Maternal Smokeless Tobacco Use in Pregnancy and Adverse Health Outcomes in Newborns: A Systematic Review.

BACKGROUND: Perinatal morbidity and mortality are important indicators of maternal health and the future health of the child. Smokeless tobacco (ST) use during pregnancy is associated with low birth weight (LBW), preterm births, stillbirths, and small for gestation age (SGA). This study systematically reviews and summarizes evidence on the association of maternal ST use with these adverse health outcomes in newborns. METHODS: Electronic databases (Medline, Embase, Lilacs) were searched in July 2013 using appropriate keywords complemented with reference list searching. Observational studies of maternal ST use and these outcomes were considered; LBW, preterm, stillbirth, SGA. A comprehensive assessment of quality and risk of bias in all included studies was performed. RevMan software was used for data analysis. Results are expressed as crude odds ratios with 95% confidence intervals. Chi-square and I(2) tests checked for heterogeneity and quantified inconsistency between results. RESULTS: There were 9 studies (16 reports) included (7 cohort-studies, 1 case-control study, and 1 cross-sectional study). They were clinically and methodologically diverse. Significant associations with ST use were seen in 5/7 studies for LBW, in 3/6 studies for preterm, in all 4 studies for stillbirth and in 1/2 studies assessing SGA. Heterogeneity between results was moderate for LBW (I(2) = 44%) and stillbirth (I(2) = 52%), and high for preterm (I(2) = 87%) and SGA (I(2) = 65%). Meta-analysis was considered inappropriate due to risk of bias and confounding. CONCLUSIONS: Although most studies show an association between ST use in pregnancy and adverse health effects in newborns, these results may be limited by confounding and bias. Quality observational studies are needed to strengthen this evidence base.

Common Temporization Techniques Practiced in Saudi Arabia and Stability of Temporary Restoration.

INTRODUCTION: Coronal leakage is detrimental to the long-term success of root canal treatment (RCT). While much emphasis is being placed on the quality of the final restoration, little attention is given to the temporary restoration placed in between root canal treatment appointments. The aim of this study was to survey temporization techniques practiced in Saudi Arabia and the frequency of observing temporary material breakdown or complete loss. MATERIALS AND METHODS: An online questionnaire was distributed among general dentists, dental specialists, and clinical trainees in undergraduate and postgraduate dental programs. The sample size was estimated at 370 participants. Data were analyzed using descriptive statistics and chi-square tests. RESULTS: The total number of participants who met the inclusion criteria was 525. The majority of them (94.6%) were practicing two-visit RCT. The most common temporization materials were Cavit (50.3%) followed by glass ionomer cement (32%). The majority (72.6%) of participants claimed they allow a thickness of 2-3 mm for temporary restorations. Many participants (60.4%) used a spacer material during temporization, and the cotton pellet was the most common spacer material. Temporary restoration breakdown or complete loss was a common observation. Although the duration between the two RCT visits was 2 weeks or less for 83.6% of participants, only 19.6% of participants claimed that they rarely observed temporization breakdown. CONCLUSION: Two-visit RCT is commonly practiced in Saudi Arabia, and endodontists performed significantly more single-visit procedures. Temporization practices may lack uniformity; however, clinicians were more likely to use calcium sulfate-derived material for two weeks or less. They allow for 2-3 mm thickness restoration and use a cotton pellet as a spacer. According to their clinical observation, temporary material breakdown or complete loss was frequent. This mandates further attention in research and education.

Third molar impaction in the Jazan Region: Evaluation of the prevalence and clinical presentation.

OBJECTIVE: To provide information on the prevalence and clinical features of impacted third molar teeth in the South-Western region of Saudi Arabia. MATERIAL AND METHODS: In this cross-sectional study, 1200 panoramic radiographs (50% males and 50% females) were retrieved from the electronic clinical records of patients at the College of Dentistry, Jazan University from December 2014 to December 2016, and impacted third molars were evaluated. Data on clinical and radiographic presentation were analyzed. RESULTS: Overall, there were 291 (24.3%) patients with impacted third molars among 1200 radiographs. The distribution of impacted third molars according to the number of impacted teeth was as follows: one impaction in 121 (41.6%); two impactions in 90 (30.9%); three impactions in 42 (14.4%); and four impactions in 38 (13.1%) patients. There was a high prevalence of all impaction types among females (54.5%). Maxillary vertical angulation was most common (50%) followed by mandibular mesioangular angulation (48.3%). The depth of impaction in maxillary teeth was higher than in mandibular teeth. Pain was uncommon (4.5% of patients). DISCUSSION: Clinically, vertical impaction in the maxilla was present in 50% of patients because of limited posterior space, and mesioangular angulation in the mandible was present in 48% of patients because of inadequate space between the ramus and the second molar. These findings are similar to other reports. Vertical impaction of the maxillary wisdom tooth is mostly related to the discrepancy between the mesiodistal size of the tooth crown and the limited retromolar space. CONCLUSION: Noiseless presentation of an impacted third molar requires raising the population's awareness about the need for diagnosis and treatment of the problem to avoid any further complications. The study can be to guide surgical procedures. This study documented the prevalence, pattern, and clinical features of impacted third molars in South Western region of Saudi Arabia.