Saudi Dental Journal最新文献

This systematic review synthesized clinical data to assess whether a temporarization phase improves outcomes compared to immediate definitive restorations when the vertical dimension of occlusion (VDO) is increased within or equal to the vertical dimension at rest (VDR). It aimed to clarify whether maintaining treatment within this physiologic range-a proposed "Vertical Safety Zone"-supports favorable restorative and functional outcomes. Following PRISMA 2020 guidelines, we searched PubMed, Scopus, Web of Science, and Embase for studies evaluating full-mouth or multi-unit rehabilitations with increased VDO ≤ VDR. Risk of bias was assessed using ROBINS-I, and certainty of evidence rated using GRADE. Meta-analysis was conducted using a random-effects model when applicable. Nine studies met inclusion criteria, with four contributing quantitative data (2,201 restorations, 3-5.5 years' follow-up). The pooled replacement-free survival rate was 97.8% (95% CI: 95.6-98.9%), and clinical success (including minor repairs) was 94.0% (95% CI: 90.5-96.5%). The annual failure rate averaged 1.28% (95% CI: 0.7-2.1%). No study reported temporomandibular or muscular complications when VDO remained within VDR limits. Temporarization protocols, when used, were typically short (< 48 h). When VDO increases are confined within the VDR, immediate definitive rehabilitation may be a viable alternative to temporarization. Although direct comparisons were limited, the findings suggest that staying within this "Vertical Safety Zone" preserves neuromuscular harmony and restoration longevity. The concept should be considered a useful framework for clinical planning, pending further controlled validation.

Oral health is an integral component of general health and quality of life; however, oral diseases remain unevenly distributed due to social, economic, and contextual factors. In Saudi Arabia, adults experience a substantial burden of dental caries, periodontal disease, and related conditions, with evidence suggesting marked disparities across socioeconomic and demographic groups. Despite growing research attention, evidence on the social determinants of oral health among Saudi adults remains fragmented. This narrative review aimed to synthesize existing evidence on the social determinants of oral health among adults in Saudi Arabia and to identify key patterns, gaps, and implications for policy and practice. A narrative review was conducted following the Scale for the Assessment of Narrative Review Articles (SANRA). Literature was gathered from PubMed, Scopus, ScienceDirect, SpringerLink, Web of Science, and Google Scholar, focusing on social determinants of oral health among Saudi adults. Empirical studies addressing social, economic, cultural, behavioral, and structural factors were included, and findings were synthesized thematically using a narrative approach. The reviewed literature consistently demonstrates that socioeconomic status, particularly income, education, employment, and geographic location, strongly influences oral health outcomes and dental service utilization among Saudi adults. Lower socioeconomic position is associated with a higher prevalence of dental caries and periodontal disease, reduced use of preventive dental care, and poorer oral health-related quality of life. A persistent gap between oral health knowledge and preventive practices was evident, shaped by financial constraints, access barriers, and cultural perceptions. Tobacco use, including smokeless tobacco, and the interaction between oral and systemic conditions, such as diabetes, further exacerbate oral health disparities, especially among vulnerable populations. Oral health disparities among Saudi adults are driven by complex social determinants that extend beyond clinical factors. Addressing these inequities requires integrated strategies that combine preventive dental care, health system reforms, culturally responsive health promotion, and policies targeting socioeconomic disadvantage, in alignment with national public health priorities such as Saudi Vision 2030.

The interproximal contact area (ICA) is the zone in which two adjacent teeth appear to meet. The absence of the ICA defines the diastema. The study aimed to assess the extent of interproximal contact zone at the level of maxillary anterior teeth among a sample representing the Tunisian population. It also aimed to assess the correlation between the anterior contact area and the dimensions. It was a cross-sectional study conducted at the Faculty of Dental Medicine, Tunisia. Only young Participants with a full, intact anterior dentition. Those who underwent previous orthodontic treatment, had decayed, restored, or crowned anterior teeth were excluded. An alginate impression was taken. Then, on casts, the height and the width of teeth and the extent of interproximal contact area of maxillary anterior teeth were measured using a digital caliper. The largest contact area was between the central incisors. Between central Incisors, its average was 4.57 ± 0.88 mm. Between central and lateral incisors, it was about 3.17 ± 0. 69 mm. Between the lateral Incisor and canine, it was about 2.46 ± 0.63. The average PCAP was 47.54 ± 8.84 mm. between central Incisors. Between the Central Incisor and the Lateral Incisor was 38.75 ± 8.22 mm, and 26.75 ± 6.23 mm between the Lateral Incisor and the Canine. Statistically significant differences between different sides were reported. It was not significant between the two genders, either. This area decreases from the midline. Guidelines about the proportionate existence of white and pink components should be respected to optimize esthetic outcomes and ensure patient satisfaction.

Exosomes containing biomarkers offer potential for non-invasive diagnostics. For screening purposes and to improve patient treatment outcomes, early diagnosis of oral cancer is essential. This study's goal is to create a non-invasive assay using Janus particles (JPs) for detecting exosomes biomarkers CD63 and CD44 derived from the H357 oral cancer cell line. The JPs were functionalized with CD63 and CD44 antibodies to enable specific binding with target exosomes. The binding events were monitored through changes in rotational diffusivity, analyzed using cross-correlation techniques. The Stokes-Einstein-Debye model was used to correlate increasing exosome concentrations with slower particle rotation. The presence of the target biomarkers is confirmed with an enzyme-linked immunosorbent assay (ELISA). The JPs detected significant differences in rotational diffusivity between exosome binding antibodies with control group (PBS only) groups (p < 0.05). The ELISA confirmed the presence of CD63 and CD44 biomarkers. The JPs based assay provides a high-sensitivity method for detecting oral cancer surface markers on exosomes. This technology shows promising potential as an effective and non-invasive method for oral cancer early screening and diagnosis.

Micro and nanoplastics (MNPs) released from dental materials and oral-care products are an emerging concern at the intersection of dentistry and environmental health. This narrative review synthesizes evidence on dentistry-related sources of MNPs, exposure pathways, biological interactions, detection approaches, and environmental dissemination, with emphasis on practical mitigation. Resin-based composites and acrylic prosthetics, as well as routine consumer products such as toothbrushes, toothpastes, floss, and clear aligners, are identified as potential sources of microscopic polymer debris. Exposure may occur during everyday use, predominantly via ingestion with saliva and, in some contexts, inhalation of fine procedure-generated aerosols. Experimental in vitro and in vivo studies indicate that MNPs can be internalized by oral cells and may trigger oxidative stress and inflammatory responses, although direct human clinical evidence linking dental-origin exposure to disease remains limited. Proposed associations with periodontal inflammation, oral carcinogenesis, or systemic outcomes are biologically plausible but unconfirmed. Environmental studies have reported polymer-containing particulate in oral-care rinse water and dental wastewater, suggesting dentistry may represent a small but potentially addressable point source of microplastic release. We summarize mitigation options including effective chairside evacuation, upstream filtration and trap maintenance, dust control for laboratory processes, and patient guidance toward lower-shedding products, and we note the relevance of evolving regulation, including the EU REACH 2023/2055 restriction on intentionally added microplastics.

Intramarrow Penetration (IMP) has recently gained attention for its potential to enhance periodontal healing with regenerative approaches for osseous deformities such as intrabony defects. This systematic review was conducted to evaluate the effect of IMP in enhancing periodontal regeneration of intrabony defects when used in conjunction with or without the use of biomaterials. A comprehensive search was performed across databases including PubMed, Scopus, Cochrane, Lilacs, and Google Scholar. Studies were selected based on the inclusion of clinical outcomes such as probing pocket depth (PPD), clinical attachment level (CAL), and bone fill following the application of IMP with Open Flap debridement (OFD) with or without biomaterials. Studies were assessed for risk of bias using the Cochrane RoB 2 tool. The quality of evidence was assessed using the GRADE approach. Initial search yielded 194 studies which eventually resulting in five eligible studies for inclusion in the review. Four of the five included studies reported that IMP significantly improved clinical and radiographic outcomes, including reduced PPD, increased CAL, and enhanced bone fill. IMP can be a potential adjunct to OFD for periodontal regeneration in intrabony defects, offering advantages such as improved healing and enhanced bone regeneration. However, as the quality of evidence is very low a definitive clinical recommendation cannot be made. Further well-designed multicentre studies are necessary to validate these findings.

Dental education is a high-stress environment where Emotional Intelligence (EI) is vital for student well-being and success. This study aimed to measure EI levels among female undergraduate dental students and to investigate the relationship between EI, academic year, and academic performance (GPA). A cross-sectional study assessed EI using the EQ-i 2.0® in 117 female undergraduate dental students at Princess Nourah Bint Abdulrahman University (PNU), Saudi Arabia. Data were analyzed using ANOVA, Tukey's post-hoc tests, and Pearson correlations to compare EI across academic years and examine EI-GPA relationships. Most EI scales showed no significant differences across years. However, fifth-year students scored significantly higher in Stress Management (93.29 ± 12.43 vs. 82.21 ± 11.96, p = 0.028) and Flexibility (97.60 ± 13.35 vs. 86.00 ± 15.71, p = 0.045) than fourth-year students. Second-year students had the lowest semester GPA (4.02 ± 0.45, p = 0.004) and concerning EI patterns. Weak but significant positive correlations were found between Total EI and semester GPA (r = 0.200, p = 0.033), Self-Perception and semester GPA (r = 0.200, p = 0.034), Interpersonal composite and cumulative (r = 0.231, p = 0.013) and semester GPA (r = 0.343, p < 0.001), and Well-Being Indicator with both GPA measures. Correlations were strongest in the first and second years. Overall EI was broadly stable across academic years, with higher Stress Management and Flexibility scores observed in final-year students. EI measures demonstrated statistically significant but weak positive associations with GPA, with the Interpersonal composite showing the most consistent relationship. These findings suggest EI may be related to academic performance in early training, but the modest effect sizes indicate limited explanatory power and warrant cautious interpretation.

Impacted maxillary canine (IMC) is a common clinical problem in Dentistry and can lead to various complications. However, the etiology is complex, and no definitive conclusions have been reached to date. Traditional etiological theories cannot fully explain the mechanisms underlying IMC and often show considerable disagreement. Inspired by the clinical effectiveness of early intervention and considering the characteristics of tooth eruption and development, this study proposes a new perspective on the etiology of IMC. The concept of timing factors is proposed, and the notion of a chronological-biological mismatch is employed to explain its significance, emphasizing that it should not be overlooked. The aim is to use timing factors as a linking element to shift IMC etiological research from the traditional static, terminal-position perspective to a dynamic, process-oriented approach, and to promote the transition from conventional single-mechanism models toward a multifactorial understanding of its etiology. Clinically, early interceptive strategies, such as extraction of primary canines and rapid maxillary expansion (RME), are highly effective when applied within critical periods, highlighting the practical significance of timing factors. Recognizing developmental timing as an important etiological element provides a new perspective for studying IMC, addresses the limitations of traditional theories, and can guide precise, individualized early interventions in the future.

Purpose: Among the various risks of cardiovascular disease, hypertension and hypercholesterolemia are the greatest risks. Renin-angiotensin-aldosterone system inhibitor medication, consisting of angiotensin converting enzyme inhibitors and angiotensin receptor blockers, as well as statins, is used to treat hypertension and hypercholesterolemia, respectively. The effect of this medication on inflammatory reactions has been demonstrated by various studies, as well as its effect on periodontal tissue. This study aims to determine the effect of renin-angiotensin-aldosterone system inhibitor medication and statins on the periodontal status of patients at risk of cardiovascular disease.

Methods: Search for studies through electronic databases using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis 2020 guidelines. Studies that met the inclusion criteria are included and assessed for risk of bias and then meta-analysed.

Results: Qualitative synthesis showed inconsistent results regarding the effect of RAAS inhibitors on periodontal status. Meta-analysis between the statin group compared with other interventions such as diet found that the mean bleeding on probing index found a statistically significant difference with a mean difference of -13.4% (95% CI:[-23.08;-3.72], p = 0.007), the mean clinical attachment loss did not show any significant difference with a mean difference of -0.16 mm (95% CI: [-0.40;-0.07], p = 0.17), and mean probing depth there was a statistically significant difference between groups with a mean difference of -0.38 mm (95% CI:[-0.53;-0.23], p < 0.00001).

Conclusion: The effect of renin-angiotensin-aldosterone system inhibitor medication in the form of angiotensin converting enzyme inhibitors and angiotensin receptor blockers in hypertensive patients on periodontal status showed inconsistent results and statin medication systemically could improve periodontal status, bleeding on probing index, and probing depth in patients with hypercholesterolemia.

Maxillectomy produces extensive oral and maxillofacial defects that disrupt normal physiology and often require obturator prostheses for functional and aesthetic rehabilitation. Although these devices are routinely used, their influence on salivary characteristics and oral microbiota remains insufficiently understood. To compare pre- and postoperative salivary parameters, periodontal indices, and selected microbial species in patients undergoing partial maxillectomy and rehabilitated with obturator prostheses. In this pilot prospective cohort study, 14 adults scheduled for maxillectomy were evaluated. Unstimulated whole saliva was collected at baseline and at 6-8 months post maxillectomy. Clinical examinations assessed salivary flow, viscosity, periodontal indices, and semi-quantitative microbial profiles using commercial hybridization assays. Statistical tests were selected according to data type. Probing depth increased modestly (3.7 ± 0.7 mm to 3.9 ± 0.8 mm; P = 0.02), while plaque and gingival indices showed no significant changes. No significant changes were detected in either salivary flow and viscosity (6.97 ± 1.86 ml to 8.58 ± 2.29 ml, P = 0.58 and 1.50 ± 0.97 cps to 1.54 ± 0.96 cps, P = 0.64, respectively). Similarly, no statistically significant changes were detected in the prevalence of the selected microbial species, although a non-significant decrease in Aggregatibacter actinomycetemcomitans and an increase in Porphyromonas gingivalis were observed. Most other fungal and bacterial species showed similar prevalence across time points. Within the early postoperative period, salivary characteristics and oral microbial patterns remained generally unchanged following maxillectomy and obturator placement. Given the small and heterogeneous cohort, these preliminary outcomes warrant cautious interpretation and underscore the need for larger studies with extended follow-up time.