Saudi Dental Journal最新文献

Recognizing the characteristics of the zygomatic process of the maxilla (ZPM) has several applications in implant dentistry and orthodontics. The present study evaluated the relationship between ZPM morphology, as obtained from panoramic images, and sinus pneumatization within the ZPM, according to cone-beam computed tomography (CBCT). CBCT and panoramic images of 300 patients were obtained, and the patients were divided into three age groups: Group I (15-34 years), Group II (35-55 years), and Group III (≥ 55 years). ZPM morphology was classified into J-shaped and non-J-shaped types based on panoramic images. The ZPM volume, maxillary sinus volume, and extent of sinus pneumatization within the ZPM were measured using CBCT scans, and their relationship to ZPM morphology classification was evaluated. Statistical analyses were performed using the Shapiro-Wilk test, one-way ANOVA, independent sample t-test, Mann-Whitney U test, Kruskal-Wallis test, and chi-square test (α = 0.05). Participants ranged in age from 17 to 82 years, and 67% were female. Most ZPMs were J-shaped (75%). J-shaped ZPMs had significantly greater sinus volume (1.83 ± 0.81 cm³), sinus pneumatization (53.56 ± 12.60%), and ZPM volume (3.50 ± 0.98 cm³) compared to non-J-shaped ZPMs (P < 0.05). Male participants had significantly larger ZPM volumes than females (P = 0.039). Sinus pneumatization and maxillary sinus volume were comparable across age groups and between gender. The presence of a non-J-shaped ZPM might be associated with less sinus pneumatization than J-shaped ZPMs, regardless of the patient's age or gender. Therefore, non-J-shaped ZPMs might offer more bone availability for various applications in dentistry.

Bone turnover biomarker levels serve as valid tools for assessing bone resorption and formation. While the standard retention protocol consists of using fixed retainers, removable retainers, or both, attempts have been made to explore alternative approaches using biological agents. Psidium guajava fruit is reported to possess osteoanabolic properties. These properties might be useful in preventing orthodontic treatment relapse. To assess the effect of orally administered Psidium guajava fruit suspension on alkaline phosphatase (ALP) and osteocalcin (OC) levels in the gingival crevicular fluid (GCF) of Wistar rats using enzyme-linked immunosorbent assay (ELISA). Fourteen rats underwent orthodontic tooth movement of the left maxillary first molar. Subsequently, the appliance was removed, then retention phase was initiated by placing composite resin in the created space between the left maxillary first and second molars. The intervention group received 250 mg/kg of P. guajava fruit suspension daily, while the control group received normal saline for 35 days. When retention ended, the left maxillary first molars were allowed to relapse for 7 days. At the end of the relapse phase, GCF samples were collected from the distal side of the left maxillary first molars using a PerioPaper and analyzed by ELISA. The mean concentration of ALP in the control and intervention groups was 0.074 ± 0.012 pg/mL and 0.075 ± 0.005 pg/mL, respectively (P = 0.704), while that of OC was 0.696 ± 0.003 pg/mL and 0.692 ± 0.011 pg/mL, respectively (P = 0.391). Oral supplementation of P. guajava fruit suspension did not have a positive impact on GCF bone turnover biomarkers (ALP and OC) in Wistar rats.

Deep Margin Elevation (DME) is a restorative technique that lifts deep proximal cavities, allowing for better restoration margins. The effect of DME materials on the fracture resistance of premolar endocrowns is not well understood. This study compared the fracture resistance of premolar endocrown employing two DME materials, SDR flowable composite and resin-modified glass ionomer (RMGI), after thermocycling. 54 endodontically treated premolars were assigned into three groups (n = 18) and prepared to receive polymer infiltrated ceramic (PIC) endocrowns. The cervical margins of the control group (E1) were set 2 mm below the cemento-enamel junction (CEJ) and restored directly with Endocrown. Group E2: Endocrown was used to reconstruct the teeth after a deep margin was raised to a height of 1 mm above the CEJ using flowable composite. Group E3: teeth were rebuilt as in the E2 group, and a deep margin was raised with RMGI. Following cementation, the samples underwent 10,000 cycles in two water baths with varying temperatures (5-55). Next, Standardized testing procedures were used to evaluate the fracture resistance. After thermocycling, Group E2 displayed the greatest mean fracture load value (621 to 833N). The group E3 values were found to be between (577 and 728 N), which was not significantly different from the values of group E1. SDR-based restorations would show improved durability compared to RMGI-based restoration. When isolation is possible, endocrowns made with the combination of SDR and PIC endocrowns may offer promising results without turning to more surgical treatment procedures.

To evaluate the (i) incidence of post-operative pain after RCT at 24 h, 48 h and 7 days, (ii) factors affecting the incidence of post-operative pain and (iii) patients' post-operative quality of life (PoQoL) at 24 h, 48 h and 7 days. One hundred and sixty two (n = 162) patients underwent either single-visit or multiple-visit RCT or retreatment at the Restorative Department. Post-operative pain was assessed via phone calls at 24 h, 48 h and 7 days via the Numeric Rating Scale (NRS) and Modified Verbal Rating Scale (MVRS) pain assessment tools. The PoQoL was assessed at the same three time points based on an adopted questionnaire which assessed pain on chewing, speaking, sleeping, ability to perform daily activities and social relations as well as the effects of pain on the overall QoL. The incidence of pain and the effects on the PoQoL were evaluated using descriptive analysis while the prognostic factors were evaluated using ordinal logistic regression analysis. Patients who felt pain after instrumentation had mild (24 h n = 24, 48 h n = 23) to moderate pain (24 h n = 13, 48 h n = 13) that decreased after 7 days. Post-obturation discomfort was highest at 24 h (n = 41), reduced at 48 h (n = 31) and 7 days (n = 11).The majority of patients who felt pain after treatment needed analgesics only at 24 and 48 h for pain control. Post-instrumentation and post-obturation pain did not affect patients' overall PoQoL, although many complained of chewing difficulty within 24 to 48 h. Only pre-operative pain within 24 h before treatment was a positive predictive factor for post-instrumentation pain in the simple ordinal logistic regression model. As for the post-obturation pain, molar tooth was associated with 2.5 times higher likelihood of post-obturation pain. Post-operative pain after RCT was common within 24 to 48 h but reduced at 7 days, with a likelihood of chewing difficulty following treatment. The pain felt was mainly mild to moderate, well controlled by analgesics and did not significantly affect the PoQoL. Clinical Trial Registration: ClinicalTrials.gov ID NCT06412263, protocol ID 295316.

There are numerous factors that can impact both the correction of jaw deficiencies and the success of a particular grafting material, including the histology and density of both the maxillary and mandibular bones and the grafting material itself. This study compares the clinical outcomes of grafted augmentations of the horizontal alveolar ridge of the anterior maxilla using mandibular symphysis onlay bone that was admixed with either injectable platelet-rich fibrin (i-PRF) or xenografts. Twelve adult patients with horizontal maxillary alveolar ridge deficiency were randomly divided into two groups of six patients each. Group I received mandibular symphysis onlay bone grafts mixed with i-PRF, while Group II received mandibular symphysis onlay bone grafts admixed with xenografts (InterOss anorganic cancellous granules). CBCT scans were used to measure alveolar ridge width and bone density both preoperatively and at 6-month follow-up. Both groups showed improvements in alveolar ridge width and bone density. The increase in measured bone width and density after 6 months in Group II was significantly greater than that in Group I (p = 0.040). Horizontal alveolar ridge augmentation using an onlay chin graft in combination with xenografts was successful and offered adequate bone quantity and quality.

Endodontic therapy in complex clinical cases poses significant challenges, often requiring tailored approaches to achieve successful outcomes. Herein, we offer an update on the present application of GE in endodontics, which reflects good therapeutic results but also reveals limitations of the required specialized training and expertise, as well as highly costly equipment and software, which prevents its widespread adoption. This review could further contribute to research aims to advance technology to address the limitations and optimize the use of this technique in routine endodontic practice. A thorough electronic search was performed across three major scientific databases-PubMed, Web of Science, and SCOPUS-to retrieve scientific literature focusing on Guided Endodontics, encompassing both Static and Dynamic Guided Endodontics, with publications considered up to April 2025. Guided endodontics (GE), which includes SGE (static guided endodontics) and DGE (dynamic guided endodontics), is an emerging technique in dentistry that utilizes advanced imaging technology and computer-guided systems to enhance the accuracy and precision of root canal treatments, which shows great potential in the application of personalized mini-invasive treatment in complicated clinical cases with the assistant of advanced imaging technology and computer-guided systems. It also provides patients with a comfortable experience and promotes faster healing. Generally, GE is an accurate new technique that facilitates the establishment of pulp access, unblocking of calcified root canals, and mini-invasive surgical trauma in endodontic surgery, for preserving more tooth tissue while extending the preservation time of the treated tooth. Static guides and dynamic navigation have different benefits and drawbacks and should be used in specific clinical conditions.

Although guidelines recommend removing aligners before eating, many patients wear them while consuming food or beverages. Understanding the response of a material to high temperatures is crucial for predicting treatment outcomes. This study aimed to assess the effects of elevated beverage temperatures on the physical and mechanical properties of Invisalign clear aligners. Sixty Invisalign aligner specimens were thermocycled and divided into four groups. The specimens in the first and second groups were immersed in coffee and tea at 57 °C, respectively, whereas the third and fourth groups consisted of raw and thermocycled specimens, respectively. Each specimen from group 1 and 2 was immersed in each solution and subsequently in artificial saliva to simulate an intermittent drinking process, which was repeated 200 times, with each immersion lasting 2 s. The elastic moduli and hardnesses of the materials were measured and compared with those of the raw and thermocycled specimens. Statistically significant differences were observed in mean hardness and elastic modulus values (p < 0.0001 and p = 0.025, respectively). The mean hardness of the raw specimens was significantly higher than those of the other three groups (p < 0.0001 each), and the elastic modulus was lower than that of the coffee group (p = 0.018) but not statistically different from those of the thermocycling and tea groups (p = 0.413 and p = 0.309, respectively). Thermocycling and exposure to beverages at 57 °C significantly decreased the hardness of Invisalign clear aligners. The coffee-exposed group exhibited an increased elastic modulus, indicating greater rigidity. Investigating the effects of increased temperature on thermoplastic materials is crucial to ensuring the durability and safety of orthodontic treatment, which directly impacts patient care.

Molar Incisor Hypomineralization (MIH) is a developmental enamel defect that affects permanent first molars (PFMs) and incisors, leading to caries and early tooth loss. This systematic review investigates the literature for the relationship between stress-related factors and the occurrence of MIH. A comprehensive literature search was conducted across PubMed, Cochrane, Scopus, Google Scholar, and BASE. Articles were screened and data extracted using the Rayyan platform for systematic reviews. The quality of the included studies was assessed using the Newcastle-Ottawa Scale (NOS). Six-studies were included, five examined maternal stress during pregnancy while one on stress experienced during early childhood. Out of them, five reported a significant association between stress and MIH. Given the significant variability in stress assessment methods across studies, we were able to include only two studies in the meta-analysis. Although not statistically significant, the meta-analysis showed a tendency for increased odds of MIH in the presence of stress, with an overall odds ratio of 1.46 (95% CI: 0.66-3.22). These findings suggest a potential association between psychological stress and MIH. However, further research is needed to confirm these results and elucidate the mechanisms involved. Addressing current research limitations will improve study reliability and inform preventive strategies to reduce maternal and early childhood stress, potentially mitigating MIH prevalence.

Aim: Salivary gland mucoepidermoid carcinoma (MEC) is a morphologically challenging tumor, harboring a canonical CRTC1/3:MAML2 fusion, if investigated. However, the large cohorts available did not invesitgate the diagnosed cases adequately; leaving any mucin-producing malignancy possible MECs although >50% of salivary gland tumors secret mucin luminally or extra-luminally. This study examined the expression of stem cell markers Nanog, SOX2, OCT4, and MENA in salivary MEC using immunohistochemistry and to confer, whether or not, they may have a potential role in defining the tumoral molecular profile.

Materials and methods: Forty well-investigated parotid MEC cases (p63+, p40+, CK7+, Ck5/6+, AE1/AE3+, EMA+, S100 -, ATF1 -, WT1-, SOX9 - and SOX10 -), all with MAML2 rearrangements and without EWSR1 alteration, were interrogated using immunohistochemical techniques to detect the immunoreactivity for Nanog, SOX2, OCT4, and MENA. Additionally, the POU5F1 FISH probe was used to confirm the immunohistochemical findings for OCT4.

Results: Immunohistochemical analysis revealed negative or nonspecific immunoreactivity of NANOG, SOX2, and OCT4 antibodies throughout all examined specimens, inferring deficient pluripotency factor within MEC cellular oncogenesis. However, MENA was widely expressed in all cases. The results of the POU5 F1 FISH probe were consistent with the immunohistochemical data, showing no detectable expression of OCT4, Nanog or SOX2, across all 40 samples.

Conclusion: Cancer stem cells likely do not play any significant role in the pathogenesis of salivary MEC. The widespread expression of MENA, however, suggests that it has functions beyond promoting stemness or pluripotency in these tumors.

Cone-beam computed tomography (CBCT) has been demonstrated to identify apical radiolucency with higher accuracy than two-dimensional radiography. The outcome of root canal treatment varies depending on the imaging modality employed. This systematic review aimed to: (1) estimate the success rate of nonsurgical root canal treatment and retreatment when assessed by CBCT and (2) investigate the influence of some factors suspected to be associated with treatment outcomes. An electronic search was performed in the following databases: MEDLINE, Embase, Web of Science, the Cochrane Library, and gray literature. Article selection and data extraction were independently conducted by 2 reviewers. The terms 'strict' (complete resolution of periapical lesion) or 'loose' (reduction in size of existing periapical lesion) were used to describe the outcome criteria. The Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach was used to evaluate the quality of the included studies. Meta-analysis and meta-regression established pooled outcome rates, 95% confidence intervals (CIs), and significant clinical prognostic factors (P < .05). Nineteen articles were included. The overall quality of evidence was moderate. The estimated weighted pooled overall success rates for NSRCT and NSReRCT assessed by CBCT were 41.03% (95% CI: 28.68%-53.95%; I² = 94.76%) under strict criteria and 85.01% (95% CI: 80.85%-88.75%; I² = 68.36%) under loose criteria. This review's findings offer valuable insights to guide the design of future studies assessing root canal treatment and retreatment outcomes through CBCT. However, they should be interpreted with caution due to the retrospective and heterogeneous nature of the data. Review registration: This protocol was registered in the international prospective register of systematic reviews: the PROSPERO database (CRD42024591017). Clinical trial number: Not applicable.