Optimizing Osseointegration in Dental Implantology: A Cross-Disciplinary Review of Current and Emerging Strategies.

The paper explores the correlation between osteointegration and dental implant stability, investigating the relationship and its implications for successful outcomes in implant dentistry. Osteointegration, defined as the direct structural and functional connection between living bone and the implant surface, plays a crucial role in determining the stability and long-term success of dental implants. This review synthesizes current knowledge from scientific literature and clinical studies to elucidate the factors influencing osteointegration and their impact on implant stability. Surface characteristics of implants, such as topography and chemistry, as well as the surgical techniques employed during implant placement, are examined in detail, emphasizing their significant influence on osseointegration and subsequent implant stability. Additionally, host-related factors such as bone quality, systemic conditions, and patient-specific considerations are explored to further comprehend the complexity of the osteointegration process. The abstract underscores the importance of achieving an optimal bone-implant interface to ensure successful implant integration and stability. Furthermore, emerging technologies and materials, such as computer-guided implant placement and biomimetic surfaces, are discussed for their potential to enhance osteointegration and improve long-term implants.

One of the First Cases with PIK3CA-related Overgrowth Spectrum (PROS) in Saudi Arabia: A Case Report and Literature Review.

PIK3CA-related overgrowth spectrum (PROS) is an umbrella that includes a broad range of rare disorders, ranging from isolated digit enlargement to extensive overgrowth of the limbs, abdomen, or brain. One of these disorders is megalencephaly capillary malformation polymicrogyria syndrome (MCAP), which is characterized by cutaneous capillary malformations, megalencephaly, cortical brain malformations, abnormalities of somatic growth with body and brain asymmetry, developmental delay, and characteristic facial dysmorphism. The diagnosis of PROS syndrome is based on the clinical features of a patient and confirmed by a pathogenic variant in one PIK3CA allele in a biopsy of the affected tissue. However, MCAP may be diagnosed by testing a blood or saliva sample. The management of patients with MCAP syndrome includes evaluation after the initial diagnosis, treatment of manifestations, and surveillance for potential complications. To date, there is no curative treatment for patients with MCAP syndrome. Therefore, reporting such cases will help us understand them and thus develop an appropriate treatment for them. Our patient was a 46-month-old boy, who is diagnosed with MCAP syndrome. The diagnosis was based on clinical presentation, imaging studies, and whole-exome sequencing (WES). Clinically, the patient had speech and developmental delay, macrocephaly, joint hyperlaxity, unsteady gait, and subtle dysmorphic facial features. The facial features include low-set ears, frontal bossing, depressed nasal bridge, and bilateral esotropia. MRI studies showed megalocephaly, bilateral perisylvian polymicrogyria, bilateral peri-regional, high T2 signal intensities, and cerebellar tonsil ectopia with crowding of the posterior fossa. Finally, the diagnosis was confirmed by WES, which detected changes in the PIK3CA gene. The patient is on overgrowth protocol for PIK3CA, which includes alpha-fetoprotein and abdominal ultrasound every three months until the age of eight years. To the best of our knowledge, this is one of the first cases of PROS in Saudi Arabia, which illustrates the classical findings of MCAP syndrome. Further studies and investigations on PROS syndrome are needed to aid in making a definitive classification and treatment of such complex and rare diseases.

Perception and attitude of the general population towards Alzheimer's disease in Jeddah, Saudi Arabia.

There are many conflicting beliefs about Alzheimer's disease in the general population. Conducting a study on public awareness, attitude, and knowledge towards Alzheimer's disease is useful in decreasing discrimination and stigmatization. This study aims to determine the public perception and attitude towards Alzheimer's disease in Jeddah, Saudi Arabia. In addition, we aim to identify the religious and cultural beliefs about the causes and treatment of Alzheimer's disease in Saudi Arabia. This is a cross-sectional study that was conducted in malls and public places in Jeddah, Saudi Arabia. The instrument used in this study was a self-administered questionnaire that consists of 40 items. A total of 32 questions were included into the survey, which was subdivided into four sources of information that include general information about Alzheimer's disease, information about Alzheimer's disease in the society, general information about persons with Alzheimer's disease, and information about the care of persons with Alzheimer's disease. In addition, eight questions were used to collect information about the demographic profile of the participants. A total of 1698 individuals participated in the study. 1511 participants (89%) had heard about Alzheimer's disease before. Around 46% of the participants think that the cause of Alzheimer's disease is a brain disease and 44.9% think that is a normal part of aging. Approximately, 30% of the participants believe that Alzheimer's disease is treated with medications and 24.6% believe that there is no treatment. Around 30% of the participant think that the society treats persons with Alzheimer's disease with stigmatization. More than half of the participants (56.2%) think that persons with Alzheimer's disease should not be admitted to the nursing home. The results of the present study suggest that the perception of the general public of Alzheimer's disease is lagging behind. Many wrong beliefs were identified in the general public regarding the causes and management. The findings of our study suggest that more information about Alzheimer's disease would be valuable and beneficial for everyone. Awareness campaigns and public education are needed to increase the knowledge of the general public regarding several aspects of the disease including prevention, causes, and management. Dissemination of information about Alzheimer's disease should be of high priority. Increased awareness will lead to earlier detection of Alzheimer's disease and other dementia cases and appropriate care and management of those persons.

Clinicoradiological Discrepancy in Multisystem Langerhans Cell Histiocytosis with Central Nervous System Involvement.

Langerhans cell histiocytosis (LCH) is a rare neoplasm that is caused by an uncontrolled proliferation of Langerhans cells. The clinical presentation of LCH is heterogeneous and can manifest as single or multiple osteolytic lesions, skin ulcerations, and involvement of single or multiple systems. Central nervous system (CNS) involvement is reported in 3.4-57% of patients with multisystem disease. In this article, we present the case of a young man with single system involvement (bone) of LCH who presented with seizures, headache, papilledema, and tinnitus. His magnetic resonance imaging (MRI) of the brain findings were reported as a normal study. The subtle signs of CNS involvement were missed by the radiologist. However, the high index of suspicion resulted in early diagnosis and treatment. The presence of empty sella turcica in neuroimaging could be the first sign of intracranial disease with chronic intracranial hypertension associated with LCH. This is especially correct if previous computed tomography (CT) scan of the brain was normal with normal appearance of the pituitary gland and the sella. Neuroimaging films should be reviewed by an expert neuroradiologist. In patients with new neurological symptoms who were diagnosed previously with LCH, intracranial disease has to be excluded. The workup in such case should include an MRI of the brain, CT of the brain and temporal bones, bone scan, cerebrospinal fluid analysis, ophthalmological assessment, and measurement of intracranial pressure. In patients with LCH who present with symptoms and signs of raised intracranial pressure, the term idiopathic intracranial hypertension should not be applied until an intracranial disease has been excluded totally. Keywords: Langerhans Cell Histiocytosis; Central Nervous System Involvement; Neuroimaging; Intracranial Hypertension.

Unethical human research in the field of neuroscience: a historical review.

Understanding the historical foundations of ethics in human research are key to illuminating future human research and clinical trials. This paper gives an overview of the most remarkable unethical human research and how past misconducts helped develop ethical guidelines on human experimentation such as The Nuremberg Code 1947 following WWII. Unethical research in the field of neuroscience also proved to be incredibly distressing. Participants were often left with life-long cognitive disabilities. This emphasizes the importance of implicating strict rules and ethical guidelines in neuroscience research that protect participants and respects their dignity. The experiments conducted by German Nazi in the concentration camps during WWII are probably the most inhumane and brutal ever conducted. The Nuremberg Code of 1947, one of the few positive outcomes of the Nazi experiments, is often considered the first document to set out ethical regulations of human research. It consists of numerous necessary criteria, to highlight a few, the subject must give informed consent, there must be a concrete scientific basis for the experiment, and the experiment should yield positive results that cannot be obtained in any other way. In the end, we must remember, the interest of the patient must always prevail over the interest of science or society.