Cigarette Smoking and Nicotine Dependence Among Dental Students in Riyadh, Saudi Arabia: A Cross-Sectional Study.

INTRODUCTION: Dental professionals have a vital role in promoting tobacco cessation interventions in dental care settings, and despite being aware of the detrimental effects of tobacco products on individuals' health, they are still engaged in using tobacco products. AIM: The aim of this study was to assess the prevalence of cigarette smoking and the level of physical and social nicotine dependence among undergraduate dental students in Riyadh, Saudi Arabia, using standardized tools to develop appropriate tobacco cessation interventions. METHODOLOGY: Dental students from six dental colleges located in Riyadh, Saudi Arabia, were invited to participate in this study. A total of 430 dental students agreed to participate by providing written informed consent. Physical dependence on nicotine was assessed using the Fagerstrom Test for Nicotine Dependence (FTND), and social dependency was assessed using the Kano Test Social Nicotine Dependence (KTSND). RESULTS: Among the 430 participants, 120 (27%) reported smoking. The level of nicotine dependence assessed for the 120 (27%) participants who had reported smoking using FTND showed 24 (20%) with high nicotine dependence and 18 (15%) with very high nicotine dependence. When compared between the genders, five (16%) of the female participants displayed high nicotine dependency, and two (6%) displayed very high nicotine dependency. Among the male participants, 19 (21%) displayed high nicotine dependency, and 16 (18%) displayed very high nicotine dependency. The study participants also displayed high KTSND scores, male participants with a mean score of 18.20 and female participants with a mean score of 17.97. CONCLUSION: Dental students, despite being the facilitators in tobacco prevention and cessation programs, have displayed a high prevalence of cigarette smoking and nicotine dependence. These findings should be considered for designing specific tobacco cessation programs for dental students, along with effective stress management programs. Emphasis should be placed on developing and implementing policies for creating supportive environments in educational institutions. Dental students should be trained and engaged in tobacco prevention and cessation intervention programs for their patients.

The role of Vitamin D as an adjunct for bone regeneration: A systematic review of literature.

Background and objectives: In spite of bone's healing capacity, critical-size bone defect regeneration and peri-implant osseointegration are challenging. Tissue engineering provides better outcomes, but requires expensive adjuncts like stem cells, growth factors and bone morphogenic proteins. Vitamin D (Vit.D) regulates calcium and phosphorus metabolism, and helps maintain bone health. Vit.D supplements in deficient patients, accentuates bone healing and regeneration. Therefore the aim of this systematic review was to evaluate the role of adjunctive Vit.D on bone defect regeneration. Methods: Comprehensive database search of indexed literature, published between January 1990 and June 2022, was carried out. English language articles fulfilling inclusion criteria (clinical/in vivo studies evaluating bone regeneration including osseointegration and in vitro studies assessing osteogenic differentiation, with adjunct Vit.D) were identified and screened. Results: Database search identified 384 titles. After sequential title, abstract and full-text screening, 23 studies (in vitro - 9/in vivo - 14) were selected for review. Vit.D as an adjunct with stem cells and osteoblasts resulted in enhanced osteogenic differentiation and upregulation of genes coding for bone matrix proteins and alkaline phosphatase. When used in vivo, Vit.D resulted in early and increased new bone formation and mineralization within osseous defects, and better bone implant contact and osseointegration, around implants. Adjunct Vit.D in animals with induced systemic illnesses resulted in bone defect regeneration and osseointegration comparable to healthy animals. While systemic and local administration of Vit.D resulted in enhanced bone defect healing, outcomes were superior with systemic route. Conclusions: Based on this review, adjunct Vit.D enhances bone defect regeneration and osseointegration. In vitro application of Vit.D to stem cells and osteoblasts enhances osteogenic differentiation. Vit.D is a potentially non-invasive and inexpensive adjunct for clinical bone regeneration and osseointegration. Long term clinical trials are recommended to establish protocols relating to type, dosage, frequency, duration and route of administration.

Effect of tongue piercing on periodontal and peri-implant health: A cross-sectional case-control study in adults.

OBJECTIVES: The authors hypothesize that periodontal and peri-implant inflammatory parameters are poorer in adult patients with tongue piercing compared with controls. The aim was to assess the influence of tongue piercing on periodontal and peri-implant health status in adults. METHODS: Test and control groups comprised of individuals with and without tongue piercing, respectively. A questionnaire was used to collect information about gender, age, duration of tongue piercing and implants in function, jaw location of the implant, reasoning for wearing the tongue ornament, and oral hygiene and ornament cleaning habits. Full-mouth and peri-implant plaque index (PI), gingival index (GI), clinical attachment loss (CAL), probing depth (PD) and marginal/crestal bone loss (MBL and CBL, respectively) on mesial and distal surfaces of teeth/implants were recorded. The material (plastic or metal) from which, the bar and ball-ends of the ornament were fabricated was also recorded. A p < 0.01 was considered statistically significant. RESULTS: Forty-eight and 49 individuals were included in the test and control groups, respectively. There was no difference in PI, GI, PD, CAL and MBL (mesial and distal) among individuals in the test and control groups. In the test group, peri-implant PI (p < 0.01), GI (p < 0.01), PD (p < 0.01) and mesial (p < 0.01) and distal (p < 0.01) CBL were significantly higher in the anterior mandible compared with implants in other jaw locations. In the control group, there was no difference in peri-implant PI, GI, PD and CBL around implants placed in both jaws. CONCLUSION: Wearing tongue piercings could increase the risks of periodontal and peri-implant diseases particularly in the mandibular anterior segment.

Combination of Levamisole with Prednisone in Treating Recurrent Major Aphthous Ulcer in a Young Boy: A Case Report.

Recurrent aphthous stomatitis (RAS) is an oral condition characterized by painful oral ulcerations. While the clinical features of this disease are easily defined, the etiology remains unclear. Thus, existing treatments are still unsatisfactory in reducing the severity, healing, and recurrence rate; however, there is no permanent and definitive treatment. Effective treatment for aphthous stomatitis is not available, and those treatments available mainly focus on suppressing its symptoms. We are reporting a case of a 17-year-old boy who presented with a 3-year history of multiple recurrent major ulcers in the oral cavity. Levamisole with steroids has been used in many clinical trials to treat aphthous ulcers, showing an improvement in pain, discomfort, healing time, and reduction in the number of ulcers. The same method was used to treat our patient, who showed promising results, with no recurrence for one year. Levamisole is a safe, easily tolerable and promising drug for the treatment of RAS.

Biosorption of oxybenzene using biosorbent prepared by raw wastes of Zea mays and comparative study by using commercially available activated carbon.

Organic pollutants present in waste water have undesirable effect on the environment. Industry activities are the key sources of organic pollutants. Prime pollutants released from various sources react instantly with the environment and become derived (secondary) pollutants, which stay for an elongated time. The present research work has been carried out using biosorbent prepared from various Zea mays wastes for elimination of oxybenzene. Different parameters viz contact time, initial concentration; adsorbent dose, temperature and pH were optimized for the biosorption of oxybenzene on to the biosorbent samples. BCS (Baby corn silk) showed higher percentage of biosorption at optimum contact time of 3 h, pH between 5 and 6 and temperature at 25 °C. Analysis of equilibrium biosorption data in terms of several isotherm models revealed that Langmuir isotherm and Freundlich isotherm indicates better agreement with the experimental data. The kinetics of oxybenzene biosorption on to the biosorbents was described with the pseudo-first-order model. Thermodynamic parameters indicated that biosorption onto biosorbent was feasible in nature, spontaneous, and endothermic for some biosorbents, but on contrary not feasible, exothermic and non spontaneous for other biosorbents. The result of this study showed that the biosorbent derived from Zea mays can be used as a prospective biosorbent for oxybenzene in wastewater and also can be an alternative for the commercially activated carbon.

An Uncommon Tooth Fusion of Mandibular Primary Lateral Incisor with Canine.

Fusion is a congenital disturbance affecting primary dentition mostly during morpho differentiation of the primary tooth germs. Fusion leads to the union of two or more primary teeth by the enamel and dentin while the pulp and roots remain separate. These abnormalities may be unilateral or bilateral. Prompt diagnosis and a treatment plan in such anomalies may help to overcome problems concerning aesthetics, caries susceptibility and space management. This report describes a case of unilateral fusion of the primary mandibular lateral incisor and canine and aims to evaluate any associated pathology.

Application and performance of artificial intelligence technology in forensic odontology - A systematic review.

Forensic odontology (FO) mainly deals with the identification of the individual through the remains, which mainly includes teeth and jawbones. Artificial intelligence (AI) technology has proven to be a breakthrough in providing reliable information in decision making in forensic sciences. This systematic review aimed to report on the application and performance of AI technology in FO. The data was gathered through searching for the articles in the renowned search engines, which have been published between January 2000 - June 2020. QUADAS-2 was adopted for the risk of bias analysis of the included studies. AI technology has been widely applied in FO for identifying bite-marks, predicting mandibular morphology, gender determination, and age estimation. Most of these AI models are based on either artificial neural networks (ANNs) or convolutional neural networks (CNNs). The results of the studies are promising. Studies have reported that these models display accuracy and precision equivalent to that of the trained examiners. These models can be promising tools when identifying victims of mass disasters and as an additive aid in medico-legal situations.

A Digital Cephalometric Study on The Morphometric Evaluation of Soft Palate in Oral Submucous Fibrosis.

OBJECTIVE: Oral submucous fibrosis (OSMF) is a chronic precancerous condition affecting the oral cavity, which is progressive and characterised by burning sensation and fibrotic change leading to restriction of mouth opening. This study evaluated the morphology of soft palate in different stages of OSMF patients using digital lateral cephalogram and compare it with healthy individuals. METHODS: The study included 60 subjects, who were grouped as 30 OSMF and 30 healthy subjects from the same geographic population. Digital lateral cephalograms were taken with Planmeca Proline XC (Oy, Helsinki, Finland). Soft palate morphology was evaluated using Lateral Cephalogram, and the results were analysed statistically. RESULTS: Leaf-shaped (Type 1) soft palate was commonly seen in the control group and stage I and II OSMF. Stage III OSMF patients presented with a butt-shaped (Type 3) soft palate. As the disease progressed, there was a conversion of Type 1 variety of soft palate to Type 3 variety. There was a gradual reduction in the length of the soft palate in the anteroposterior direction in OSMF patients compared to the control group. CONCLUSION: Early cephalometric diagnosis of soft palate changes may play a pivotal role in the overall management of OSMF.
.

Clinicoradiographic markers of peri-implantitis in cigarette-smokers and never-smokers with type 2 diabetes mellitus at 7-years follow-up.

BACKGROUND: It is hypothesized that in the long-term, (a) peri-implant inflammatory variables (plaque index [PI], bleeding on probing [BOP], probing depth (PD) and crestal bone loss [CBL]) are worse in cigarette-smokers (CS) and patients with type-2 diabetes mellitus (T2DM) than never-smokers (NS) without T2DM. The aim of the present 7-year follow-up clinical observational study was to assess the survival of dental implant in CS and NS with T2DM. METHODS: Study participants were divided into four groups based on glycemic status and self-reported cigarette-smoking habit: a) CS with T2DM; b) CS without T2DM; c) NS with T2DM; and d) NS without T2DM. Demographic information was collected using a questionnaire and hemoglobin A1c (HbA1c) levels were measured. Peri-implant PI, BOP, PD, and CBL were measured. Sample-size was estimated was statistical analysis was done using analysis of variance. P <0.01 was considered significant. RESULTS: In total, 101 male patients were included. There was no significant contrast in age among the groups. Every partaker in the study groups had one dental implant placed in posterior maxilla or mandible. The mean HbA1c levels were significantly higher among CS (P <0.01) and NS (P <0.01) with T2DM than individuals without T2DM. Peri-implant PI (P <0.01), PD (P <0.01), and CBL (P <0.01) were significantly higher among CS and NS with T2DM and CS without T2DM than NS without T2DM. Peri-implant BOP was significantly higher among CS and NS with T2DM than CS and NS without T2DM (P <0.01). CONCLUSIONS: Peri-implant inflammatory variables were worse among CS and NS with T2DM than NS without T2DM. A state of chronic hyperglycemia seems to be a stronger mediator of inflammation than cigarette smoking in patients with T2DM.

Association between ENAM polymorphisms and dental caries in children.

AIM: Dental enamel, the most rigid biological tissue of the tooth known to mankind, is the most integral and fundamental part of the tooth. Enamel matrixes compile 5% of Enamelin peptides and at the time of tooth development, they are considered to effect the formation and elongation of enamel crystallites. ENAM plays critical role in enamel formation. Any changes in ENAM may affect the thickness of enamel and may lead to dental caries. The present study is aimed to evaluate the association of ENAM gene polymorphisms and susceptibility of dental caries development risk. MATERIAL AND METHODS: The present study was carried out on 168 South Indian children, children's with dental caries were included in study. Written consent was taken from their parents/guardians. Additionally 193 healthy individuals were enrolled as controls. Sampling was done after dental examination of the individuals. Three ENAM gene single nucleotide polymorphisms (SNPs) were rs7671281, rs3796704 and rs12640848 was genotyped to check their role in susceptibility of dental caries development risk. RESULTS: Out of three SNPs rs7671281 showed statistically significant risk association with dental caries susceptibility in this ethnic population at heterozygous allele CT (OR: 1.939, p = .01865) and with minor allele T (OR: 1.451, p = .001292). SNP rs3796704 showed significant protective association with dental caries in Indian population at heterozygous allele GA (OR: 0.409, p = .0192) and with minor allele A (OR: 0.645, p = .00875). SNP rs12640848 showed significant protective association with dental caries in Indian population at heterozygous allele AG (OR: 3.041, p = .00642) and with minor allele G (OR: 1.478, p = .02184). Preliminary insilico analysis also showed that rs7671281 (Ile648Thr) amino acid change will cause the structural and functional changes in ENAM protein. CONCLUSIONS: In the present study significant association was observed between ENAM gene SNP rs7671281 and dental caries susceptibility in South Indian children. These results suggested that ENAM gene variants may contribute to dental caries in children.

High proportions of Staphylococcus epidermidis in dental caries harbor multiple classes of antibiotics resistance, significantly increase inflammatory interleukins in dental pulps.

Staphylococcus epidermidis is one of most prevalent in dental caries or dental pulp which has the capability of horizontal genetic transfer between different bacterial species in the oropharynx, suggesting that it may evolve with the dissemination of resistant determinants, This study was performed to molecularly characterize and differentiate S. epidermidis isolated from dental caries and healthy individual. Also, two important cytokines in inflammation were assayed caused due to S. epidermidis of health and dental caries sources. Dental caries strains were more resistant with high MIC 50 and MIC 90 value. These isolates also showed the presence of mecA gene and another virulence gene i. e sea and seb comparatively more than healthy individual isolates. SCCmec types, III and IV was more prevalent in dental caries isolates where an as healthy individual was more non-typable. Additionally, the quantity of IL-1ß and IL-8 caused due to dental caries isolates was seen more which indicate dental caries isolates are able to induce. This study showed that S. epidermidis a normal flora of oropharyngeal are more diverse to those strains which cause dental caries. S. epidermidis owns a prodigious genetic plasticity that permits to obtain, lose or regulate genetic elements that provide compensations to improve its colonization in the host.

Effect of disinfection and sterilization on the tensile strength, surface roughness, and wettability of elastomers.

AIM: The aim of the present study was to evaluate the effect of chemical disinfection, autoclave, and microwave sterilization on some of the key properties of elastomers. METHODS: Five polyvinylsiloxane elastomeric impression materials were evaluated. Forty samples were fabricated from each material. The samples were randomly selected and assigned to four experimental groups with 50 samples each: group I, control; group II,chemical disinfection; group III, autoclave sterilization; and group IV, microwave sterilization. The differences in the mean values were contrasted and compared with the control group and analyzed using two-way analysis of variance (P < 0.05). RESULTS: The results showed that chemical disinfection and autoclave sterilization had no significant effect on the tensile strength and surface roughness, whereas microwave sterilization showed a statistically-significant reduction in tensile strength, and an increase in surface roughness. None of the disinfection and sterilization techniques had a significant effect on wettability. However, autoclave and microwave sterilization resulted in an increase in hydrophilicity of all the materials tested. CONCLUSION: Chemical disinfection and autoclave sterilization had no statistically-significant effect on the tested properties of elastomers, thus autoclave sterilization can be considered as an alternative and an effective mode of disinfection and sterilization to eliminate all forms of disease causing microorganisms from dental impressions.

Sex determination using discriminant function analysis in Indigenous (Kurubas) children and adolescents of Coorg, Karnataka, India: A lateral cephalometric study.

Aim: To test the validity of sex discrimination using lateral cephalometric radiograph and discriminant function analysis in Indigenous (Kuruba) children and adolescents of Coorg, Karnataka, India. Methods and materials: Six hundred and sixteen lateral cephalograms of 380 male and 236 females of age ranging from 6.5 to 18 years of Indigenous population of Coorg, Karnataka, India called Kurubas having a normal occlusion were included in the study. Lateral cephalograms were obtained in a standard position with teeth in centric occlusion and lips relaxed. Each radiograph was traced and cephalometric landmarks were measured using digital calliper. Calculations of 24 cephalometric measurements were performed. Results: Males exhibited significantly greater mean angular and linear cephalometric measurements as compared to females (p < 0.05) (Table 5). Also, significant differences (p < 0.05) were observed in all the variables according to age (Table 6). Out of 24 variables, only ULTc predicts the gender. The reliability of the derived discriminant function was assessed among study subjects; 100% of males and females were recognized correctly. Conclusion: The final outcome of this study validates the existence of sexual dimorphism in the skeleton as early as 6.5 years of age. There is a need for further research to determine other landmarks that can help in sex determination and norms for Indigenous (Kuruba) population and also other Indigenous population of Coorg, Karnataka, India.

Paget's disease with craniofacial and skeletal bone involvement.

Paget's disease is a metabolic disorder of bone caused due to defect in the remodelling process and is very common in western countries but is very rare in Asians and Africans. It was first described by a British scientist Sir James Paget in 1877. It can be monostotic or polyostotic depending on the number of bones involved. It most commonly affects older people of more than 50 years. Disease involvement can be symptomatic or asymptomatic depending on the extent of the disease process. Diagnosis of Paget's disease can be made by raised serum alkaline phosphatase levels, radiological examination and by radioisotope bone scans.

Antimicrobial effects of Citrus sinensis peel extracts against dental caries bacteria: An in vitro study.

BACKGROUND: Ethnomedicine is gaining admiration since years but still there is abundant medicinal flora which is unrevealed through research. The study was conducted to assess the in vitro antimicrobial potential and also determine the minimum inhibitory concentration (MIC) of Citrus sinensis peel extracts with a view of searching a novel extract as a remedy for dental caries pathogens. MATERIAL AND METHODS: Aqueous and ethanol (cold and hot) extracts prepared from peel of Citrus sinensis were screened for in vitro antimicrobial activity against Streptococcus mutans and Lactobacillus acidophilus, using agar well diffusion method. The lowest concentration of every extract considered as the minimal inhibitory concentration (MIC) values were determined for both test organisms. One way ANOVA with Post Hoc Bonferroni test was applied for statistical analysis. Confidence level and level of significance were set at 95% and 5% respectively. RESULTS: Dental caries pathogens were inhibited most by hot ethanolic extract of Citrus sinensispeel followed by cold ethanolic extract. Aqueous extracts were effective at very high concentrations. Minimum inhibitory concentration of hot and cold ethanolic extracts of Citrus sinensis peel ranged between 12-15 mg/ml against both the dental caries pathogens. CONCLUSIONS: Citrus sinensispeels extract was found to be effective against dental caries pathogens and contain compounds with therapeutic potential. Nevertheless, clinical trials on the effect of these plants are essential before advocating large-scale therapy. KEY WORDS: Agar well diffusion, antimicrobial activity, dental caries, Streptococcus mutans, Lactobacillus acidophilus.

Incidental radiographic finding of the concealed art of susuk.

Susuk, or charm needles, are small, metallic needles inserted under the skin, considered to enhance beauty, health and luck. This hidden secret of inserting susuk is a traditional superstitious ritual, widely practiced among women of Southeast Asia. Here, we present an interesting case of incidental radiographic finding of the concealed art of susuk, which was exposed on a panoramic radiograph taken on a routine basis as a part of diagnostic work up at our centre. An orthopantomogram revealed bilateral metallic foreign bodies in the maxillo-facial region. Anamnestic data affirmed the practice of the body art of susuk. The charm needles were present in the orofacial region without the patient experiencing any pathological signs or symptoms.

Prevalence of skeletal fluorosis in fisherman from Kutch coast, Gujarat, India.

BACKGROUND: In health terms, consuming fluoride is well recognised to be a double-edged sword. Consumption of optimal amounts is beneficial to health, however an excess constitutes a health hazard. OBJECTIVES: To assess the prevalence of skeletal fluorosis in fishermen from the Kutch coast, Gujarat, India. MATERIALS AND METHOD: A descriptive cross-sectional survey was conducted on 653 fishermen from the Kutch District, Gujarat, India, from October 2014 to December 2014. Clinical skeletal fluorosis was assessed using three diagnostic tests. Drinking water fluoride concentrations in different regions of the study area were determined. General information regarding age, gender and adverse habits were also collected. The Chi square test was used for comparisons and the confidence level and critical p-value were set at 95% and 5% respectively. RESULTS: Fluoride concentrations in water from the study area ranged between 3.4-6.9 ppm. The prevalence of skeletal fluorosis was 30.3%, out of which, the majority of the subjects had mild skeletal fluorosis (18.4%). This condition was found to be significantly associated with age and gender along with tobacco and alcohol consumption; depending on the habit's duration. CONCLUSION: Being a public health problem in the fishermen community, skeletal fluorosis requires a-priori attention. Measures for preventing this disease should be undertaken on a communitywide basis.