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Background Breast cancer is one of the most lethal neoplasms causing death. Oral cavity is the rare site of distant metastasis from breast cancer. Very little research has been conducted to date to analyze breast cancer as the sole primary source of metastasis to the oral soft tissues. The goal of this study was to examine the published cases of oral soft tissue metastasis from breast cancer as the only primary source to date.

Objective: To assess oral healthcare-seeking behaviors during the COVID-19 lockdown period in eastern Saudi Arabia. Methods: A cross-sectional questionnaire-based study was conducted from October 2020 to December 2020 at Dental Clinic Complex, College of Dentistry, King Faisal University Al Ahsa, Saudi Arabia. Three hundred and sixty patients who visited the Dental Clinic Complex after relaxation of lockdown and consented to participate were included in this study. Participants were instructed to complete a questionnaire on oral health and dental care during the lockdown period, consisting of five sections. Results: Out of 360 participants, 168 reported requiring dental help during the lockdown period; however, only 27 participants contacted a dentist to emergency advice on phone, and 102 participants visited a dentist. ​Most participants used ​toothpaste for sensitive teeth, followed by over-the-counter pain killers, and ​clove oil. In this regard, 72.8% of females used toothpaste for sensitive teeth. A considerable number of participants needed filling, followed by root canal treatment, ​denture repair, and dental extraction. Most participants were treated with pain killers, followed by antibiotics, and referral to a hospital. More than 80% of them expressed that regular visits to the dentist are beneficial. Conclusion: A substantial proportion of participants sought oral health care during the lockdown period, mainly for restorative treatment. This was mostly achieved by visiting a dentist, or via telephone consultation to a lesser extent. Analgesics were the most common prescriptions, followed by antibiotics. Dental patients should be encouraged to regularly visit dentists to mitigate the drawbacks that lockdowns may cause in the provision of oral healthcare services.

Background: The present study was conducted to assess quality of root canal (RC) filling before and after RC re-treatment. Materials and Methods: Two hundred and thirty-eight radiographs of failed endodontic treatment were assessed. The periapical status of the endodontic treatment was evaluated with periapical index (PAI) scoring system. PAI 3 showed presence of periapical lesion. Results: There was a statistically significant increase in scores 1 and 3 and decrease in scores 2, 4, 5, and 6 after treatment (P < 0.05). PAI score >3 was seen in 37% before which decreased to 16% after endodontic retreatment. 34.6% obturation was homogenous and 65.4% was nonhomogenous before endodontic retreatment. After endodontic retreatment, 95.2% became homogenous and 4.8% nonhomogenous. The reason for endodontic failure was furcation in 2%, iatrogenic causes in 3%, loss of coronal seal in 16%, periapical pathology in 25%, and inadequate root filling in 54%. Conclusion: There was significant improvement and decrease in size of periapical lesions in re-endodontic cases as compared to primary RC treated teeth.

Background: The present study focused on assessing the level of titanium in submucosal plaque in the peri-implant area with peri-implantitis in comparison to healthy implants. Methodology: Sixty patients with titanium dental implants were recruited. The degree of titanium in submucosal plaque around peri-implantitis and healthy implants was estimated using inductively coupled plasma mass spectrometry. Results: The mean ± standard deviation probing depth in Group I was 3.12 ± 1.1 and in Group II was 7.2 ± 2.5; gingival index was 0.64 ± 0.3 and 1.64 ± 0.8 in Group I and Group II, respectively. The plaque index was 0.82 ± 0.2 in Group I and 1.5 ± 0.6 in Group II. The mean plaque mass in Group I was 24.1 ± 3.8 ng/ul and 49.3 ± 6.4 ng/ul in Group II. The mean titanium level in Group I was 0.08 ± 0.02 μg and in Group II was 0.91 ± 0.04 μg. A highly significant difference between both groups was found (P < 0.05). Conclusion: There was a significantly higher titanium level in submucosal plaque around dental implants with signs of peri-implantitis as compared to healthy dental implants.

Background and Objectives: Smear layer forms during cleaning and shaping can obstruct the entry of both irrigant and sealant into the dentinal tubules, resulting in the accumulation of the bacteria and their byproducts. To ensure effective adhesion and better periapical healing, it is strongly advised to remove the smear layer before proceeding with root canal obturation. This study was designed to compare the efficiency of laser-activated irrigation (LAI) in removing the smear layer and debriding the most apical third of the root canal. Materials and Methods: Sixty-five extracted human teeth with straight single roots were randomly and equally divided into four laser and one control groups. Root canals in all samples were shaped using prime size TruNatomy rotary files. During preparation, each canal was irrigated with 3 mL of 3% NaOCl and 3 mL of 17% EDTA alternately, followed by the irrigation with 10 mL of distilled water to avoid the prolonged effect of EDTA and NaOCl solutions. Final irrigation of 5 mL of 17% EDTA of the root canal was done to eliminate the smear layer and was subsequently activated by an endodontic ultrasonic tip for 20 s three times (control group), a flat-end laser tip (test groups 1 and 3) or a taper-end laser tip (test groups 2 and 4) for two cycles. The time of each cycle activation was 10 s (groups 1 and 2) or 20 s (groups 3 and 4) in which the Er:YAG laser of 2940 nm was used. The laser operating parameters were 15 Hz and 50 μs pulse duration. The samples were then split longitudinally and subjected to scanning electron microscopy (SEM). Results: The remaining smear layer at the apical part of the root canals was statistically significant between the control group and the laser groups 1 (p = 0.040) and 2 (p = 0.000). Within the laser groups, the exposed tubules count was greater in the laser with the flat tip as compared with the tapered tip (Laser 1 > Laser 2 and Laser 3 > Laser 4). Finally, no significant differences in the count of debris between the laser groups and control group were observed, except for laser 4 (p < 0.05), which had the highest count of debris. Conclusion: LAI to remove debris and smear layer at the apical third of the root canal is inferior to the current ultrasonic technique. However, when using the Er:YAG LAI, it is recommended to use a flat tip design for 10 s for two cycles to ensure maximum debridement of the apical dentin surface.