Saudi Dental Journal最新文献

Corneal blindness remains a significant challenge in modern ophthalmology, accounting for 12% of global blindness cases. While corneal transplantation is often an effective treatment, its success is limited in patients with severe ocular surface diseases such as Stevens-Johnson syndrome, trachoma, or autoimmune-related dry eye disease. For these patients, osteo-odonto-keratoprosthesis (OOKP) has emerged as a highly specialized surgical solution, utilizing a patient's tooth as a scaffold for an artificial cornea, providing long-term visual restoration. This article traces the historical evolution of keratoprostheses, beginning with early 19th-century attempts at artificial cornea implantation to the modern Rome-Vienna protocol of OOKP. The surgical procedure is outlined from both ophthalmological and surgical perspectives, detailing key modifications, such as complete removal of the iris and lens, use of custom-made optical cylinders, and advanced biocompatible materials. These improvements have significantly enhanced the stability and longevity of the procedure while reducing the risk of complications such as glaucoma, inflammation, and implant rejection. A systematic review of scientific literature was conducted, analyzing 39 sources primarily obtained from PubMed. Researchers carefully selected these articles based on their abstracts to ensure relevance, providing a comprehensive analysis of OOKP.This article highlights its role as an advanced alternative for treating end-stage corneal blindness, offering hope to patients who are not candidates for conventional corneal transplantation. Osteo-odonto-keratoprosthesis (OOKP) is an innovative method for restoring vision in patients with severe corneal damage, significantly improving their quality of life. While the procedure presents challenges and risks, many individuals who undergo OOKP regain the ability to see and regain independence. Technological advancements should focus on refining the technique, minimizing complications, and increasing its accessibility. Additionally, patient education and support are crucial for successful rehabilitation and adaptation. OOKP is a remarkable achievement in medicine and biomedical engineering, offering hope to patients and inspiring further research to enhance the quality of life for people worldwide.

To report the histological changes in the periodontium after oral supplementation with a suspension of P. guajava fruit in Wistar rats compared with negative controls. A total of 24 male Wistar rats (aged 8-12 weeks) were randomly assigned to the intervention and negative control groups and received 250 mg/kg P. guajava fruit suspension and normal saline, respectively, via oral gavage. Rats underwent orthodontic treatment and a relapse protocol on the left maxillary side. At the end of the relapse period, the rats were sacrificed, and the left maxillary jaw was excised, processed, and stained for histological assessment using Hematoxylin and Eosin. Of 24 enrolled rats, 20 completed the study. PDL fiber uniformity was observed in 70% of rats in the intervention group on both the pressure and tension sides, whereas 90% of their counterparts in the control group exhibited excessively wide and narrow irregular PDL fiber thickness, respectively (P < 0.001). On the pressure side of both the intervention and control groups, 70% of rats showed a moderate number of osteoclasts. The remaining 30% in the same groups, however, either lacked or expressed few osteoclasts, respectively. Differences between the study groups were statistically significant (P < 0.05). Oral administration of P. guajava fruit suspensions may promote favorable histological changes in the periodontium.

Artificial intelligence (AI)-driven genetic analysis is crucial for the advancement of personalized dental treatments. Despite progress in genetic research, its clinical application remains limited. This case-control study utilized an association-rule mining algorithm (Apriori) implemented using Python software (version 0.22.0, 2024) to predict dental impaction based on MSX1, PAX9, and AXIN2 polymorphisms. The study was carried out at two centers in Saudi Arabia in October 2023 and involved 106 participants (42 males, 64 females; mean ± standard deviation age = 20.56 ± 8.07 years). Participants were categorized into 52 controls and 54 individuals with hypodontia, among whom 13 had impacted teeth. Saliva samples were analyzed for three single nucleotide polymorphisms: AXIN2 (rs2240308), PAX9 (rs61754301), and MSX1 (rs12532). Although multinomial logistic regression analysis indicated genotypic variations, no statistically significant associations with dental impaction were identified (P = 0.112). However, association-rule mining identified notable genotype patterns with the MSX1 A/A genotype (support = 0.224, confidence = 0.827, lift = 1.475). The combination of PAX9 (C/C) and MSX1 (A/A) had the highest predictive value (lift = 1.671), followed by MSX1 (A/A) with AXIN2 (G/G) (lift = 1.646), and PAX9 (C/C) with AXIN2 (G/G) (lift = 1.475). Based on available scholarly literature, this is among the pioneering studies to use association-rule algorithms to predict dental impaction, highlighting the potential of AI in genetics-based orthodontic diagnostics.

Medical emergencies (MEs) are sudden and severe health issues that pose an immediate threat to patients' lives or well-being if not addressed expeditiously. Annually, between 50 and 70% of dental professionals experience at least one medical emergency, with over a quarter encountering several emergencies each year. Therefore, it is essential to be familiar with the frequency and types of medical emergencies that may occur in dental offices so that dental professionals can be prepared to deal with life-threatening situations. This systematic review aims to report the prevalence and incidence of medical emergencies at teaching dental clinics in Saudi Arabia. Additionally, it aims to highlight assessments of practitioners' knowledge regarding these emergencies and report on the most encountered MEs. Furthermore, the study highlights recommendations from previous research on effective prevention and management strategies for MEs in dental teaching hospitals. The included articles were obtained from three different databases: EBSCO, SCOPUS, and PubMed. Eight studies were included in our analysis based on the eligibility criteria, and their quality assessment was assessed using the Newcastle-Ottawa Scale. The findings show a wide range of emergency reporting among the included articles, ranging from 49.4% to 0.2%. The dental students' knowledge in managing MEs was generally poor to below-average, except for one study that reported above-average performance. Postgraduate students showed better performance. Two studies reported a lack of confidence and practical competence in managing medical emergencies. This review demonstrates that although foundational awareness exists, readiness is often lacking, especially among students and junior practitioners. A standardized, competency-based training framework across Saudi dental institutions is imperative to bridge this gap and ensure patient safety. Further studies are recommended to evaluate the prevalence of medical emergencies and the level of knowledge across dental institutions in Saudi Arabia.

Chemotherapeutic agents used in the treatment of head and neck cancers can induce adverse effects on healthy tissues, including hematopoietic cells. Saliva and salivary glands are also vulnerable to the toxic effects of chemotherapy. Notably, the incorporation of herbal products or their natural constituents offers the potential for mitigating the adverse effects of chemotherapy. Mangifera indica L., commonly known as mango, is a globally significant tropical fruit renowned for its production and consumer appeal. It possesses a range of bioactive properties, including antioxidant and anti-cancer effects. This study assessed the cytoprotective activity of mango peel extract (MPE), specifically its ability to mitigate the adverse effects of carboplatin/5-fluorouracil (5-FU) on parotid glands and hematopoietic cells. Sixty male albino rats were equally divided into control (no treatment), Drug (carboplatin/5-FU), MPE only, and Drug + MPE (carboplatin/5-FU + MPE). All treatments were administered for three weeks. Body weight, blood glucose levels, and hematological values were evaluated. Parotid gland biopsies were analyzed using H&E staining and transmission electron microscopy. The concurrent administration of MPE and carboplatin/5-FU significantly increased body weight compared to carboplatin/5-FU treatment alone. However, MPE did not counteract the decrease in blood glucose levels induced by carboplatin/5-FU. Notably, the combined use of MPE and carboplatin/5-FU resulted in a modest increase in total hematopoietic cell count compared to the substantial decrease observed with carboplatin/5-FU monotherapy. Parotid glands revealed that MPE partially restored parenchymal structure, characterized by reduced periductal fibrosis, fewer pyknotic nuclei, and milder acinar vacuolation. While some striated ducts still showed a loss of striation, excretory ducts exhibited partial improvement in cell lining in certain areas. Transmission electron microscopy confirmed these histological observations. MPE demonstrated myeloprotective effects on hematopoietic cells, improved weight loss, and reduced blood glucose levels. Furthermore, concurrent administration of MPE and carboplatin/5-FU significantly attenuated parotid gland injury induced by carboplatin/5-FU.

This study aimed to evaluate the impact of acid erosion and mechanical abrasion-mimicking conditions associated with gastroesophageal reflux disease (GERD)-on the color stability and surface hardness of five commercially available dental composite resins, including four bulk-fill and one flowable composite. Standardized disc-shaped specimens were fabricated from Filtek Bulk Fill (FTB), SureFil SDR (SDR), Tetric N-Ceram (TNC), Beautifil Bulk Restorative (BBR), and Dynamic Flow (DYF). Specimens underwent 24-hour acidic storage (pH 2.8) and brushing simulation (5000 cycles) in acidic medium. Color changes (ΔE₀₀) were measured using a spectrophotometer, and surface microhardness (Vickers Hardness) was evaluated before and after treatment. Data were analyzed using one-way ANOVA, independent t-tests, and linear regression. All composites exhibited varying degrees of color change and hardness reduction, with BBR and SDR showing the most pronounced degradation, while FTB demonstrated the highest resistance. Composites with hydrophobic monomers (e.g., Bis-EMA) and high filler content exhibited improved resilience, whereas materials with hydrophilic matrices and lower filler loadings were more susceptible to deterioration Acid erosion and brushing significantly affect the aesthetic and mechanical properties of dental composites. Material composition-particularly polymer matrix type and filler matrix integration-plays a critical role in determining resistance to oral stressors. These findings underscore the importance of tailored material selection for patients with conditions like GERD and support the need for further development of durable restorative materials.

The all-on-four treatment concept is widely used to rehabilitate edentulous dental arches; however, its biomechanical effect on supporting jawbones requires careful evaluation. This study aims to optimize the all-on-four implant design to minimize cortical bone stress using finite-element analysis (FEA). A three-dimensional FEA model was developed based on the mean average dimensions of Japanese edentulous mandibles (Takahashi et al. 2010). Implants (length = 12-16 mm and diameter = 3-5 mm) were placed between the two mental foramina with two parallel anterior implants positioned at distances ranging from 9.6-15 degree from the mandibular midline. Posterior implants are angled from 1-45° with lengths varying between 12-18 mm. A rigid superstructure splints all implants and an occlusal load of 50 N was applied at distal ends. The maximum Von Mises stress on the cortical bone was measured. The adaptive optimization approach identified eight optimal design configurations. These designs results in a peak Von Mises stress of 2.26 MPa which demonstrate 32% reduction compared with previous findings by Takahashi et al. (2010). The optimized all-on-four configuration significantly reduces cortical bone stress while accommodating anatomical variability. This approach offers clinical insights into improving implant longevity and outcomes in edentulous patients.

This systematic review aims to evaluate the efficacy of probiotic interventions in the prevention of enamel demineralization, with a specific focus on randomized clinical trials (RCTs). A comprehensive literature search was conducted in the Cochrane Library, PubMed, Scopus, and Web of Science electronic databases, covering studies published until April 2025. The review follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Article selection and data extraction were independently conducted, with methodological quality evaluated using the Jadad Score. A total of 34 RCTs were included, with 17 studies scoring 5 and 8 studies scoring 3 on the Jadad scale, indicating moderate to high methodological quality. The majority of the trials involved children aged 1 to 15 years, while eight studies focused on adult cohorts aged 18 to 65 years. Intervention durations varied from 6 days to 2 years. The most commonly used probiotic strains were Lactobacillus, Bifidobacterium, or a combination of both, delivered via dairy-based products, lozenges, mouth rinses, or probiotic tablets. Twenty-seven research studies demonstrated a significant reduction in the main cariogenic pathogen, Streptococcus mutans (p < 0.05 - p < 0.001), while findings on Lactobacillus reduction, plaque index, gingival status, salivary pH, and buffering capacity were inconsistent across studies. Long-term studies (≥ 6 months) showed more sustained effects, emphasizing the need for continuous probiotic intake to maintain oral health benefits. The findings suggest that probiotic interventions may represent a potential approach for preventing enamel demineralization, primarily through their ability to reduce cariogenic bacteria and increase salivary pH.

Dental erosion is mainly linked to consumption of acidic foods and drinks, potentially including fermented dairy products. The aims of this primary in vitro study were to determine the acidity of different fermented milk products commonly consumed in Saudi Arabia and to evaluate their potential erosive effects on dental enamel. Extracted bovine tooth crowns were embedded in resin with the enamel exposed and randomly divided into three groups (n = 3/group): laban (buttermilk), yogurt, and milk (control). Each specimen was immersed in the test product (60 min, 25 °C), then submitted to surface profile analysis using optical profilometry and confocal laser scanning microscopy. Further, pH and titratable acidity were evaluated for seven dairy products: laban, Activia laban, ayran laban, full-fat yogurt, fruited yogurt, plain Greek yogurt, and milk (control). All tested fermented dairy products were acidic and had significantly lower pH than the control (p < 0.0001), with ayran laban the lowest (pH 4.1 ± 0.02) and Greek yogurt the highest (pH 4.6 ± 0.01). Tested yogurt products exhibited significantly higher titratable acidity than laban products. The yogurt group had the highest enamel surface roughness, which was significantly different to the untreated surface on profilometric analysis (p < 0.0001). All characterized fermented dairy products were acidic with erosive potential. Yogurt and laban both increased enamel surface roughness, and the effect was more pronounced with yogurt. These findings underscore the need to moderate fermented milk product intake, to prevent dental erosion, and to include guidance on their consumption in oral health dietary recommendations.

Virtual articulators have emerged as promising digital tools for simulating jaw movements and occlusal contacts in dentistry. However, few studies have compared the performance of different virtual articulators and their impact on recording occlusal contacts. This study designed to evaluate the effects of various virtual articulators on occlusal contact distribution and morphology and identify the most accurate system. TRIOS 3Shape intraoral scans of lower and upper arches of five dentate patients with digital bite registration on both sides were performed and exported to dental CAD software (3Shape OrthoSystem). The occlusal plane was standardized using three points on 3Shape OrthoAnalyzer. Eight virtual articulators were evaluated during this study in motion: Ivoclar Vivadent, SHUFO Proarch IV, Kavo Protar, 3Shape Generic, Denar Marta 330, ACR (Atex compatible), SAM 2P, and BIO ART A7 Plus. Occlusal contacts were recorded during motions for left, right, retrusive, and protrusive movements. The result of occlusal map was recorded and analyzed by Python code written by the researcher (Ian Code) to capture the information for the number and regions of occlusal contact and convert it to numerical values for comparison. Significant differences were found between articulators in the number and area of occlusal contact distributions. The 3Shape Generic articulator showed the highest number of contact regions with a mean of 19.6 ± 6.8 regions, while the ACR (Atex compatible) articulator showed the lowest number with a mean of 15.8 ± 7.3 regions. The result of contact areas shows the highest area with mean of 32 ± 6.4 mm² in the Ivoclar Vivadent articulator and the lowest area with a mean of 26.6 ± 6.3 mm² in the BIO ART A7 Plus articulator. These findings suggest that the choice of a virtual articulator can significantly influence the representation of occlusal contact regions and area, with potential effects on its implications for planning and treatment outcomes. Dental laboratories and clinicians should be aware of the specific characteristics and limitations of their chosen virtual articulator system and consider these factors when interpreting the results and making decisions in treatment. Future researches consider on validating these findings in clinical application in dentistry by investigation the effect of dynamic and static virtual articulation, this may lead to developing a new virtual articulator that incorporates advanced algorithms and technologies that can improve the accuracy of occlusal contact simulations.