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Background/purpose: Exploration of early practicing dental professionals' awareness and attitude toward inferior alveolar nerve block IANB will directly inform efforts to improve clinical practices and ensure patient safety. The aim was to highlight the students, interns, and junior dentists' awareness and attitude toward the IANB, failure, and related complications in the Kingdom of Saudi Arabia (KSA)., Materials and Methods: An open web-based survey prepared according to the Checklist for reporting results of Internet e-surveys CHERRIES recommendations was designed and carried out across different regions of the KSA. The questionnaire was composed of four main sections including the participant's details, and qualifications; inferior alveolar nerve block delivery; participants' education, and training-related questions; and attitudes toward proposed solutions to overcome the related failure and complications., Results: 262 participants completed the questionnaire (94 dental students, 79 interns, and 89 junior dentists). There was a significant difference in the following findings: males performed IANBs more frequently than females ( P  < 0.05); females, students, and private practice/University type showed less attendance to workshops and seminars on IANB with more need for training ( P  < 0.05); females were more in agreement with ''continuous education courses'' and ''workshops done by specialists'' to propose solutions to overcome IANB failure ( P  < 0.05). The multivariate logistic regression analysis showed that qualification and attendance of a training course were strong predictors of participants' readiness to manage IANB complications ( P  < 0.05)., Conclusion: The findings emphasize how crucial it is for early dental practitioners to participate in continuing professional development programs to enhance their capacity to administer IANB and handle complications., (© 2024 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.)

Competing Interests: Declaration of competing interest The authors declare that they have no conflict of interest.

Objectives: Team-based learning (TBL) is a student-centered method where learning can be promoted and facilitated by changing the traditional teaching lecture into an active, dynamic, and more engaging problem-solving process. The present study evaluated the student's learning experience and satisfaction using a TBL method in a preclinical oral surgery course., Methods: Twelve TBL sessions were designed for second-year dental students. Six 3-h and 2-h sessions with various preclinical topics were conducted in academic Terms 1 and 2, respectively. Teaching activities such as tests and group discussions were included in the sessions. The last post-session questionnaire sought students' feedback and satisfaction to assess four parameters related to students' knowledge acquirement, interpersonal skills enhancement, learning environment, and teacher-student relationships., Results: Most average scores of the responses agreed with the related statements in the four parameters. The results of the Pearson's correlation test revealed that there was a significant relationship (r = 0.735; P  < 0.05) between the parameters of the 3-h and 2-h sessions., Conclusion: The TBL method yielded positive and high levels of satisfaction, which may be attributed to the proper implementation of TBL methodology by the teacher and students., (© 2024 The Authors.)

Bone deficiency in the posterior maxillary bone can be associated with a large sinus cavity and this dilemma can limit implant placement for dental rehabilitation in this area. The maxillary sinus lifting technique can be the solution for many clinical situations with minimal bone height, allowing the placement of longer implants. Autogenous bone graft is a safe and reliable material for reconstructive surgery. In this article, a case of an elderly male patient with inadequate maxillary bone height is presented. Simultaneous maxillary sinus elevation and implant placement with autogenous parietal bone graft were performed., Competing Interests: There are no conflicts of interest., (Copyright: © 2024 Contemporary Clinical Dentistry.)

Background/purpose: Concerns about the indications for the surgical removal of third molars have not yet reached a decisive agreement. The aim of the study was to evaluate the perception and practice of Saudi' dentists when encountering third molars clinical situations including diagnosis, treatment, and postsurgical care., Materials and Methods: A cross-sectional survey was conducted and approved by the ethics research committee at Prince Sattam Bin Abdulaziz (PSAU). The survey comprised of four sets of questions with multiple-choice answers including the participants' details and type of practice (private or government), clinical awareness and attitude regarding lower third molars surgery, and the confidence level of dentists when performing third molars extraction. The survey was published online with a timeframe of three months to respond., Results: 196 participants responded to the designated survey (55 dental interns and 141 general dental practitioners (GPs)). Most responses (80.1%) were from Riyadh province (central region). There was a significant difference between GPs and interns in terms of impacted third molars with associated cystic lesions, bony impactions, and diffuse pain ( P  < 0.05). Male dentists tend to prescribe antibiotics more than female dentists ( P  = 0.001) and GPs more than interns ( P  = 0.027). The results also indicated that male dentists were more confident than females when performing third molar extraction. Generally, female dentists preferred to have further training on such surgery ( P  < 0.05)., Conclusion: Continuing professional development programs both during dental internship and general practice are recommended to improve the required skills of third molar extraction., Competing Interests: The authors declare that they have no conflict of interest., (© 2023 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.)

This study was carried out to investigate the effect of a complete exchange of Ca 2+ with Zn 2+ ions on the structure of brushite (CaHPO 4 ·2H 2 O), which might be advantageous in the production process of Ca x Zn 1-x HPO 4 ·nH 2 O. To acquire the starting solutions needed for the current study, (NH 4 ) 2 HPO 4 , Ca(NO 3 ) 2 ·4H 2 O, and Zn(NO 3 ) 2 ·6H 2 O were utilized in several molar concentrations. The findings indicate that Ca is partly substituted by Zn when the Zn/Ca molar ratio is below 0.25 and that Zn doping hinders the crystallization of brushite. A continued increase in the Zn/Ca molar ratio to 1 (at which point the supersaturation of the Zn solution rises) led to a biphasic compound of monoclinic brushite and parascholzite precipitate. Elevating the Zn/Ca molar ratio to 1.5 resulted in a precipitate of a parascholzite-like mineral. Finally, increasing the Zn/Ca molar ratio to 4 and above resulted in the formation of the hopeite mineral. Future biomaterial production with specific and bespoke characteristics can be achieved by adjusting the Zn/Ca ratio in the starting solution. It Rhas been established that the Zn/Ca ratio in the starting solution can be adjusted to obtain minerals with specific compositions. Thus, new synthesis methods for parascholzite and hopeite were introduced for the first time in this manuscript.

Objective: The objective of the study is to determine the role of Lateral Pterygoid Muscle LPM in the articular disc displacement ADD, which is considered controversial due to the variations in the pattern of insertion of the Superior Lateral Pterygoid Muscle SPLM., Background: It is well understood that the superior head of the lateral pterygoid muscle has only a single insertion pattern among individuals, in which the muscle is attached to the articular disc and capsule. However, recent findings in many studies have shown a noticeable variation in the insertion pattern of the upper LPM., Methods: MRI examinations were collected at King Faisal Specialist Hospital & Research Centre, Riyadh, Saudi Arabia. Scans of 61 patients (41 females, 20 males; mean age 33 years old) with symptoms of temporomandibular dysfunction were reviewed retrospectively. The direction of their articular disc displacement was evaluated through sagittal and coronal views in both open and closed mouth positions., Results: There was no statistical significance found between the LPM attachment types and TMJ disc position. The chi-square test also showed no significant difference between the type of LPM attachment and the condylar location. Forty-five percent of the articular discs were located between the articular eminence and the glenoid fossa. The majority of the disc displacement was in the anterior direction., Conclusion: There was no statistically significant association found between the type of LPM attachments and the direction of disc displacement., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Background and Aims: The long duration of orthodontic treatment is a major patients' concern. A noninvasive method of accelerating tooth movement in a physiological manner is needed. The aim of the study was to evaluate the effects of Er:YAG laser application during orthodontic treatment of deep bite and to evaluate its analgesic effect during that movement., Materials and Methods: A prospective randomized controlled clinical trial (RCT) was performed on 30 patients with deep bite. Sample was divided into two groups: (A), 15 patients (orthodontic treatment-control group) and (B), 15 patients (orthodontic treatment and Er:YAG Laser - laser group). The tooth movement was evaluated as the primary outcome variable by measuring angular and linear changes on three progress lateral cephalometeric radiographs (T1, T2 and T3); Lateral cephalograms were taken before treatment (T1), immediately after finishing the stage of leveling and alignment (T2) and after completion of the intrusion stage (T3).Laser parameters were 400 mJ/10 Hz/4 W and 400 mJ/15 Hz/6 W, depending on the handpiece used. The levels of pain and discomfort were evaluated and ranked according to a visual analog scale. Paired t-tests or Wilcoxon matched-pairs signed-rank tests were used to detect significant differences., Results: The main findings of the treatment were (1) significant positive difference in the rates of tooth intrusion movement on the experimental group compared with the control group at the baseline to T2 and T3 interval and the tooth movement rate was approximately 3 times faster in the experimental group. (2) The pain score in the experimental group was significantly lower compared with the control group on day 3 as on day 7., Conclusion: The application of Er:YAG laser is an effective mean to speed orthodontic tooth movement with a significant reduction in pain and discomfort after application., (2018, Japan Medical Laser Laboratory.)

Evidence-based practice is the integration of individual clinical expertise with the best available external clinical evidence from systematic research and patient's values and expectations into the decision making process for patient care. It is a fundamental skill to be able to identify and appraise the best available evidence in order to integrate it with your own clinical experience and patients values. The aim of this article is to provide a robust and simple process for assessing the credibility of articles and their value to your clinical practice.

Writing a research proposal is probably one of the most challenging and difficult task as research is a new area for the majority of postgraduates and new researchers. The purpose of this article is to summarize the most important steps and necessary guidelines for producing a standard research protocol. Academic and administrative success of any project is usually determined by acquiring a grant for the related field of research. Hence, the quality of a protocol is primarily required to achieve success in this scientific competition.

The distinction between ailing and failing implants is clinically important. Changes in the peri-implant soft or hard tissues will indicate whether the implant is ailing, failing, or has failed. This article discusses these clinical situations and provides an overview and description of peri-implant diseases and their treatment alternatives., (© 2012 Wiley Publishing Asia Pty Ltd.)

Understanding the anatomy of the floor of mouth is very important as severe submandibular hemorrhages are life threatening. This case report illustrates the potential hemorrhage consequences of implant surgery within the interforaminal region. The highly vascularized interforaminal region is susceptible to hemorrhage, which can be induced simply by instruments causing vascular trauma. The risk of intraoperative bleeding can be minimized by painstaking preoperative clinical and radiological examination but cannot be averted as it is inherent in the underlying anatomy of the region.

Cryosurgery is a method of achieving lesion destruction by rapid freezing in situ. Application of cryosurgery in medicine widespread and its use within dentistry is also well documented, using both open and closed liquid nitrogen and carbon dioxide. The major advantages of oral cryosurgery include bloodless treatment, very low incidence of secondary infection, and a relative lack of scarring and pain. This review outlines knowledge on the mechanisms, tissue response, and current practices of cryosurgery in the oral and peri-oral region. More experimental studies are needed to better understand this important modality at cellular and molecular levels. Inconsistency in the current protocols used for the treatment of the oral lesions is evident. Additional studies are needed to define the treatment protocols for different types of oral lesions. Information on the cryogen type and dose and the delivery technique required would help to produce reproducible outcomes for the treatment of targeted lesions., (© 2012 Wiley Publishing Asia Pty Ltd.)

Objective: To investigate the effect of a 1-week postoperative course of 600 mg of ibuprofen taken four times a day on marginal bone level around oral implants., Materials and Methods: Twenty-eight patients were allocated to the ibuprofen group (14 patients) or no-ibuprofen group (14 patients). Overall, 57 implants were inserted, 31 implants in the ibuprofen group and 26 in the no-ibuprofen group. The primary outcome measure was the change in marginal bone level around oral implants from baseline (2 weeks postplacement) to the 3- and 6-month radiographic examinations. The paralleling technique and a film holder coupled to a beam-aiming device were used to take the periapical radiographs. Measurement of changes in bone level was made using a viewing box and ×8 magnifier., Results: Three subjects were withdrawn from the therapy early as they did not complete the dose of ibuprofen (e.g. because of self-reported stomach upset). The mean marginal mesial bone loss from the baseline was 0.37 mm at the 3-month and 0.27 mm at the 6-month follow up for the ibuprofen group, while the corresponding values for the no-ibuprofen group were 0.15 mm and 0.08 mm. The mean marginal distal bone loss from the baseline was 0.42 mm at the 3-month and 0.2 mm at the 6-month follow up for the ibuprofen group, while the corresponding values for the no-ibuprofen group were 0.08 mm and 0.15 mm. There were no significant differences between the ibuprofen and no-ibuprofen groups when comparing the bone changes., Conclusion: Administration of a short course of systemic ibuprofen for postoperative pain management following implant insertion may not have a significant effect on the marginal bone loss around oral implants in the early healing phase., (© 2012 Wiley Publishing Asia Pty Ltd.)

For patients with shortened dental arches, many treatment options are available. The existing situation can be maintained by stabilizing the present dentition and improving the occlusion without extending the arch. Alternatively, the shortened dental arch can be extended by either a free-end saddle removable partial denture, cantilevered fixed bridge, or by an implant-supported prosthesis. The free-end saddle removable partial denture can be considered a simple, non-invasive, and relatively cheap treatment option for the shortened dental arch. It was believed that such prosthodontic rehabilitation would be beneficial for the patients in terms of improving oral functions. However, the existing literature indicates that the prognosis of free-end saddle removable partial denture is not predictable, it is problematic, and its contribution to oral functions in patients with shortened dental arches is considered to be dubious. This paper reviews and summarizes the current literature about the outcome of extending the shortened dental arch by a free-end saddle removable partial denture. It also outlines factors that may affect the prognosis of this prosthetic treatment.

Objective: This study aimed to characterize alteration in the immunohistochemical expression of p16 in normal tissue of the salivary gland surrounding pleomorphic adenoma, and the tumor cells of pleomorphic adenomas., Material and Method: A selected series of 120 cases of pleomorphic adenomas were examined., Results: The results showed that p16 expression in non tumor duct cells was strong positive nuclear staining in 98 (81.6%) cases out of 120, while there were 20 (16.6%) with moderate staining, and 2 (1.6%) with weak staining in the components of normal tissue of the salivary gland surrounding pleomorphic adenoma. p16 expression in pleomorphic adenomas showed 71 (59.1%) cases with moderate nuclear staining in the duct cells, 45 (37.5%) cases with nuclear weak staining, and 4 (3.3%) cases with negative staining. p16 nuclear staining in myxochondroid tissue was identified in 4 (3.3%) cases with strong staining, 65 (54.1%) cases had moderate staining, and 51 (42.5%) cases had weak staining., Conclusion: This study suggests alteration of p16 expression in pleomorphic adenomas. P16 might have a role in the development of pleomorphic adenoma.

Osseointegration is a good indication of the clinical success of titanium implants referring to the direct anchorage of such implants to the surrounding host bone. Despite the high success rate of endosseous dental implants, they do fail. A lack of primary stability, surgical trauma, and infection seem to be the most important causes of early implant failure. Early signs of infection may be an indication of a much more critical result than if the same complications occur later, because of disturbance of the primary bone healing process. Occlusal overload and periimplantitis seem to be the most important factors associated with late failure. Suboptimal implant design and improper prosthetic constructions are among those risk factors responsible for implant complications and failure. This concise review highlights the main causes associated with early and late implant failure, as thorough knowledge of this unavoidable clinical fact is essential in the field of oral implantology., (© 2012 Wiley Publishing Asia Pty Ltd.)

Background: The knowledge of the root canal morphology and the possible anatomical variations of mandibular premolars are important for the successful endodontic treatment of such cases. The aim of this study was to investigate the presence of two or three root canals in extracted first and second mandibular premolars which were collected from health centers in Syria., Materials and Methods: One hundred and ten human mandibular premolars (70 first premolars and 40 second premolars) with fully developed roots were investigated. After access the cavity of the teeth, the root canals were explored and radiographs were taken., Results: Premolars with one canal were found in 87% of cases (53% first premolar and 34% second premolar) and premolars with two canals were found in 12% of cases (10% first premolar and 2% second premolar). There was just one case (1%) where a first premolar had three canals. These differences were statistically significant with P<0.05., Conclusion: Clinicians should be aware of the anatomical variation in the mandibular premolars and be able to apply this knowledge in radiographical and clinical interpretation.

Aside from clinical evaluation, the interpretation of radiographic images is one of the most frequently applied diagnostic procedures in patients with oral implants. Radiology is an important part of treatment with tissue-integrated prostheses, both at the pre-operative stage to obtain full assessment of the bony host and at the post- operative stage to assess the clinical result. Radiographic examination of peri-implant tissues is an essential diagnostic prerequisite for the evaluation of success and failure of oral implants. A case of peri-implant radiolucency detected 3 months after surgical placement is presented. A remarkable regression of the radiolucency was noticed after a successful anti-infective therapy. The aim was to stress the role of oral radiology in exploring peri-implant bone defects. At this point, appropriate intervention might save early-failing implants from complete loss of osseointegration.

The aim of this study was to retrospectively evaluate the surgical technique of sinus floor elevation with autogenous parietal bone grafting in conjunction with immediate dental implants for the reconstruction of the maxilla in deficient maxillary alveolar ridges. Seventeen patients who underwent sinus floor elevation with bone graft from the parietal bone between 2005 and 2007 were included in the study. Cases of extremely deficient bone level in the alveolar ridge<4mm were included in the study. Seventy-seven implants (49 Staumann®, 24 Replace® and 4 Ankylos®) with different length and diameter were placed immediately after the graft was placed. Strict oral hygiene was required for the patients. Presurgical and postsurgical panoramic radiographs were taken. A high-quality reconstruction with an increase in lifted sinus bone height was achieved with parietal bone particulates. Seventy-three implants were clinically osseointegrated and four implants were lost giving a success rate 94.8%. No correlation was found between failure and the surgery. The encouraging results of this study suggest that the technique of reconstruction of the sinus floor and the resorbed alveolar ridge using an autogenous parietal bone graft is reliable, giving the surgeon the opportunity to successfully perform immediate implant placement in more difficult and deficient maxillary alveolar bone height., (Copyright © 2010. Published by Elsevier Ltd.)

Objectives: The aims of this study were to investigate the biochemical topography of collagen types I and III and to describe the histological structure at the implant placement site to determine the clinical significance of the findings and their possible interaction with bone healing around dental implants., Material and Methods: Bone cores from 9 mandibles were taken from the site of placement of dental implants. The reliable technique for rapid preparation of fresh-frozen undecalcified bone sections and the indirect immunofluorescent technique as an immunohistochemical procedure were applied. All sections were viewed under U.V light. For comparative purposes the tissue blocks remaining were used for general histology examination., Results: A homogenous distribution of collagen type I throughout the sections of all cores was evident. Whereas, the distribution of collagen type III throughout the sections of all cores was heterogeneous with different staining patterns. On the other hand, seven cores of the general histology study showed a structure of lamellar mature bone and two cores showed a structure of less mature woven bone., Conclusion: The biochemical and histological structures of the hosted bone may have an impact on the speed of bone healing around dental implants.

The possible occurrence of implant failure is a major concern for implantologists and knowledge in such unavoidable fact is clinically essential. Periimplantitis is an inflammatory response in which there is a loss of the bony support of the implant. Diagnosis is based on the clinical signs of infection such as hyperplastic soft tissues, suppuration, colour changes of the marginal peri-implant tissues and gradual bone loss. This site-specific infection may have many features in common with chronic adult periodontitis. Surgical trauma, micromotion and overload are also considered to be associated with implant failures. The lack of osseointegration is generally distinguished by implant mobility and radiological radiolucency. Here, the implant is considered to be failed . Progressive marginal bone loss without marked mobility is referring to a failing implant. The purpose of this concise review was to discuss the implant complications and failure by highlighting the major etiologic factors as well as the parameters used for evaluating such failure.

This article subscribes to the initial condition of bone quality and its ultimate effect on the success of dental implant treatment. A high success rate for the preservation of the alveolar bone around oral implants is predicated on good bone quality. For implantologists, the classification of bone quality should be based on the key elements required for osseointegration. These include structural morphology and cellular characteristics such as monocytes/macrophages, mesenchymal progenitor cells, fibroblasts, osteoclasts, and cells associated with angiogenesis.

Purpose: This randomised double-blind placebo-controlled trial was carried out to investigate the effect of a one-week post-operative course of 600 mg of ibuprofen taken four times a day on marginal bone level around dental implants., Materials and Methods: A total of 61 patients were allocated to the ibuprofen (31 patients) or placebo group (30 patients). Overall, 132 implants were inserted, 67 implants in the ibuprofen group and 65 implants in the placebo group. Preparation of the implant sites was carried out with an intermittent drilling sequence adapted to the fixture diameter and the local bone quality according to the Astra Tech implant installation guide. The primary outcome measure was the change in marginal bone level around dental implants from the baseline (2 weeks post-placement) to the 3- and 6-month radiographic examinations. The paralleling technique and a film holder coupled to a beamaiming device were used to take the periapical radiographs. Measurement of changes in bone level was made using a viewing box and x8 magnifier., Results: Two patients from the ibuprofen group were unable to complete the prescribed course of ibuprofen owing to a minor self-reported stomach upset. A patient from the control group did not attend any of the scheduled appointments following implant placement. A total of three patients dropped out. All implants survived in either group during the 6-month observation period. The mean marginal bone level changes from the baseline were (-0.33 mm) at the 3-month and (-0.29 mm) at the 6-month follow-up for the ibuprofen group while the corresponding values for the placebo group were (-0.12 mm) and (-0.30 mm). There were no statistically significant differences between groups for mean marginal bone level changes at 3 months (P = 0.27) or 6 months (P = 0.97)., Conclusions: Administration of a short course of systemic ibuprofen for post-operative pain management subsequent to implant placement may not have a significant effect on the marginal bone around dental implants in the early healing period.

The purpose of this study was to test whether a handheld magnifier could be used as an accurate instrument to examine the periapical radiographs and measure the marginal bone levels around dental implants system. A radiologic evaluation of marginal bone loss around 11 Astra Tech (Astra Tech AB, Mölndal, Sweden) oral implants was performed. A total of 22-recorded readings of mesial and distal bone loss were performed using a handheld magnifier with a graticule. There were 3 independent examiners who determined radiographic bone assessment. Thevalues of interclass correlation coefficient for the agreement between pairs of examiners showed a relatively high agreement (0.993 for A vs B, 0.995 for B vs C, and 0.995 for A vs C) and the same for intra-examiner reliability result (0.998 for B vs B). These results showed that a handheld magnifier could be used as a simple, reliable, and reproducible method for measuring bone loss around oral implants.

Ocular involvements of Biermer's anaemia are rarely reported in literature. We present a case of Biermer's anaemia associated with diabetes. Ocular examination showed important conjinctival paleness, diffuse retinal ischemia, Roth's tasks, macular oedema and ischemic optic neuropathy. The patient was treated with vitamin B12 intramusculary. A month later, on examination, we noted a regression of optic neuropathy, the aggravation of ischemic retinopathy and persistence of macular oedema. The patient was treated with laser photocoagulation. The majority of ocular manifestations are reversible if treatment is underlaken early. The combination of diabetes with Biermer's anemia deteriorates the ischemic retinopathy and aggavates its prognosis.