The prevalence of premature loss of primary teeth and its impact on malocclusion in the Eastern Province of Saudi Arabia.

OBJECTIVES: The present study was designed to determine the prevalence of premature loss of primary teeth and its effect on malocclusion in Eastern Province, Saudi Arabia. MATERIALS AND METHODS: This is an observational, cross-sectional study that included 307 male children aged 9-11 years old. Clinical examinations were performed using a disposable sharp explorer, a UNC periodontal probe and a dental mirror. The samples were examined clinically to detect the following traits: Angle's classification of malocclusion, overjet, overbite, anterior open-bite, lateral open-bite, midline shift and cross-bite. Additionally, a dental caries examination was performed using WHO methods. Questionnaires in Arabic were coded and sent to the students' parents. RESULTS: The mean DMFT was 5.61 (SD = 3.01). The d-component was the highest, with a mean of 4 (SD = 2.83). Of the 307 children, it was found that 204 (66.4%) had a high DMFT score, which is defined as a score above 4. It was found that 156/307 (51%) children had premature loss of deciduous teeth. CONCLUSION: A high prevalence of premature loss of teeth was found in this study. This finding emphasizes the importance of increasing awareness levels about this issue and focuses attention on the need for more preventive efforts to maintain healthy and normal dentitions that would improve the masticatory function and aesthetics of individuals and the whole population. In addition, the findings emphasize the importance of the early detection of premature loss of primary teeth to prevent future malocclusion.

Mandibular tori as bone grafts: an alternative treatment for periodontal osseous defects - clinical, radiographic and histologic morphology evaluation.

OBJECTIVES: The present study was designed to evaluate the clinical, radiographic and histochemical significance of using the mandibular tori as autogenous bone graft for treatment of intraosseous defects in patients with chronic periodontitis. MATERIALS AND METHODS: Twenty-eight sites from 14 patients with chronic periodontitis were included in this study. Each patient was treated with split mouth design; one site received torus mandibularis bone graft and the other site received a full-thickness fap alone. Histopathologic assessment was evaluated on removal of torus mandibularis to evaluate its histologic structure and by the end of the study 9 month later. Clinical and radiographic parameters were re-evaluated at 3 months interval for 1 year. RESULTS: The results of the present study revealed significant gain in the clinical attachment level (CAL) (88.4%, 4.53 ± 0.06 mm) for torus mandibularis sites compared to (39.7%, 2.01 ± 0.04 mm) for full-thickness fap. Moreover, there was a reduction in the probing pocket depth (PPD) of (75.4%, 5.75 ± 0.12 mm) for torus mandibularis sites and (49.6%, 3.73 ± 0.14 mm) for sites treated with a full-thickness fap only; CAL and PPD differences were significant at p-value ≤0.01. Concomitantly, significant radiographic increase in the bone height and density were recorded in the test group. CONCLUSION: The use of mandibular tori as autogenous bone graft could provide benefits as a periodontal therapeutic modality and enhance regenerative potential of periodontal intraosseous defects.

Does grafting of third molar extraction sockets enhance periodontal measures in 30- to 35-year-old patients?

PURPOSE: This study was designed to evaluate the use of xenograft plus a membrane as grafting material for periodontal osseous defects distal to the mandibular second molar compared with nongrafted extraction sites after removal of impacted mandibular third molars. MATERIALS AND METHODS: We performed a single-blind, randomized, controlled clinical trial, and the sample comprised of subjects at high risk for the development of periodontal osseous defects distal to the second molar after third molar extraction (aged 30-35 years), pre-existing osseous defects distal to the second molar, and horizontal third molar impaction. The predictor variable was the treatment status of the second molar osseous defects. The third molar extraction sites were grafted with an anorganic xenograft plus a membrane. The other sites received a full-thickness flap and extraction of the third molar without placement of the grafting materials. The outcome variables were the change in gingival index, pocket probing depth, and clinical attachment level on the distobuccal aspect of the second molar preoperatively and at 3, 6, 9, and 12 months after surgery. Data were statistically analyzed by multivariate analysis of variance, and the statistical significance was set at P < .05. RESULTS: The study was composed of 28 sites that were selected by use of a split-mouth design for each patient, and this was randomly determined through a biased coin randomization. Twelve months after third molar removal, there was a statistically significant gain in the clinical attachment level and a reduction in the probing pocket depth in the grafted sites compared with the nongrafted sites (P < .001). Moreover, there was a significant difference in the alveolar bone height during the monitoring periods for the grafted sites compared with the nongrafted sites (P < .001). CONCLUSIONS: Grafting of osseous defects distal to mandibular second molars with an anorganic xenograft plus a membrane predictably resulted in a significant reduction in the probing pocket depth, clinical attachment level gain, and bone fill, which suggests that grafting the extraction sites with an anorganic xenograft plus a membrane could prevent periodontal disease in the future.

Platelet-Rich Plasma Gel Combined with Bovine-Derived Xenograft for the Treatment of Dehiscence Around Immediately Placed Conventionally Loaded Dental Implants in Humans: Cone Beam Computed Tomography and Three-Dimensional Image Evaluation.

PURPOSE: This study clinically and radiographically investigated the potential of platelet-rich plasma (PRP) gel combined with bovine-derived xenograft to treat dehiscence defects around immediate dental implants. MATERIALS AND METHODS: This study was performed on 32 sites from 16 patients who each received an immediate implant for a single tooth replacement at a maxillary anterior or premolar site. Patients were divided into two groups according to the augmented materials used. One group received an immediate implant and filling of defects using a PRP gel plus bovine-derived xenograft. The other group received an immediate implant and filling of defects with a bovine-derived xenograft without PRP gel. Cone beam computed tomography (CBCT) was taken before placement, and at 6 and 12 months postsurgery. RESULTS: Both treatment procedures resulted in significant improvements for the primary outcome regarding bone fill, as well as the marginal bone level. In addition, statistically significant differences were found in the bone density for the combined therapy compared with sites treated with bovine-derived xenografts alone (P ≤ .01). CONCLUSION: Autogenous PRP gel combined with bovine-derived xenograft demonstrated superiority to the bovine-derived xenograft alone, which suggested that it could be successfully applicable for the treatment of dehiscence around an immediate dental implant. Moreover, CBCT can be used to measure dehiscence and to assess bone thickness along the implant.

Sensitivity and specificity of subgingival bacteria in predicting preterm birth- a pilot cohort study.

OBJECTIVE: Preterm birth (PTB) increases the risk of adverse outcomes for new born infants. Subgingival bacteria are implicated in causing PTB. The aim of the present study was to assess the accuracy of some subgingival gram positive and gram negative bacteria detected by routine lab procedures in predicting PTB. METHODOLOGY: Pregnant Saudi women (n= 170) visiting King Fahad hospital, Dammam, Saudi Arabia, were included in a pilot cohort study. Plaque was collected in the 2nd trimester and screened for subgingival anaerobes using Vitek2. Pregnancy outcome (preterm/full term birth) was assessed at delivery. Sensitivity, specificity and positive and negative likelihood ratios were calculated for the identified bacteria to predict PTB. RESULTS: Data about time of delivery was available for 94 subjects and 22 (23.4%) had PTB. Three gram negative and 4 gram positive subgingival bacteria had sensitivity ≥ 95% with two of each having negative likelihood ratios ≤0.10. Three gram positive bacteria had specificity > 95% with only one having positive likelihood ratio >2. CONCLUSION: Subgingival bacteria identified using readily available lab techniques in the plaque of pregnant Saudi women in their 2nd trimester have useful potential to rule out PTB.

Composite bone graft for treatment of osseous defects after surgical removal of impacted third and second molars: case report and review of the literature.

The aim of this case report was to evaluate the clinical and radiographic measurements of mandibular first molar bone support after mandibular third and second molar extraction and immediate augmentation of the extraction site with a combined autogenous bone graft with Bio-Oss materials. A pyramidal full-thickness mucoperiosteal flap with 1 distal releasing incision was used for removal of impacted third and second molars. During the procedure, autogenous bone graft was collected with a bone trap and then combined with Bio-Oss materials. The osseous defects distal to first molar and extraction site was filled with the composite bone graft and covered with Bio-Gide membrane. After 1 year, there was a successful defect regression and gain of bone and clinical attachment level. Moreover, there was a reduction of probing pocket depth and gingival inflammation. From the results of this study, it can be concluded that grafting of osseous defects and extraction site with autogenous bone graft combined with Bio-Oss materials will predictably result in a decreased risk of developing a periodontal defect on the distal aspect of mandibular first molar.

Autogenous bone graft combined with polylactic polyglycolic acid polymer for treatment of dehiscence around immediate dental implants.

The use of composite bone grafts in dehiscence defects around immediate dental implants are aimed at improving the outcome of the regenerative process. The present study was designed to evaluate the efficacy of combinations of autogenous bone graft with a synthetic copolymer polylactic and polyglycolic acid (Fisiograft) on bone healing of buccal dehiscence defects around immediate dental implants. Sixteen adult male patients who each received an immediate implant for a single tooth replacement at a maxillary anterior or premolar site were included in this study. Patients were divided into 2 groups. One group received immediate dental implants augmented with autogenous bone graft combined with Fisiograft. The other group received immediate dental implants augmented with autogenous bone graft alone. The results revealed that both treatment modalities led to significant improvements for the primary outcome regarding bone fill as well as a significant reduction of probing pocket depth and gain of attachment level. Moreover, there were slightly statistically significant differences between the groups. In conclusion, the combination of autogenous bone graft and Fisiograft showed a slight superiority to autogenous bone graft alone, suggesting that it could be an optimum bone substitute for treatment of dehiscence around immediate dental implant.

A comparative evaluation of immediate dental implant with autogenous versus synthetic guided bone regeneration.

Immediate implant is a placement of the implant immediately into fresh extraction socket site after tooth extraction and is considered to be a predictable and acceptable procedure. The present work is designed to evaluate the periodontal condition after immediate implant placement and the success rate of implant with autogenous versus synthetic guided bone regeneration. Twenty adult male patients with an endodontic failure, tooth fracture decayed tooth (hopeless tooth) were included in this study. Patients were divided into 2 groups: One group (I) received immediate implants augmented with autogenous bone graft, and the other (group II) received immediate implants augmented with a synthetic bone graft. The results revealed that there was a significant difference between the groups for pocket depth and clinical attachment level. The difference between the groups was statistically highly significant only at 12 months (P < .01). In addition, there was statistically significant difference between the groups at 9 and 12 months (P < .001). Moreover, there was significant decrease of marginal bone loss in group I compared with group II (P < .01). In addition, there was statistically significant difference between the both groups at 9 and 12 months for bone density (P < .001). Moreover, there was significant decrease of marginal bone loss in group I compared with group II (P < .01). In conclusion, the immediate dental implant placement with autogenous bone graft showed a significant superiority to synthetic bone graft. In addition, the immediate placement-delayed loaded dental implant remains the procedure of choice for predictable achieving of osseointegration.