SARS-CoV-2 genome variations and evolution patterns in Egypt: a multi-center study.

A serious global public health emergency emerged late November 2019 in Wuhan City, China, by a new highly pathogenic virus, SARS-CoV-2. The virus evolution spread has been tracked by three developing databases: GISAID, Nextstrain and PANGO to understand its circulating variants. In this study, 110 diagnosed positive COVID-19 patient's samples, were collected from Kasr Al-Aini Hospital and the Children Cancer Hospital Egypt 57357 between May 2020 and January 2021, with clinical severity ranging from mild to severe. The viral genomes were sequenced by next generation sequencing, and phylogenetic analysis was performed to understand viral transmission dynamics. According to Nextstrain clades, most of our sequenced samples belonged to clades 20A and 20D, which in addition to clade 20B were present from the beginning of sample collection in May 2020. Clades 19A and 19B, on the other hand, appeared in the mid and late 2020 respectively, followed by the disappearance of clade 20B at the end of 2020. We identified a relatively high prevalence of the D614G spike protein variant and novel patterns of mutations associated together and with different clades. We also identified four mutations, spike H49Y, ORF3a H78Y, ORF8 E64stop and nucleocapsid E378V, associated with higher disease severity. Altogether, our study contributes genetic, phylogenetic, and clinical correlation data about the spread of the SARS-CoV-2 pandemic in Egypt.

Case Report: Ectopic third molar in the maxillary sinus with infected dentigerous cyst assessed by cone beam CT.

Ectopic development of teeth in nondental areas is uncommon, especially in the maxillary sinus. A panoramic radiograph is the routine diagnostic radiographic examination performed for this type of eruption, although cone beam computed tomography (CBCT) is highly recommended for further localization of the ectopic tooth and assessment of the characteristics of any associated lesion before a surgical procedure. We report a case of a 13-year-old female student who presented with purulent discharge posterior to the upper right second molar with a bad taste and foul odour. Radiographic examination revealed a maxillary third molar tooth located at the posterosuperior aspect of the right maxillary sinus with a hyperdense lesion surrounding the crown, obliterating the sinus cavity. Both the tooth and dentigerous cyst were surgically removed under general anaesthesia through Caldwell-Luc antrostomy. After a three-month follow-up, the patient was symptom free and had an uneventful recovery. The rare and critical location of the reported third molar along with the infected dentigerous cyst indicates its complete enucleation to avoid complications as recurrence or malignant transformation.

Case Report: An association of the gubernacular canal, supernumerary tooth and odontoma with an impacted canine on cone-beam computed tomography.

This report describes a clinical case of asymptomatic compound odontoma in the anterior left side of the maxilla associated with an impacted canine and supernumerary tooth with a gubernacular canal of a 47- year-old female with no relevant medical history. Cone-beam computed tomography (CBCT) was performed for precise three-dimensional localization of each structure and assessment of their spatial relationship with the associated structures before surgery. The treatment protocol involved surgical enucleation of the odontoma and open extraction of both impacted and supernumerary teeth. The patient had uneventful healing and proceeded with the prosthodontic treatment plan. The dentist should be aware of the probability of a close relationship between the development of odontoma and presence of the gubernacular tract, which could be used as a future radiographic diagnostic criterion of an odontoma. Also, we recommend that more studies be performed in this field to deeply analyze the imaging characteristics of GT and its spatial association with various pathological lesions in the future.

Relationship of Mandibular Ramus Dimensions to Lower Third Molar Impaction.

OBJECTIVES: The aim of this study was to investigate the mandibular ramus features that could contribute to the etiology of mandibular third molar impaction. MATERIALS AND METHODS: Two hundred and forty subjects were divided into two groups: impacted group: 115 subjects presented with an impacted mandibular third molar, and control group: 125 subjects with the normal mandibular third molar eruption. Digital panoramic radiographs were used, and four angular and twelve linear measurements were done. Comparisons between groups were done using Student's t-test. Pearson correlation and linear regression tests were used to assess the degree of relationship between retromolar space and mandibular measurements. RESULTS: Control group showed significant greater measurements in most of the variables, whereas the impacted group showed significant larger gonial angle and larger inclination of lower posterior teeth than the control group. Significant correlations were found between retromolar space and coronoid height, ramal heights, ramus notch depths, the inclination of lower posterior teeth, and retromolar space/3M width ratio in both groups. CONCLUSION: The present study found that the configuration of the mandibular ramus appears to be discrete in many aspects in the erupted other than impacted lower third molars subjects, which might be a possible cause for the impaction.

A Retrospective Analysis of Radiographic Jaw Findings in Young Women; Prevalence and Predictors.

AIMS AND OBJECTIVES: To determine the prevalence and types of jaw pathologic findings as detected in panoramic radiographs of a sample of young women attending a teaching hospital in Al Madinah Al Munawarah, Saudi Arabia, and to determine the most important factors that predict the occurrence of jaw pathologic findings. MATERIALS AND METHODS: The electronic clinical files of a representative sample of female patients who attended the outpatient dental clinics were retrieved. Patients were aged 18 to 25 years. Types of pathologic radiographic jaw findings and their prevalence were determined through screening of panoramic radiographs. Data were analyzed using the statistical analysis software [SPSS version 21 (IBM Corp.)]. Multiple linear regression was used to explore the significance of some types of dental lesions as predictor variables for the occurrence of jaw pathologic findings. RESULTS: A total of 190 patients (mean age, 22.4 ± 2.46 years) were included in the study. Periapical lesions, retained roots, and alveolar bone loss were detected in 53.6%, 24.8%, and 17.4% of the participants, respectively. Other odontogenic abnormalities such as supernumerary and impacted teeth (6.4% and 33.7%, respectively) were also detected. Patients' age was found to be a good predictor for alveolar bone loss and number of periapical lesions (P ≤ 0.05). CONCLUSIONS: A high prevalence of periapical lesions, retained roots, and alveolar bone loss was found among a sample of young female dental attendees, as shown by their panoramic radiographs. Further studies are needed to explore potential risk factors for such a noticeable trend of poor oral health, and the needed strategies to counteract this trend.

Incidental cone beam computed tomographic findings among Taibah University patients, KSA: A retrospective study.

OBJECTIVES: The aim of this study was to retrospectively evaluate the prevalence, type, and location of incidental findings by cone beam computed tomography (CBCT) scans. This study was performed to diagnose dental problems in the female population at Taibah University Dental Clinics (TUDC), KSA. METHODS: A series of 150 consecutive CBCT scans were identified between January 2014 and February 2016. The record was retrieved from the Carestream (CS) R4 Clinical and Practice Management Software database of TUDC. We retrospectively assessed them for incidental findings and then summarized and categorized them into five anatomical regions: nasopharyngeal airway, temporomandibular joint (TMJ), paranasal sinuses, dental findings, and alveolar bone region. We then analysed the frequency and percentage of findings in each category. RESULTS: A total of 248 incidental findings were reported in 83 of 90 scans (2.76 findings/scan). The prevalence of all incidental findings was 92.2%. The most common incidental findings were located in the paranasal sinuses and alveolar area, each representing about a quarter (27.4%) of all of the findings. Other common findings were in the TMJ (22.9%), followed by those in the nasopharyngeal airway (10.9%), dental area (10.5%), and others (0.8%). CONCLUSION: This study confirms the high prevalence of incidental maxillofacial findings as shown by CBCT scans in a sample of female patients at TUDC. This emphasizes the need to thoroughly examine CBCT volumes for clinically significant findings inside and beyond the region of interest for the benefit of patients and the protection of practitioners.

Radiographic assessment of impacted teeth and associated pathosis prevalence. Pattern of occurrence at different ages in Saudi male in Western Saudi Arabia.

OBJECTIVES: To assess the prevalence of both impaction and associated pathosis in a Saudi population in Al-Madinah, Saudi Arabia based on digital panoramic radiographs. METHODS: This study was carried out from December 2013 to February 2015. Panoramic radiographs of 359male patients attending the Oral Diagnosis Clinics, Faculty of Dentistry, Taibah University, Al-Madinah, Saudi Arabia were reviewed. All images were evaluated to determine the prevalence and pattern of impacted third molars and canines, and associated pathosis. RESULTS: Among 359 panoramic radiographs examined, 124 patients had impacted teeth. The impacted mandibular third molars were the most prevalent impacted teeth, 77.6% had class II pattern of impaction. Among the impacted maxillary canines, 75% were mesioangular and among 66 impacted maxillary third molars, 63.6% had class C. Our study showed that 5.8% of Saudi patients had 3 or more impacted teeth, 13.1% had 2 impacted teeth, and 15.6% had one impacted tooth. Associated pathosis was found in 18.2% among impacted maxillary third molars, and 31.5% among impacted mandibular third molars. The incidence of impaction decreases with age.  CONCLUSION: The prevalence and pattern of impacted third molars among Saudis are almost similar to other racial populations. The number of missing wisdom increases with age. Although the percentage of pathosis associated with impaction was considerably low, it is essential to carry you regular oral examinations to preserve asymptomatic impacted teeth in good health.