IntroductionAfter insertion into the bone, implants osseointegrate, which is required for their long-term success. However, inflammation and infection around the implants may lead to implant failure leading to peri-implantitis and loss of supporting bone, which may eventually lead to failure of implant. Surface chemistry of the implant and lack of cleanliness on the part of the patient are related to peri-implantitis. The only way to get rid of this infection is decontamination of dental implants.ObjectiveThis systematic review intended to study decontamination of microbial biofilm methods on titanium implant surfaces used in dentistry.MethodsThe electronic databases Springer Link, Science Direct, and PubMed were explored from their inception until December 2020 to identify relevant studies. Studies included had to evaluate the efficiency of new strategies either to prevent formation of biofilm or to treat matured biofilm on dental implant surfaces.Results and DiscussionIn this systematic review, 17 different groups of decontamination methods were summarized from 116 studies. The decontamination methods included coating materials, mechanical cleaning, laser treatment, photodynamic therapy, air polishing, anodizing treatment, radiation, sonication, thermal treatment, ultrasound treatment, chemical treatment, electrochemical treatment, antimicrobial drugs, argon treatment, and probiotics.ConclusionThe findings suggest that most of the decontamination methods were effective in preventing the formation of biofilm and in decontaminating established biofilm on dental implants. This narrative review provides a summary of methods for future research in the development of new dental implants and decontamination techniques.

Contamination of titanium dental implants may lead to implant failure. There are two major types of contaminants: the inorganic and organic contaminants. The inorganic contaminants mostly consist of elements such as calcium, phosphorus, chlorine, sulphur, sodium, silicon, fluorine and some organic carbons. Whereas organic contaminants consist of hydrocarbon, carboxylates, salts of organic acids, nitrogen from ammonium and bacterial cells/byproducts. Contaminants can alter the surface energy, chemical purity, thickness and composition of the oxide layer, however, we lack clinical evidence that contaminations have any effect at all. However, surface cleanliness seems to be essential for implant osseointegration.These contaminants may cause dental implants to fail in its function to restore missing teeth and also cause a financial burden to the patient and the health care services to invest in decontamination methods. Therefore, it is important to discuss the aetiology of dental implant failures. In this narrative review, we discuss two major types of contaminants: the inorganic and organic contaminants including bacterial contaminants. This review also aims to discuss the potential effect of contamination on Ti dental implants.

To compare the different surface topographies of titanium implants used in dentistry against the formation of bacterial biofilm. To identify relevant studies, the electronic databases PubMed, Science Direct and Springer Link were searched from inception until January 2019. A total of 38 studies were selected for the systematic review (n = 38). The most commonly used titanium surfaces were machined titanium (16.3%), sandblasted, large-grit, acid-etched titanium (10.9%), untreated or pure titanium (10.9%), polished titanium (9.8%), physically textured titanium (9.8%), acid-etched titanium (8.7%) and anodized titanium (5.4%). The majority of the studies (78.9%) found that surface topographies (with varying degrees of roughness) had a beneficial effect on the ability to allow low bacterial biofilm on the surfaces. A low roughness value (R a) of below 1 µm was found in 68% of these surfaces. Overall, no specific surface topography was found to be the ideal surface in allowing the least bacterial biofilm attachment. In this study, meta-analysis was not performed. This narrative systematic review provides a summary of the effects of surface topographies for future research and development of new dental implant surfaces and decontamination techniques.

Purpose: To determine the prevalence of diabetic retinopathy (DR) and the factors associated with retinopathy among type 2 diabetes mellitus (DM) patients in Brunei Darussalam.Methods: Cross-sectional study of all type 2 DM patients who attended diabetic eye screening over a 3-month period at one of four government hospitals. We assessed association between DR with the following variables: age, sex, glycated hemoglobin (HbA1c), duration of DM, hypertension, hyperlipidemia, and microalbuminuria.Results: There were 341 patients (female, 58.9%; mean age, 55.3 ± 11.9 years) with a mean duration of DM of 9.4 ± 7.4 years and mean serum HbA1c of 8.4% ± 1.9%. The overall prevalence of any DR was 22.6% (95% confidence interval, 18.8–27.1) with prevalence rates of 4.1% (95% confidence interval, 2.1–6.4) for proliferative DR and 9.7% (95% confidence interval, 6.8–13.2) for vision-threatening DR. Multivariate analysis showed that DR was significantly associated with certain age groups (reduced in older age groups), longer duration of DM (11 years or more), poor control (HbA1c >9.0%) and presence of any microalbuminuria.Conclusions: DR affects one in five patients with DM in Brunei Darussalam, comparable to rates reported for other Asian populations. It is especially worrying that one in ten patients with DM had vision-threatening DR. DR was significantly associated with longer duration of DM, poor control and presence of microalbuminuria but reduced in older age groups. It is important to advocate good control right from the time of diagnosis of DM and institute timely and effective management of retinopathy. DR was significantly associated with longer duration of DM, poor control of diabetes, and presence of microalbuminuria but reduced in older age groups.

BackgroundAdmission scores have been used to select highly capable students for an undergraduate medical programme. This study examines the relationship between three admission criteria: (i) multiple-mini-interview (MMI); (ii) pre-university final results (PUFR); (iii) entrance scores (combination of 50% MMI and 50% PUFR), with students’ academic performance in the medical programme at Universiti Brunei Darussalam (UBD).MethodsWe performed linear regression analysis on 125 students who completed the programme from 2013 to 2018 and compared their MMI, PUFR and entrance scores with their academic performance throughout their three years of undergraduate study. Academic performance outcomes were assessed from students’ Grade Point Average (GPA), cumulative Grade Point Average (cGPA) and marks in the modules ‘Health Sciences’ (HS), ‘Patient Care’ (PC), ‘Our Community and Personal Professional Development’ (OCPPD) and Special Study Modules, for overall (six-semesters average) and individual semesters.ResultsSimple linear regression results revealed that one unit increase in MMI score was associated with a significant increase in overall PC marks by 0.09. A 20-unit increase in PUFR was associated with a significant increase in students’ cGPA by 0.05; overall HS marks by 1.0; GPA in semesters 1,2,3,6; HS marks in semesters 1,2,3,6 and OCPPD marks in semesters 2,3. Meanwhile, one unit increase in entrance score was associated with a significant increase in cGPA by 0.01; overall HS by 0.2 marks and overall OCPPD by 0.11 marks. The effect of entrance score was also seen with increase in students’ GPA in semesters 1,2,3,4,6 by at least 0.01, as well as marks for HS in semesters 1,2,3,4,6 and OCPPD in semesters 2,3.ConclusionOur findings support that both PUFR and entrance scores as selection criteria for admission into a medical programme were associated with better academic performances, with PUFR showing a greater mark increase than entrance scores. Meanwhile, MMI showed better academic performance in the patient care module only, inferring that MMI grants a glimpse of candidates’ bedside attitude towards patients.