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Browsing by Author "Alfaraj, Amal"
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Item Barriers to Dental Care in Individuals with Special Healthcare Needs in Qatif, Saudi Arabia: A Caregiver’s Perspective(Dove Press, 2021-01-22) Alfaraj, Amal; Halawany, Hassan S.; Al-Hinai, Muntasar T.; Al-Badr, Abid H.; Alalshaikh, Marwa; Al-Khalifa, Khalifa S.; Prosthodontics, School of DentistryObjective: Access to dental care is a key factor influencing oral health outcomes. Individuals with special healthcare needs are at risk of not having access to dental care services which they need to maintain their oral health. This study assessed the magnitude of this problem and identified barriers responsible for the difficulties in accessing dental care in Qatif, Saudi Arabia, as reported by caregivers of individuals with special healthcare needs. Methods: This cross-sectional study collected data using a self-administered survey questionnaire from caregivers of individuals with special healthcare needs across 11 centers (eight special needs centers and three schools) in Qatif, Eastern Province of Saudi Arabia, between February and April 2019. Results: A total of 186 caregivers participated in the study, 102 (54.8%) of whom reported difficulties in getting access to dental care. The key barriers included lack of time on the part of caregivers (60.8%), unsuitable clinic environment (53.9%), difficulties with transportation (51.9%), medical/health status of the individual with special healthcare needs (51.0%), and geographically distant dental clinics (51.0%). Caregiver demographics (age, gender, and educational level) had no significant influence on the difficulties reported by caregivers in getting access to dental care for individuals with special healthcare needs (p>0.05). Conclusion: A large proportion of caregivers in Qatif, Saudi Arabia, experience difficulties with access to dental care services for individuals with special healthcare needs. The most common barriers are physical accessibility of dental facilities (for individuals with special healthcare needs), affordability, and lack of skills and knowledge of dental care providers.Item CAD-CAM Hollow Obturator Prosthesis: A Technical Report(Wiley, 2022) Alfaraj, Amal; Su, Fang-Yu; Lin, Wei-Shao; Prosthodontics, School of DentistryAn obturator with a hollow bulb can decrease the overall weight of the prosthesis, stress on the underlying tissues, and patient discomfort. Although many techniques and materials have been proposed in the literature for hollowing the obturator prosthesis, they are often time-consuming and technique sensitive. This proposed technique used an open-source software program to hollow digital design of solid obturator base from a commercially available software in one single convenient step. The hollowing process allowed precise control of prosthesis thickness at the hollow space area for desirable hermetic seal and prosthesis strength.Item Caregivers' Perception about the Relationship between Oral Health and Overall Health in Individuals with Disability in Qatif, Saudi Arabia: A Cross-Sectional Study(Hindawi, 2022-10-03) Alalshaikh, Marwa; Alsheikh, Rasha; Alfaraj, Amal; Al-Khalifa, Khalifa S.; Prosthodontics, School of DentistryBackground: In Saudi Arabia, there are many people with disabilities that do not receive adequate healthcare, especially in the field of dentistry. Objective: This study focused on assessing caregivers' perception of the relationship between oral healthcare and the overall health status of individuals with special healthcare needs (SHCN) in Qatif, Saudi Arabia. Methodology Design. This cross-sectional study was conducted using a questionnaire that was divided into two sections. The first part included demographic information such as the age and gender of both the caregiver and the person with a disability and the type of disability. The second part investigated the systemic health of the individual with a disability and the caregivers' perception of the relationship between the management and treatment of systemic health and oral healthcare in relation to the overall health status. The results of descriptive analyses were summarized using frequency distribution tables. Bivariate analyses (chi-square test) were also performed. Significant differences were considered at a p value of 0.05. Setting. Initiated in school setting. Results: A total of 186 caregivers participated in the study. As much as 83.3% agree that oral health affects overall health, and 48.9% agreed that untreated dental problems could affect cardiac health. Age was the only factor found to be significantly associated with caregiver perception as younger caregivers were more likely to rightly understand the relationship between oral health and general health (p < 0.05). Conclusion: This study has shown the extent to which caregivers of individuals with special care needs to understand the role of oral health in the general health of an individual. Three-quarters of the caregivers agree that dental health affects overall health, and age is a factor that might influence this understanding.Item Marginal Fit, Mechanical Properties, and Esthetic Outcomes of CAD/CAM Interim Fixed Dental Prostheses (FDPs): A Systematic Review(MDPI, 2023-02-28) Al-humood, Hussain; Alfaraj, Amal; Yang, Chao-Chieh; Levon, John; Chu, Tien-Min Gabriel; Lin, Wei-Shao; Prosthodontics, School of DentistryThis systematic review aimed to study the outcomes of CAD-CAM (milled and 3D-printed) interim dental prostheses when compared to conventional ones. The focused question of "In natural teeth, what are the outcomes of CAD-CAM interim FDPs compared to the conventionally-manufactured ones regarding marginal fit, mechanical properties, esthetics, and color stability" was formulated. The systematic search was conducted electronically in the PubMed/MEDLINE, CENTRAL, EMBASE, Web of Science, New York Academy of Medicine Grey Literature Report, and Google Scholar databases by using the MeSH keywords and keywords associated with the focused question and limiting articles to those published between 2000 and 2022. A manual search was conducted in selected dental journals. The results were analyzed qualitatively and are presented in table format. Of the included studies, 18 studies were in vitro and 1 was a randomized clinical trial. Of the eight studies analyzing the mechanical properties, five studies favored the milled interim restorations, one study favored both 3D-printed and milled interim restorations, and two studies reported better mechanical properties in conventional interim restorations. Among four studies evaluating the marginal discrepancies, two studies favored the marginal fit in milled interim restorations, one study reported a better marginal fit in both milled and 3D-printed interim restorations, and one study found conventional interim restorations have a better marginal fit and smaller marginal discrepancy when compared to both milled and 3D-printed restorations. Among five studies that evaluated both the mechanical properties and marginal fit, 1 study favored 3D-printed interim restorations and four studies favored milled interim restorations over the conventional ones. Two studies analyzing the esthetics outcomes demonstrated better results with milled interim restorations compared to conventional and 3D-printed interim restorations in terms of their color stabilities. The risk of bias was low for all the studies reviewed. The high level of heterogeneity within the studies excluded meta-analysis. Most of the studies favored the milled interim restorations over the 3D-printed and conventional restorations. The results suggested that milled interim restorations offer a better marginal fit, higher mechanical properties, and better esthetic outcomes in terms of color stabilities.Item The Trueness of Obturator Prosthesis Base Manufactured by Conventional and 3D Printing Techniques(Wiley, 2021) Alfaraj, Amal; Yang, Chao-Chieh; Levon, John A.; Chu, Tien-Min G.; Morton, Dean; Lin, Wei-Shao; Prosthodontics, School of DentistryPurpose : To compare the intaglio surface trueness of obturator prosthesis bases manufactured by traditional compression molding, injection molding, and 3D printing techniques. Materials and Methods : A complete edentulous master cast with Aramany Class I maxillary defect was selected for this in vitro study. Four study groups (n = 10/group) were included in this study, Group A: Compression Molding, Group B: Injection Molding, and Group C: Cara Print 3D DLP Printer, and Group D: Carbon 3D DLS Printer. All obturator prostheses' intaglio surfaces were scanned with a laboratory scanner (E4; 3Shape Inc, New Providence, NJ) and the dimensional differences between study samples and their corresponding casts were calculated as the root mean square (measured in mm, absolute value) using a surface matching software (Geomagic design X; 3D Systems, Rock Hill, SC). One-way Analysis of variance (ANOVA) and Fisher's least significant difference (LSD) test were used to compare groups differences in RMS (α = .05). Results There was a significant effect of manufacturing technique on the RMS values for the 4 conditions [F(3,36) = 5.743, p = .003]. Injection Molding (0.070 mm) and Compression Molding groups (0.076 mm) had a lower interquartile range, and the Cara Print 3D-Printer group (0.427 mm) and Carbon 3D-Printer (0.149 mm) groups had a higher interquartile range. The Injection Molding group showed the best and uniform surface matching with the most area in green in the color maps. The Injection Molding group (0.139 ±0.049 mm) had significantly lower RMS than all other groups (p<.001 for all comparisons). Compression Molding (0.269 ±0.057 mm), Cara Print 3D-Printer (0.409 ±0.270 mm), and Carbon 3D-Printer (0.291 ±0.082 mm) groups were not significantly different from each other (Compression Molding versus Carbon 3D-Printer, p = .59; Compression Molding versus Cara Print 3D-Printer, p = .25; Cara Print 3D-Printer versus Carbon 3D-Printer, p = .40). Conclusion : Obturator prosthesis bases manufactured with injection molding technique showed better intaglio surface trueness than ones made by the compression molding technique and 3D printers. Although obturator prosthesis bases manufactured from different 3D printers showed similar trueness, a DLP 3D printer produced less consistent outcome than a DLS 3D printer.Item The trueness of scans using one intraoral scanner in different partially edentulous conditions(Wiley, 2023) Majeed-Saidan, Ahmad; Dutra, Vinicius; Levon, John A.; Chu, Tien-Min G.; Morton, Dean; Alfaraj, Amal; Lin, Wei-Shao; Prosthodontics, School of DentistryPurpose To investigate the trueness of intraoral scanning in 8 commonly seen partially edentulous conditions. Materials and methods A maxillary dentoform was modified into the 8 commonly seen partially edentulous conditions. Each modification was scanned with a laboratory desktop scanner. Each modification was then scanned 10 times (n = 10) with an intraoral scanner. All scans were exported as STL files and then imported into a surface matching software using the best-fit alignment method. The dimensional differences between the study STL files from the intraoral scanner were compared to the corresponding reference STL files. The measurements were calculated as the root mean square (RMS) and defined as the trueness of the intraoral scans. In addition to the RMS values, qualitative assessments were completed on the color maps. The color maps produced by the surface matching software were used to visualize the areas of deviation between scans from the intraoral scanner and their corresponding reference files. One-way analysis of variance (ANOVA), followed by pair-wise comparisons using Fisher's Protected Least Significant Difference were utilized to compare the differences between the groups in RMS values (α = 0.05). Results Partially edentulous condition significantly affected the trueness of the intraoral scans. Group 8 (Class IV) had significantly lower RMS (0.1878 ± 0.0455 mm) than all other groups (p < 0.001). Group 2 (Class II) and Group 7 (Class III modification I) are not significantly different from each other (Group 2: 0.5758 ± 0.0300 mm; Group 7: 0.5602 ± 0.0231 mm, p = 0.571), while they both had significantly higher RMS than all other groups (p < 0.001). The remaining groups showed the RMS values were within the range of 0.3001 ± 0.0891 mm (Group 6 – Class III with Long Edentulous Span) and 0.4541 ± 0.1039 mm (Group 1 – Class I). Conclusion Different partially edentulous conditions affected the trueness of the scans generated from the selected intraoral scanner. Class IV edentulous condition had the highest intraoral scan trueness. It is unknown if RMS values are clinically significant, and the validity of using intraoral scans directly for PRDP fabrication will need further studies.