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Objectives: To investigate the relationship between the presence of periapical lesions (PL) and levels of glycosylated hemoglobin (HbA1c), and C-reactive protein (CRP) in patients with type 2 diabetes.  Methods: This cross-sectional study was conducted at Ibn Sina National College for Medical Studies, Jeddah, Kingdom of Saudi Arabia, between September 2013 and February 2015. Medical and dental history and Sociodemographic data were obtained from participants. Dental and periodontal examinations were conducted and blood samples were obtained to determine levels of HbA1c and CRP. The presence of PL was recorded from panoramic and periapical radiographs. Descriptive statistics and multivariable linear and logistic regression models were used for data analyses.  Results: One hundred patients were included; mean age was 48.9 ± 8.5 years. Of these patients, 14% had no PL, whereas 25% had one or 2 lesions, 32% had 3 or 4 lesions, and 29% had ≥5 PL. The mean HbA1c was 9.8% (± 2.5) mg/L and CRP was 6.9 mg/L (± 6.3). The presence of PL was significantly associated with a higher level of HbA1c independent of age, gender, probing depth, and plaque index (p=0.023). Individuals with PL were also more likely to have a high CRP level (greater than 3 mg/L) independent of the previous covariates (odds ratio: 1.19; 95% confidence interval: 1.01-1.41).  Conclusion: Periapical lesions are associated with a poorer glycemic control and a higher CRP level in type 2 diabetic patients.

Objectives: To evaluate the accuracy of using routine 2-dimensional (2D) radiographs (panoramic and periapical) when evaluating the position of orthodontic temporary anchorage devices (mini-implants) in the maxilla, and to compare the results to 3-dimensional cone-beam computed tomography (CBCT)., Methods: This cross-sectional study was conducted at King Abdulaziz University, Faculty of Dentistry, Jeddah, Kingdom of Saudi Arabia from February 2014 to January 2015. Panoramic and periapical radiographs were used to examine the position of mini-implants in relation to the adjacent roots. Rating of mini-implants position was performed by 82 dentists from different specialties, using 2D images according to the following criteria: 1) away from the root; 2) mini-implant tip appears touching the lamina dura; and 3) mini-implant overlays the lamina dura. The results were compared with CBCT findings., Results: There was no difference between dentists from different specialties when rating the position of the mini-implants (Cronbach's alpha=0.956). The accuracy of the periapical images was 45.1%, while the panoramic images 33.6%. However, both panoramic and periapical radiographs were significantly inaccurate when assessing the mini-implant position when compared with the CBCT findings (p=0.0001)., Conclusion: Three-dimensional CBCT technology allows better visualization of mini-implant placement. The use of CBCT when assessing the position of mini-implants is recommended.

Objectives: To compare periodontal findings in systemic lupus erythematosus (SLE) patients and healthy controls, and to determine, whether there is a correlation between periodontal parameters and SLE biomarkers., Methods: This cross-sectional study was conducted in the Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia between November 2012 and February 2014. Twenty-five participants diagnosed with SLE and 50 healthy controls were selected. Periodontal assessment consisted of clinical attachment level (CAL), probing depth (PD), bleeding on probing, and plaque scores. For the SLE group, several laboratory tests were obtained, such as, white blood cell count, hemoglobin level, platelet count, anti-nuclear antibody, anti-double-stranded DNA antibody, calcium level, and vitamin D., Results: Periodontal findings in SLE patients and controls were not significantly different. The SLE patients who had no flare-ups for more than a year showed significant bleeding on probing and deeper PD compared with those who had flare-ups less than a year before starting the study. The SLE patients with arthritis symptoms showed more CAL than those without arthritis. In the SLE patients, no significant correlation was found between their periodontal findings and SLE biomarkers., Conclusion: Periodontal health was not different between SLE patients and healthy controls. In SLE patients however, flare-ups and presence of arthritis had a significant relation with periodontal health.

Objectives: To study the association between gingival biotypes and inclination and position of the maxillary and mandibular incisors., Methods: This cross-sectional study included 142 consecutive orthodontic patients (64 males and 78 females) who were seeking orthodontic treatment at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia from February 2013 to January 2014. Gingival biotype was assessed independently for the maxillary and mandibular central incisors using the transparency of periodontal probe method. Maxillary and mandibular incisors' inclination and position were measured using cephalometric analysis., Results: The mean age was 23.56 (±2.55) years. The prevalence of thin gingival biotype was 43% for the maxillary and 52.1% for the mandibular incisors. Females were 4 times more likely to have thin gingiva for the maxillary incisors and 5 times more likely for the mandibular incisors. A significant association was found between mandibular incisor inclination and position and thin gingival biotype, while there was no association between the maxillary incisor inclination and position and gingival biotypes., Conclusion: Mandibular incisor proclination and protrusion is associated with thin gingival biotype while no association is found in the maxilla. The evaluation of the gingival biotype is essential during diagnosis and treatment planning for potential orthodontic patients.

Objective: To assess the effect of ovariectomy on the expression of estrogen receptor-beta (ER-beta) in periodontal ligament and alveolar bone., Methods: This animal study was conducted at King Fahad Research Center, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia from March to October 2012. Thirty 12-week-old female Wistar rats were divided into 2 groups (15 each): ovariectomized (OVX) and sham-operated. Levels of estrogen and progesterone in the sera were measured using the enzyme linked immunosorbent assay (ELISA). To detect the expression of ER-beta, immunostaining was performed on the tibia, alveolar bone, and periodontal ligament specimens followed by quantitative histomorphometric analysis., Results: Estrogen (p=0.001) and progesterone (p=0.007) levels were significantly decreased in the OVX rats compared to their controls. Histologically, the thickness and area percentage of the tibia and alveolar bone trabeculae were significantly reduced in OVX rats compared to the controls (p=0.001). The periodontal ligament fibers in the control group exhibited well-organized and appropriately oriented fibers, while in the OVX group they appeared disrupted with loss of orientation. The ER-beta expression in the OVX rats was significantly decreased in the periodontal tissues (p=0.005) and tibia (p=0.008)., Conclusion: Estrogen deficiency resulted in a significant decrease in the expression of ER-beta in both tibia and periodontal tissues.

Objective: To compare the expression of human beta-defensins (HBD) in the gingival tissues of obese and normal weight systemically healthy subjects., Methods: This cross-sectional study was conducted at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia from March 2010 to November 2011. Twenty obese (10 affected with periodontitis and 10 periodontally healthy), and 20 normal weight subjects (10 affected with periodontitis and 10 periodontally healthy) were selected. Gingival tissue samples were collected and subjected to immunohistochemistry assay to evaluate the expression of HBD-1 and -2., Results: In the epithelium, the staining was almost limited to the basal and supra-basal cells, while the superficial layers and keratin were negative. In the connective tissue, some of the chronic inflammatory cells and fibroblasts were also stained. Endothelial cells lining blood or lymphatic vessels were mostly positive with HBD-2 and were almost negative with HBD-1. The percentage of positively stained areas did not show any differences in the expression of HBD-1 and -2 in obese compared to normal weight subjects whether they were affected or not affected with periodontitis., Conclusion: The results of this study did not demonstrate an association between the expression of HBD-1 and -2 and obesity and periodontitis.

Objective: To study the prevalence of different gingival biotypes in a sample of patients and the association between gingival biotype and different dental malocclusions., Methods: Two hundred adult patients (100 males and 100 females) who presented for treatment at the Faculty of Dentistry, King Abdulaziz University, Jeddah, Saudi Arabia were recruited from February 2011 to February 2012. Gingival thickness was assessed for the maxillary central incisors using the transparency of periodontal probe technique. Angle's classification of malocclusion and smoking habit were also recorded., Results: The mean age was 32.1 (+/-11.0) years. Thin gingival biotype was observed in 44.5% of the sample, of which 64% were females and 25% were males (p=0.001). Only 31.4% of current smokers had thin gingival biotype compared to 51.9% of subjects who never smoked (p=0.011). No significant association between dental malocclusions and the presence of thin gingival biotype was found (Class I = 42.9%, Class II = 44.1%, and Class III 53.9%, p=0.6)., Conclusion: A high prevalence of thin gingival biotype especially among females was observed. Smokers had thicker gingival biotype. No relationship was found between gingival biotypes and Angle's classification of malocclusion.