Childhood absence epilepsy: Electro-clinical manifestations, treatment options, and outcome in a tertiary educational center.

Purpose and Background: To evaluate the electro-clinical manifestations and outcomes of children with absence epilepsy at a tertiary center in Saudi Arabia. Methods: This retrospective study reviewed the medical and EEG records of patients who were diagnosed to have CAE as per the International League Against Epilepsy (ILAE) definition for CAE. The study was conducted in the pediatric neurology clinic of King Khalid University Hospital, King Saud University Medical City, Riyadh, Saudi Arabia, between January 2000 and December 2019. Patients who did not meet (ILAE) criteria, lost follow-up, and those who did not receive treatment at KKUH were excluded. Data regarding the patient's disease, electro-clinical manifestations, anti-seizure medication response, and outcomes were collected. Results: A total of 35 patients, with an average age at diagnosis of 7 ± 2.1 y, were included in the study; among them, 51.4% were female and approximately 48.6% presented with a family history of epilepsy. Regarding clinical features, all patients experienced staring and altered awareness, 94.2% had less than 20 spells per day at the time of diagnosis, and 65.7% were provoked by the hyperventilation test. Regarding EEG findings, all patients had bilateral, symmetrical, and synchronous discharges in the form of regular 3 Hz spike-and-wave complexes, and 94.3% had a generalized initial ictal discharge. Also, 22.8% had eye fluttering with electrographic seizures. Ethosuximide (ESM) was used as the drug of choice in 45.7% of the patients. Regarding clinical outcomes, 94.3% had their disease clinically controlled, and 80% had a normalized EEG after few months of starting anti-seizure medication. Finally, 37.2% experienced complete remission of epilepsy after 3-5 y; however, one patient developed juvenile myoclonic epilepsy. Conclusion: This study described the electro-clinical manifestations of patients with childhood absence epilepsy and outcomes. Furthermore, early diagnosis and prompt treatment of childhood absence epilepsy improve treatment outcomes.

The current considerations in the fabrication of implant prostheses and the state of prosthetic complications: A survey among the dental technicians.

PURPOSE: To investigate the current considerations in the fabrication of dental implant prostheses (DIP) and the state of prosthetic complications from the dental technicians (DT) perspective. METHODS: A self-designed pretested questionnaire and an informed consent were distributed to 150 certified DT working in dental laboratories of Riyadh, KSA. The demographic data, questions related to the implant fixed/removable prostheses and questions on the prosthetic complications related to the DIP were collected. Descriptive statistics and Chi-square test were used for statistical analysis, considering a P-value of <0.05 using SPSS. RESULTS: 130 responses (response rate 83.6%) were received. 53% (n = 69) of the DT received job orders for DIP from >20 dentists. 49% (n = 64) of dentists took the leading role in the treatment planning/designing. 48% (n = 62) and 52% (n = 68) of requests were for Cement and Screw retained DIP respectively. Custom abutments 37% (n = 49) choice of abutments. Porcelain fused to metal (PFM) 34% (n = 44) and PFM with metal occlusal surface 55% (n = 71) were material of choice. 49% (n = 64) designing of implant overdentures were according to the dentist's instructions with Ball and Socket 48% (n = 63) to be the most common attachment. DT regarded poor implant location/orientation 38% (n = 49) and inaccuracies in impression/bite-registration 40% (n = 52) as the obstacles to success. Half 50% (n = 65) of the repairs were for facing damage/chipping of ceramic. Fracture of the denture base/tooth detachment 50% (n = 65) was common with implant over dentures. CONCLUSIONS: DT played a role and took decisions regarding the DIP. Frequent problems found by DT were poor implant location, discrepancies in impression/bite-registration, facing damage/chipping and damage/fracture of the denture base/prosthetic teeth. The frequency of these complications can be minimized by an increase in the prosthetic knowledge of the dentists and establishing clear protocols for communication between the dentist and the DT.

Esthetic outcome for maxillary anterior single implants assessed by different dental specialists.

PURPOSE: The aim of this study was to assess the esthetic outcome of maxillary anterior single implants by comparing the esthetic perception of dental professionals and patients. MATERIALS AND METHODS: Twenty-three patients with single implants in the esthetic zone were enrolled in this study. Dentists of four different dental specialties (Three orthodontists, three oral surgeons, three prosthodontists, and three periodontists) evaluated the pink esthetic score (PES)/white esthetic score (WES) for 23 implant-supported single restorations. The satisfactions of the patients on the esthetic outcome of the treatment have been evaluated according to the visual analog scale (VAS). RESULTS: The mean total PES/WES was 12.26 ± 4.76. The mean PES was 6.45 ± 2.78 and mean WES was 5.80 ± 2.82. There was a statistically significant difference among the different specialties for WES (P<.01) and Total PES/WES (P<.01). Prosthodontists were found to have assigned poorer ratings among the other specialties, while oral surgeons gave the higher ratings than periodontists, orthodontists, and prosthodontists. CONCLUSION: Prosthodontists seemed to be stricter when assessing aesthetic outcome among other specialties. Moreover, a clear correlation existed between dentists' and patients' esthetic perception, thereby providing rationales for involving patients in the treatment plan to achieve higher levels of patient satisfaction.

Causes of adverse pregnancy outcomes and the role of maternal periodontal status - a review of the literature.

Preterm (PT) and Low birth weight (LBW) are considered to be the most relevant biological determinants of newborn infants survival, both in developed and in developing countries. Numerous risk factors for PT and LBW have been defined in the literature. Infections of the genitourinary tract infections along with various biological and genetic factors are considered to be the most common etiological factors for PT/LBW deliveries. However, evidence suggests that sub-clinical infection sites that are also distant from the genitor-urinary tract may be an important cause for PT/LBW deliveries. Maternal periodontal status has also been reported by many authors as a possible risk factor for PT and LBW, though not all of the actual data support such hypothesis. The aim of this paper is to review the evidence from various published literature on the association between the maternal periodontal status and adverse pregnancy outcomes. Although this review found a consistent association between periodontitis and PT/LBW, this finding should be treated with great caution until the sources of heterogeneity can be explained.

Assessment of Osstell™ and Periotest® systems in measuring dental implant stability (in vitro study).

OBJECTIVES: The objectives of this in vitro study were to investigate the sensitivity and reliability of the Osstell™ systems (Resonance Frequency Analysis - RFA) compared to the Periotest® system in implant bone simulated conditions. Three conditions were simulated: (1) the direct fixture-bone contact and fibrous tissue fixture contact, (2) The different levels of horizontal bone loss, and (3) The hardening implant-bone interface. MATERIALS AND METHODS: Forty-nine dental implant fixtures were placed in the center of acrylic cubes. In Part I seven fixtures were placed in direct contact with acrylic and another seven were placed in contact with polyvinyl siloxane impression material as soft interface. Part II: four sets of 0, 2, 4 and 6 mm horizontally exposed fixture samples were made (seven fixtures in each set). Part III: seven fixtures were placed in contact with a thin mix of autopolymerizing resin. The stability of these fixtures was measured using Osstell™ and Periotest® systems. RESULTS: The mean Periotest® value(PTV) and Osstell™ measurements showed a significant difference between the direct contact and soft interface (P < 0.001). These values also showed statistically significant difference between the different levels of horizontally exposed fixture groups (P < 0.001). The level of horizontal fixture exposure was strongly correlated with the PTVS (r = 0.967) and strongly negatively correlated with Implant Stability Quotient (r = -0.946). A strong correlation was found between the Osstell™ readings and the change in the stiffness of the autopolymerizing resin fixture interface group (r = 0.986). CONCLUSIONS: Both Osstell™ and Periotest® systems proved to be sensitive in measuring dental implant stability in hard and in soft interfaces. Osstell™ also proved to be sensitive in detecting changes in the fixture interface stiffness. Osstell™ system proved to be more reliable compared to Periotest® system in measuring dental implant stability in hard and in soft interfaces.