Effect of Maxillary Expansion on the Maxillary Arch Width in Patients with Bilateral Cleft Palate: A Review.

OBJECTIVES: To perform a comprehensive review of the literature to compare the effects of slow maxillary expansion (SME) and rapid maxillary expansion (RME) on maxillary arch width in patients with bilateral cleft palate. METHODS: The databases include Medline, PubMed, Cochrane (CENTRAL) and (CDSR), OpenGrey, and ClinicalTrials.gov were searched for relevant studies that met the eligibility criteria published before or on 31 October 2022. The search was confined to the English language. The selection of eligible studies and collection of data were performed independently. Risk of bias assessment was conducted using the Cochrane Risk of Bias tool 2.0. RESULTS: Two randomized controlled trials were available based on the search in the published literature. Both studies compared arch width between SME and RME in cleft palate patients and digitals casts and three-dimensional images used for the evaluation. A moderate risk of bias was evident in the available studies. CONCLUSIONS: Both SME and RME can achieve similar amounts of maxillary expansion in patients with bilateral cleft palate.

A retrospective assessment of the dental malpractice cases filed in Riyadh from 2009-2015.

Introduction: Malpractice is one of the most significant hazards to patient safety in healthcare and is considered the second factor associated with the overall quality of the healthcare system. Aims and Objectives: This study aimed to assess the prevalence of malpractice in dentistry and its possible causes in Riyadh, Saudi Arabia during 2009-2015. Methodology: A cross-sectional retrospective analysis of the dental complaints filed by the patients in the general directorate of forensic medicine centers in Riyadh was reviewed, and the data was collected. Descriptive statistics of frequency distribution and percentages were calculated using the collected data. The Chi-square test for categorical variables was performed with a significance level set at P < 0.05. Results: The Riyadh region reported 168 (14.5%) dental malpractice cases during 2009- 2015. The highest number of malpractice cases was reported in 2010 (18.45%), and the least number of cases was reported in 2011 (10.1%). Prosthodontic specialty had the highest number of lawsuits (32.4%), followed by orthodontics (20.2%) and endodontics (15.8%). The Chi-square test showed no association between the different specialties and types of malpractice (P = 0.881) and between compensation and the type of malpractice (P = 0.832). Among the 114 cases, financial compensation was the most common retribution. Conclusion: Dental malpractice prevalence was high in the private sector, followed by the government and military sectors, with the highest number of cases registered against the prosthodontic specialty. Dental malpractice is a serious concern that can be prevented by fair and honest policies and thorough patient education.

The need for a Smart Phone Application to Facilitate Communication Between Deaf-Mute and Hearing-Impaired Patients and Dentists.

OBJECTIVE: This study aims to determine the difficulty of communication between deaf-mute and hearing-impaired individuals, and their dentists and the need for an application to facilitate communication. MATERIALS AND METHODS: This is a cross-sectional study. A self-reported questionnaire was distributed among individuals with hearing disability. We measured demographic data, deaf-mute and hearing-impaired patients experience at the dental office, their interest and ability to use modern means of communication, and their willingness to use smartphones, tablets or computers to communicate with their dentists. Fisher's Exact test was used to determine association between different variables with cut-off point (P < 0.05). RESULTS: 58.5% of individuals with deafness or hearing impairment have visited dental offices. 51% of individuals reported they could not understand their dentists during visits. 45.3% stated that their complaints were understood. 30.2% of the information given by dentists were clear to them and only 24.5% of individuals were given all necessary information. 73.58% of all individuals are willing to use mobile applications to facilitate communication if recommended by their dentists. CONCLUSIONS: Many individuals with hearing disability are facing difficulties in communication in the dental office. The majority of them are willing to use a mobile application to help them communicate better with their dentists.

Effectiveness of mechanical debridement with and without antimicrobial photodynamic therapy against oral yeasts in children with gingivitis undergoing fixed orthodontic therapy.

OBJECTIVE: The aim was to assess the effectiveness of mechanical debridement (MD) and antimicrobial photodynamic therapy (aPDT) against oral yeasts in children with gingivitis undergoing fixed orthodontic therapy (FOT). METHODS: Individuals undergoing orthodontic treatment were included. Patients were randomly divided into 2-groups. In the test-group, patients underwent MD with adjuvant aPDT; and in the control-group, patients underwent MD alone. Demographic information was recorded using a questionnaire. An ultrasonic scaler was used to perform MD and aPDT was done using methylene blue and visible light. In both groups, gingival index, unstimulated whole salivary flow rate and oral yeasts counts were measured at baseline and compared at 6-months' follow-up. Group comparisons were performed and P < 0.05 was selected as an indicator of statistical significance. RESULTS: Eighteen (10 males and 8 females) and 18 individuals (9 males and 9 females) were included in the test- and control groups. The mean age of individuals in the test and control groups were 16.6 ± 0.5 and 16.8 ± 0.4 years, respectively. At 6-months' follow-up, the GI was comparable among patients in the test- and control-group. In the test-group, the CFU/ml of oral yeasts were significantly higher at baseline compared with 6-months' follow-up (P < 0.05). In the control-group, there was no statistically significant difference in the CFU/ml of oral yeasts at baseline and 6-months' follow-up. CONCLUSION: aPDT is a useful adjuvant to MD in reducing whole salivary oral yeasts counts among adolescents undergoing orthodontic treatment. In the sort-term, MD with and without aPDT is useful in reducing GI in adolescents undergoing orthodontic treatment.

Massive Ascites Following Robot-Assisted Radical Prostatectomy and Extended Pelvic Lymph Node Dissection: A Case Report.

Background: Lymph leakage is regarded as one of the rare complications of major abdominal, pelvic, and thoracic surgeries. Lymphangiogram seems to be the principal diagnostic modality. Management strategies that have been shown in the literature range from conservative measures to surgical exploration. However, the rarity and diversity in the presentation of this complication have attributed to the lack of consensus and guideline on its management. Case Presentation: A 49-year-old obese man with prostate-specific antigen of 10 and preoperative Gleason score of 8 prostate cancer and initial staging of T3N0M0 has undergone robot-assisted radical prostatectomy and extended pelvic lymph node dissection with unilateral nerve sparing. Our patient was admitted with significant ascites on day 14 postoperative, which was confirmed on CT abdomen and initially managed with nutritional support and percutaneous drainage. A lipidiol lymphangiogram demonstrated lymphatic leakage near the right external iliac vein. While he was awaiting elective surgical exploration, he has had two further successive admissions with massive ascites, anemia and raised C-reactive protein with acute kidney injury. A laparoscopic exploration was performed with interventional radiology assistance to direct dissection to the site of leak. An abscess cavity was found and excised. The lymphatic leak tailed off to insignificance rapidly thereafter. Conclusion: Each case of lymphatic leakage seems to require an individualized approach according to the nature and severity of the lymphatic leak and patient condition. Although it is possible that the collection was infected lymphatic fluid, the position of the abscess cavity in proximity to the site where the lipidiol was seen to leak from the lymphatics suggests that it is possible that the lipidiol was the nidus for infection. Either way what is interesting is that the presence of the abscess caused prolonged and profuse lymphatic leakage.

Dental Arch Dimensions in Saudi Adults.

OBJECTIVE: The aim of this study was to investigate the arch dimensions (width, length, and depth) in Saudi Arabia. MATERIALS AND METHODS: 169 orthodontic models (73 males and 96 females) made of white stone were selected according to inclusion criteria. Measurement of arch dimensions was taken including width, length, and depth at different reference points. Differences between males and females were tested using independent samples t-test. RESULTS: The sample comprised subjects aged 18-33 years old. Most measurements showed higher values for males compared to females. Saudi males showed smaller intercanine widths compared to Caucasians and Southern Chinese but larger widths in females compared to Caucasians and smaller widths compared to Southern Chinese. Saudi males and females showed larger intermolar widths compared to Caucasians but smaller intermolar widths compared to Southern Chinese. For arch length, Saudis showed longer arches compared to Yemenis for both males and females but smaller palatal depths compared to Yemenis. CONCLUSIONS: Differences in intercanine width, intermolar width, and palatal length and depth were found between Saudis and other nationalities. Male and female participants had differences in most of the measurements.

The effect of using mobile applications for improving oral hygiene in patients with orthodontic fixed appliances: a randomised controlled trial.

OBJECTIVE: To investigate the effect of using mobile applications active reminders to improve oral hygiene in comparison to verbal oral hygiene instructions. DESIGN: Two-arm parallel randomised controlled trial. SETTING: orthodontic clinics at two branches of a university hospitals of the college of dentistry of Riyadh Colleges of Dentistry and Pharmacy, Riyadh, Saudi Arabia. PARTICIPANTS: Forty-four 12-year-old and older subjects. METHOD: Subjects undergoing orthodontic treatment with fixed appliances were randomly assigned to one of two groups using simple randomisation. Group I: subjects received a mobile application that sends active reminders of oral hygiene three times a day (n = 22). Group II: subjects received verbal oral hygiene instructions verbally during their routine orthodontic visits (n = 22). Two primary outcomes were assessed using plaque index (PI) and gingival index (GI) for Ramfjord teeth to evaluate the level of oral hygiene at baseline and after 4 weeks. RESULTS: Mean differences for PI and GI for group I were reduced from T1 to T2 (P < 0.05, P < 0.05) but did not significantly change for group II (P > 0.05, P > 0.05). Both PI and GI significantly reduced for group I compared to group II between T1 and T2 (P < 0.05, P < 0.05). CONCLUSIONS: PI and GI all significantly decreased after 4 weeks of using active reminders of oral hygiene instructions on mobile application compared to verbal oral hygiene instructions. The study was registered at clinicaltrials.gov with number: NCT03109769.