Factors Affecting Patients' Atttendance for Periodontal Follow-up Visits after Crown Lengthening Surgery.

PURPOSE: To assess adherence to follow-up maintenance visits among patients who had previously undergone crown-lengthening surgery and investigate the different factors impacting their compliance. MATERIALS AND METHODS: A total of 314 patients were identified for follow-up appointments. Based on their responses, participants were categorised into four groups: attendees, non-attendees, refusals, and unreachable. Furthermore, data on sociodemographic factors (age, sex, nationality, marital status, education, occupation, and residential area), medical history, dental history (including missing teeth, implants, or orthodontic treatment history), and past appointment attendance (average yearly appointments, missed appointment percentage, and last appointment date) were collected and analysed to understand their influence on patient compliance. RESULTS: In a sample of 314 patients, 102 (32.5%) attended the appointments successfully. Improved attendance rates were significantly associated with being female, Saudi Arabian, married, and employed (p < 0.05). Moreover, patients with a high frequency of annual appointments and a recent history of appointments exhibited better compliance. None of the analysed dental factors affected the attendance rates. CONCLUSION: About one-third of patients who had undergone crown lengthening surgery were compliant with the follow-up visits. Different factors influenced this compliance pattern to varying extents, with more efforts needed to enhance patients' commitment to these visits.

Perceived stress among dental students and the role of parental influence in career decision-making.

OBJECTIVES: The current study aimed to assess perceived stress levels among dental students at Riyadh, Saudi Arabia, and to explore the influence of parental roles in their decision to pursue dentistry as a potential source of social stress. METHODS: This cross-sectional study employed the validated Dental Environmental Stress (DES) Scale to evaluate perceived stress, and incorporated additional questions to fulfill the research aim. We approached all undergraduate dental students at King Saud University, both male and female, across all academic years, using online channels (such as emails, WhatsApp, Twitter, etc.) and hard copy distribution. Data collected were analyzed using SPSS version 20, utilizing descriptive and correlation statistics. RESULTS: A total of 326 students participated in the study, with an even distribution of male and female students. Female students reported higher levels of stress compared to their male counterparts across most DES domains. A notable correlation emerged between mean DES scores in certain domains and influence of parents in the decision to pursue dentistry. CONCLUSION: Our findings indicate that female dental students experience higher stress levels than males in all examined areas, barring social stressors. Furthermore, the study underscores the significant impact of parental involvement in choosing dentistry as a career on students' stress level.

Prevalence of Radiographic Alveolar Bone Loss as a Function of Age in the Periodontics Clinic Population at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia.

PURPOSE: The purpose of the present observational study was to assess the prevalence of radiographic alveolar bone loss (ABL) as a function of age at the Periodontics Clinics at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia. MATERIALS AND METHODS: Medical and dental healthcare records of individuals visiting the Periodontics Clinics at College of Dentistry, King Saud University, Riyadh Saudi Arabia were assessed. The following information was retrieved: age, gender, educational status, and systemic diseases (diabetes mellitus [DM], hypertension, osteoporosis and obesity). Digital full-mouth radiographs were retrieved from patients' dental records, and marginal bone loss (MBL) was assessed on the mesial and distal surfaces of all teeth. Logistic regression analyses (LRA) were done to assess the correlation between ABL and gender, age, educational status and duration since diagnosis of the aforementioned systemic conditions. p < 0.05 was considered statistically significant. RESULTS: In total, medical and periodontal healthcare records of 495 individuals were retrieved and assessed. All individuals were citizens of the KSA. Among these, 107 were healthy controls and 98, 95, 96 and 99 individuals had a medical diagnosis of type-2 DM, hypertension, obesity and osteoporosis, respectively. There was no statistically significant difference in the mean age and gender of all medically compromised participants. The prevalence of mild, moderate, and severe periodontitis in the total patient population was 51.4%, 37.5% and 36.5%, respectively. Among all healthy controls, the prevalence of mild, moderate, and severe periodontitis was 16.3%, 25.5% and 33.4%, respectively. There was no difference in the prevalence of mild, moderate, and severe periodontitis in relation to advancing age in the entire patient population. CONCLUSION: Advancing age did not seem to affect ABL in the present patient population. Patient education, oral hygiene maintenance and SES seem to be more predictable indicators of ABL than increasing age.

Can periodontal measures assist in the identification of adults with undiagnosed hyperglycaemia? A systematic review.

AIM: The aim of this review was to answer the following question: Can periodontal measures be used to identify dental patients with undiagnosed hyperglycaemia? MATERIALS AND METHODS: Systematic searches of electronic databases and the grey literature were carried out to identify studies developing and/or validating prediction models, based on any periodontal measure, to screen adults for undiagnosed hyperglycaemia (pre-diabetes and diabetes). Risk of bias was evaluated using the PRediction mOdel risk-of-Bias ASsessment Tool (PROBAST). RESULTS: Ten studies were identified, of which eight were model development studies. The remaining two studies reported the external validation of one existing prediction model. The periodontal prediction model with some evidence of external validation showed moderate diagnostic performance in the development sample but lower performance in the external validation samples. According to PROBAST, all studies had high risk of bias mainly due to methodological limitations in data analysis, but also in the recruitment of participants, choice and measurement of periodontal predictors and diabetes. CONCLUSIONS: There is a need for more robust external validation studies of existing prediction models adhering to current recommendations. Dental professionals who see patients at risk of diabetes and routinely collect periodontal measures have an important role to play in their identification and referral.

The Relationship Between Periodontal Disease and ABO Blood Groups: A Cross-Sectional Study.

PURPOSE: The objective of this cross-sectional study was to evaluate the relationship between ABO blood groups and periodontal diseases. MATERIALS AND METHODS: Four hundred sixteen subjects (223 females, 193 males) were recruited according to the eligibility criteria. Periodontal examination was performed, including full-mouth plaque index (PI), bleeding on probing (BOP), clinical attachment level (CAL), and interproximal bone loss (IBL). ABO blood group patterns were determined based on self-reports, confirmed by medical records. The chi-squared test was done to evaluate the data (p < 0.05). RESULTS: Out of the 416 subjects, 52.2% were blood group O, whereas 27.8% were blood group A. 46.8% of patients with blood group O had gingivitis and 49.6% had periodontitis. 31.2% of patients with blood group A had gingivitis,while 29.5% had periodontitis. The blood group with the lowest percentage among patients with gingivitis was AB, with a rate of 6.2%; in this blood group, 8.1% had periodontitis. CONCLUSIONS: There is no association between periodontal diseases and ABO blood group types.

The added value of periodontal measurements for identification of diabetes among Saudi adults.

BACKGROUND: The aims of this study were to develop a prediction model for identification of individuals with diabetes based on clinical and perceived periodontal measurements; and to evaluate its added value when combined with standard diabetes screening tools. METHODS: The study was carried out among 250 adults attending primary care clinics in Riyadh (Saudi Arabia). The study adopted a case-control approach, where diabetes status was first ascertained, and the Finnish Diabetes Risk Score (FINDRISC), Canadian Diabetes Risk questionnaire (CANRISK), and periodontal examinations were carried out afterward. RESULTS: A periodontal prediction model (PPM) including three periodontal indicators (missing teeth, percentage of sites with pocket probing depth ≥6 mm, and mean pocket probing depth) had an area under the curve (AUC) of 0.694 (95% Confidence Interval: 0.612-0.776) and classified correctly 62.4% of participants. The FINDRISC and CANRISK tools had AUCs of 0.766 (95% CI: 0.690-0.843) and 0.821 (95% CI: 0.763-0.879), respectively. The addition of the PPM significantly improved the AUC of FINDRISC (P = 0.048) but not of CANRISK (P = 0.144), with 26.8% and 9.8% of participants correctly reclassified, respectively. Finally, decision curve analysis showed that adding the PPM to both tools would result in net benefits among patients with probability scores lower than 70%. CONCLUSIONS: This study showed that periodontal measurements could play a role in identifying individuals with diabetes, and that addition of clinical periodontal measurements improved the performance of FINDRISC and CANRISK.

External Validation of a Periodontal Prediction Model for Identification of Diabetes among Saudi Adults.

AIM AND OBJECTIVE: To externally validate the performance of a novel periodontal prediction model (PPM) for identification of diabetes among Saudi adults. MATERIALS AND METHODS: The study was carried out among 150 adults attending primary care clinics in Riyadh (Saudi Arabia). The study adopted a temporal external validation approach, where the performance of the PPM was evaluated in the same location as the development study, but at a later time to allow for some variation between samples. A case-control approach was adopted, where diabetes status was first ascertained, followed by the completion of the Finnish Diabetes Risk Score (FINDRISC), Canadian Diabetes Risk (CANRISK) tools, and periodontal examinations. RESULTS: The area under the curve (AUC) of the PPM (based on the number of missing teeth, the proportion of sites with pocket probing depth ≥6 mm, and mean pocket probing depth) was 0.514 (95% CI: 0.385, 0.642). The FINDRISC and CANRISK tools had AUC values of 0.871 (95% CI: 0.811-0.931) and 0.927 (95% CI: 0.884-0.971), respectively. The addition of the PPM did not improve the AUC of FINDRISC (p = 0.479) or CANRISK (p = 0.920). The decision curve analysis showed that there was no clinical benefit in adding the PPM to either tool. The PPM was updated with an overall adjustment factor for all existing predictors and three more periodontal measures. CONCLUSION: In an external sample, the PPM had poor performance for identification of diabetes and no added value when combined with FINDRISC and CANRISK. The performance of the PPM improved after recalibration and extension. CLINICAL SIGNIFICANCE: The results underscore the value of externally validating prediction models before applying them in clinical dental practice.

Influence of orthodontic treatment with first premolar extraction on the angulation of the mandibular third molar.

OBJECTIVES: To evaluate the influence of orthodontic treatment that involved first premolars extraction on the angulation of the developing mandibular third molars, and whether this will result in an improvement in it's path of eruption during tooth development. METHODS: A cross-sectional radiographic study was conducted using 80 panoramic radiographs of 40 orthodontic patients previously treated at the College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia. The sample consisted of 2 groups, extraction and non-extraction orthodontic therapy group with equal number of patients in each group. The orthodontic treatment of the extraction group involved the extraction of first premolars, whilst non-extraction group had received orthodontic therapy without teeth extraction. The angulation of the right and left third mandibular molars was measured in each patient separately, and the data was analyzed using the non-parametric Mann-Whitney Test. RESULTS: The present data has shown significant improvement in the third molars angulation in the extraction orthodontic therapy group compared to non-extraction group, Although this finding was significant in both genders, females tend to show better response in the improvement of third molar angulation to extraction therapy than males (p=0.001, p=0.006). CONCLUSION: Orthodontic treatment with first premolars extraction has improved the third molars angulation during their course of eruptions and consequently supports the decision of the orthodontic extraction therapy approach in borderline cases.