Association of blood heavy metal levels with osteocalcin abnormality and incidence of osteoporosis in Saudi subjects / Associação de anormalidades de osteocalcina nos níveis de metais pesados no sangue e incidência de osteoporose em indivíduos sauditas

Abstract Serum toxic metals have been implicated in development of many diseases. This study investigated the association between blood levels of lead and cadmium with abnormal bone mineral density (BMD) and incidence of osteoporosis. Sixty Saudi male adults age matching were assigned into two groups: A healthy control group (n = 30) and osteoporosis patients diagnosed according to T-score (n = 30). Serum calcium, vitamin D, osteocalcin, lead, cadmium were measured. Osteoporotic group showed a highly significant elevation of blood lead and cadmium levels compared to the control group (p <0.001). BMD was negatively correlated with serum osteocalcin level compared with control. There was a significant negative correlation between the cadmium and lead levels (r=-0.465 and p-value = 0.01) and calcium (p < 0.004). Our findings suggested that high cadmium and lead were negative correlated to BMD and increased the risk factor for osteoporosis.

Resumo Os metais tóxicos do soro têm sido implicados no desenvolvimento de muitas doenças. Este estudo investigou a associação entre os níveis sanguíneos de chumbo e cádmio com densidade mineral óssea anormal (DMO) e incidência de osteoporose. Sessenta adultos sauditas do sexo masculino com idades iguais foram divididos em dois grupos: um grupo de controle saudável (n = 30) e pacientes com osteoporose diagnosticados de acordo com o T-score (n = 30). Cálcio sérico, vitamina D, osteocalcina, chumbo, cádmio foram medidos. O grupo osteoporótico apresentou elevação altamente significativa dos níveis de chumbo e cádmio no sangue em comparação ao grupo controle (p < 0,001). A DMO foi negativamente correlacionada com o nível de osteocalcina sérica em comparação com o controle. Houve correlação negativa significativa entre os níveis de cádmio e chumbo (r = -0,465 ep = 0,01) e cálcio (p < 0,004). Nossos achados sugeriram que cádmio e chumbo elevados foram correlacionados negativamente à DMO e aumentaram o fator de risco para osteoporose.

Assessment of Children's Oral Health-Related Knowledge and Self-Efficacy in Expectant Mothers of Najran, Saudi Arabia

Abstract Objective: To assess the knowledge of pregnant women regarding their child's oral health. Material and Methods: A questionnaire was developed and the 1st section comprised sociodemographic variables. The second section contained questions about the eruption of teeth, fluoride importance, cariogenic food, and dental visits. The questionnaire was shared electronically via a link to the receptionist of the gynaecologist at different health centres of Najran to be filled by expectant mothers. The convenient sampling method was used to collect the responses. Data were presented using descriptive statistics. Results: A total of 572 pregnant women participated in this survey. Three hundred and fifteen (55.1%) knew that 1st primary tooth erupts at the age of 6 months. The majority of the respondents (n=332) agreed that toothbrushes and toothpaste could be used to clean a child's teeth; only 5.4%, 10%, and 24.5% preferred miswak, mouthwash, and toothbrush, respectively. Participants were well familiar with cariogenic food and occasionally allowed their children to take it. They have enough knowledge about fluoride toothpaste, but they were not familiar with the benefits of fluoride varnish. Almost 50% of the respondents agreed that the child should visit the dentist within six months, and 27.4% said they should visit the dentist whenever there is a problem. Conclusion: Almost 50% of participants showed a positive attitude towards most questions. However, there is a need to improve their behaviour and knowledge about many aspects of dental care.

Cone Beam Computed Tomography Evaluation of Root Morphology of the Premolars in Saudi Arabian Subpopulation

Abstract Objective: To evaluate root canal configuration and morphology of premolar teeth among Saudi subpopulations using cone beam computed tomography (CBCT). Material and Methods: In this retrospective cross-sectional study, CBCT images of 314 patients comprising 346 maxillary and 412 mandibular first premolar (FPM) teeth, 298 maxillary and 387 mandibular second premolar (SPM) teeth were analyzed to evaluate the number of roots, root canal morphology, and configuration based on the Vertucci's classification. The average intra-class correlation coefficient value was 0.931. Results: In the maxillary first premolar, 52.6% were two separate rooted and single rooted teeth, with one canal in 81.2% of the maxillary second premolar. Among the mandibular FPM, 96.6% of the teeth had one root and canal, and 97.9% of mandibular SPM had one root and canal. Type 1 canal configuration was seen as most common in all premolars. The number of roots in mandibular premolars did not reveal the difference among gender. Conclusion: Wide variations in root canal morphology and canal configuration system exists among maxillary and mandibular premolar teeth (AU).

Clinical Competence of Undergraduate Dental Students in Pediatric Dentistry at a Saudi Dental School

ABSTRACT Objective: To assess the clinical competence of undergraduate dental students in pediatric dentistry at Qassim University dental school. Material and Methods: A retrospective audit of students' clinical competency sheets of fourth and fifth-year students (n= 102) over two years was performed. Mean competency scores for each clinical procedure aswell as overall scores of the students were compared according to their academic level and gender. Also, the percentage of competent students was compared according to the academic level. Chi-square and t-tests were used to analyze the data (p<0.05). Results: Compared to fifth-year students, fourth-year students were significantly more competent in pediatric dentistry (100% scored >50% overall compared to 86.9 % of fifth-year students). They had significantly higher mean overall scores (84.63 ± 9.15 compared to 67.68 ± 13.83) as well as individual scores in performing an examination, diagnosis, and treatment planning of a child patient, restorations, and stainless steel crowns than fifth-year students. In addition, females had significantly higher mean scores in the aforementioned procedures and in placing esthetic crowns (p<0.05). Conclusion: Fourth-year dental students at Qassim University were more competent clinically than fifth-year students in pediatric dentistry. Also, in most of the shared procedures, females were more competent than males. A deficiency in the competence of fifth-year students was noted in pulp therapy, stainless steel and esthetic crowns procedures, and these are currently being addressed.

Qualitative Analysis of Root Canal Treatments performed by Undergraduate Students: A Retrospective Study

ABSTRACT Objective: Toanalyze the technical quality of endodontic treatment carried out at the undergraduate dental clinics. Material and Methods: Random radiographic records of 92 patients' were selected who received endodontic treatment by the undergraduate students from June 2018 to July 2019. The quality of root canal filling was determined in relation to the adequate density, length, and taper. Statistical analysis was performed by using GraphPad (Prism 5), and to determine the association between different variables Chi-square test was used. Results: Adequate technical quality of canal obturation conducted by the undergraduate students was found in less than 65% of the cases. The frequency of adequate root canal taper was significantly greater in maxillary teeth (75%) as compared to mandibular teeth (33%); however, adequacy of acceptable density was found more in maxillary teeth (62%) as compared to mandibular teeth (55%).A statistically significant difference was seen in the quality of root canal fillings between anterior and posterior teeth (p=0.001). Conclusion: The root canal therapy performed by undergraduate students was less than optimum in terms of technical quality. Hence, it is suggested that the endodontic training courses delivered at pre-clinical and clinical levelsfor undergraduate students must be thoroughly revised.

Awareness, Knowledge, and Attitude of Saudi Students towards Basic Life Support: A Cross-Sectional Study

ABSTRACT Objective: To evaluate the knowledge and attitude in relation to basic life support (BLS) and cardiopulmonary resuscitation (CPR) skills among the dental undergraduates and interns in Sakaka, Saudi Arabia. Material and Methods: This cross-sectional study was undertaken between October 2019 and December 2019 in Sakaka, Saudi Arabia. One hundred and eighty randomly selected dental students aged over 18 years participated in the study. Their knowledge and attitude towards BLS were gathered through a questionnaire. Results: A total of 158 (out of 180) UG students and interns participated in this study, making the responses of 87.8%. The mean age of the participants was 24.6 years. The samples comprised 86 (54.4%) males and 72 (45.6%) females. The assessments showed that overall the participants had average knowledge towards BLS and CPR, with males responding significantly better than the females (p˂0.05). Furthermore, as students climb the academic ladder, their knowledge regarding BLS and CPR tends to rise. Also, their attitude was positive, and they were willing to receive CPR training. Conclusion: Attitude toward acquiring knowledge about CPR was very positive. However, their knowledge about the topic was average. Students should understand the importance of such skills and efficiently involve in these life-saving procedures.

Personnel Protective Equipment: Forgotten Protocol, Invigorated by COVID-19

Abstract Objective: To make the readers cognizant about the use of Personnel Protective Equipment (PPEs) and infection control practices which should always form a part of basic patient management and not arise with every emerging disease. Material and Methods: Authors personal clinical experiences and existing literature were summed up to infer relevant information related specifically to dentistry. A comprehensive review was done for the last 15 years in an attempt to explain the current state of understanding on the topic. Results: The authors have tried to compile the most probable reasons as to why PPEs have been a forgotten protocol, which can be enumerated as follows: decreased awareness, financial issues, boredom and lethargy, time constraints, unavailability, carelessness, and burnout due to long procedure and patient feeling discomfort/offended. Conclusion: COVID-19 being highly infectious, a dental clinic is a potential and genuine point of source for many new infections, and no confabulation is less to underline the importance of using PPEs during this pandemic or even otherwise.

Clinical Consequences of Untreated Dental Caries among Primary School Children: A Cross-Sectional Study

Abstract Objective: To evaluate the dental caries experience and clinical consequences of untreated dental caries (UDC) among primary school children of Al Jouf region, Saudi Arabia and to determine the correlation between dental caries experience and clinical consequences of UDC. Material and Methods: A 250 primary school children 6-7 years were recruited using systematic random sampling. The prevalence of dental caries in deciduous dentition was assessed by following WHO criteria using the dmft index and the clinical consequence of UDC was assessed with the pufa index. The pufa score was calculated cumulatively following the pufa diagnostic criteria. The Student's t-test was used to equate the mean dmft and pufa scores between boys and girls. The correlation between the dmft and the pufa scores was evaluated using Pearson's correlation coefficient (r), and the p-value was set at 0.05 for statistical significance. Results: Out of which 154 (61.60%) boys and 94 (37.60%) were girls. The mean (SD) values of dmft for boys reported to be 5.37 (± 3.31) and for girls 6.35 (± 3.27), which was statistically significant with gender (p<0.001). Statistically, significant mean values of pufa were 1.20 (± 1.37) in boys and 1.71 (± 1.58) in girls, respectively was observed (p<0.001). The Pearson correlation between dmft and pufa values showed a highly significant positive correlation among dmft and pufa values (r= 0.635, p<0.001). Conclusion: The present study revealed that high caries prevalence and experience of the clinical consequences of UDC in the primary dentition, and there was a strong positive correlation between dmft and pufa score values.

Assessment of Caries Spectrum of First Permanent Molars in 7- to 8-Year-Old School Children in Northern Saudi Arabia: A Cross-Sectional Study

Abstract Objective: To estimate caries spectrum in first permanent molars (FPMs) of 7- to 8-year-old children in Saudi Arabia using Caries Assessment Spectrum and Treatment (CAST) index, and examine the correlation between distributions of CAST codes among contralateral and opposite arches. Material and Methods: A cross-sectional survey was conducted of 7- to 8-year-old Saudi school children in Sakaka, Aljouf, Saudi Arabia. A total of 385 children were examined. CAST codes were determined for FPMs, and their distribution was analyzed using Spearman's rank correlation coefficient. Statistical significance was set as p<0.05. Intra-examiner reliability was determined using the unweighted kappa coefficient. Results: The results indicated most of the FPMs were scored as code 3 (enamel lesions) such as upper contralateral FPM 44.40% for right, 53.50% for left, respectively, and lower contralateral molars were 61.30% for right and 64.90% for left, respectively. It was also observed that upper FPMs had scored code 0 (sound teeth) more than that of lower FPMs. Serious morbidity (codes 6 and 7) and mortality (code 8) showed a low prevalence in FPMs. Strong correlations were observed between upper contralateral FPMs (r=0.586) and lower contralateral FPMs (r=0.567, p<0.001). Conclusion: A high prevalence of enamel caries lesions (code 3) was observed in FPMs; in addition, a strong correlation was present between upper contralateral FPMs and between lower contralateral FPMs.

Seroprevalence of Toxoplasma gondii and Neospora caninum in Dromedary camels ( Camelus dromedarius ) from Saudi Arabia / Soroprevalência de Toxoplasma gondii e Neospora caninum em camelos dromedário (Camelus dromedarius) da Arábia Saudita

Abstract Serological screening of 199 serum samples from Dromedary camels—from different cities in Saudi Arabia—was performed using enzyme-linked immunosorbent assay for detecting antibodies against two cyst-forming coccidian parasites, namely Toxoplasma gondii and Neospora caninum. Antibodies against T. gondii were detected in 68 (34.2%) samples, while those against N. caninum were present in 33 (16.6%) samples. The highest seroprevalence of T. gondii antibodies was reported in samples from Taif (51.2%), while the lowest seroprevalence was reported in samples from Riyadh and Hofuf (15.1%). The highest seroprevalence of N. caninum antibodies was reported in samples from Jizan (35.9%) while the lowest was reported in samples from Taif (2.4%). A total of 47 male and 21 female camels exhibited antibodies against T. gondii , while 19 male and 14 female camels showed antibodies against N. caninum . Concurrent detection of both T. gondii and N. caninum antibodies was observed in 18 camels. It has been demonstrated that T. gondii and N. caninum antibodies are prevalent in camels from different cities of the Kingdom of Saudi Arabia.

Resumo A triagem sorológica para a detecção de anticorpos para Toxoplasma gondii e Neospora caninum no camelo dromedário foi realizada investigando 199 amostras de soro coletadas em diferentes cidades da Arábia Saudita. As amostras foram testadas utilizando imunoensaios enzimáticos para a detecção de anticorpos de ambos os parasitas coccídeos formadores de cistos (Laboratórios IDEXX, Bommeli Diagnostics, AG, Berna, Suíça). Anticorpos contra T. gondii foram detectados em 68 (34,2%) amostras, enquanto 33 (16,6%) apresentaram anticorpos contra N. caninum. A maior soroprevalência de anticorpos contra T. gondii (51,2%) foi relatada em Taif, enquanto a menor soroprevalência (15,1%) foi relatada em Riyadh e Hofuf. A maior soroprevalência de anticorpos contra N. caninum foi relatada em Jizan (35,9%), enquanto a menor foi em Taif (2,4%). Um total de 47 machos e 21 fêmeas revelou anticorpos para T. gondii , enquanto 19 machos e 14 fêmeas revelaram anticorpos para N. caninum . A detecção de ambos os anticorpos contra T. gondii e N. caninum foi de 18 indivíduos. Foi demonstrado que os anticorpos contra T. gondii e N. caninum são predominantes em camelos de diferentes cidades do Reino da Arábia Saudita.

Oral Habits: Prevalence and Effects on Occlusion Among 7 to 13 Years Old School Children in Aseer, Saudi Arabia

Abstract Objective: To evaluate the prevalence of deleterious oral habits and its effect on occlusion in school going children from 7 to 13 years old, in Aseer region of Saudi Arabia. Material and Methods: A cross-sectional study was conducted by clinical examination for the total sample of 750, who were attending private/ government schools in Aseer region school. Students were selected by stratified cluster random sampling. Clinical findings of each oral habits, including assessment of malocclusion, were examined involving the following parameters, i.e., crowding, spacing, open bite, crossbite and deep bite. Logistic regression analysis was conducted. Results: Boys had 26.2 % of crowded teeth, while 16.3% of girls were found to have crowded teeth; the difference was found to be significant (p=0.002). Spacing was present in 26.4% of boys and 16.7% girls; a significant difference was found between the two (p=0.002). Sleep bruxism was observed more among male subjects than females with a statistically significant difference in detrimental habits (p<0.001). Those subjects having tongue thrusting are 1.264 times at more risk of having crowded teeth than those with no tongue thrusting. Conclusion: There was a high prevalence of malocclusion associated with harmful oral habits in children. This highlighted the need to implement programs of oral care and health education for preventive orthodontic treatment at an early age.

Prevalence of Peg-Shaped Lateral Incisors in Non-Syndromic Subjects: A Multi-Population Study

Abstract Objective: To evaluate the prevalence and gender-wise distribution of peg-shaped maxillary permanent lateral incisors among populations in Saudi Arabia representing different geographical locations (Saudi, Jordan, Egypt, Syria, Philippine, Pakistan, India and Bangladesh). Material and Methods: Panoramic radiographs of 9945 patients attending outpatient university dental clinics of College of Dentistry, Jouf University, Saudi Arabia between February 2014 and January 2018 were collected from the archives randomly. Two calibrated investigators examined the data, which were collected from the dental radiology department archives with prior permission from the authorities. The anomalies of maxillary lateral incisors (right and left) were investigated. Results: Among all geographic locations, the prevalence of peg laterals was more in males in comparison to females except in Pakistani and Philippine populations. Among the Saudi population, peg laterals' prevalence was more in case of right lateral incisor than the left incisor. Conclusion: A higher prevalence of peg laterals was found in Saudi. Conclusion: A higher prevalence of peg laterals was found in Saudi region, followed by Egypt. Among all geographic locations, the prevalence of peg laterals was higher in males than females except for Pakistan and Philippines populations. Among Saudi population prevalence of peg laterals was found to be higher in case of right lateral incisor when compared to the left.

What do Parents Know About Oral Health and Care for Preschool Children in the Central Region of Saudi Arabia?

Abstract Objective: To assess the knowledge level of parents from the central region of Saudi Arabia about oral health and care of preschool children and its relation with sociodemographic variables, parents' self-perception toward their dental health, importance of teeth, and frequency of dental visits. Material and Methods: A random sample of 754 parents participated in this cross-sectional study and completed an internationally accepted questionnaire. Chi-square test and logistic regression analysis were used to analyze the data (p<0.05). Results: Mean knowledge score of the parents was 4.8 (out of 11). Less than 20% of the parents were knowledgeable about the best position for tooth brushing, the concentration of fluoride in a child's toothpaste, timing of first dental check-up, and best time to give a sugary snack. Mothers, parents with high educational level and family income, parents with a positive attitude towards teeth and excellent self-perception of their dental health were significantly more likely to score higher (p<0.05). Conclusion: Knowledge of parents about oral health and care of preschool children in the central region of Saudi Arabia was deficient. Gender, education level of parents, family income, attitude about teeth and self-perception of parents' own dental health were factors, which influenced their knowledge. To improve parents' knowledge, health professionals' role should be improved, and TV commercials directed toward the areas, which had gaps in knowledge.

Prevalence of Dental Fluorosis in Saudi Arabia: A Meta-Analysis

Abstract Objective: To identify the prevalence of dental fluorosis in Kingdom of Saudi Arabia. Material and Methods: Literature search for the present study aimed to include all the relevant studies conducted in Saudi Arabia that reported prevalence of dental fluorosis. A literature search was done using keywords (dental, fluorosis, prevalence) using three databases (Scopus, PubMed, and Web of Science). Grey literature was also searched using Google Scholar and research gate. Literature was searched from 1939 till April 2020. The risk of bias was reported using JBI Critical Appraisal Checklist for Studies Reporting Prevalence Data. Twelve studies were included based on inclusive criteria. The only inclusive criteria were studies that were conducted among people living in Saudi Arabia, and studies that reported the prevalence of dental fluorosis. Samples from all age groups that reported prevalence of dental fluorosis were included. MedCalc statistical software was used to perform the analysis. Results: The overall prevalence of dental fluorosis was found to be 46.52%, 95 CI (26.52% to 67.12%). I2 value was reported 99.8%, 95 CI (99.78% to 99.83%), indicating high heterogeneity amongst the finding of studies. Funnel plots indicate the presence of a strong publication bias. Overall, we found some contrasting findings. One study reported prevalence of dental fluorosis as 0% and other with a comparatively large sample size found dental fluorosis to be 90.6%. Conclusion: The present study adds to the literature regarding dental fluorosis in Saudi Arabia by providing an overview of its prevalence. It is concluded that prevalence of dental fluorosis was a bit high. However, findings indicate publication bias. We did not account for severity of dental fluorosis. All the available data was analyzed to measure dental fluorosis prevalence without considering the sample size and sampling technique.

Oral Health-Related Quality of Life (OHRQoL) in Patients with Dental Prosthesis

Abstract Objective: To determine the Oral Health-Related Quality of Life (OHRQoL) for post-treated fixed dental prostheses in selected sample of patients. Material and Methods: 120 patients treated with fixed dental prostheses, either single crowns or fixed partial dentures in maxillary or mandibular arches were asked to express their views about their quality of life. Patients' files were randomly selected from the archives of Department of Prosthetic Dental Sciences, College of Dentistry, Jouf University, Saudi Arabia. For this purpose, a self-structured questionnaire was prepared and their responses recorded. The responses were categorized on a 5 point scale and frequencies calculated. Results: Of 120 patients approached, 79 responded with the mean age group of 37 years. From the survey, it was noted that only three variables were statistically significant, those relating to the importance of natural teeth over fixed prostheses (p=0.046), the ability to chew all kinds of foods (p=0.021) and satisfaction with the occlusion (p<0.001). Conclusion: Oral health remains important, which directly or indirectly is related to many systemic diseases. In the present study, the majority of patients were satisfied with the treatment given.

Getting to Know SARS-CoV-2: Towards a Better Understanding of the Factors Influencing Transmission

Abstract In November 2002, a virus known as SARS-CoV was identified in Guangdong, China, and it was implicated as the etiology of severe acute respiratory syndrome. Seventeen years later, in the same month of November, a similar disease with more dramatic outcomes was identified in neighboring Wuhan. It has been six months since the identification of first cases of COVID-19 pandemic; however, unveiling clinical characteristics and modes of transmission of the disease are taking longer than expected. This overview aims to highlight some important points regarding the mode of transmission for which continuously surprising facts are being revealed every day. We also raise some vital questions to alert the scientific community to find the right answers and minimize the drastic fatal outcomes of this disease. It can be stated that SARS-CoV-2 could be transmitted as aerosol infection as well as through contacting infected surfaces. The possible role of abdominal gases as a route of spread of the virus should be considered and a fecal sample might be a useful diagnostic tool. Moreover, medical face masks are not protective from virus transmission during treating COVID-19 patients in settings where aerosol-generating procedures are performed. Doffing of PPE for healthcare workers needs more attention as this might be a source of infection unless additional measures of PPE disinfection are employed before doffing.

Challenges of Autism Spectrum Disorders Families Towards Oral Health Care in Kingdom of Saudi Arabia

Abstract Objective: To assess the knowledge, attitudes, and practice regarding oral health care among parents of autistic children and also the challenges faced by them in providing dental care for their Autism Spectrum Disorders (ASD) children's in four regions of Kingdom of Saudi Arabia. Material and Methods: In total, 263 parents of autistic children participated in this cross-sectional study who were enrolled from 4 major regions of Kingdom of Saudi Arabia. A self-administered questionnaire formulated in simple Arabic was distributed to parents of children diagnosed with autism or any form of ASD. The questionnaires consisted of demographic questions and also to assess their knowledge on oral health, child's oral hygiene practices and visits to their dentist, oral hygiene, experience and challenges in waiting room area before the dental treatment, acceptance of treatment or rejection, accessibility to find non-dental centers either government or private for treatment and their recommendations. Results: All the parents brushed their child's teeth using a toothbrush and fluoridated toothpaste. A total of 29.7% of the parents informed that their child never brushes teeth. A total of 41.4% of the parents visit the dental clinic when the child complains about dental problems and 54% find difficulty in locating appropriate dental clinic to deal with their ASD children. Most parents reported taking their child to a private office (38.8%). Only 3.8% of parents reported that their children had seizures during dental procedures. Conclusion: The knowledge toward oral health was found to be inadequate among the majority of the parents. Parents of ASD children need to be educated about the consequences of oral health neglect and the importance of regular check-ups.

Knowledge of Primary School Teachers Regarding Dental Trauma Management in Hail Region, Saudi Arabia

Abstract Objective: To evaluate the knowledge of elementary school teachers about the management of dental trauma. Material and Methods: An observational study, with the cross-sectional design, was conducted among primary school teachers in Hail, Saudi Arabia during January 2017. The questionnaire distributed among 400 primary school teachers from 18 different schools using convenient sampling. Data were gathered and analyzed using SPSS version 20 Results: 378 (94.5%) respondents to the questionnaire. It was found that only 37.8% of the primary school teachers were able to distinguish between the primary and permanent teeth. Only 59.5% reported starting the management of a child with trauma immediately. Merely 38.4% believed that it is important to search for the missing tooth or the broken pieces, whereas 31% would re-implant the permanent tooth into the socket by themselves. Regarding the storage media, only 16.6% respond correctly. According to school teachers, the best way of learning the management of dental trauma at school is through videos (36.2%) and phone application (33.9%) Conclusion: School teachers lack knowledge regarding the management of dental trauma. We strongly recommend planning for dental trauma educational based on the teacher's perception after pilot testing its effectiveness.

Discord Between the Facial and Maxillary Midline and Intermaxillary Midline Among the Population of Asir, Saudi Arabia

Abstract Objective: To determine the proportion of Saudi population in the Asir region that displayed discordance between the facial and maxillary midline and intermaxillary midline, to form an informative guideline for esthetic rehabilitation of patients. Material and Methods: We evaluated 2418 Saudi citizens using positioning guides of the orthopantomography machine to record the relationship of the dental midline to the facial midline. The relationship of the maxillary midline to that of the mandible was observed clinically, and diagnostic mounting of particular cases was performed for confirmation. The examination was carried out by four trained observers (two dentists and two radiology technicians) to overcome the parallax effect. The cases with disagreements were repeated. The record was grouped into (1) coincidence, (2) deviation of the mandible to the right, and (3) deviation to the left. The relationship between facial-dental midline concordance and intermaxillary concordance was assessed using the Chi-squared test Results: Facial and maxillary midline did not coincide in 42.5% participants, whereas intermaxillary midline discordance was observed in 51.5%. Among those exhibiting discordance, 57% had right discordance and 43% had left discordance Conclusion: A significant proportion of the population displayed discordance between the facial-maxillary midline as well as the intermaxillary midline. The female population showed not only a higher number of intermaxillary discordance than males but also a significant number of intermaxillary discordance towards the right.

Prevalence of hypercementosis in a saudi arabian population: a cone beam computed tomography study

Objective: to determine the prevalence of hypercementosis in a Saudi Arabian population. material and methods: a total of 642 CBCT scans from patients comprising 4471 teeth were incorporated in the study sample. all teeth were analyzed for the presence of hypercementosis in sagittal, axial and coronal plains by two qualified and experienced observers. the characteristics of the involved tooth in terms of gender, jaw and location were recorded from the CBCT scans. the obtained data were statistically analyzed using SPSS 21.0. the reliability of measurements was evaluated by kappa statistics. results: out of total 642 subjects hypercementosis was observed in 31 patients (4.82 percent) and 43 teeth (0.96 percent). Eight (2.68 percent) maxillary 1st molars, 6 (1.88 percent) mandibular 1st molars, 5 (1.46 percent) maxillary second molars, 7 (1.95 percent) mandibular 2nd molars, 9 (4.76 percent) maxillary 3rd molars and 8 (3.58 percent) mandibular 3rd molars were observed to have hypercementosis. among males, 4.76 percent were affected with hypercementosis as compared to 4.86 percent of females (p=0.97). likewise, no significant difference in the occurrence of hypercementosis was observed between maxillary and mandibular arches or between sides (p>0.05). conclusion: the prevalence of hypercementosis in a Saudi population was found to be 4.82 percent with respect to patients and 0.96 percent with respect to teeth. No significant propensity for gender, jaw and arch side was noted.