Saudi Dental Journal最新文献

Background: TMDs are frequently occurring musculoskeletal disorders that affect the orofacial region, leading to pain and functional limitations. Among conservative treatments, centric stabilization splints are widely used, but their superiority over other noninvasive therapies remains uncertain.

Objective: To systematically review and quantitatively evaluate the clinical effectiveness of centric stabilization occlusal splints versus other conservative managements in TMD patients.

Methods: Literature was searched in Cochrane, PubMed, Scopus, WoS, EMBASE, and LILACS from 2000 to 2023. The study included randomized controlled trials (RCTs) that compared centric stabilization splints to other conservative therapies. The main outcome assessed was the reduction in pain, determined through the Visual Analogue Scale (VAS). The quality of the evidence was appraised using the GRADE framework. Meta-analysis employed a random effect model.

Results: The analysis encompassed eight randomized controlled trials (RCTs) that included more than 400 participants. The combined standardized mean difference (SMD) found that centric stabilization splints had a substantial advantage in reduction of pain (SMD = 0.75; with 95% confidence interval: 0.32 to 1.18; p < 0.01). The evidence was assessed as moderately certain. Sensitivity analysis excluding high-risk studies showed minimal change in effect (SMD = 0.72). Functional outcomes and quality-of-life metrics were also identified as additional advantages.

Conclusion: Centric stabilization splints demonstrate clinically meaningful short-term pain relief in TMD compared to other conservative treatments. Their use is supported in patients with myogenous TMD, but long-term outcomes require further validation.

Oroantral fistula (OAF) is a persistent pathological communication between the oral cavity and the maxillary sinus, often arising as a complication of dental extractions, trauma, or surgical procedures involving the maxilla. Despite various treatment options, a standardized, algorithmic approach remains lacking. To develop and present a comprehensive, evidence-based clinical decision-making algorithm for the diagnosis and management of OAF based on defect size, chronicity, sinus involvement, and infection status. A narrative review and synthesis of the literature were conducted, evaluating diagnostic modalities, microbiological profiles, and both conservative and surgical treatment options from 1990 to 2025. The resulting data informed the development of a stepwise flowchart that integrates clinical parameters and radiographic findings to guide practitioners in selecting the most appropriate therapeutic approach. The algorithm begins with an initial assessment including patient history, clinical and radiographic evaluation. Small asymptomatic OAFs (< 2 mm) are managed conservatively with hygiene protocols and nasal precautions. Infected small fistulas warrant antibiotics. Medium-sized OAFs (5-10 mm) in favorable locations are treated with local flaps, whereas large or unfavorably located fistulas (> 10 mm) require advanced surgical techniques such as buccal fat pad grafts, distant flaps, and regenerative materials like platelet-rich fibrin. Sinus health and chronicity are considered pivotal in determining treatment timing and method. This algorithm provides a structured, patient-centered framework for the management of OAF. By incorporating anatomical, pathological, and microbiological factors, it enhances clinical decision-making, improves treatment outcomes, and supports interdisciplinary coordination.

Nanoparticle incorporation into orthodontic adhesives has emerged as a strategy to enhance antimicrobial properties, improve mechanical performance, and prevent enamel demineralization during fixed appliance therapy. This scoping review aimed to synthesize evidence on the effectiveness of nanoparticle-modified orthodontic adhesives. A systematic search and independent screening process were conducted by two reviewers across multiple databases following the PRISMA-ScR guidelines. Among the 153 initially identified records, 25 studies met the inclusion criteria. Most studies (72%) were in vitro, whereas only 12% used in situ models. Preclinical studies are scarce (4%), emphasizing the gap between laboratory findings and clinical application. Silver nanoparticles (AgNPs), which demonstrate strong antimicrobial activity against S. mutans, E. coli, and S. aureus while maintaining acceptable bond strength at moderate concentrations, have been the most frequently investigated. Other nanoparticles, such as titanium dioxide (TiO₂), β-AgVO₃, mesoporous bioactive glass nanoparticles (MBNs), calcium phosphate compounds, and calcium phosphate compounds, also show promising antimicrobial and remineralization properties. However, variations in study designs, nanoparticle concentrations, and adhesive formulations hinder direct comparisons. Despite promising laboratory findings, the clinical application of nanoparticle-modified orthodontic adhesives remains uncertain due to the lack of standardized methodologies and long-term clinical validation. Further well-designed clinical trials are essential to confirm their efficacy, safety, and impact on orthodontic bonding performance under real-world conditions. Standardization of nanoparticle formulations and biocompatibility assessments are crucial to ensure their practical integration into orthodontic practice, promoting safer and more effective treatments.

Delayed permanent anterior teeth eruption, accompanied by insufficient space in the dental arch, presents a significant challenge during mixed dentition. The aim of this study was to assess the effectiveness of a modified orthodontic appliance that combines transverse maxillary expansion and mesio-distal maxillary elongation, with controlled distalization of permanent molars, in treating cases of delayed anterior teeth eruption during the mixed dentition period. The present study included a prospective comparative design, with a study group of 35 patients and a control group of 32 patients, all demonstrating clinical and radiological signs of delayed permanent anterior teeth eruption. The study group received treatment with a modified orthodontic appliance designed to achieve both maxillary expansion and molar distalization simultaneously. The control group was treated with the Haas appliance for maxillary expansion and the Distal Jet for molar distalization. The level of significance was determined using statistical tests, with p-values calculated for key outcomes. The study revealed that the modified orthodontic appliance significantly reduced the treatment time required for adequate space creation within the dental arch compared to the control group (p = 0.017). The rate of complications in the study group was lower (17.14%) compared to the control group (28.12%), with a significant difference (p = 0.046). Patients in the study group also reported a higher rate of positive perception (68.57%) compared to the control group (43.75%), with a statistically significant difference (p = 0.031). No significant difference was found in the amount of molar distalization and maxillary expansion between the two groups (p > 0.05). A redesigned orthodontic appliance that combines transverse maxillary expansion and molar distalization reduces treatment time and difficulties in delayed permanent anterior teeth eruption. These data indicate that the appliance improves treatment efficiency and patient comfort without reducing spatial adjustments. Its mixed dentition use needs more research with larger sample sizes and regulated treatment techniques.

Following the publication of the CONSORT statement, numerous dental journals have recommended its use for the reporting of randomized clinical trials (RCTs). While numerous RCTs have been published assessing the efficacy of desensitizing mouthwashes for treating dentin hypersensitivity (DH), none of these studies have been evaluated for their quality using CONSORT guidelines. This study assessed RCTs investigating mouthwashes for DH treatment for adherence to CONSORT guidelines and their risk of bias. The databases of Cochrane Library, MEDLINE, Embase, BBO, LILACS, Scopus, and Web of Science were systematically searched from August to October 2024 for RCTs assessing the effectiveness of desensitizing mouthwashes. Adherence to CONSORT recommendations was evaluated using a specific tool, while the Cochrane risk-of-bias tool 2 was employed to assess the individual quality of the included papers. Out of the 2,883 papers retrieved, 36 were included in the qualitative analysis. The mean overall CONSORT score was 23.3 ± 1.4, out of a maximum of 32 points. Intervention, outcomes, hypothesis testing, and effect size were the most comprehensively described elements. Meanwhile, settings and protocol registration were only described by 12.5% of the articles. Significant differences in CONSORT scores were identified based on journal and publication dates. Low risk of bias was identified in 14 studies, two papers were judged to have an unclear risk, and no articles showed a high risk of bias. Full adherence to CONSORT recommendations was not attained in the analyzed papers, but most of the papers had a low risk of bias.

Purpose: This study assessed the prevalence of apical periodontitis (AP) and associated risk factors in healthy Saudi adults attending dental school at Najran university during the period from 2021-2024.

Methods: CBCT scans from 420 healthy subjects (6,440 teeth) were reviewed. Data on AP prevalence, both overall and on untreated versus treated teeth, were collected. Scans were retrieved from the School of Dentistry at Najran university, spanning January 2021 to July 2024. Chi-square and multivariable logistic regression analyses were performed to investigate associations with risk factors such as gender, tooth type, root canal treatment adequacy, final restoration status, dental caries, and periodontal disease.

Results: AP was diagnosed in 78.6% of subjects, with a per-tooth prevalence of 12.9%. AP was highly observed in root-canal treated teeth (42.9%) than in untreated teeth (7%). The highest odds of AP were associated with dental caries (OR = 239.8, 95% CI = 151.02-380.72) and endodontic mishaps (OR = 87.03, 95% CI = 38.14-198.64).

Conclusion: This study found a high prevalence of AP among healthy Saudi adults attending dental school at Najran university from 2021 to 2024. Significant risk factors included dental caries, periodontal disease, molar teeth, inadequate endodontic treatment, and the absence of full-coverage crowns, while female gender was correlated to greater occurrence of AP. The strong association with dental caries and inadequate root canal treatment highlights the need for early intervention and preventive strategies to reduce the burden of AP.

Periodontal disease is an inflammatory disease that affects periodontal tissue, such as the gingiva, periodontal ligament and alveolar bone. Recently, a link between periodontal disease, oral cancer and inflammation has been suggested. In this study, the concentration of the inflammatory cytokine salivary IL-6 was measured to determine its role in the inflammatory process of periodontitis and oral squamous cell carcinoma. An analytical cross-sectional study was conducted at the Khartoum Dental Teaching Hospital, Sudan. Three study groups were enrolled with their consent: patients diagnosed with chronic periodontitis with at least two interproximal sites showing clinical attachment loss > 4 mm and pocket depth > 5 mm. (n = 32); patients with chronic periodontitis and oral squamous cell carcinoma (OSCC) pathology reports of OSCC at the time of saliva collection (n = 22); and matched healthy controls (n = 30). Patients were excluded if they had any chronic inflammatory condition or disease; had a history of recent trauma, acute infection, burns, laceration, previous surgery, chemotherapy, or radiotherapy; had used antibiotics within the previous three months; had a history of periodontal treatment within the previous three months; were pregnant or lactating; were taking drugs that induce hyposalivation; or had a history of previous radiation therapy to the head and neck area. A trained dentist clinically examined the participants. Periodontal parameters (plaque index, bleeding on probing, probable pocket depth and clinical attachment level) were measured, and the IL-6 concentration in the saliva samples was measured via enzyme-linked immunosorbent assay. A statistically significant difference in periodontal parameters was observed between the OSCC patient group and the other groups. OSCC patients had significantly greater IL-6 concentrations in their saliva (log 2.40 ± 0.37) pg/ml) than did chronic periodontitis patients (CP) (log 1.42 ± 0.418 pg/ml) and healthy controls (log 1.25 ± 0.13 pg/ml) (P < 0.001). High salivary IL-6 levels suggest potential utility as a biomarker for OSCC unconfounded by chronic periodontitis.

Considering the significant impact of the nasal form on the appearance of an individual, this study aimed to investigate the relationship between nasal morphology and skeletal malocclusion in a sample of Iranian population. In this descriptive cross-sectional study, 141 lateral cephalograms of individuals of both genders, aged 18 to 30 years were selected. The participants were classified into Class I, II, and III malocclusions. Then, naso-facial landmarks related to the form and shape of the nose and facial skeleton were manually traced on each lateral cephalogram and 13 angular and linear parameters were measured. These parameters were compared among the three types of malocclusions. Statistical analysis of the data was performed using ANOVA, Kruskal-Wallis, and Chi-square tests. P < 0.05 was considered significant. Most of the measurements such as nasal morphology as well as nasal height, nasal bone length, nasal bone angle, nasofrontal angle, dorsum length, total nasal length, nasal depth, columellar convexity, and nasal hump did not show significant differences among different malocclusions (p > 0.05). However, lower dorsum convexity, soft tissue convexity, naso-facial angle, and naso-mental angle were reported to have significant differences among different malocclusions (p < 0.05). According to the results of the present study, the overall shape of the nose is not affected by the type of underlying skeleton in the sample studied. However, future studies with larger sample sizes are recommended to further confirm the results of the present study.

Dynamic navigation system (DNS) is an emerging technique providing more accuracy and precise positioning during dental surgical procedures. Studies have shown the application of DNS across several areas of dentistry, including implant surgery, oral and maxillofacial surgery, endodontics, and the treatment of supernumerary teeth. The use of DNS has demonstrated improved accuracy, reduced trauma, and safer approach. Key elements of DNS include a computer, tracking system specialized tracing tools and navigation software. The process of DNS operation begins with obtaining data and reconstructing imaging information. Next calibration of surgical instruments and spatial registration is carried out. The last phase involves executing time guided procedures using the navigation system. DNS applications have seen enhancements, in representation, precision in treatment, efficiency, safety measures and adaptability during procedures. While these advancements offer benefits the adoption of DNS comes with challenges such as high expenses the necessity for thorough training, extended preparation time and heightened exposure to radiation. Despite these hurdles continuous progress, continued advancements in DNS technology are expected to further broaden its applications in dentoalveolar surgery and greatly enhance the field of digital dentistry. Therefore, the application of DNS will be reviewed in dentoalveolar surgery.

The aim of this study was to analyze the presence of C-shaped canal configurations in mandibular molar teeth of patients who presented to our clinic, using cone-beam computed tomography (CBCT) and three-dimensional (3D) modeling, in relation to the contralateral counterparts in the same jaw and by gender. Additionally, root canal morphologies of mandibular molars were investigated. CBCT images obtained from a total of 504 patients between March 2016- September 2021 were evaluated. The patients included 244 females (48.42%) and 260 males (51.58%) aged between 13 and 79 years (mean age: 36.3). C-shaped canal configurations detected in the CBCT images were further analyzed using 3D modeling techniques. A total of 1495 mandibular molar teeth were examined. After excluding extracted teeth and those not meeting the inclusion criteria, C-shaped canal configurations were identified in 68 teeth (4.54%). According to gender, the incidence was 9.8% in females and 8.1% in males. There was no statistically significant difference in the incidence of C-shaped canals between genders (P = 0.53). Among the qualified 61 teeth with C-shaped canals, 46 (75.4%) also showed C-shaped canal morphology in their contralateral counterparts. Of the 45 patients in whom C-shaped canals were identified, 38 had bilateral mandibular second molars, and 23 of these (60.5%) exhibited bilateral C-shaped canal configurations. C-shaped canal configurations can be precisely identified using CBCT and 3D modeling methods. Early detection of such anatomical variations may facilitate clinical procedures and contribute to the success of root canal treatments.