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Background: Alkalization of local anesthetics may have an impact on alleviating the injection pain by buffering these solutions with sodium bicarbonate. The present study aimed to evaluate the pain during local anesthetic buccal infiltration for the maxillary canines after adding sodium bicarbonate 8.4% during local anesthesia. Materials and Methods: A buffered 2% lidocaine with 1:80,000 epinephrine and sodium bicarbonate 8.4% was used for one site, and an unbuffered 2% lidocaine with 1:80,000 epinephrine was used for the other site at the same appointment. Two groups of volunteers (15 male and 15 female) participated. Each participant received 0.6 mL of the anesthetic solution. Injection discomfort was assessed using a visual analog scale. Results: 73% and 93% of patients in group 1 experienced pain in sites A and B, respectively, during the injection, whereas 80% and 100% of patients in group 2 experienced pain in sites A and B, respectively, during the injection. Both groups showed a significant difference in pain scores between the two injected sites (P ˂ 0.01). Conclusion: Upper canine infiltration anesthesia with buffered lidocaine and epinephrine with sodium bicarbonate has less pain during injection than when unbuffered lidocaine with epinephrine is used. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

This study was carried out to investigate the effect of a complete exchange of Ca2+ with Zn2+ ions on the structure of brushite (CaHPO4·2H2O), which might be advantageous in the production process of CaxZn1−xHPO4·nH2O. To acquire the starting solutions needed for the current study, (NH4)2HPO4, Ca(NO3)2·4H2O, and Zn(NO3)2·6H2O 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. [ABSTRACT FROM AUTHOR]

The principal aim of this concise review is to provide an updated practical knowledge with reference to the relationship between diabetes mellitus and periodontal disease. It mainly outlines their characteristics and clarifies their interrelationship. Contemporary scientific research indicated that diabetes mellitus may increase the risk of periodontitis. On the other hand, a chronic periodontal disease may affect the natural development of diabetes. Various triggering and modifying factors can induce both diseases, and interindividual variances are involved in the risk of their progress. Well-controlled periodontal disease may enhance glycemic control in diabetics. On the other hand, improved glycemic control may lead to a wellcontrolled periodontal disease. It is essential to establish a good consultation between the dentist and the specialist responsible for a diabetic patient, efforts being made to evidence the interrelated impact of the diseases, whose control will lead to significant clinical results. [ABSTRACT FROM AUTHOR]

Aim: to investigate the possible correlation between personality traits and higher grade point average GPA among dental students at a Saudi dental college. Materials and methods: Dental students and interns at College of Dentistry, "King Saud Bin Abdulaziz" University for Health Sciences were asked to participate in the study. Method of assessment: an online 50-question Five Factor Model Test conducted by a specialized company in the field of human resources (www.truity.com), performed using I-Pad devices. The GPA was collected by each student and plotted against each of the five personality traits (openness, conscientiousness, extraversion, agreeableness and neuroticism). Results and discussion: The final study sample consisted of 159 participants representing all levels in the college of dentistry. The study showed that the most dominant personality trait is agreeableness, while high conscientiousness was the least dominant personality trait found among both males (17.8%) and females (21.1%). When looking into the GPA, most of the females were above 4.5 and only 1.7% of them were below 4. However, among males only 11.1% had a GPA above 4.5, while 46.7% had a GPA below 4. Openness was found as significantly correlated with agreeableness and conscientiousness, whereas agreeableness was found as significantly associated with neuroticism. However, they are inversely related. There was a significant inverse correlation between GPA and agreeable female students. Also, a significant relation between extravert male students and conscientiousness was observed. Conclusions: The more open a person is, the more agreeable and conscientious he/she is. Female students registered higher GPA than male students. [ABSTRACT FROM AUTHOR]

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 ×8 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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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.)

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.

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.

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.

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.