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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.)

BACKGROUND Surgical extraction of impacted mandibular third molars is the most commonly performed procedure in oral surgery; its associated complications include sensory nerve damage, swelling, and trismus. This study aimed to evaluate the effects of hyaluronic acid (HA) on healing of the socket following extraction of the lower impacted third molar tooth in 40 dental patients. MATERIAL AND METHODS This prospective, double-blind, randomized, controlled study was carried out on 40 adult healthy patients indicated for surgical removal of bilateral impacted mandibular third molars with equal surgical difficulty (moderate surgical difficulty according to the Koerner index. Patients with right mandibular third molars were included into the study (HA) group and those with left mandibular third molars were included into the control group. Surgical removal of impacted teeth was performed at different times for each patient for proper measurement of postoperative clinical variables, including pain, swelling, and mouth opening. RESULTS Postoperative pain evaluation results using the visual analog scale (VAS) showed reduced pain levels at all observation periods. Postoperative swelling peaked in intensity within 12-48 hours, resolving between the 5th and 7th days, and there was no significant difference in pre- and postoperative measurements of interincisal opening between both groups (P>0.05). CONCLUSIONS We found that intra-socket application of hyaluronic acid after surgical extraction of impacted mandibular third molars promoted normal wound healing, and there was a clinical benefit of reduced postoperative pain and swelling.

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

Background: Temporomandibular disorders (TMDs) pose diagnostic challenges, and selecting appropriate imaging modalities is crucial for accurate assessment. This study aimed to compare the diagnostic accuracy and efficacy of ultrasonography (US) and magnetic resonance imaging (MRI) in identifying TMDs., Methods: A comprehensive meta-analysis was conducted, including studies that compared US and MRI for TMJ disorder assessments. Fixed-effects models were utilized to calculate pooled odds ratios (ORs) and relative risks (RRs) with 95% confidence intervals (CIs). Heterogeneity was assessed using the chi-squared test and I 2 statistic. Newcastle-Ottawa scale was used to assess the methodological quality of the studies included., Results: Six studies were included, involving a total of 281 participants. The meta-analysis demonstrated that MRI was statistically somewhat better than US in identifying TMJ disorders. The summary OR was 0.64 (95% CI: 0.46-0.90), and the summary RR was 0.80 (95% CI: 0.68-0.95). Heterogeneity among the studies was low (χ 2  = 2.73, df = 5, p = .74; I 2  = 0%). Demographic variables revealed variations in sample size, gender ratio and mean age across the studies., Conclusion: This meta-analysis provides evidence that MRI may be more effective than US in diagnosing TMDs. However, the study is limited by the small number of included studies and variations in demographic variables and study designs. Future research with larger samples and standardised protocols is essential to confirm and strengthen these findings. Understanding the diagnostic accuracy of MRI and US for TMJ disorders will aid clinicians in making informed decisions for effective TMJ disorder assessments and patient management., (© 2024 The Author(s). Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

The present study aimed to investigate the impact of resveratrol on oral neoplastic parameters through a systematic review and meta-analysis. Resveratrol, a naturally occurring polyphenol, has shown promising potential as a therapeutic agent in various cancer types, including oral neoplasms. Understanding the collective findings from existing studies can shed light on the efficacy and mechanisms of resveratrol in oral cancer management. The systematic review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A comprehensive search was performed to identify relevant studies from various databases, registers, websites, and citation searches. The inclusion criteria encompassed in-vivo studies investigating the impact of resveratrol on oral neoplastic parameters in animal models. After screening and assessment, a total of five eligible studies were included in the meta-analysis. The meta-analysis of the selected studies revealed that resveratrol treatment exhibited a potential impact on reducing oral neoplastic proliferation and promoting neoplastic apoptosis. The combined analysis showed a statistically significant decrease in neoplastic parameters with an overall effect size (ES) of 0.85 (95% CI: [0.74, 0.98]). Subgroup analyses were conducted to explore potential variations among different cellular types and exposure compounds, providing further insights into the efficacy of resveratrol in specific contexts. This systematic review and meta-analysis support the potential of resveratrol as a promising therapeutic agent in oral cancer management. The findings indicate that resveratrol may effectively modulate neoplastic proliferation and apoptosis in various cellular types within animal models of oral cancer. However, further well-controlled studies and clinical trials are warranted to validate these observations and elucidate the underlying mechanisms of resveratrol's actions. Resveratrol holds promise as a complementary therapeutic approach in the prevention and treatment of oral neoplastic conditions., (© 2024. The Author(s).)

Background: The present review aimed to investigate the association between salivary biomarkers and temporomandibular disorders (TMD). TMD is a multifactorial condition characterised by pain and dysfunction in the temporomandibular joint (TMJ) and surrounding structures. Salivary biomarkers have emerged as potential diagnostic tools due to their non-invasiveness and easy accessibility. However, the literature on salivary biomarkers in relation to TMD is limited and inconsistent., Methods: Electronic databases of Pubmed, Embase, Web of Science, Scopus, Cochrane Library, PsychINFO, CINAHL and Medline were searched using specific search terms and Boolean operators. The search was limited to articles published in English that assessed salivary biomarkers in individuals diagnosed with TMD. Two reviewers independently screened the articles and extracted data. ROB-2 was used to assess the risk of bias., Results: Eleven clinical papers met the inclusion criteria and were included in the review. The findings provided consistent evidence of a clear association between salivary biomarkers and TMD. Various biomarkers, including cortisol, IL-1, glutamate and several others, were assessed. Some studies reported higher levels of cortisol and IL-1 in TMD patients, indicating potential involvement in stress and inflammation. Glutamate levels were found to be elevated, suggesting a role in pain modulation. Other biomarkers also showed alterations in TMD patients compared to controls: CONCLUSION: The findings from the included studies suggest that salivary biomarkers may play a role in TMD pathophysiology. Though a definitive conclusion can be drawn regarding the specific salivary biomarkers and their association with TMD, the results must be interpreted with caution considering the heterogeneity of the biomarkers assessed. Further research with larger sample sizes, standardised methodology and rigorous study designs is needed to elucidate the role of salivary biomarkers in TMD., (© 2023 The Authors. Journal of Oral Rehabilitation published by John Wiley & Sons Ltd.)

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.)

Background/purpose: Medication-related osteonecrosis of the jaw (MRONJ) is a serious complication among dental patients undergoing treatment with antiresorptive medications such as bisphosphonate and denosumab. The present survey investigated the awareness and practice of dentists in the Gulf Cooperation Council (GCC) countries regarding MRONJ., Materials and Methods: This questionnaire-based study was conducted among dental practitioners in all six GCC countries. A questionnaire was designed and distributed among all potential participants via different social media platforms. SPSS version 22 was used for data analysis, and P -value <0.05 was considered statistically significant., Results: Overall, 1685 dentists from the six GCC countries participated in the present study. The surveyed dentists revealed relatively fair practices and awareness regarding MRONJ and its prevention, with the majority reported asking their patients about history of anti-osteoporotic medications (67.8%), recording name of the medication (73.1%) and duration of treatment (75.5%). However, the majority of the participants were unconfident about the duration of drug holiday prior to dental surgical interventions (70.6%) and the overall good level of knowledge/practice related to MRONJ was just 50.6%. The regression analysis revealed that previous exposure to MRONJ cases and attending a seminar, course, meeting, or conference about osteonecrosis of the jaw were independent predictors for positive awareness/good practice regarding MRONJ ( P  < 0.05)., Conclusion: The results show inadequate awareness and practices of dentists practicing in GCC countries regarding MRONJ, with significant variations among the countries. Therefore, appropriate interventions such as periodic continuous education courses are required to improve dentists' knowledge and practices regarding MRONJ., Competing Interests: The authors declare no conflict of interest., (© 2023 Association for Dental Sciences of the Republic of China. Publishing services by Elsevier B.V.)

Background: Dental implants emerge as a dependable and efficacious alternative for patients experiencing partial or complete tooth loss. The stability of these implants is influenced by surface topography and macro-level design. In cases where the height of the maxillary posterior region is diminished, employing short implants can prove advantageous. With the aim of examining the distribution of von Mises stress, strain, and micromovement in D4 bone quality surrounding platform-switched short implants, measuring 6 mm in length and featuring diameters ranging from 4 to 6 mm, as well as different thread designs, an in-depth finite element analysis was conducted under immediate loading conditions., Methodology: A 3D finite element model was constructed to simulate maxillary molar crowns, incorporating an implant with a length of 6 mm and varying diameters and thread designs. The diameters utilized were 4/3.6 mm, 5/4 mm, and 6/4.8 mm, while the thread designs included buttress, square, and triangle patterns. Each model underwent analysis with a 100 N force applied in two directions: vertical and oblique, relative to the long axis of the implant. Stress, strain, and micromovement in the peri-implant region were recorded, employing the Ansys Workbench R v.18.1 software for modelling and analysis., Results: When comparing all three diameters, the wide diameter (6 mm threads) exhibited the lowest values of peri-implant von Mises stresses (3.3 MPa and 35.1 MPa), strains (194 Ɛ and 484 Ɛ), and micromovements (0.7 μm and 1.3 Ɛ) subjected to axial and non-axial loading of a 100 N force. Notably, square microthreads yielded the most favorable stress parameters among the different thread shapes, manifesting the minimum values of stress, strains, and micromovements in their vicinity., Conclusion: For the treatment of atrophic ridges or in scenarios necessitating extensive surgical preparation of the implant site, a combination of short implants, wide diameters, and platform switching can be employed. In situations with reduced bone height and the requirement for an implant-supported prosthesis to replace a missing permanent maxillary molar, the utilization of wide-diameter platform-switched short implants measuring 6 mm in length, featuring a square thread design, should be taken into consideration., (© 2023. BioMed Central Ltd., part of Springer Nature.)

Titanium is the main component of dental implants. It is also routinely used as a framework material for implant-supported full-arch prostheses due to its low density, biocompatibility, and other mechanical properties. Remarkable mechanical properties such as lesser mass density and higher young's modulus of graphene have gained popularity among scientists, improving the properties of biomedical implants. Thus, our study aimed to compare the outcome through the von Mises stresses generated on All-on-6 and All-on-3 implant models, as well as on the framework, and evaluate the effect of stress patterns on the crestal bone around implants in the mandible. FEA (Finite Element Analysis) study was carried out using edentulous mandible models. Four 3D FEA models with 3 and 6 implants were used (Model 1: Titanium bar-supported 6 straight implants; Model 2: Graphene bar-supported 6 straight implants; Model 3: Titanium bar-supported 3 implants with 30 degrees-tilted; Model 4: Graphene bar-supported 3 implants with 30 degrees-tilted) in order to simulate endosseous implant designs. The implant measuring 4.2 mm in diameter and 11.5 mm in length were used. The most distal implants in the 3-implant models were placed with angulation of 30 degrees; in 6 implants, they were vertically placed. All the models were analyzed for vertical and oblique axis with a single force magnitude of 100 N. In all four implant models and under loading conditions, the peak stress points were always on the neck of the most distal implant. von Mises stresses were within the normal stress range. In a conventional six-straight implant model supported by a titanium framework, the cortical stress in the region of implants was 25.27 MPa, whereas, in the graphene framework, it was 12.18 MPa. Under vertical load, there was a significant difference in the cortical stress around the tilted implants (30 degrees) in the 3-implant system of titanium and graphene frameworks, respectively, 70.31 MPa and 21.27 MPa. The graphene framework demonstrated better results than the titanium framework for the conventional six-implant system under vertical load, achieving stress of 30.09 MPa and 76.60 MPa, respectively. In the case of the 3-implant system, a significant difference in the bar stress was observed between graphene and titanium, respectively, 256.32 MPa and 180.1 MPa of bar stress. Within the limitation of this study, the peri-implant stresses were decreased using graphene framework models. Hence, it was possible to conclude that the best load-bearing capacity results were found in the graphene framework group compared to the titanium framework for All-on-6 and All-on-3 implant models, even though both materials are reliable options used as framework materials in implant-supported full-arch prostheses.

Nowadays, smartphone applications are widely used in different areas of life, including medical science. The present study aimed to assess the effectiveness of a smartphone application of oral hygiene instructions (OHI) on periodontal health compared to the traditional chairside OHI. All the participants ( n = 39) were divided into two groups: control group and test group. Participants of the control group were given verbal OHI and participants of the test group were asked to use a smartphone application to upkeep their oral habits. The gingival index (GI) and Quigley-Hein Turesky modification index (QHTMI) were used for scoring the plaque accumulation at baseline and after one month of the periodontal treatment. A paired t -test and an independent t -test were performed to compare the mean of GI and QHTMI between intra-group and inter-group, respectively. The paired t -test showed significant differences in GI and QHTMI improvement after one month in both groups. Moreover, the independent t -test showed no significant differences between the two groups. However, the test group showed a lower mean score in GI and QHTMI assessments compared to the control group. Smartphone applications in oral health applications did not exhibit any superiority in periodontal health over the traditional OHI method in the current study.

Dental professionals are playing an imperative role in the healthcare system. It is important to distribute the dental workforce across the country. Therefore, this study aimed at analyzing the recent distribution of the dental workforce in the Kingdom of Saudi Arabia (KSA) and determining the current dentist-to-population ratio in the KSA. This is a cross-sectional study focused on the dental workforces working in the KSA between 2015 and 2020. Complete data of dentists working in the KSA with different professional ranks were obtained. The data were stratified by gender, professional rank (Saudi and non-Saudi), area of working (13 provinces in the KSA), and sector of working (public and private). A complete list of all dental universities was obtained to identify the increasing number of dental institutes at this current moment. In addition, the dentist-to-population ratio was also evaluated based on the current inhabitant in the KSA and the total dental surgeons. There are a total of 27181 dental surgeons and 8022 dental auxiliaries registered in different specialties as of 2020. Saudi citizens are holding the majority of the posts in both dentist and dental auxiliary categories. The percentage of males and female is slightly higher in dentists and dental auxiliaries, respectively. It also indicated that where most of the dental personnel work in the private sector, dental auxiliaries work in the public sector. Moreover, the highest number of dental workforces is identified in the Riyadh region among all the 13 provinces. Based on the databases, the current dentist-to-population ratio is 1 : 1288.16. In conclusion, the number of dental professionals is ample; however, rural areas lack specialists. Saudi dentists are progressively replacing foreign dentists in different professional ranks working in the KSA., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2022 Abdullah Saad Alqahtani et al.)

This study aimed to evaluate the association between periodontitis and chronic rhinosinusitis (CRS) via cone-beam-computed tomography (CBCT) using the Lund-Mackay staging system. CBCT images from different departments of the school of dentistry, at Prince Sattam University were evaluated for the presence of rhinosinusitis. All the CBCT scans were exposed for multiple indications, and no patients had a scan exposed solely for this study. The Lund-Mackay staging system was used to measure the CRS in the CBCT. Descriptive statistics for the frequencies and percentages were used to summarize the data. Logistic regression was used to examine the associations between periodontitis and CRS. Each variable was assessed individually by using multivariable analysis. Collinearity issues among the variables were solved to select a limited set of factors using a stepwise variable selection procedure. A total of 399 CBCT images were included in the current research. Logistic regression showed that only gender was significantly associated ( p = 0.0001) with the presence of CRS. However, a stepwise variable selection procedure included gender and bone loss as significantly associated with CRS. No significant difference was observed between unilateral vs. bilateral CRS in gender, bone loss, medical status, and periodontitis. However, only gender showed a significant difference in both bilateral vs. no CRS and unilateral vs. no CRS. Periodontitis is not associated with CRS. However, gender has a significant influence on CRS.

Introduction: The temporomandibular joint is a complex synovial joint in the body. It is the area in which the mandible articulates with the cranium. The temporomandibular joint space is located between the articular eminence and the glenoid fossa of the temporal bone at the base of the skull and the condylar process of the mandible. This interarticular space is divided into superior joint space (1.2 ml) and inferior joint space (0.9 ml) by the articular disc. The purpose of this study is to detect and evaluate the variations in the temporomandibular joint space among patients having temporomandibular joint disorders., Materials and Methods: In this retrospective study, 60 magnetic resonance imaging scans were evaluated at King Faisal Specialist Hospital in Riyadh, Saudi Arabia, between the years 2006 and 2016. Measurements were done in sagittal view in three areas: anterior, central, and posterior areas. However, coronal view readings were recorded in two different areas: medial and lateral joint spaces. All measurements were recorded at the highest point of the condyle that is perpendicular to the opposing bone. The SPSS program was used for statistical analysis., Results: The central joint space values were higher than the anterior and posterior joint spaces in both coronal and sagittal views. We also found that joint spaces among male patients were higher than female patients (right side P =0.015 and left side P =0.006). It is worth mentioning that the number of temporomandibular joint disorder female patients was more than the number of male temporomandibular joint disorder patients (52 females versus 24 males). Additionally, patients who were older than 55 years old had wider joint spaces than patients who were younger than 25 years old., Conclusion: The central joint space value was the highest among the other joint spaces on both views of magnetic resonance imaging, and the values of joint spaces among males were larger than those of females on sagittal magnetic resonance imaging. Patients with elderly temporomandibular joint disorders showed larger joint spaces than young patients. This study spotlights the importance of magnetic resonance imaging evaluation in temporomandibular joint disorder patients for a better understanding of the clinical evolution of temporomandibular disorders., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Nasser Raqe Alqhtani et al.)

Accomplishing painless endodontic treatment, especially in the mandibular molar region, is challenging. Hence, the aim of the study was to compare the efficacy of 2% lidocaine and 4% articaine when used as supplemental intra-ligamentary (IL) anesthesia in mandibular molars having symptomatic irreversible pulpitis with symptomatic apical periodontitis after failed Inferior Alveolar Nerve Block (IANB) injection. In this prospective study, one-hundred and forty-seven adult patients diagnosed with irreversible pulpitis in a mandibular tooth were included who received IANB with 1.8 mL of 2% lidocaine with 1:100,000 epinephrine. Patients who experienced pain were recorded using the Heft-Parker visual analog scale (HP-VAS score ≥ 55 mm) and received supplement intra-ligament injection with either4% articaine or 2% lidocaine with 1:100,000 epinephrine. Supplementary intra-ligament injections resulted in 82.6% and 91.3% of profound anesthesia in the first molar region for 2% lidocaine and 4% articaine, respectively. Similarly, an additional IL injection of articaine success percent (78.9%) in the second molar region was higher than lidocaine (63.1%). The overall success ratio revealed no significant difference in achieving profound anesthesia of either solution. In this study population, there was no difference in the success ratio of anesthesia between 2% lidocaine and 4% articaine when used as supplemental IL injection.

Background: It is essential for practicing dentists to have adequate knowledge of HIV/AIDS and its implications in the dental practice. Their attitudes should also be up to the professional expectations. This study aimed to assess knowledge of HIV/AIDS infection and attitudes towards its patients among dental students in Saudi Arabia., Methods: A questionnaire was prepared and distributed among a sample of dental students in Saudi Arabia. Twenty questions related to knowledge, attitudes, and oral manifestation of HIV were presented., Results: A total of 405 questionnaires were completed (67% response rate). Participants showed low knowledge of safety regarding HIV (39.5%) and 44.2% indicated that they would take an HIV test after needle stick injury. The proportion of correct answers regarding transmission of HIV through saliva, cardiopulmonary resuscitation, and aerosols by hand pieces was 41%, 37.5%, and 26.4%, respectively. Almost 50% of the surveyed dental students expressed unwillingness to treat HIV-positive patients. Poor knowledge was noted regarding oral manifestations of HIV (32.7%). Of the participants, 57.8% indicated that infection control procedures are very important for the treatment of HIV patients and 50.6% believed that a dentist can make a decision to reject the treatment of HIV patients. According to the participating dental students, the three major oral manifestations in HIV patients are hairy leukoplakia (47.4%), oral candidiasis (44.7%), and Kaposi's sarcoma (43.5%)., Conclusion: Inadequate knowledge and unprofessional attitude towards HIV/AIDS patients were identified among this group of dental students in Saudi Arabia. Dental educators and health care planners in Saudi Arabia should plan to promote the knowledge and attitudes of dental students in Saudi Arabia towards the treatment of HIV patients.

Objective: Understanding the labial alveolar bone thickness (ABT) and buccolingual teeth angulation may reduce the complication that might arise during or post-operative treatment. The operator could determine the precise method to ensure long-term treatment success. This study aimed to evaluate the ABT with buccolingual upper incisor teeth angulation based on the maxillary plane by using the cone-beam computed tomography (CBCT)., Materials and Methods: A total of 371 CBCT radiographs were initially assessed and 100 CBCT radiographs were included. On the maxillary incisors, the labial alveolar bone thickness is evaluated at three points (Point A: Four mm below from CEJ, Point B: Midpoint from the labial alveolar-palatal alveolar crest plane and root apex. Point C: Root Apex of the tooth). The distance from these points to labial alveolar bone was measured for the ABT. Moreover, buccolingual angulation of the tooth was measured by the angle formed by the maxillary plane and the long axis of the tooth., Results: There is no significant difference observed between genders in the labial alveolar bone thickness. The labial alveolar bone thickness grew gradually from the cementoenamel junction (CEJ) level to the apical level. Moreover, there was a statistically significant positive correlation observed between labial alveolar bone thickness at the apical level (Point C) and angulation (p<0.05)., Conclusions: The labial bone thickness was less than 2 mm in the majority of cases at the three points among maxillary incisors. In addition, there is a correlation between buccolingual angulation of the maxillary incisors and labial alveolar bone thickness.

(1) Background: The purpose of this prospective study was to determine the changes in primary hemodynamic parameters and oxygen saturation in systemically healthy patients during the surgical procedure involving crown lengthening. (2) Methods: A total of 44 patients who required a crown-lengthening procedure in a single tooth in the maxillary arch were included in this study. Heart rate (HR), blood pressure (BP) and oxygen saturation (SpO 2 ) were measured in all the subjects at three different intervals: before injecting the anesthetic (T1), after the anesthetic injection (T2) and after the procedure (T3). Descriptive statistics were computed, and observations were recorded as mean and standard deviation (SD). Analysis of variance (ANOVA) was used to compare the mean observation within parameters at different time intervals. (3) Results: All primary hemodynamic parameters were increased in the T2 phase over T1 and decreased in the T3 phase over T2. However, SpO 2 decreased in both the T2 and T3 phases compared to the initial T1 phase. No significant differences were observed among the primary hemodynamic variables. However, SpO 2 showed a significant difference ( p = 0.013) among the T1, T2 and T3 phases. (4) Conclusions: Further study with larger sample size is required in order to analyze the accurate hemodynamic alterations.

Objective: It is currently presumptuous that electric cigarettes are less harmful than the conventional ones; this is increasing the consumption of electric cigarettes. Therefore, this study intended to evaluate the periodontal treatment needs among conventional smokers, electronic cigarette smokers and non-smokers. This cross-sectional designed study involved 150 patients with a mean age of 29.88±7.81 years., Patients and Methods: Among all patients, 50 patients were recruited in each group. The periodontal condition and the treatment need for the patients were assessed using the community periodontal index treatment need (CPITN). Fisher exact test was used to find the significant association of all three groups with the periodontal status and the treatment need. Female patients (12.5%) showed better periodontal status than the male patients (87.5%) and required less complicated periodontal treatment independently from smoking type., Results: Furthermore, deeper pocket depth ≥6 mm (75%) has been found among the conventional cigarette smokers whereas the majority of the electric cigarette smokers (50%) have calculus deposition. Thus, 50% of the electric smokers require professional scaling whereas 57.1% of conventional smokers prerequisite complex periodontal treatment., Conclusions: Besides, there was a significant difference (p≤0.05) observed among all groups in periodontal health index and treatment need. Conventional cigarette consumers need more complicated periodontal treatment compared to the patients who consume electric cigarettes.

The aim of this study was to evaluate the clinical need and impact of socket preservation to protect the bone for future dental implant placement. Moreover, we aimed to list down various methods of socket preservation by going through randomized clinical trials. We searched PubMed, Google Scholar, and Cochrane databases for all relevant publications, where researchers compared various methods and tools for socket preservation. All eight randomized controlled trials mentioned several methods that are helpful in preserving bone levels both horizontally and vertically. The studies included in this systematic review demonstrate that each material has certain efficacy in preserving the socket after tooth extraction for future implant placement. Socket preservation methods and materials are effective in preparing patients for future prostheses., (©Carol Davila University Press.)

Background: Dental implants are considered the first option to replace missing teeth. Alveolar bone resorption gradually progresses following tooth extraction leading to loss of vertical bone dimension for implant placement. The lateral window approach is the most commonly used procedure to treat vertical bone loss., Objective: The aim of the present study is to evaluate the Lateral Wall Thickness (LWT) of the maxillary sinus and determine the influence of gender and side on maxillary LWT., Methods: This study involved a cross sectional retrospective study. Cone- beam computed tomography data were collected from 99 patients with a total of 198 maxillary sinuses that met the inclusion criteria. The patient age ranged between 18 to 35 years. On the selected sagittal section, the points of measurement are determined by a perpendicular line at 5 mm from the lowest point of the sinus floor. Measurements were taken at four different areas; first premolar (P1), second premolar (P2), first molar (M1), and second molar (M2). Descriptive statistics were used to calculate mean lateral wall thickness for each tooth, and student's t-test was used to test the effect of gender and side on maxillary LWT., Results: The greatest mean LWT was observed around the left first maxillary molar (2.43±0.82), while the lowest mean LWT was observed around the right second maxillary premolar (1.62±0.61). There was no significant difference in the LWT around any tooth (M1 p=0.56, M2 p=0.92, P1 p=0.14, P2 p=0.19)., Conclusion: There was no significant difference in both males and females of the lateral wall thickness in the left and right side of maxillary sinus., (Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.net.)

Aim: To assess the relations between the divergence angle of the maxillary molar roots and their proximity to the maxillary sinus floor using CBCT., Method: This study comprised CBCT scans of the maxilla, including at least the inferior one-third of the maxillary sinus and at least one molar present in any quadrant with complete eruption and root formation. Evaluation included the vertical relations between the maxillary molar root apices and the maxillary sinus floor (MSF), and the root divergence was measured from the root apices to the floor of the pulp chamber. The chi-square test was used for the associations between the study parameters. For the correlation between root divergence angles and MSF vertical relationship types, the Spearman test was used. A P-value < 0.05 was considered significant., Results: A total of 100 scans were analyzed, including 316 permanent maxillary first and second molars. The MSF Type II vertical relationship was the most prevalent (39.6%), followed by Type I (31.3%). The highest divergence angle was found between the distobuccal and palatal roots (mean = 44.9 ± 10.5°). For the mesiobuccal-distobuccal angle groups, there were higher percentages of the MSF Type I and II relationships among the angle groups < 1° and 21-45°. For the mesiobuccal-palatal angle groups, a higher prevalence of the MSF Type II relationship was found in the <21⁰ and >45⁰ angle groups, and a higher prevalence of the Type I relationship was found in the 21-45⁰ angle group. For the distobuccal-palatal angle groups, higher percentages of the MSF Type II relationship were found in the three angle groups. For all teeth, there was a significant positive correlation between the MSF vertical relationship and the mesiobuccal-palatal angle (r = 0.116; P = 0.039)., Conclusion: There was a positive correlation between the divergence angle of the roots and their vertical relationship with the MSF. Clinicians should assess the divergence between the roots before performing extraction or endodontic treatments., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2021 The Authors.)

Cortisol is a hormone that is naturally produced by the zona fasciculata of the cortex in the adrenal gland. One of its main functions is to decrease inflammation, particularly in areas where an inflammatory response is not necessary. In the field of oral and maxillofacial surgery, cortisol is used to improve the outcomes of surgical procedures and to make the postoperative period more comfortable for the patient. However, cortisol is considered a double-edged sword because its use is associated with both benefits and adverse effects. It is imperative to use cortisol following an accurate diagnosis, in addition to clarity regarding the desired surgical procedure for treating the acute or chronic condition affecting the patient. When used with caution, cortisol can serve as a valuable agent for reducing the postoperative inflammatory response in patients undergoing moderate as well as moderately severe surgical procedures., Competing Interests: The authors declare no conflicts of interest., (Copyright © 2021 Muslat A Bin Rubaia'an et al.)

Dental professionals have a major role in the fight against the spread and transmission of COVID-19. This study aimed to evaluate awareness and practice of dentists in Saudi Arabia regarding COVID-19 and the utilization of infection control methods. A 24-item questionnaire was developed and distributed through social media to 627 dentists working in Saudi Arabia. 177 questionnaires were completed (28.2% response rate). Most dentists were aware about the transmission, incubation time and main clinical symptoms of COVID-19. Almost 83% of the respondents appreciate the risk of droplets, aerosols and airborne particles in transmission of COVID-19 in the dental clinic. Among the common practices of participants are measuring patient's body temperature before undertaking a dental treatment (88.7%), cleaning the environmental surfaces at the dental clinic after each patient (91.5%) and restriction of dental treatment to emergency cases (82.5%). It seems that practicing dentists in Saudi Arabia are fairly aware about COVID-19. The practices of the surveyed dentists appear to be mostly consistent with the current guidelines and recommendations for infection control of COVID-19 in the dental clinic. Some drawbacks in knowledge and a number of inappropriate practices can be identified and require the attention of health authorities.

Background: Medication-related osteonecrosis of the jaw (MRONJ) is an intense negative drug response causing increasing bone destruction in the maxillofacial area of patients., Aims and Objectives: To evaluate the knowledge and attitude of dental practitioner regarding risk factors of MRONJ in Saudi Arabia., Materials and Methods: A cross-sectional, questionnaire survey was carried out in King Khalid Hospital, Al-Kharj among dental practioners., Results: Approximately 60% of the practioners had a poor knowledge and there was a weak positive correlation with work experience., Conclusion: Poor knowledge regarding the MRONJ invites a continuing dental education specially to focus on general practioners., Competing Interests: There are no conflicts of interest., (Copyright: © 2020 Journal of Pharmacy and Bioallied Sciences.)

Since the 1980s, titanium (Ti) implants have been routinely used to replace missing teeth. This success is mainly due to the good biocompatibility of Ti and the phenomenon of osseointegration, with very early events at implant placement being important in determining good osseointegration. However, enhancing implant performance with coatings such as hydroxyapatite (HA) and calcium phosphate has proved largely unsuccessful. Human mesenchymal stem cells (hMSCs) are the first osteogenic cells to colonise implant surfaces and offer a target for enhancing osseointegration. We previously reported that small doses of bisphosphonate (BP) may play an integral role in enhancing hMSC proliferation and osteogenic differentiation. The aim of this study is to investigate whether small doses of bisphosphonates enhance proliferation and osteogenic differentiation of hMSCs on Ti surfaces, to enhance bone osseointegration and to accelerate wound healing around the implant surface. Our data suggests that treating cells with small doses of BP (100 nM & 10 nM) induces significant hMSC stimulation of osteogenic markers including calcium, collagen type I and ALP compared to control group on titanium surfaces (P < 0.05). In addition, cell proliferation and migration were significantly enhanced on titanium surfaces (P < 0.05).