Saudi Dental Journal最新文献

Oral squamous cell carcinoma (OSCC) is the most common oral malignancy, with neck metastasis significantly affecting prognosis and treatment. This study examines clinicopathological factors associated with neck metastasis in a Middle Eastern cohort of OSCC patients. A retrospective analysis of 84 OSCC patients treated at King Hussein Cancer Center (2018-2024) was conducted. Clinicopathological factors, including tumor subsite, T stage, depth of invasion, differentiation, perineural invasion, and lymphovascular invasion were evaluated for their association with lymph node metastasis. Pathological neck involvement was observed in 47.6% of cases. Late T stage (T3-T4) and LVI positivity were identified as independent predictors of nodal metastasis (aOR = 4.25, p = 0.009; aOR = 4.39, p = 0.027, respectively). These findings highlight the importance of comprehensive pathological assessment in OSCC.

This research compilation examines the frequency and consequences of abnormalities in the temporomandibular joint (TMJ) associated with various autoimmune diseases, with an emphasis on arthritic conditions. When the immune system of the body unintentionally targets its own tissues, autoimmune illnesses arise. This causes inflammation and damage to several organs, including joints. This study describes how rheumatoid arthritis affects the TMJ and emphasize how it affects oral dysfunction; provide a preliminary report on TMJ involvement in Psoriasis, highlighting the need of early diagnosis and care. Our study investigates TMJ abnormalities in individuals who have psoriatic arthritis and osteoporosis, respectively. These findings suggest a complicated interaction between systemic health and TMJ function. We examined instances of TMJ ankylosis in patients with ankylosing spondylitis as well as the frequency of TMJ issues in this group of patients. We conducted a scoping review to gather information on the role of the TMJ in ankylosing spondylitis and to guide clinical practice. When taken as a whole, these studies highlight how important it is to use multidisciplinary techniques to treat TMJ issues in autoimmune illness patients in order to improve patient outcomes. This study aimed to evaluate the involvement of the TMJ in six specific autoimmune conditions which are, Rheumatoid arthritis, Juvenile idiopathic arthritis, Osteoporosis, Psoriasis, Ankylosing spondylitis and systemic lupus erythematous (SLE). A total of 24 research studies were included in the analysis, sourced from PubMed, Google scholar and web of science starting from 2003 to 2023. The selection criteria were based on relevance to TMJ manifestation, clinical significance, and peer-reviewed status. Data extraction focused on TMJ structural change, functional impairment, and the clinical outcomes associated with each autoimmune condition. Advanced imaging techniques, such as Cone Beam Computed Tomography (CBCT) were prioritized for assessing subtle bony changes not visible on conventional radiographic images.

Remakes in fixed prosthodontics present ongoing clinical and logistical challenges, including increased chairside time, laboratory costs, and patient dissatisfaction. Understanding the prevalence and causes of these remakes is essential for improving restorative outcomes and workflow efficiency. This study aimed to estimate the prevalence of laboratory remakes for fixed prosthodontic restorations and examine associations with restoration type, material, and operator classification in a multicenter setting. We conducted a retrospective, multicenter audit of 40,344 indirect restorations fabricated in seven dental laboratories in Riyadh. Predefined null hypotheses posited no associations between remake reasons and (a) restoration type, (b) material, or (c) operator classification. Pearson χ² tests were used (α = 0.05). There were 2,612 remakes. By restoration, remake prevalence was veneers 7.5%, onlays 7.1%, crowns 6.9%, bridges 4.8%, and endocrowns 4.0%. Leading reasons were margin-fit discrepancy 29.5%, proximal-fit issue 23.2%, and improper fit 22.7%. Materials were differentially associated with remake reasons (e.g., shade mismatch more frequent with lithium-disilicate; proximal-fit problems more frequent with monolithic zirconia; all p < 0.05). Reason profiles differed by operator classification. Remakes were common and patterned by restoration type, material, and operator classification. Addressable targets include margins and proximal contacts, clearer laboratory prescriptions, and staged adoption of digital workflows with competency-based training. These observations can inform local quality-improvement initiatives.

Traumatic dental injuries (TDI) are a common problem especially in the field of paediatric dentistry and constitute a serious health issue in the young population. Prognosis of TDI treatment depend on various factors, for a long - term success immediate and proper first aid is crucial to preserve the vitality and function of damaged teeth. Since most cases of dental trauma occur at school - teachers and students are the first ones to encounter and to provide first aid in the emergency situation. Little attention is paid to educating primary and secondary school children about the first aid when the dental trauma occurs. The aim of our study was to investigate the knowledge of Polish secondary school students in management of traumatic injuries. A 34-item questionnaire on TDI experience and management was distributed amongst secondary school students attending different types of school in Poland. Statistical analyses were carried out using the IBM SPSS Statistics 25 package. It was used to perform Mann-Whitney's U tests, Kruskal-Wallis non-parametric ANOVA and Spearman's rank correlations. Two hundred and fifty eight questionnaires were obtained in the study. 76,7% of all responders have witnessed dental trauma in the past. 64,3% of them had suffered from TDI. Over 50% of students were unaware of a suitable medium in which to transport an avulsed permanent tooth. Only 32,2% decided that an avulsed tooth can be put back in its place. This study indicates a lack of adequate knowledge of management of TDI among secondary school students in Poland. Additional education about first aid of TDI should be developed and implemented. Appropriate first aid, emergency care at the accident site can save the patient more costly and time consuming treatment as well as negative health consequences including tooth loss.

This study evaluated the effectiveness of various adhesive removal methods following orthodontic bracket debonding. Eighty extracted human premolars were bonded, debonded, and randomly assigned to four groups (n = 20) based on the adhesive removal method: (1) low-speed round tungsten carbide (TC) bur, (2) high-speed, 18-fluted tapered TC bur, (3) high-speed extra-fine needle-shaped diamond bur, and (4) sequential polishing discs. Each group was further subdivided into two subgroups (n = 10) based on the inspection method for surface cleanliness: tactile examination with a dental explorer or marking the surface with a black pencil. Adhesive removal time was recorded for each group, and surface roughness was measured. Pre- and post-treatment tooth surface scans were superimposed using Geomagic Wrap software to quantify enamel loss and residual adhesive height. Data were analyzed using two-way ANOVA (α = 0.05). The 18-fluted TC bur had the shortest adhesive removal time (52.80 ± 6.74 s) but caused the greatest enamel loss (70.56 ± 56.44 μm) and highest residual adhesive height (75.60 ± 57.35 μm) (P < 0.05). Surface roughness was significantly higher in the 18-fluted TC bur group (186.20 ± 65.98 μm) than in the polishing disc (123.70 ± 40.64 μm) group (P < 0.05). Adhesive removal time was significantly longer for the polishing disc group (P < 0.05). Using a black pencil for surface inspection did not affect enamel characteristics, but significantly increased treatment time (P < 0.001). A low-speed round-shaped TC bur or an extra-fine needle-shaped diamond bur is recommended for adhesive removal after bracket debonding. Enamel inspection with a dental explorer provides comparable results to black pencil marking regarding enamel preservation.

Purpose: This systematic review, conducted per PRISMA guidance, evaluated clinical outcomes of titanium-base (TiB) versus multi-unit (MU) abutments in immediate-loading dental implant protocols, focusing on implant survival, prosthetic and biological complications, and patient-reported outcomes.

Methods: PubMed and Scopus were searched for original English-language clinical studies published between 2001 and 2025, including RCTs, cohort studies, and clinical series with at least 12 months of follow-up. Only studies evaluating TiB and MU abutments in immediate-loading protocols were included. Due to heterogeneity in study designs, case selection, outcome measures, and follow-up duration, a narrative descriptive synthesis was performed without pooled statistical analysis.

Results: Seventeen clinical studies met the inclusion criteria. Both TiB and MU abutments showed high implant survival rates, generally in the high 90 s. TiB abutments performed well in single-tooth anterior restorations, showing fewer mechanical complications and better esthetic ratings. MU abutments were predominantly used in full-arch cases, demonstrating reliable long-term function but with higher mechanical maintenance needs. Marginal bone loss remained within acceptable limits across studies. Patient-reported outcomes were inconsistently assessed, though TiB tended to score higher for esthetics and MU for functional comfort.

Conclusions: Both TiB and MU abutments effectively support immediate loading when primary stability and proper prosthetic planning are achieved. TiB may be preferable for esthetic single-tooth cases, while MU abutments remain suitable for full-arch rehabilitation. The limited number of head-to-head studies highlights the need for well-designed randomized trials with standardized outcomes and validated patient-reported measures.

Canine teeth are essential to dentofacial aesthetics and functional harmony. When impacted they impair both form and function leading to psychological distress and poor health-related quality of life. This study investigates the approaches to managing impacted canines in the southern region of Najran, Kingdom of Saudi Arabia. This was a retrospective study with data collection from Najran Specialty Regional Dental Center in Najran, Kingdom of Saudi Arabia from 2020 to 2024. Clinical record data extracted include age, sex, radiographs, position of impacted canine, location of impacted canine and management protocol. The data were analyzed using IBM SPSS Statistics for IOS Version 25 (Armonk, NY: IBM Corp). P-value ≤ 0.05 was considered statistically significant. A total of 98 patients comprising 44 males (44.9%) and 54 females (55.1%) with impacted canines were managed during the study period. Age ranged from 13 to 30 years with mean ± SD age of 19.3 ± 3.3 years. Age group 16-20 years were in the majority (56 (57.1%)) while age group 26-30 were the least (3 (3.1%)). The majority of the impacted canines were located in the maxilla (85 (86.7%). Considering, management protocol, the majority (57 (58.2%)) of the patients with impacted canine were treated by non-surgical canine exposure. Most of our patients are young adults with the majority having maxillary canine impaction in the palatal location. Our favorite option is non-surgical canine exposure. Treatment durations ranges from two to four years with the majority in the 2.5 to 3 years.

The aim of this study was to evaluate the shear bond strength and tooth discoloration of resin-modified glass ionomer cement (RMGIC) and high-viscosity glass ionomer cement (HGIC) restorations in primary teeth treated with either nano-silver fluoride (NSF) or silver diamine fluoride (SDF). Sixty-six primary molars with dentin caries were randomly assigned to six groups of 11 teeth each: two NSF-treated groups (one RMGIC, one HGIC) and two SDF-treated groups (one RMGIC, one HGIC). Two additional control groups received direct RMGIC and HGIC restorations, respectively. All samples were tested for tooth discoloration using a spectrophotometer before and after the thermocycling aging process (20,000 cycles). Shear bond strength was compared between the groups. Kruskal-Wallis test with a P-value of < 0.05 was used for statistical significance. The samples treated with SDF and restored with RMGIC exhibited the highest ΔE value (mean ± standard deviation (SD) of 8.27 ± 6.51). In contrast, the samples treated with NSF and restored with RMGIC demonstrated the lowest ΔE value (mean ± SD of 1.45 ± 0.77). No statistically significant differences were found between the groups in the shear bond strength test. NSF provided a better color masking effect compared to SDF when using RMGIC without visible black stains through the restoration. Additionally, neither NSF nor SDF affected the shear bond strength of either type of restoration applied to them. NSF may be preferred over SDF in cases where aesthetics is a priority, with similar bond strength and enhanced color matching.

Purpose: Nickel-titanium (NiTi) instruments have advanced root canal preparation through enhanced precision. Thermal pretreatment improves both flexibility and cyclic fatigue resistance (CFR). While irrigating solutions are essential for decontamination, they may also affect the properties of heat-treated NiTi instruments. This study aimed to evaluate the impact of different irrigating solutions on the cyclic fatigue resistance of heat-treated NiTi files.

Methods: Four heat-treated reciprocating NiTi-files were analyzed: EdgeOne R-Utopia, Reciproc Blue, Procodile Q and CC One Blue. Files were immersed (5 min; 37 °C and 60 °C) in 5.25% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA), 96% ethanol, NaOCl + EDTA, distilled water, or left in a no-immersion control group. CFR was measured in an artificial root canal (60° curvature, 5 mm radius), and fragment length (FL) was documented. The surface features of the fragments were assessed through scanning electron microscopy.

Results: File system, irrigating solution, and temperature significantly influenced CFR (p < 0.001). Across all immersion conditions, the CFR reached its highest value with Procodile Q (37 °C distilled water) and its lowest with EdgeOne R-Utopia (60 °C NaOCl + EDTA). EDTA reduced CFR across all files, particularly at elevated temperatures and when combined with NaOCl. Microscopy revealed micropitting and roughened surfaces, particularly on CC One Blue (60 °C NaOCl), as well as material degradation and heterogeneous surfaces with NaOCl + EDTA.

Conclusions: Heat-treated NiTi instruments are influenced in their mechanical and metallurgical behavior by the chemical and thermal impact of irrigating solutions. Heated EDTA and NaOCl + EDTA were detrimental, while Procodile Q demonstrated the highest CFR. Within the limitations of this study, exposure to irrigating solutions, particularly heated EDTA and NaOCl + EDTA, reduced the cyclic fatigue resistance of heat-treated NiTi files. Clinically, prudent selection and temperature control of irrigants may help preserve instrument performance and reduce the risk of file fracture during root canal preparation.

The global rise in antibiotic resistance among oral pathogens necessitates exploring natural and innovative alternatives for dental caries management. This study aimed to synthesize, characterize, and evaluate a novel clove extract-loaded nano-hydroxyapatite composite (nHA-CE) for its dual functionality: biomimetic remineralization and enhanced antimicrobial activity against dental caries-associated microbes. Nano-hydroxyapatite (nHA) was synthesized via wet chemical precipitation and characterized using XRD, FTIR, AFM, and DLS. Clove extract was obtained by ethanolic extraction and analyzed by GC-MS. The nHA-CE composite was prepared, and its antibacterial efficacy was tested against oral pathogens using agar well diffusion and compared to standard antibiotics. The nHA particles were spherical, with an average size of ~ 80 nm. Eugenol (72.5%) was the major component in clove extract. The nHA-CE composite showed significantly larger inhibition zones against all pathogens, especially Streptococcus mutans (50 ± 0.8 mm), outperforming conventional antibiotics. The composite also exhibited sustained eugenol release and maintained stability over 30 days. The nHA-CE composite is a promising biomaterial for dental caries prevention, combining effective remineralization with potent, broad-spectrum antimicrobial activity, offering a natural alternative to conventional treatments.