( < .05). Older participants were found to have a lower mean movement reinvestment score, compared to younger reinvesters ( < .05). On the other hand, younger reinvesters had a lower mean decision reinvestment score compared to the older age group ( < .05). When compared with participants in previous studies our participants obtained a significantly higher reinvestment score ( < .05). In conclusion, gender and age may be related to dental students' self-reported propensity to reinvest. Moreover, dental students were found to be more self-conscious when compared with individuals who perform gross motor skill tasks. These results provide insight into the acquisition of dental skills that may assist in designing pre-clinical training curriculum in dental education.
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http://dx.doi.org/10.1177/00315125211014869DOI Listing
May 2021

Analysis of inferior nasal turbinate width and concha bullosa in subjects with nasal septum deviation: a cone beam tomography study.

BMC Oral Health 2021 04 24;21(1):206. Epub 2021 Apr 24.

University of Science and Technology of Fujairah, Fujairah, United Arab Emirates.

Background: In individuals with nasal septal deviation (NSD), compensatory hypertrophy of the nasal turbinates occurs as a protective mechanism of the nasal passage from dry and cold air. NSD associated nasal turbinate hypertrophy is usually recurrent, requiring repetitive imaging. Therefore, a multiplanar imaging modality with a low radiation dose is best suited for long-term follow-up of this condition. This study aimed to evaluate the association of width of inferior turbinates and presence of concha bullosa with the degree of NSD using Cone beam computed tomography (CT).

Methods: The CBCT scans of 100 patients with NSD were selected as per convenience sampling and were evaluated by two maxillofacial radiologists. The width of the non-hypertrophied inferior turbinate (NHT) on the convex side of the NSD, and hypertrophic inferior turbinates (HT) on the concave side of the NSD were measured at three locations. The septal deviation angle (SDA) and the presence of concha bullosa (CB) were determined.

Results: A significant difference was observed in the anterior, middle, posterior, and mean widths between HT and NHT (p < 0.001). There was a significant difference in the widths of the HT and NHT among different types of NSD. A strong positive correlation (r = 0.71, p < 0.001) was found between SDA and the mean width of the HT. Age (P = 0.71) and gender (P = 0.65) had no significant difference among different types of NSD. Regression analysis revealed that the presence of CB (p = 0.01) and middle width of the HT (p < 0.001) are significant predictors of SDA and type of NSD.

Conclusion: The results of the present study reveal that the middle width of the HT and the presence of CB influence the degree of NSD. The present study results recommend the use of CBCT as a substitutive low radiation dose imaging modality for evaluation of NSD, CB, and associated inferior turbinate hypertrophy.
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http://dx.doi.org/10.1186/s12903-021-01576-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8066481PMC
April 2021

A mixed methods approach to determine the climate of interprofessional education among medical and health sciences students.

BMC Med Educ 2021 Apr 10;21(1):203. Epub 2021 Apr 10.

College of Medicine, University of Sharjah, Sharjah, United Arab Emirates.

Background: High-quality patient care is a complex phenomenon that requires collaboration among healthcare professionals. Research has shown that Interprofessional Education (IPE) carries promise to improve collaborative work and patient care. So far, collaboration among various health professionals remains a challenge. Very few focus group discussions to determine the medical students' readiness and positive attitudes towards IPE have been reported from the Arabian context.

Methods: A two-staged sequential mixed methods study was conducted among medical, dental, pharmacy, and health sciences students of the University of Sharjah United Arab Emirates. The perspectives of students toward IPE and collaborative practice were first gathered by administering a validated instrument, Readiness for Interprofessional Learning Scale (RIPLS). This was followed by focused group discussions. A quantitative as well as a qualitative data analysis was performed.

Results: This study cohort included 282 students. All respondents showed readiness to adopt IPE as all statements of the RIPLS inventory scored high median scores. All participants showed positive attitudes and readiness towards IPE. Three main domains of themes were generated from focus group discussions; prior knowledge, need for IPE framework and its implementation. Information workload, lack of clarity and less focused teaching pedagogies of IPE were considered as perceived barriers.

Conclusion: This study demonstrated a substantial agreement of medical and health sciences students towards readiness and perceived effectiveness of IPE. Educators are urged to embed new IPE programs into existing curricular frameworks, which can potentially enhance collaborative learning and improve quality of patient care.
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http://dx.doi.org/10.1186/s12909-021-02645-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8035734PMC
April 2021

The impact of smoking different tobacco types on the subgingival microbiome and periodontal health: a pilot study.

Sci Rep 2021 Jan 13;11(1):1113. Epub 2021 Jan 13.

Department of Pediatrics, School of Medicine, New York University, New York, USA.

Smoking is a risk factor for periodontal disease, and a cause of oral microbiome dysbiosis. While this has been evaluated for traditional cigarette smoking, there is limited research on the effect of other tobacco types on the oral microbiome. This study investigates subgingival microbiome composition in smokers of different tobacco types and their effect on periodontal health. Subgingival plaques were collected from 40 individuals, including smokers of either cigarettes, medwakh, or shisha, and non-smokers seeking dental treatment at the University Dental Hospital in Sharjah, United Arab Emirates. The entire (~ 1500 bp) 16S rRNA bacterial gene was fully amplified and sequenced using Oxford Nanopore technology. Subjects were compared for the relative abundance and diversity of subgingival microbiota, considering smoking and periodontal condition. The relative abundances of several pathogens were significantly higher among smokers, such as Prevotella denticola and Treponema sp. OMZ 838 in medwakh smokers, Streptococcus mutans and Veillonella dispar in cigarette smokers, Streptococcus sanguinis and Tannerella forsythia in shisha smokers. Subgingival microbiome of smokers was altered even in subjects with no or mild periodontitis, probably making them more prone to severe periodontal diseases. Microbiome profiling can be a useful tool for periodontal risk assessment. Further studies are recommended to investigate the impact of tobacco cessation on periodontal disease progression and oral microbiome.
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http://dx.doi.org/10.1038/s41598-020-80937-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7806658PMC
January 2021

Rethinking Assessment Concepts in Dental Education.

Int J Dent 2020 14;2020:8672303. Epub 2020 Oct 14.

Department of Preventive and Restorative Dentistry, University of Sharjah, PO Box 27272, Sharjah, UAE.

Introduction: Dental education involves teaching and assessing the acquisition of verifiable domains that require superior psychomotor, communication, and cognitive skills. Evolving technologies and methods of assessment could enhance student's learning environment and improve tutor assessment experience. The aim of this study was to review the current body of research and evaluate the effectiveness of various methods of assessments in improving learning and performance in preclinical and clinical dental practice.

Materials And Methods: A search strategy was implemented using electronic search in major databases. The following key terms, clinical skills, preclinical, dental students, and assessment, were included in the search. Two reviewers independently screened all the articles retrieved following very specific inclusion criteria.

Results: The initial search generated 5371 articles and 24 articles were selected for review and data extraction. Cohen's kappa coefficient was used to measure interrater agreement and a score of 94.7% was obtained.

Conclusion: Preclinical assessment is an effective tool for promoting skills transfer to clinical phase. Early psychomotor skills assessment is valuable. It allows early intervention in the learning process and assists in effective utilization of learning resources. Technology-enhanced assessment systems allow better patient simulation, enhance learning and self-assessment experiences, and improve performance evaluation. However, these systems serve as an adjunct to conventional assessment methods. Further research should aim at calibrating and integrating these systems to optimize students learning and performance.
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http://dx.doi.org/10.1155/2020/8672303DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7584943PMC
October 2020

Nanoscale Thermosensitive Hydrogel Scaffolds Promote the Chondrogenic Differentiation of Dental Pulp Stem and Progenitor Cells: A Minimally Invasive Approach for Cartilage Regeneration.

Int J Nanomedicine 2020 12;15:7775-7789. Epub 2020 Oct 12.

Research Institute of Medical and Health Sciences, University of Sharjah, Sharjah 27272, United Arab Emirates.

Purpose: Several scaffolds and cell sources are being investigated for cartilage regeneration. The aim of the study was to prepare nanocellulose-based thermosensitive injectable hydrogel scaffolds and assess their potential as 3D scaffolds allowing the chondrogenic differentiation of embedded human dental pulp stem and progenitor cells (hDPSCs).

Materials And Methods: The hydrogel-forming solutions were prepared by adding β-glycerophosphate (GP) to chitosan (CS) at different ratios. Nanocellulose (NC) suspension was produced from hemp hurd then added dropwise to the CS/GP mixture. In vitro characterization of the prepared hydrogels involved optimizing gelation and degradation time, mass-swelling ratio, and rheological properties. The hydrogel with optimal characteristics, NC-CS/GP-21, was selected for further investigation including assessment of biocompatibility. The chondrogenesis ability of hDPSCs embedded in NC-CS/GP-21 hydrogel was investigated in vitro and compared to that of bone marrow-derived mesenchymal stem cells (BMSCs), then was confirmed in vivo in 12 adult Sprague Dawley rats.

Results: The selected hydrogel showed stability in culture media, had a gelation time of 2.8 minutes, showed a highly porous microstructure by scanning electron microscope, and was morphologically intact in vivo for 14 days after injection. Histological and immunohistochemical analyses and real-time PCR confirmed the chondrogenesis ability of hDPSCs embedded in NC-CS/GP-21 hydrogel.

Conclusion: Our results suggest that nanocellulose-chitosan thermosensitive hydrogel is a biocompatible, injectable, mechanically stable and slowly degradable scaffold. hDPSCs embedded in NC-CS/GP-21 hydrogel is a promising, minimally invasive, stem cell-based strategy for cartilage regeneration.
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http://dx.doi.org/10.2147/IJN.S274418DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7567564PMC
November 2020

Post COVID-19 lockdown: measures and practices for dental institutes.

BMC Oral Health 2020 10 27;20(1):291. Epub 2020 Oct 27.

Department of Oral and Craniofacial Health Sciences, College of Dental Medicine and University Dental Hospital Sharjah, University of Sharjah, P.O. Box 27272, Sharjah, UAE.

Resuming regular clinical activities at dental premises after the COVID-19 lockdown period or post COVID-19 is likely to be a challenge for all dental institutes. When returning to the dental practice or training, staff and students alike should abide by the new rules and regulations. In the process of controlling viral spread, clinical dental facilities face a higher risk of disease transmission among patients as well as clinical and non-clinical staff. Aerosols formation and diffusion into the surrounding air can be a real concern of viral transmission, if no protective measures are established. We aim in this review to present the currently implemented measures and propose changes in clinical dental facilities to minimize the risk of transmission. Dental professionals should be prepared to treat every patient as a suspected COVID-19 carrier and be ready to receive and manage an overwhelming number of patients. We suggest that dental practices establish a sensible workforce shift schedule, improve ventilation levels, reduce dental aerosol generating procedures, and develop a comprehensive guidance to Healthcare Workers to reduce the risk of COVID-19 transmission.
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http://dx.doi.org/10.1186/s12903-020-01281-6DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7590562PMC
October 2020

Introducing a comprehensive high-stake online exam to final-year dental students during the COVID-19 pandemic and evaluation of its effectiveness.

Med Educ Online 2020 Dec;25(1):1826861

College of Dental Medicine, University of Sharjah , Sharjah, UAE.

Background: Dental education involves teaching and assessing the acquisition of verifiable domains that require superior psychomotor, communication, and cognitive skills. Evolving technologies and methods of assessment could enhance student learning environment and improve tutor assessment experience.

Objective: The aim of this study was to introduce the application of a comprehensive high-stakes online exam to final-year dental students during the COVID-19 pandemic and evaluate its effectiveness.

Design: A high-stakes exam was introduced and implemented online to the final-year dental students prior to their graduation. The exam consisted of four components: MEQs, MCQs, OSCE and an oral exam. The exam and invigilation were conducted using Blackboard and MS Teams programs. Stakeholders' views of the exam were obtained using two tailored surveys, one for students and another for faculty; both included closed- and open-ended questions.

Results: The exam was run successfully without untoward events. Both students and staff were satisfied with the online exam with the latter being more satisfied than the former. Students with previous experience in online learning system were more satisfied with the online exam compared with those with less experience ( < 0.05). The main issues raised by students' satisfaction with the exam were: inadequacy of time for the MEQ part, prevention of back tracking in the MCQ part and minor technological issues, whereas those raised by faculty members were increased time required to complete the exam setup and grading compared to the paper-based exam and minor technological issues.

Conclusions: A newly introduced, multi-format, online high-stakes exam was implemented successfully to final-year dental students with minor technological issues and good satisfaction by students and staff alike.
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http://dx.doi.org/10.1080/10872981.2020.1826861DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7580847PMC
December 2020

Effectiveness of technology-enhanced teaching and assessment methods of undergraduate preclinical dental skills: a systematic review of randomized controlled clinical trials.

BMC Med Educ 2020 Aug 28;20(1):286. Epub 2020 Aug 28.

Department of Preventive and Restorative Dentistry, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.

Background: To investigate the effectiveness of technology-enhanced teaching and assessment methods of undergraduate preclinical skills in comparison to conventional methods.

Methods: A comprehensive search strategy was implemented using both manual and electronic search methods, including PubMed, Wiley, ScienceDirect, SCOPUS, and the Cochrane Central Register of Controlled Trials. The search and selection of articles that met the inclusion criteria were carried out in duplicates. A Cochrane data extraction form for RCTs was used to extract the relevant information from all included articles. Risk of bias of all included articles was assessed independently by two authors using the Cochrane risk of bias tool.

Results: A total of 19 randomized controlled clinical trials met the inclusion criteria and were included in this review. The majority of the studies included in this review have a high risk of bias mainly due to incomplete data, lack of blinding of the examiners, and due to other biases, such as small sample sizes, not accounting for additional hours of training, and the lack of calibration of examiners grading the preparations. Conflicting results were reported in the included studies with regards to whether there were differences between the intervention and control groups in the outcome measure of quality of students' performance. A meta-analysis could not be done for this study due to the heterogeneity among the included studies.

Conclusions: Technology-enhanced teaching and assessment tools used in preclinical skills training of undergraduate dental students have the potential to improve students' performance. However, due to the conflicting outcomes reported in the 19 studies included in this systematic review and their high risk of bias, better quality studies are required to find a definitive answer to the research question of this systematic review.
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http://dx.doi.org/10.1186/s12909-020-02211-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7455918PMC
August 2020

Clinical and Radiological Evaluation of Sinus Membrane Osteogenicity Subsequent to Internal Sinus Lifting and Implant Placement.

J Craniofac Surg 2020 May/Jun;31(3):e233-e236

Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah.

To evaluate the ability of the maxillary sinus membrane to produce bone after internal sinus lifting and implant placement without adding exogenous bone graft, and to assess the quality of bone that has been produced 6 months postoperatively.In this retrospective study, 10 subjects who underwent maxillary sinus floor lifting and met the inclusion criteria were selected and then subdivided into: Group-A underwent internal sinus elevation and placement of implants without the use of bone graft and Group-B underwent classical internal sinus lifting and placement of bovine bone particles and then placement of the implant as a control group. Radiofrequency analysis (RFA) values for measuring the Implant Stability Quotient (ISQ) of all implants were measured by Osstell device. CBCT was performed involving linear measurements of the site of sinus lifting for both groups.High RFA values demonstrating excellent biomechanical stability were observed in Group-A compared to Group-B at 6 months postoperatively. Group-A showed a median of ISQ value;78 (8), 77(12), 79(3.5) and 77(4.50). Group-A was significantly higher in ISQ values than Group-B, which showed median and interquartile range (IQR) of ISQ value of [51(12.50), 54(14.50), 55(9), and 55(7.50)]. However, the amount of bone available in group B was significantly higher than group A; [3.5 mm (0.75) and 3.8 mm (0.69)].Internal sinus lifting without bone graft has the ability of bone formation by osteogenic potential of the sinus membrane. Nevertheless, the high quality of bone being produced is of high importance for the success of an implant without the need for an exogenous bone graft. The newly formed bone was significantly of a better quality in Group-A. Thus, it is recommended to perform internal sinus lifting, without adding bone graft material and allow the osteogenic potential of the maxillary sinus membrane to produce its own osteogenic cells.
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http://dx.doi.org/10.1097/SCS.0000000000006106DOI Listing
August 2020

Self-medication for oral health problems among adults attending the University Dental Hospital, Sharjah.

J Taibah Univ Med Sci 2019 Aug 23;14(4):370-375. Epub 2019 Jul 23.

Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates.

Objective: The aim of this study was to investigate the self-medication practices for oral health problems among adults attending the University Dental Hospital Sharjah (UDHS). The reasons for visits and types, durations, and sources of self-medication were recorded.

Methods: This cross-sectional study was conducted among adult patients attending UDHS. A total of 566 participants were recruited using pre-determined inclusion and exclusion criteria. Data collection was performed using a self-administered closed-ended questionnaire, and information was analysed using SPSS software version 22.

Results: Four hundred of 566 (70.7%) respondents indicated that they practice self-medication. Among those who practiced self-medication for oral health problems, the mean age was 26 ± 9.4 years (52% men and 48% women), and the majority (46%) had obtained higher education, although their profession was not related to the medical field (69.97%). The most common factor that triggered self-medication practices was toothache (56.5%), while the main reasons for self-medication were both lack of time to visit a dental clinic (37.6%) and the perception that dental ailments were not serious health issues (36.8%). Analgesics were the main medicines used for self-medication.

Conclusion: Self-medication for oral health problems is a common practice in UAE. Lack of time to visit dental clinics and the perceived low importance of oral health problems were the main reasons for self-medication. Analgesics for toothache were the most frequent medications purchased from the local pharmacy.
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http://dx.doi.org/10.1016/j.jtumed.2019.06.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6717111PMC
August 2019

Biomechanical and radiological assessment of immediate implants for alveolar ridge preservation.

Dent Res J (Isfahan) 2018 Nov-Dec;15(6):420-429

Department of Oral and Craniofacial Health Science, College of Dental Medicine, University of Sharjah, Sharjah, UAE.

Background: The aim of this study was to evaluate the stability of immediate implant placement for alveolar bone augmentation and preservation with bovine bone graft following atraumatic tooth extraction.

Materials And Methods: This was a prospective interventional study with convenient sampling ( = 10). Thirty patients aged between 18 and 40 years, who needed noncomplicated tooth extraction of mandibular premolar tooth, were sequentially divided equally into three groups. In Group I, simple extraction was done and the empty extraction socket left to heal conventionally. In Group II, extraction sockets were filled with lyophilized bovine granules only. In Group III, immediate implants were placed into extraction sockets, and the buccal gap was also filled with bovine granules. All groups were subjected to cone beam computed tomography scan for radiological evaluation. Assessment of biomechanical stability (radiofrequency analysis [RFA] was performed at 9 months postoperative for Group III to assess the degree of secondary stability of the implants using Osstell. Repeated measure analysis of variance (ANOVA) test was applied when comparing within each group at three different time intervals, whereas one-way ANOVA was applied followed by -tukey test when comparing between groups. < 0.05 was considered statistically significant.

Results: Radiological assessment reveals a significant difference of bone resorption in alveolar dimension within Group I; 1.49 mm ( = 0.002), and 0.82 mm ( = 0.005), respectively, between day 0 and 3 months. Comparison between Group I and III showed a highly significant difference of bone resorption in ridge width at 3 months 2.56 mm ( = 0.001) and at 9 months interval 3.2 mm ( < 0.001). High RFA values demonstrating an excellent biomechanical stability were observed in Group III at 9 months postoperatively.

Conclusion: The insertion of immediate implants in extraction sockets with bovine bone augmentation of the buccal gap was able to preserve a greater amount of alveolar ridge volume.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6243806PMC
December 2018

Can probiotic cleaning solutions replace chemical disinfectants in dental clinics?

Eur J Dent 2018 Oct-Dec;12(4):532-539

Department of Oral and Craniofacial Health, College of Dental Medicine, University of Sharjah, Sharjah, UAE.

Objectives: We aim to assess the antibacterial effectiveness of probiotic cleaning in a dental clinic at the University Dental Hospital Sharjah (UDHS), UAE.

Materials And Methods: The current cleaning protocol of UDHS was evaluated by the surface swabbing of three dental clinics routinely cleaned using regular chemical disinfectants. Then, a new probiotic cleaning solution containing was applied for 3 weeks in a selected clinic. Bacteria were grown onto selective culture media for colony counting from surfaces cleaned with probiotic solution compared to those obtained from the same surfaces cleaned with the regular chemical solutions. Isolates identity was confirmed by biochemical tests or polymerase chain reaction.

Results: There was a significant reduction of the bacterial counts of various bacterial species (, , and Gram-negative rods) from almost all the surfaces in the dental clinic after the application of the probiotic solution compared to the same surfaces cleaned with the regular chemical solutions. However, the antibiotic resistance rates were not significantly reduced within the short period of 3 weeks of using the new probiotic cleaning product.

Conclusions: This study demonstrated that the use of probiotic cleaning is effective in reducing microbial growth in dental settings. This approach may be tested further to examine the long-term effect and to evaluate the opportunity of applying this novel biotechnology as part of the infection control routine in dental settings instead of the chemical disinfectants which are known to cause serious health problems. This is the first study testing the application of probiotic-based solution in dental settings.
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http://dx.doi.org/10.4103/ejd.ejd_124_18DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6178676PMC
October 2018

The Effect of Number of Teeth and Chewing Ability on Cognitive Function of Elderly in UAE: A Pilot Study.

Int J Dent 2017 14;2017:5732748. Epub 2017 Nov 14.

College of Dental Medicine, University of Sharjah, Sharjah, UAE.

Cognitive decline is one of the major causes of disability among the aging population. The aim of this study was to explore the relationship between oral health parameters (number of teeth, chewing ability, and presence of a denture) and cognitive function in the elderly across the UAE. Fifty persons (age ≥ 60; 71.26 ± 10.23) were enrolled in the study. Cognitive status was assessed using the standardized mini-mental state examination (SMMSE) and accordingly, cognitively normal subjects scoring ≥24 were considered as the control group and cognitively impaired individuals scoring ≤23 were considered as the low scoring group. Chewing ability was examined, number of teeth was noted, and demographical data was collected. The results of this pilot study showed that individuals with low SMMSE scores were significantly less educated ( < 0.01) and had fewer number of remaining teeth ( < 0.05) and impaired chewing ability ( < 0.05). These results demonstrate a significant link between the number of teeth, chewing ability, and cognitive function. However, this pilot study had its limitations and was the first of its kind in the UAE and Gulf region; therefore, future research addressing the limitations is needed to further explore this association.
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http://dx.doi.org/10.1155/2017/5732748DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734010PMC
November 2017

Three-Dimensional Radiological Assessment of Alveolar Bone Volume Preservation Using Bovine Bone Xenograft.

J Craniofac Surg 2018 Mar;29(2):e203-e209

Tissue Bank, School of Medical Sciences, Universiti Sains Malaysia, Kubang Kerian, Malaysia.

Introduction: Alveolar bone is critical in supporting natural teeth, dental implants as well as a removable and fixed prosthesis. Alveolar bone volume diminishes when its associated natural tooth is lost.

Objective: The aim of this study is to evaluate the effectiveness of bovine bone granules on alveolar bone socket augmentation for ridge preservation following atraumatic tooth extraction.

Materials And Methods: Twenty medically fit patients (12 males and 8 females aged between 18 and 40 years) who needed noncomplicated tooth extraction of 1 mandibular premolar tooth were divided randomly and equally into 2 groups. In control group I, the empty extraction socket was left untreated and allowed to heal in a conventional way. In group II, the empty extraction socket wound was filled with lyophilized bovine bone xenograft granules 0.25 to 1 mm of size, 1 mL/vial. A resorbable pericardium membrane was placed to cover the defect. Clinical and 3-dimensional radiological assessments were performed at day 0, 3 months, and 9 months postoperative.

Results: There were no clinical differences in general wound healing between the groups. Comparisons within the groups showed a significant difference of bone resorption of 1.49 mm (95% confidence interval, 0.63-2.35) at 3 months, and further resorption of 1.84 mm (P ≤ 0.05) at 9 months in the control group. No significant changes of bone resorption were observed in group II during the same time interval. Comparison between groups showed a significant difference of bone resorption at 3 and 9 months (2.40 and 2.88 mm, respectively).

Conclusion: The use of lyophilized demineralized bovine bone granules in socket preservation to fill in the extraction socket seems essential in preserving the alveolar bone dimension as it showed excellent soft and hard tissue healing. This study concludes that the alveolar bone socket exhibited a dynamic process of resorption from the first day of tooth extraction. Evidence shows the possibility of using bovine bone granules routinely in socket volume preservation techniques following tooth extraction.
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http://dx.doi.org/10.1097/SCS.0000000000004263DOI Listing
March 2018

The Efficacy of Immediate Implant Placement in Extraction Sockets for Alveolar Bone Preservation: A Clinical Evaluation Using Three-Dimensional Cone Beam Computerized Tomography and Resonance Frequency Analysis Value.

J Craniofac Surg 2017 Jun;28(4):e318-e325

*Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah †Sharjah Institute for Medical Research (SIMR), Sharjah, United Arab Emirates ‡School of Dental Sciences Health Campus, Universiti Sains Malaysia, Penang Kubang Kerian, Malaysia.

The aim of this study was to determine the efficacy of immediate implant placement with alveolar bone augmentation on socket preservation following atraumatic tooth extraction and comparing it with a tooth alveolar socket that was allowed to heal in a conventional way.Twenty medically fit patients (8 males and 12 females aged between 18 and 40 years) who needed noncomplicated tooth extraction of mandibular premolar teeth were divided randomly and equally into 2 groups. In Group I, the empty extraction socket was left untreated and allowed to heal in a conventional way. In Group II, the immediate implant was placed and the gap between the implant and the inner buccal plate surface of the socket wall was filled with lyophilized bovine bone granules and the wound was covered with pericardium membrane. The patients were followed up clinically and radiologically for regular reviews at 1 week, 3 months, and 9 months postoperative. Cone beam computerized tomography images of the alveolar ridge and socket were analyzed to determine the structural changes of the alveolar ridge. Resonance frequency analysis was measured at 9 months for Group II to assess the degree of secondary stability of the implants by using Osstell machine.A significant difference of bone resorption of 1.49 mm (confidence interval, CI 95%, 0.63-2.35) was observed within the control group at 3 months, and 1.84 mm (P ≤ 0.05) at 9 months intervals. No significant changes of bone resorption were observed in Group II. Comparison between groups showed a highly significant difference at 3 months; 2.56 mm (CI 95% 4.22-0.90) and at 9 months intervals; 3.2 mm (CI 95%, 4.70-1.62) P ≤ 0.001 between Group I and II. High resonance frequency analysis values were observed at 9 months postoperative in Group II.In conclusion, the insertion of immediate implants in fresh extraction sockets together with grafting the circumferential gap between the bony socket wall and the implant surface with bovine bone granules was able to preserve a greater amount of alveolar ridge volume when compared with an extraction socket that was left to heal in a conventional way.
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http://dx.doi.org/10.1097/SCS.0000000000003569DOI Listing
June 2017

Work-related Musculoskeletal Pain among Different Dental Specialists in United Arab Emirates.

J Contemp Dent Pract 2016 Aug 1;17(8):639-44. Epub 2016 Aug 1.

Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, United Arab Emirates.

Introduction: Dentists are at a very high risk of developing work-related musculoskeletal pain. The present study aimed at studying the prevalence of musculoskeletal pain among different dental specialists in the United Arab Emirates (UAE), and correlating the region of pain with the type of clinical work done by the specialists.

Materials And Methods: A sample of more than 100 dentists was chosen randomly from different emirates in UAE. An interview questionnaire was administered regarding the number of years of experience and the presence, region, duration, and type of musculoskeletal pain they experienced.

Results: Musculoskeletal pain is experienced by 83.3% of periodontists, 80% of conservative dentists, 77.8% of endodon-tists, 72.7% of orthodontists, 70% of oral surgeons, 63.6% of prosthodontists, 63% of general dental practitioners, and 50% of pedodontists. The results have also indicated that the region of experienced musculoskeletal pain does vary according to the specialty. From those dentists who experience work-related musculoskeletal pain, 80% of conservative dentists experience pain in neck and shoulders, 66.7% of periodontists, and 54.5% of orthodontists experience pain in the lower back region. More than 50% of endodontists experience pain in the neck and shoulders regions, and 39% of general dental practitioners who experience pain in the neck region.

Conclusion: Preventive measures need to be taken to decrease the risk of dentists and dental specialists developing work-related musculoskeletal pain.

Clinical Significance: The prevalence and distribution of musculoskeletal disorders (MSDs) among registered general dental practitioners and dental specialists in UAE was not clearly documented. The study results indicated that the region that experienced musculoskeletal pain does vary according to the specialty.
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http://dx.doi.org/10.5005/jp-journals-10024-1904DOI Listing
August 2016

Chitosan-Based Thermosensitive Hydrogel for Controlled Drug Delivery to the Temporomandibular Joint.

J Craniofac Surg 2016 May;27(3):735-40

*Department of Oral and Craniofacial Health Science, College of Dental Medicine, University of Sharjah, Sharjah, UAE†Department of Oral and Maxillofacial Surgery, College of Dentistry, Suez Canal University, Ismaillia, Egypt‡Department of Pharmaceutics and Pharmaceutical Technology, College of Pharmacy, University of Sharjah, Sharjah, UAE§Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University||Department of Chemistry, Faculty of Women, Ain Shams University, Heliopolis, Cairo, Egypt¶Institute of Fundamental Sciences, Massey University, Palmerston North, New Zealand.

Intra-articular injections of hyaluronic acid (HA) and corticosteroids have been extensively used in treating temporomandibular disorders. However, rapid clearance from the site of injection is a major concern that is commonly managed by frequent dosing, which is not without complications. This study aimed to determine the suitability of thermosensitive chitosan-based hydrogels for intra-articular controlled release of drugs in the rabbit temporomandibular joint (TMJ). A series of hydrogels were prepared using different chitosan (Ch) to β-glycerophosphate (β-GP) ratios. The gelation time, swelling ratio, the shape, and surface morphology of the prepared gels were investigated to select the formulation with optimum characteristics. The left TMJ in 13 adult male New Zealand white rabbits was injected with 0.2 mL of Chitosan/β-glycerophosphate/HA while the right TMJ was injected with 0.2 mL of control solution of HA. Hyaluronic acid concentrations in experimental and control groups were measured using Hyaluronan Quantikine Enzyme-Linked Immunosorbent Assay Kit. In vitro characterization showed that both the Ch:β-GP ratio and incorporation of HA had a significant effect on gelation time, degree of swelling, and surface morphology of the hydrogels. No morphological changes were observed in the joints in both groups. The mean concentration of HA in the experimental joints after 7 days (1339.79 ± 244.98 μg/g) was significantly higher than that in the control (474.52 ± 79.36 μg/g). In conclusion, the chitosan-based thermosensitive hydrogel can be considered as a promising controlled drug release system to the TMJ in a rabbit model that would potentially overcome many of the current limitations of intra-articular formulations.
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http://dx.doi.org/10.1097/SCS.0000000000002588DOI Listing
May 2016

Sleep medicine education and knowledge among undergraduate dental students in Middle East universities.

Cranio 2016 May 24;34(3):163-8. Epub 2016 Mar 24.

a College of Dental Medicine, University of Sharjah , UAE.

Objectives: The aim of this study was to assess the undergraduate dental education in sleep medicine in Middle East universities as well as the students' knowledge in this field.

Methods: A cross-sectional observational study was carried out during the period from September 2013 to April 2014.Two different questionnaires were used. A self-administered questionnaire and a cover letter were emailed and distributed to 51 randomly selected Middle East dental schools to gather information about their undergraduate sleep medicine education offered in the academic year 2012-2013.The second questionnaire was distributed to the fifth-year dental students in the 2nd Sharjah International Dental Student Conference in April 2014, to assess their knowledge on sleep medicine. A survey to assess knowledge of sleep medicine in medical education (Modified ASKME Survey) was used.

Results: Thirty-nine out of 51 (76%) responded to the first questionnaire. Out of the responding schools, only nine schools (23%) reported the inclusion of sleep medicine in their undergraduate curriculum. The total average hours dedicated to teaching sleep medicine in the responding dental schools was 1.2 hours. In the second questionnaire, 29.2% of the respondents were in the high score group, whereas 70.8% scored low in knowledge of sleep-related breathing disorders.

Discussion: Dental students in Middle East universities receive a weak level of sleep medicine education resulting in poor knowledge in this field.
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http://dx.doi.org/10.1179/2151090315Y.0000000019DOI Listing
May 2016

CBCT analysis of bony changes associated with temporomandibular disorders.

Cranio 2016 Mar;34(2):88-94

a College of Dental Medicine, University of Sharjah , UAE.

Objectives: The aim of the present study was to compare cone-beam computerized tomography (CBCT) findings and joint space measurement in temporomandibular disorder (TMD) and non-TMD joints, and to correlate these findings with the clinical diagnosis.

Methods: The study was conducted on patients diagnosed with temporomandibular joint (TMJ) osteoarthritis or closed lock according to the Research Diagnostic Criteria for TMDs (Group IIb, IIc, and III). CBCT and clinical records of non-TMD patients who sought treatment for purposes other than TMD were used retrospectively as a control. The following radiographic criteria were assessed: flattening, osteophyte, Ely's cyst, condylar surface irregularities, and joints' space measurements.

Results: Osteoarthritic joints had significantly more condylar irregularities (P50.0), osteophytes (P50.0), and condylar flattening (P50.003) than non-TMD joints. Osteoarthritic joints had significantlymore superior surface irregularities (P50.0) and osteophytes (P50.006) than closed lock joints.Non-TMDjoints had significantlymore joint space (5.64+1.88) compared with osteoarthritic joints (4.57+1.97), (P50.025). The correlation among TMD, osteophytes, and flattening of the condylar surface was statistically significant (r50.331, Pv0.000).

Discussion: Cone-beam computerized tomography findings are significantly associated with the clinical diagnosis of TMD. Osteophytes and flattening of the condylar surface are common features of TMD.
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http://dx.doi.org/10.1179/2151090315Y.0000000002DOI Listing
March 2016

Response from the authors.

Dent Traumatol 2013 Jun;29(3):250

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June 2013

Assessing dental students' knowledge of oral cancer in the United Arab Emirates.

Int Dent J 2013 Apr;63(2):80-4

Department of General and Specialist Dental Practice, University of Sharjah, Sharjah, United Arab Emirates.

Objective: The purpose of this study was to assess the knowledge of future dentists of the United Arab Emirates on risk and non-risk factors for oral cancers and correlate it with their own tobacco use, whether they assess their patients' tobacco use and their opinion about the relation of oral cancer and smokeless tobacco use.

Methods: A total of 270, first- to fifth-year undergraduate dental students who consented to participate in the study filled in a questionnaire enquiring about their knowledge of oral cancer risk factors. A score of oral cancer risk factor knowledge was calculated for each participant based on their correct answers.

Results: Eighty-three per cent of participants identified the use of tobacco as a risk factor for oral cancer, 52% identified old age, 45.6% knew about low consumption of fruits and vegetables and 74.4% of students could correctly identify use of alcohol as a risk factor for oral cancer. A significant association was found between being a current and previous tobacco user and having low knowledge of risk factors score (P = 0.015). No significant associations were found between the year of study in the dental college, gender, nationality and knowledge of oral cancer risk factor scores.

Conclusion: This study showed an apparent lack of knowledge of oral cancer risk factors among dental students that may later result in a deficiency in integrating optimal oral cancer diagnostic procedures in their practices. There is an urgent need to enhance the oral cancer curricula in oral cancer education and clinical training in oral cancer prevention and examination for dental students.
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http://dx.doi.org/10.1111/idj.12017DOI Listing
April 2013

The relationship between dental health behavior, oral hygiene and gingival status of dental students in the United Arab Emirates.

Eur J Dent 2013 Jan;7(1):22-7

General and Specialist Dental Practice, College of Dentistry, University of Sharjah, UAE.

Objective: The purpose of this study is to assess the impact of knowledge acquired in preventive aspects of dental education on dental students' own health attitudes, oral hygiene and gingival status in the United Arab Emirates.

Methods: To compare the self-reported oral health behavior of first year dental students in the University of Sharjah with their actual oral hygiene and gingival conditions, 93 volunteers who participated in the study completed the Hiroshima University-Dental Behavioral Inventory (HU-DBI) questionnaire. Subsequently a clinical examination for their Plaque Scores (Modified Quigley Hein Plaque Index) and Gingival Bleeding Index was performed by a calibrated dentist.

Results: 29% of the participants reported bleeding gums; 83% were concerned by the color of their gums while 63% reported that it was impossible to prevent gum disease with brushing alone; and only 10% noticed some sticky white deposits on their teeth. However, approximately 92% were not in agreement that they would have false teeth when they grew older. 56% mentioned that they used dental floss regularly and 86% brushed twice daily or more. Male students had higher bleeding and plaque scores than female students. There appeared to be a significant relationship between plaque scores and HU-DBI responses; in addition to the significant relationship noted between recorded bleeding percentages and HU-DBI responses.

Conclusion: Female students have shown better dental care behavior than male students. The dental students with better self-reported oral health attitudes were expected to have lower plaque scores but instead had moderate plaque and gingival bleeding scores. This indicates the need for more emphasis on preventive measures in oral health education.
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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3571505PMC
January 2013

Potential uses of human salivary protein and peptide analysis in the diagnosis of disease.

Arch Oral Biol 2012 Jan 19;57(1):1-9. Epub 2011 Jul 19.

Department of Oral & Craniofacial Health Sciences, College of Dentistry, University of Sharjah, Sharjah, United Arab Emirates.

Saliva is an important body fluid containing a complex mixture of proteins, peptides and other substances. These are not only important in maintaining the health of the oral cavity but also may yield information about oral and systemic disease. Comprehensive analysis and identification of the proteomic content of human saliva may contribute to the understanding of oral pathophysiology and provide a foundation for the recognition of potential biomarkers of human disease. The collection of saliva samples is non-invasive, safe, and inexpensive. It seems likely that testing methods can be developed which can be used in general medical or dental practice. However, it is important to realize that the collection of saliva must be carefully controlled. In this paper we review the progress in the analysis of the human salivary proteome and summarise the diagnostic possibilities that have been explored. The precautions in collecting saliva, and some of the factors which would have to be considered if a diagnostic test were to be generally adopted are discussed.
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http://dx.doi.org/10.1016/j.archoralbio.2011.06.013DOI Listing
January 2012

Prevalence and etiological factors related to dental injuries amongst 18-22-year-olds in United Arab Emirates.

Dent Traumatol 2010 Oct;26(5):388-92

College of Dentistry, University of Sharjah, Sharjah, UAE.

Background: Dental injuries in children and adolescents living across the globe are a serious public health problem. There are no data on dental injuries in United Arab Emirates (UAE). For the development of effective preventive measures, the present study was conducted to investigate the etiology and environment where dental injuries occurred, and to assess the relationship between traumatic dental injuries and socioeconomic status.

Material And Methods: This study was undertaken in different colleges of University of Sharjah, UAE. 412 participants aged 18-22 years were screened using Dental Trauma Index (DTI), following the questionnaire phase of the study.

Results: Prevalence of dental injury was 25.9%, mostly (46.9%) with restored teeth; followed by 42.3% of minor injury (untreated enamel fracture), affecting one upper central incisor (53%). The mean age at the time of dental injury was 10.5 years (SD = 1.52; range 8-13 years) in females vs 14 years (SD = 1.71; range 12-16 years) in males. Dental injuries among males mostly occurred at public places such as on streets (27%) with (19%) of injuries were related to motor bike/micro scooters followed by bicycles (17%) and traffic accidents (9%). Socioeconomic indicators chosen were not statistically significant with the exception of family income (P = 0.01).

Conclusion: The findings of this study show that dental traumas are prevalent among middle and high socioeconomic groups. There is a need for potential interventions like educating parents, caretakers, and older siblings on how to reduce the risk factors related to dental injuries.
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http://dx.doi.org/10.1111/j.1600-9657.2010.00917.xDOI Listing
October 2010

Immunohistochemical analysis of P(53) and bcl-2 in benign and malignant salivary glands tumors.

J Oral Pathol Med 2010 Jan 16;39(1):48-55. Epub 2009 Sep 16.

College of Dentistry, University of Sharjah, Sharjah, UAE.

Background: Salivary glands tumors are relatively uncommon neoplasm with widely variable histopathologic and biologic characteristics. Alteration in some proto-oncogenes and tumor suppressor genes may lead to the development and progression of these tumors.

Aims: The purpose of this study was to analyze the immunohistochemical expression of P(53) and bcl-2 in some salivary gland tumors in relation to tumor size, histologic grade, and extent of invasion.

Setting And Design: The sample consisted of 22 formalin-fixed paraffin embedded blocks of benign and malignant salivary glands tumors.

Material And Method: P(53) and bcl-2 immunoreactivity was semi-quantitatively evaluated in at least 1000 cells examined under the microscope at 40x magnification and recorded as percentage of P(53) or bcl-2 positive tumor cells over the total number of cells examined in the same area. Percentage scores were subsequently categorized using the 5% cut-off point for positive staining.

Results And Conclusion: Pleomorphic adenoma (PA) showed negative expression of P(53) and bcl-2 in 70% of cases, whereas all malignant salivary glands tumors were positive for P(53) and bcl-2. P(53) positive/bcl-2 positive immunostaining reaction was week in small size PA and was totally absent in larger lesions. However, all malignant tumors expressed P(53), with the highest record in low-grade adenocarcinoma (76%) and the lowest score was observed in both low-grade carcinoma in PA and adenocystic carcinoma. bcl-2 immunostaining was also assessed, the highest recorded score was in high-grade adeno cystic carcinoma (90%) and the lowest in both low-grade carcinoma ex-PA and low-grade cystic mucoepidermoid carcinoma (3%). P(53)/bcl-2 immunostaining reactivity could be helpful in demonstrating salivary glands tumor behavior in terms of progression and extent of invasion.
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http://dx.doi.org/10.1111/j.1600-0714.2009.00816.xDOI Listing
January 2010

Ultrastructure and composition of basement membrane separating mature ameloblasts from enamel.

Arch Oral Biol 2008 Apr 4;53(4):310-7. Epub 2007 Dec 4.

Department of Oral and Craniofacial Health Sciences, College of Dentistry, University of Sharjah, United Arab Emirates.

At a late stage of amelogenesis, a basement-membrane-like (BML) structure appears between mature ameloblasts and the enamel surface. Although this BML structure is known to contain certain basement membrane components, its detailed nature and role were not well defined. As such, this study examined the BML structure using high-resolution electron microscopy combined with immunohistochemical staining. Mandibular rat incisors were processed for the preparation of Epon sections for ultrastructural observations, and frozen sections were used for immunostaining laminin, heparan sulphate proteoglycan (HSPG) and type IV collagen. The BML structure was characterized by the presence of abundant ribbon-like 'double tracks', 4.5-5.0 nm wide; the form known to be taken by HSPG in basal laminae. The main ultrastructural component of basal laminae, known as 'cords', was replaced by fine filaments of type IV collagen. Immunohistochemical staining of the BML structure showed an intense reaction for HSPG, moderate staining for type IV collagen and negligible staining for laminin. These observations indicate that this structure is an atypical basement membrane in which the cord network is replaced by type IV collagen filaments. However, the BML structure was found to be unusually rich in HSPG, similar to kidney glomerular basement membrane. It is likely that this specialized basement membrane mediates firm attachment of mature ameloblasts to the enamel surface, and filters the influx and efflux of materials to and from enamel during maturation.
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http://dx.doi.org/10.1016/j.archoralbio.2007.10.008DOI Listing
April 2008