Saudi Dental Journal最新文献

To evaluate the effect of bioactive varnish application on the shear bond strength (SBS) of orthodontic brackets bonded to demineralized enamel. Bovine incisors were selected and randomly assigned to four groups based on enamel treatment: Group 1 - sound enamel, no treatment (positive control); Group 2 - enamel subjected to a pH-cycling demineralization protocol (negative control); Group 3 - demineralized enamel treated with bioactive varnish (PRG Barrier Coat®, Shofu) and stored in distilled water for 24 h; and Group 4 - demineralized enamel treated with the same varnish and stored in distilled water for 28 days. For SBS and Adhesive Remnant Index (ARI) tests (n = 15 per group), orthodontic brackets (Roth Max® slot 22, Morelli) were bonded to the enamel using the Transbond XT® adhesive system (3 M Solventum). Samples underwent thermocycling (500 cycles between 5 °C and 55 °C), followed by SBS testing using a universal testing machine (0.5 mm/min) and ARI evaluation using stereomicroscopy. Enamel surfaces from each group (n = 3 per group) were also examined using scanning electron microscopy (SEM). SBS data were analyzed using the Kruskal-Wallis test, followed by Dunn's post hoc test. ARI scores were analyzed using Fisher's exact test, with significance set at 5%. The positive control group showed significantly higher SBS values compared to Groups 3 and 4 (p < 0.001). The negative control group showed intermediate values, with no significant differences from the other groups. A significant association was found between groups and ARI scores: in the positive control group, 53.3% of samples had ARI = 0 and 33.3% had ARI = 3; in the negative control group, 93.3% had ARI = 0. In Groups 3 and 4, 100% of the samples showed ARI = 0. SEM analysis revealed an intact surface in the positive control group, a porous surface in the negative control, and a varnish-covered surface in Groups 3 and 4, with Group 3 exhibiting a more homogeneous coating than Group 4. Conclusion: The application of bioactive varnish to demineralized enamel significantly reduced bracket bond strength and resulted in predominantly adhesive failures at the enamel interface. Clinically, this suggests that bonding orthodontic brackets directly to enamel treated with this bioactive varnish may compromise bond integrity, regardless of the waiting period after application.

Molar incisor hypomineralization (MIH) is a developmental defect in enamel that affects the oral health of children. This study assessed the prevalence of dental caries among 7-10-year-olds and its association with MIH in Jeddah, Saudi Arabia. This epidemiological study used stratified random sampling of 12 primary schools in Jeddah city. To recruit children, two calibrated examiners in classrooms performed dental examinations for caries using the World Health Criteria and MIH based on the MIH criteria of the European Academy of Pediatric Dentistry (EAPD). Among 2010 children, caries prevalence was 1719 (85.5%) and MIH was 359 (17.9%). A total of 1872 (93.1%) children lived with both parents. The mean dmft score for primary dentition was significantly higher in children with MIH (4.920 ± 3.400) compared to those without MIH (4.490 ± 3.315) (P = 0.031). The presence of caries in permanent dentition was significantly associated with MIH (P = 0.028). MIH presence was associated with a statistically significant reduced likelihood of dental caries in primary dentition (AOR = 0.732, 95% CI: 0.547-0.980, P = 0.036) and statistically significant increased likelihood of dental caries in permanent dentition (AOR = 1.432, 95% CI: 1.303-1.574, P < 0.001). MIH was a risk factor for increasing dental caries in primary and permanent dentitions. This study provides new insights specific to a population in Jeddah, Saudi Arabia, which has not been extensively studied in the literature. Implications for children diagnosed with MIH to follow a strict preventive program to prevent dental caries in affected teeth.

The aim of this study was to assess the awareness of general dentists in Saudi Arabia on clinical dental privileges, evaluate the practicality of these privileges in clinical practice, and to explore dentists perceived competence in performing procedures that are considered beyond their authorized scope. A questionnaire was distributed randomly to general dentists across Saudi Arabia through the research offices of the Saudi Commission for Health Specialties and the Saudi Dental Society. The questionnaire included demographic data, self-reported awareness of MOH dental privileges, and responses to six clinical scenarios to assess privilege awareness, perceived competence, and clinical practice. Chi-square tests were used to analyze associations between these variables, with significance set at p < 0.05. Out of 238 respondents, 72% reported awareness of MOH dental privileges. However, significant mismatches were observed between awareness and actual practice across most scenarios. Procedures most commonly performed outside authorized privileges included in-office vital tooth bleaching, placement of single-unit crowns, and molar root canal treatment (RCT). A strong association was found between lack of awareness of the privileges or perceived competence and performing these procedures. Despite moderate levels of awareness, significant gaps remain between general dentists' awareness, perceived competence, and actual clinical practice. The majority of the sample perform procedures beyond their authorized scope of care, often due to misunderstandings about privilege boundaries or confidence in their skills. These findings highlight the need for enhanced communication of privilege regulations, integration of privilege education into undergraduate curricula, and alignment between training and policy. Such reforms are essential to ensure safe, standardized dental practice in line with the goals of Saudi Vision 2030.

Tooth loss is a prevalent oral health issue with significant implications for individuals' quality of life, nutrition, and psychosocial well-being. Despite advancements in preventive dentistry, disparities in tooth loss persist, particularly among socioeconomically disadvantaged populations. This study aimed to examine the association between socio-demographic factors and patterns of tooth loss specifically the number and location of missing teeth among adult patients seeking prosthodontic treatment in Makkah, Saudi Arabia. A cross-sectional study was conducted among 307 adult patients attending prosthodontic clinics. Data were collected through clinical examination combined with short interviews to capture socio-demographic variables (age, gender, education level, income, and nationality) and teeth loss status. Pearson chi-square and fisher exact probability tests were used to assess associations between these variables and both the number and location of missing teeth. Data were analyzed using SPSS 29. Nearly half of the participants (48.9%) had more than two missing teeth, with posterior tooth loss being the most common (76.2%). Age, education level, and income were significantly associated with the number of missing teeth (p < 0.05), while gender and age were significantly associated with the location of missing teeth (p < 0.05). Lower education and income levels were linked to higher rates of tooth loss, and older adults were more likely to have missing teeth in both anterior and posterior regions. This study underscores the need for policymakers to prioritize disadvantaged populations by developing inclusive, cost-effective oral health strategies that address social determinants and support community-based prevention in Makkah and similar regions.

This study aimed to objectively assess masticatory performance and to identify related factors among healthy adults. An experimental study was conducted on 75 healthy adults with a mean age of 51 years between January and June 2023. Masticatory performance was objectively assessed using the sieve method. Spearman correlation examined the association between masticatory performance and age, Functional Tooth Units (FTUs), and total Oral Behavior Checklist-21 (OBC-21) scores. Mann-Whitney U test was used to examine its relationship with sex. Linear Regression was performed to test each factor's relationship with masticatory performance after controlling for other factors. Masticatory performance was associated with age (Spearman coefficient: -0.35, p = 0.002), and FTUs (Spearman coefficient: 0.66, p < 0.001), with higher FTU scores associated with a 30% improvement in chewing performance. Sex and OBC scores showed no significant effect on mastication performance. Multiple linear regression confirmed strong association between masticatory performance and FTUs (standardized ß = 0.670, p < 0.001). FTUs is the major determinant of masticatory performance. Restoring and preserving FTUs through dental care can significantly improve mastication, nutrition, and quality of life, particularly for older individuals.

Research evaluating the clinical and radiographic outcomes of lesion sterilization and tissue repair (LSTR), particularly in terms of mobility, pain, sinus tract, fistula, swelling, root resorption, and interradicular radiolucency is yet to be conducted. This systematic review aimed to assess the clinical and radiographic success of LSTR using three antibacterial drug combinations-"three Mix" (3MIX)-and compare their success rates with those of conventional pulpectomy and pulpotomy in treating primary teeth. Additionally, the review sought to determine which antibiotic combination is most effective in LSTR in primary teeth.  A comprehensive search strategy was applied across three electronic databases: PubMed, Scopus, and King Abdulaziz Digital Library. Two independent reviewers screened 536 titles and 70 abstracts, ultimately selecting 14 articles based on the predefined inclusion criteria. Clinical and radiographic outcomes were evaluated at 6, 12, and 18-month follow-up intervals. The Cochrane's risk of bias tool was used to assess the quality of randomized trials, and the Newcastle-Ottawa Scale was used to assess the methodological quality of non-randomized trials. A total of 14 clinical studies were included in the review. Only two studies compared LSTR to MTA pulpotomy. The composition of 3MIX and other antibacterial mixtures used in LSTR varied significantly, though consistent clinical and radiographic success was observed across the studies. All studies demonstrated relatively high success rates for 3MIX antibiotic paste, both clinically and radiographically. No significant differences were found between the success rates of 3MIX, Vitapex, zinc oxide eugenol, and other 3MIX combinations in pulpectomy of primary teeth. At the 12-month follow-up, the meta-analysis found no significant difference in clinical and radiographic success rates between 3MIX and conventional pulpotomy and pulpectomy. 3MIX may be effective for primary teeth pulpectomy, especially when conventional pulpectomy treatments are not suitable in young, uncooperative children.

To assess and compare the post-fatigue fracture resistance of two types of ceramic crowns, zirconia and lithium-disilicate, when used with two margin designs (vertical and horizontal). Forty sound human premolar teeth collected from the orthodontic department were divided randomly into two main groups according to the type of ceramic material (n = 20): Group A: Lithium-disilicate and Group B: Monolithic zirconia. Each group was further subdivided according to the margin design into two subgroups (n = 10): feather-edge (1) and shoulder (2) preparation designs. After digital scanning and designing, the crowns were bonded with self-adhesive resin cement. Each assembly underwent cyclic loading (1,000,000 cycles; 100 N; 1 Hz) in water and was then subjected to axial compressive loading till fracture. Failure modes were analyzed through fractographic analysis under SEM. The highest mean of fracture resistance was recorded for subgroup B1 (Zirconia with vertical preparation: 3129 N), followed by subgroup B2 (Zirconia with horizontal preparation: 2616 N). while lithium-disilicate crowns showed lower fracture values (Group A1: 1880 N, Group A2: 1512 N). One-way ANOVA test revealed statistically significant differences in fracture resistance between the two crown materials (p < 0.05). However, there was no statistically significant difference between the vertical and horizontal preparation designs within the same material group (p > 0.05). Both zirconia and lithium-disilicate crowns demonstrated fracture strengths exceeding the level of biting forces in the premolar area, supporting the use of conservative feather-edge preparation for lithium-disilicate and zirconia crowns in posterior regions.

Purpose: This study aimed to provide a comprehensive national overview of the prosthodontic workforce in Saudi Arabia, focusing on its demographic composition, educational background, geographic distribution, and workforce trends. The findings are intended to support policymakers in postgraduate education planning, and equitable access strategies to prosthodontics care.

Materials and methods: A retrospective cross-sectional analysis was conducted using official data obtained from the Saudi Commission for Health Specialties (SCFHS) as of May 2025. The dataset included all registered practicing prosthodontists across Saudi Arabia. Key variables included gender, nationality, professional classification, practice region, and postgraduate training background. The prosthodontist-to-population ratio was calculated based on the 2024 national census data. Descriptive statistics were used to analyze the characteristics of the prosthodontic workforce.

Results: A total of 1,542 prosthodontists were identified across Saudi Arabia, resulting in a national ratio of 4.37 prosthodontists per 100,000 population. The workforce was predominantly male (65.8%), with females representing 34.2%. Non-Saudis accounted for 56.5% of the workforce, while Saudis made up 43.5%. Most prosthodontists were located in major metropolitan areas, with 34.1% practicing in Riyadh, 24.6% in Makkah, and 11.8% in the Eastern Region. The most common countries of postgraduate education were Egypt (29.3%), Saudi Arabia (27.3%), India (9.0%), and the United States (7.2%). The workforce was almost evenly divided between the public sector (48.3%) and the private sector (47.8%).

Conclusion: Saudi Arabia has witnessed steady growth in its prosthodontics workforce, marked by increased training capacity, diverse educational backgrounds, and encouraging participation of female practitioners. Despite this progress, challenges remain in achieving balanced gender representation, equitable regional distribution, and consistency in training standards. These findings highlight the importance of thoughtful workforce planning and the need to reassess classification systems and align training pathways with internationally recognized benchmarks. Such efforts will be essential to ensure high-quality, inclusive, and sustainable prosthodontics care across all regions.

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.