Saudi Dental Journal最新文献

Gingival recession (GR) is a prevalent condition characterized by the apical migration of the gingival margin, leading to root exposure and aesthetic and functional challenges. While conventional surgical techniques like coronally advanced flaps and connective tissue grafts are considered the gold standard for root coverage, these methods are limited by patient morbidity and inconsistent long-term outcomes. Adjunctive strategies such as laser therapy, hyaluronic acid (HA), and nanomaterials have been introduced to improve clinical results. This narrative review explores the rationale and clinical relevance of these adjunctive therapies in root coverage procedures. This narrative review (2017-2025) critically examines laser therapy, hyaluronic acid, and nanomaterials as adjuncts in surgical root coverage. Human studies were prioritized, with preclinical data included for nanomaterials. Biological mechanisms, clinical efficacy, and limitations were analyzed to provide a comparative perspective and highlight future research directions in periodontal regeneration. The literature indicates that while these therapies offer distinct benefits, their clinical effectiveness remains inconclusive. Laser therapy aids tissue healing, HA offers regenerative effects, and nanomaterials facilitate bioactive delivery. However, clinical evidence on long-term efficacy, especially in achieving consistent root coverage, remains limited. Adjunctive therapies such as laser therapy, HA, and nanomaterials show promise in improving outcomes for gingival recession treatment. However, further high-quality clinical trials are needed to validate their efficacy, safety, and long-term results.

Purpose: Oral cancer is the sixteenth most common malignancy globally and is characterized by a 5-year survival rate of less than 40%. In recent years, innovative methods have been developed to facilitate its early diagnosis, including the GOCCLES® device. This study aimed to evaluate the diagnostic value of GOCCLES® in detecting dysplasia in oral potentially malignant disorders (OPMDs) and diagnosing oral squamous cell carcinoma (OSCC). Additionally, this study sought to compare the device's efficacy with toluidine blue (TB) staining and assess the value of combining both methods.

Methods: Patients clinically diagnosed with OPMDs or OSCC were included. Anamnesis, oral examination, inspection with GOCCLES®, and TB staining were performed. Finally, lesions were biopsied and the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of each technique were determined.

Results: Thirty-two patients were included in this study. The GOCCLES® device had a sensitivity of 33.3%, specificity of 40%, PPV of 25%, NPV of 50%, and accuracy of 37.5%. For TB staining, the sensitivity, specificity, PPV, NPV, and accuracy were 58.3%, 85%, 70%, 77.27%, and 75%, respectively. The respective values for the combined method were 44.4%, 77.78%, 66.67%, 58.33%, and 61.11%.

Conclusions: GOCCLES® and TB staining could help in the early diagnosis of OSCC and OPMDs, but a biopsy of the lesion remains essential for obtaining a definitive diagnosis.

As a biofilm-mediated disease, dental caries is primarily attributed to the activity of Streptococcus mutans and Streptococcus sobrinus, key contributors to enamel mineral loss under acidic conditions. Current broad-spectrum antimicrobials disrupt the oral microbiota and carry undesirable side effects, prompting interest in targeted, microbiome-friendly alternatives. This study evaluated the antimicrobial, anti-cariogenic, and cytotoxic properties of pomegranate (Punica granatum) derived compounds, corilagin, ellagic acid, gallocatechin, kaempferol-7-O-glucoside, punicalagin, punicalin, and rutin against cariogenic S. mutans and S. sobrinus, and the commensal S. gordonii. Antibacterial activity was assessed using disc diffusion, minimum inhibitory concentration (MIC), and minimum bactericidal concentration (MBC) methods. Anti-virulence effects were evaluated through glycolytic pH drop and cell surface hydrophobicity assays. Cytotoxicity was determined using the brine shrimp lethality assay. Punicalagin, punicalin, and ellagic acid showed strong, selective bactericidal activity against S. mutans and S. sobrinus, with low MICs and MBC/MIC ratios, while sparing S. gordonii. These compounds significantly suppressed acid production, maintaining pH above the critical demineralisation threshold, and reduced surface hydrophobicity in cariogenic strains without affecting the commensal. Most compounds exhibited low toxicity (LC₅₀ > 500 µg/mL), indicating a favourable safety profile. Overall, punicalagin and punicalin demonstrated dual antimicrobial and anti-virulence activity with selective targeting of cariogenic pathogens. These findings support the potential inclusion of punicalagin and punicalin in oral care formulations aimed at preventing dental caries while preserving beneficial oral microbiota. As this is a preliminary screening study, the results should be interpreted cautiously, and further biofilm and host-cell assays are needed to confirm translational potential.

The objective of this research was to evaluate and compare the flexural strength and practical uses of provisional crown materials such as self-curing polymethylmethacrylate (PMMA), heat-curing PMMA, self-curing temporary acrylic resin (Tempron), fast-setting Bis-Acrylic self-cure (Structur 2 SC), and Bis-Acryl composite (Protemp-III Garant). Standardized specimens (25 mm x 10 mm x 2 mm) of each material were fabricated (n = 15 per group) and allowed to bench cure for 20 min under a constant load of 500N. Heat-activated PMMA specimens were polymerized at 90 °C for 2 h. Specimens were polymerized in normal saline at 37 °C for five days to simulate oral conditions. A universal testing machine (UTM) assessed their flexural strength and elastic modulus. Significant differences were observed among the materials (p < 0.05). Protemp III Garant showed the highest mean flexural strength, followed by Structure 2 SC and Tempron, while self-cure and heat-cure PMMA exhibited the lowest values. However, the elastic modulus values did not differ significantly among groups (p > 0.05. Within the limitations of this in vitro study, Protemp III and Structure 2 SC demonstrated superior flexural performance compared with other tested materials, suggesting their potential suitability as provisional crown materials. Further long-term in vivo studies are recommended to validate these findings.

The temporomandibular joint disorders (TMD) involve the mastication muscles, the temporomandibular joint (TMJ), and its related structures. To determine the role of Michigan oral splint aided by OTC drug versus removal of distoverted maxillary 3rd molars in the treatment of TMD. The randomized controlled clinical trial study enrolled 280 patients with confirmed TMD who attended different private/public dental centers, from November 2023 to August 2024. Patients had chief complaints of pain and clicking noise/sounds in their TMJ during mouth opening, chewing, muscle tension in the neck/face region, and pain in the head, neck, and pre-auricular/facial areas. Then, patients were randomly assigned to a control group (n = 140) and a study group (n = 140). Patients in the control group (Y1) underwent extraction of distoverted maxillary only, while patients in the study group (Y2) received Michigan oral splint aided by OTC drugs. Then, the Visual Analogue Pain Rating Scale was used to determine the intensity of pain among patients in both groups. Finally, patients were evaluated for treatment outcomes. Most patients were female (67.5%, n = 186) and had a mean age of 38 ± 8 years. Their pain intensity before treatment was 6.47 ± 1.49, and after treatment, it was 0.0 ± 0.0, indicating that the patients were completely healed after using the selected treatment. The results of the normality tests for pain scores before and after treatment showed strong evidence against the null hypothesis (p = 0.000). Additionally, a significant difference (p ≤ 0.05) between both groups suggests that the Michigan occlusal splint, aided by OTC drugs, had a positive effect on healing the patients. Consequently, the occlusal splint has a significant (p = 0.000) behavioural effect on increasing cognition related to mandibular position and function of the stomatognathic system. Michigan occlusal splint aided by OTC drugs was a superior modality than extraction of distoverted maxillary 3rd molars in treatment of TMD.

To evaluate how vitamin D levels affect specifically the incidence of peri-implantitis rather than early implant failure. The comprehensive review of the literature resulted in 5 studies being included in qualitative synthesis. The Joanna Briggs Institute (JBI) checklist was applied to assess study quality, revealing that most studies had moderate to high methodological quality. Significant heterogeneity across all included studies precluded the performance of a meta-analysis. The findings indicate that both hypovitaminosis and hypervitaminosis D influence peri-implant health. Elevated 25(OH)D levels have been linked with greater marginal bone loss (MBL) and reduced implant survival, whereas low levels of vitamin D have been linked to an increased risk of peri-implant disease. Retrospective studies further indicate that reduced vitamin D status is associated with greater MBL compared with normal levels, and that vitamin D supplementation may enhance implant success. While existing evidence designates that vitamin D status may influence implant survival and peri-implant health, methodological inconsistencies limit definitive conclusions. Further research with standardized vitamin D assessment protocols, larger sample sizes, and longitudinal study designs is needed to elucidate its role in peri-implant disease prevention and implant success.

This article aims to comprehensively review the clinical indications for esthetic crown lengthening (CL) and to propose a decision-making framework that incorporates key yet often overlooked factors influencing treatment planning. To gain a deeper understanding of the various clinical scenarios in which esthetic CL may be indicated, individual conditions are examined in detail, each accompanied by an appropriate treatment approach. Based on this analysis, we introduce a decision-making framework designed to guide clinicians in selecting the optimal treatment modality by accurately identifying the underlying esthetic concerns. The majority of published clinical guidelines for esthetic CL focus predominantly on cases with excessive gingival display. However, patients presenting without gingival display who may still benefit from esthetic CL are frequently neglected in the literature. Additionally, the influence of the smile arc and its relationship to incisal edge positioning remains underrepresented in current discussions. Our proposed decision-making framework integrates these critical factors to support more individualized and comprehensive treatment planning. Clinicians must possess a thorough understanding of all relevant esthetic and functional parameters when evaluating candidates for esthetic CL. Moreover, early and coordinated consultation with the prosthodontist is essential to define the appropriate balance between surgical and restorative interventions prior to surgical execution.

This research assessed the effect of acidic surface treatment in two different approaches involving airborne-particle abrasion (APA) surface treatment, relative to APA by itself, on the shear bond strength (SBS) of composite cement adhered to zirconia. Sixty cubes of 5 mol% yttria-stabilized zirconia (10 × 10 × 8 mm) were created and categorized into three groups (n = 20 each): APA Group, treated with 50 µm Al₂O₃ APA; APA + ZE 30 Group, underwent the same treatment as APA Group, followed by a 30 min ultrasonic application of Zircos-E etchant (ZE); and APA + ZE 120 Group, which received the same treatment as APA Group, followed by ZE for 120 min. SEM analyses were performed on three samples for each surface treatment. Each group was subdivided (n = 10 each) to receive either self-adhesive composite cement (RelyX U200) or MDP-containing primer (G-Multi primer) combined with BisGMA-based composite cement (G-CEM LinkForce). Composite cement cylinders were cast onto zirconia samples utilizing a mold (Ø4 × 3 mm). Samples were kept in an incubator at 37ºC with purified water for 24 h. An SBS test was subsequently performed using a universal testing machine (0.5 mm/min crosshead speed). Both ZE treatment groups demonstrated a significant level of difference compared to APA (p < 0.001), while there was no notable variation between the ZE treatment groups (p = 0.841). Moreover, there was no meaningful difference observed between the two varieties of composite cements (p > 0.05). Ultimately, SEM examinations of both ZE groups showed pits and porosities. Using acidic surface etchant is promising as an additional to APA for increasing SBS of composite cement to zirconia.

Background: Seventy-two percent of 12-year-old children in Indonesia experience dental caries, among 10-14-year-olds is 73%, and in 15-year-olds is 68.5%. Islamic boarding schools (pesantren) are one of the educational institutions in Indonesia, and dental caries status among the school students is moderate to severe. A preventive approach according to ecological balance has been proposed to prevent oral cavity disorders, especially dental caries.

Objectives: This study aimed to investigate the correlation of Lactobacillus reuteri probiotic consumption with plaque index, salivary pH, and Streptococcus mutans quantification.

Method: This research has been done at the Ibnu Hajar boarding school. A total of 40 research subjects aged 12-15 years were allocated into two groups (treatment and control), each consist of 20 subjects. Children in the treatment group took one Lactobacillus reuteri probiotic lozenge daily. Saliva samples of the subjects were taken at baseline and 7th days. Plaque index, salivary pH, and Streptococcus mutans quantification measurements were done before and after consumption of the Lactobacillus reuteri probiotic. Statistical analyses used the T-test and Spearman correlation test.

Results: There was a significant difference in plaque index, saliva pH, and an insignificant difference in Streptococcus mutans quantification after consuming the probiotics. The correlation coefficient between Lactobacillus reuteri probiotics consumption and plaque index is 0.672, between probiotic consumption and salivary pH is r = 0.433 (p < 0,05), while between probiotic consumption and Streptococcus mutans quantification is 0.162 (p > 0,05).

Conclusion: A significant correlation between Lactobacillus reuteri probiotic consumption with plaque index and salivary pH was found, but the correlation with Streptococcus mutans quantification was found insignificant.

Chronic periodontitis (CP) is associated with subgingival microbial dysbiosis and demonstrates specific microbial patterns, though definitive causal connections with microbiomes in distinct anatomical regions remain undetermined. Genome-wide association datasets for CP and oral microbial communities were sourced from a large European cohort and China National GeneBank DataBase (CNGBdb), respectively. Employing single-nucleotide polymorphisms (SNPs) as genetic instruments, Mendelian randomization (MR) analyses were conducted through the inverse-variance weighted (IVW) approach. Analysis methods were implemented through the 'TwoSampleMR' package (v0.6.4) in R software. Sensitivity analyses were performed to validate the robustness of the findings and mitigate the occurrence of horizontal pleiotropy. The MR analyses revealed three salivary bacterial taxa, Neisseria meningitidis (OR = 0.67, 95% CI, 0.49-0.98), Streptococcus vestibularis (OR = 0.74, 95% CI, 0.56-0.98), and Lancefieldella unclassified (OR = 0.68, 95% CI, 0.52-0.91) to be significantly associated with a reduced risk of CP (p < 0.05). In contrast, tongue microbial taxa Solobacterium unclassified (OR = 1.45, 95% CI, 1.04-2.04), Fusobacterium sp000235465 (OR = 1.40, 95% CI, 1.02-1.94), and Haemophilus parainfluenzae (OR = 1.56, 95% CI, 1.12-2.18) were associated with an increased CP risk (p < 0.05). No evidence of heterogeneity and directional pleiotropy was noted for these associations. This study highlights the association between specific salivary and tongue microbial taxa and CP, providing mechanistic linkages into the plausible relationship. It also suggests that some microbial taxa may be further explored as indicators for risk-stratified preventive measures and novel targets for precision prebiotics and therapies.