Comparison of mechanical properties and color stability of various vacuum-formed orthodontic retainers: An in vitro study.

Vacuum-formed retainer (VFR) is the most used retainer due to its higher aesthetic properties and lower cost, their mechanical properties of are important in determining the stability and long-term use of appliances made out of them. AIM: This study aimed to evaluate and compare the flexural modulus, surface hardness, and color stability of three different VFR materials. METHODS: Three different VFR materials, namely Duran, Keystone, and Zendura, of 1 mm thickness, were tested after thermoforming for flexural modulus, hardness, and color stability. They were formed over a stainless-steel model of 12 mm diameter and 6 mm height. RESULTS: There were significant statistical differences (p = 0.000) in the flexural modulus and hardness of the three materials. Regarding color stability, Zendura exhibited significantly higher ΔE* values than Keystone and Duran (p < 0.05). CONCLUSIONS: Zendura had the highest flexural modulus and hardness compared with Duran and Keystone; however, it is more susceptible to color change compared to the other tested materials.

Students' Perceptions of their Dental Curriculum and Education.

Objective: To evaluate the satisfaction of dental students toward their dental curriculum and education at dental colleges in the central region of Saudi Arabia. Methods: Two forms of the questionnaire were established, a paper version and an electronic internet-based survey (Google online form). Paper versions were distributed to interns graduated from universities in Riyadh. The electronic versions were used to obtain responses from students at dental colleges and universities outside of Riyadh, such as Prince Sattam bin Abdulaziz University (PSAU) and Majmaah University, by emailing the links to the participants who were dental interns that had graduated in the 2018/2019 academic year. Results: A total of 388 interns answered the questionnaire. Overall, 48.4% of the interns were highly satisfied with the Operative Department while regarding Orthodontic Department 16.9% were satisfied while 11.2% were highly satisfied. Regarding the non-clinical satisfaction score, the interns were mostly unsatisfied with their research skills (15.5%). Comparing the interns' satisfaction at different institutions, there was a statistically significant difference in the clinical satisfaction score (P ≤0.01), but there was no difference in the non-clinical satisfaction score (P > 0.05). Conclusion: Dental students need a greater focus and exposure to research skills during their dental school studies. To improve dental students' level of clinical satisfaction, it is more important for them to have early exposure to comprehensive clinical training than specialty-based clinical training.

Parents' Awareness of Early Orthodontic Consultation: A Cross-Sectional Study.

OBJECTIVE: The aim of this paper is to assess parents' knowledge about early orthodontic consultation and treatment, and to determine the association of this knowledge with number of children, monthly income, children's age and perceived dental problems. METHODS: A questionnaire was distributed to 3000 school children aged 6-11 years. The children were asked to take the questionnaire to their parents and bring it back the next day. It consisted of 13 questions. Some of these questions were related to the gender of the child, number of children, and parents' monthly income. The remaining questions assessed the parents' awareness of their children's need for orthodontic treatment. RESULTS: In total, 2538 parents completed the questionnaire. Of these, 2014 (79%) of the parents thought that their children's teeth would have a significant impact on their personality. Moreover, 1637 (64.5%) parents thought that their children had a problem with their teeth; 1080 (66%) of these parents consulted a dentist. Of these 1080 parents, 821 (76%) consulted an orthodontist, and of these 821 parents, 449 (55%) initiated the required orthodontic treatment. The number of children who visited an orthodontist was found to increase with an increase in age (p = 0.0057). Moreover, a perceived overjet was associated with a higher number of orthodontic consultations (p = 0.0326). CONCLUSION: Although parents' awareness regarding their children's orthodontic treatment is important, other factors, such as the age of the child, the severity of the malocclusion and the consulted dentist, play a role in initiating orthodontic treatment.

Evaluation of the airway space changes after extraction of four second premolars and orthodontic space closure in adult female patients with bimaxillary protrusion - A retrospective study.

BACKGROUND & OBJECTIVES: Previous studies have found that first premolar extractions during orthodontic treatment may alter the upper airway dimensions. The objective of this study is to investigate the effects of second premolar extraction during orthodontic treatment on the dimensions of the upper airway in a sample of female adults. METHODS: Twenty-nine female adult patients with ages between 18 and 30 years old and incisor bimaxillary protrusion were included in this study. They were treated with comprehensive orthodontic treatment which included the extraction of four second premolars. Pre and post cephalometric radiographs were analyzed using Dolphin imaging software for changes in tongue length and height, soft palate thickness and length, the superior, middle, and inferior airway space, and vertical airway length. Descriptive statistics were used to characterize measurements. Student's paired t-test was preformed to compare the pre- and post-test mean values of the dimensions. RESULTS: A significant increase in the vertical airway length was observed after the extraction of the second premolars (p = 0.02). The soft palate length showed a tendency towards an increase that did not reach statistical significance (p = 0.053). No other significant changes in the airway soft tissue measurements were observed. The proclination and protrusion of the upper and lower incisors were significantly decreased compared to pre-treatment measurements.Interpretation & conclusions.Orthodontic treatment involving the extraction of all four second premolars in females with bimaxillary protrusion increases the vertical airway length, which is the amount of distance between base of the tongue and posterior nasal spine. No other significant alterations in the upper airway measurements were observed.

Dento-skeletal characteristics of cleft patients with missing teeth.

OBJECTIVE: The objective of this study was to compare the cephalometric skeletal and dental characteristics of unilateral complete cleft lip and palate (UCCLP) subjects with and without missing teeth. DESIGN: A retrospective records review was conducted for patients who are being treated at the cleft lip and palate (CLP) clinics in the College of Dentistry. METHODS: Ninety-six consecutive records of non-syndromic UCCLP subjects were recruited (33 subjects without missing teeth, 50 subjects with only one missing tooth, and 13 subjects with two or more missing teeth). Skeletal and dental characteristics were assessed using lateral cephalometric radiographs in UCCLP subjects with missing teeth and compared to the group with no missing teeth. A total of 25 linear and angular measurements were analyzed and compared between the sample groups. RESULTS: Of the dental variables tested, overjet was significantly different between the three groups. The UCCLP subjects with multiple missing teeth had the smallest overjet (-3.89±2.75 mm; P=0.015) among the three groups. None of the skeletal characteristics reached statistical significance. CONCLUSION: Missing teeth influence the dental but not skeletal characteristics of UCCLP. Overjet is significantly reduced in UCCLP subjects with multiple missing teeth. Future studies with larger sample sizes are warranted.

The characteristics of dental occlusion in patients with moderate to severe obstructive sleep apnea in Saudi Arabia.

OBJECTIVES: To evaluate characteristics of dental occlusion among non-obese Saudi adult patients suffering from moderate to severe obstructive sleep apnea(OSA). METHODS: Following ethical approval, a cross-sectional study was conducted at Sleep Disorders Center, King Khalid University Hospital, Riyadh, Kingdom of Saudi Arabia, between January and March 2017. Non-obese adult Saudi patients with moderate/severe OSA (apnea-hypopnea index more than 15) and without history of malocclusion or edentulism were included with an estimated sample size of 50. Demographic details and severity of OSA as diagnosed by polysomnography were recorded. Characteristics of dental occlusion, namely molar, canine and incisor relationship, overjet, overbite, crossbite and arch form were obtained through calibrated examiners (kappa 0.81). Descriptive statistical analysis and Chi-square test, with 95% significance level (p less than 0.05), were used to identify relationships between the severity of OSA and characteristics of dental occlusion. RESULTS: A total of 51 patients (31 males, 20 females; mean age 49.45±10.35 years), were enrolled in the study. Severity of OSA was moderate in 17 patients and severe in 34 patients. Severe form of OSA was more among males (64.7%) and in patients with Class-II division-1 incisor relationship (94.1%). Neither the demographic characteristics, nor characteristics of dental occlusion showed statistically significant relationship with the severity of OSA. CONCLUSION: The results of the present cross-sectional study indicate that the characteristics of dental occlusion are not related to the severity of OSA among non-obese adult Saudi patients.

Elementary school staff knowledge about management of traumatic dental injuries.

AIM: This study investigated the knowledge of elementary school staff regarding the management of traumatic dental injuries (TDIs) in children. METHODS: The present cross-sectional study analyzed data collected between September 2016 and April 2017. The sample consisted of 2,027 elementary school staff members in Riyadh, Saudi Arabia. A stratified cluster random sampling technique was used to select the required sample. Those who agreed to participate in the study completed a 4-part self-administered questionnaire comprising questions regarding demographic data, knowledge on management of tooth fracture, and avulsion using photographs of TDI cases. RESULTS: The majority of the school staff showed inadequate basic knowledge regarding the importance of saving the broken piece of the tooth and identifying the tooth involved in the trauma (67% and 66.3%, respectively), P<0.05. However, they had a significantly high number of correct responses regarding the immediate management of TDIs for the 2 case scenarios presented in the questionnaire (P<0.05), and the majority (41%) reported normal saline as a suitable storage medium (P<0.01). CONCLUSION: This study revealed a lack of knowledge in certain aspects of TDIs among elementary school staff.

Knowledge on management of traumatic dental injuries among Saudi mothers.

OBJECTIVE: This study investigated the knowledge of Saudi mothers regarding the management of traumatic dental injuries (TDIs) in children. MATERIALS AND METHODS: A cross-sectional study using structured questionnaires was employed for mothers chosen by stratified-cluster random sampling technique from primary health care centers in Riyadh, Saudi Arabia, over a period of 12 months (July 2016-June 2017). The questionnaire surveyed mothers' background and knowledge on management of tooth fracture and avulsion using photographs of TDI cases. RESULTS: The sample consisted of 3,367 Saudi mothers. More than half of the mothers (55.3%) gave the correct response, which was to send the child with tooth fracture immediately to the dentist (p<0.01). The majority of mothers (41.6%) gave the correct response for the immediate mode of action, which was to save the avulsed tooth in storage medium and send the child to the dentist immediately (p<0.001). However, they prioritized the immediate management of TDIs, and most reported saline as a suitable storage medium (p<0.001). The mothers expressed a positive interest in further education. CONCLUSION: Educational programs and TDI protocols must be implemented to increase mothers' awareness and improve the prognosis of children with TDIs.

Learning style preferences of dental students at a single institution in Riyadh, Saudi Arabia, evaluated using the VARK questionnaire.

BACKGROUND: Students differ in their preferred methods of acquiring, processing, and recalling new information. The aim of this study was to investigate the learning style preferences of undergraduate dental students and examine the influence of gender, Grade Point Average (GPA), and academic year levels on these preferences. METHODS: The Arabic version of the visual, aural, read/write, and kinesthetic (VARK) questionnaire was administered to 491 students from the first- to the fifth-year academic classes at the College of Dentistry, King Saud University. Descriptive statistics were used to characterize the learning styles of the students, and Chi-square test and Fisher's test were used to compare the learning preferences between genders and among academic years. Significance was set at a p-value of <0.05. RESULTS: A total of 368 dental students completed the questionnaire. The multimodal learning style was preferred by 63.04% of the respondents, with the remaining 36% having a unimodal style preference. The aural (A) and the kinesthetic (K) styles were the most preferred unimodal styles. The most common style overall was the quadmodal (VARK) style with 23.64% having this preference. These differences did not reach statistical significance (p>0.05). Females were more likely to prefer a bimodal learning style over a unimodal style (relative risk =2.37). Students with a GPA of "C" were less likely to have a bimodal or a quadmodal style preference compared to students with a GPA of "A" (relative risk =0.34 and 0.36, respectively). Second-year students were less likely to prefer a bimodal over a unimodal style compared to first-year students (relative risk =0.34). CONCLUSION: The quadmodal VARK style is the preferred learning method chosen by dental students, followed by unimodal aural and kinesthetic styles. Gender was found to influence learning style preferences. Students with a "C" GPA tend to prefer unimodal learning style preferences. The VARK questionnaire is a relatively quick and simple tool to reveal the learning style preferences on an individual or a group level. Dental educators should adjust their delivery methods to approximate the learning preferences of their students. Dental students are encouraged to adapt a multimodal style of learning to improve their academic results.

Retention practices and factors affecting retainer choice among orthodontists in Saudi Arabia.

OBJECTIVES: To identify the retention protocols practiced by orthodontists in Saudi Arabia, and the factors affecting retainer choice.  METHODS: This cross-sectional study took place between February and March of 2015 at the College of Dentistry, University of Dammam, Dammam, Saudi Arabia. A previously tested electronic survey of 34 items was sent to all 1,200 orthodontic members of the Saudi Orthodontic Society. The questionnaire elicited data on the subjects' demographics, orthodontic treatment practices, retention, and post-retention protocols.   RESULTS: One hundred and sixty-seven (13.9%) responses were received during the study period. The results showed predominant use of Hawley in the maxillary arch (61.3%), and fixed lingual in the mandibular arch (58.5%). Approximately 90.3% recommended full-time maxillary removable retainer wear. Overall, orthodontists who performed fewer extractions tended to use fixed retainers, and those who performed more extractions used removable retainers (p=0.018). Interproximal enamel reduction was used by 28% of the respondents as an adjunct procedure to enhance retention. Approximately 64% practiced a post-retention phase of retainer wear. Participants who used removable retainers most commonly prescribed lifetime retention.  CONCLUSION: Hawley in the maxilla, and fixed lingual in the mandible were the most common retention protocols prescribed. Lifetime retention was the most common choice for participants who used removable retainers, especially when extractions were carried out.

Evaluation of the fit of preformed nickel titanium arch wires on normal occlusion dental arches.

AIM: To determine the fits of preformed nickel titanium (NiTi) archwires on dental arches with normal occlusion. METHODS: Forty sets of upper and lower plaster models were obtained from men and women with Class I occlusions. Preformed 0.016″ × 0.022″ NiTi archwires from Rocky Mountain Orthodontics (RMO), 3 M Unitek, Ormco, and Dentaurum were evaluated in terms of their fits on dental arches from male, female, and combined cases. Data were analyzed by using fourth- and sixth-order polynomial equations, analysis of variance (ANOVA), and the Duncan post hoc test. RESULTS: In the upper arches, the best fit and least error were obtained with RMO Ovoid and Ormco Orthos Large archwires for male cases, but with 3 M Orthoform LA archwires for female and combined cases. In the lower arches, the best fit and least error were obtained with Ormco Orthos Large for male cases, with 3 M Orthoform LA and RMO Normal for female cases, and with 3 M Orthoform LA, RMO Normal, Ormco Orthos Large, and Ormco Orthos Small for combined cases. When both dental arches were matched, Ormco Orthos Large was the best wire for male cases. 3 M Orthoform LA was the best wire for female and combined cases. CONCLUSIONS: Using an archwire form with the best fit to the dental arch should produce minimal changes in the dental arch form when NiTi wires are used and require less customization when stainless-steel wires are used.

Live demonstration versus procedural video: a comparison of two methods for teaching an orthodontic laboratory procedure.

BACKGROUND: To measure the effectiveness of procedural video compared to live demonstration in transferring skills for fabricating orthodontic Adam's Clasp. MATERIALS AND METHODS: Forty-nine fourth-year undergraduate male dental students were randomly assigned to two groups. The students in group A (n = 26) attended a live demonstration performed by one faculty, while students in group B (n = 23) watched a procedural video. Both the procedural video and live demonstration described identical steps involved in fabricating the Adam's Clasp. Students in both groups were asked to fabricate an Adam's Clasp in addition to completing a questionnaire, to measure their perceptions and satisfaction with the two teaching methods and lab exercise. Blind assessment was performed by one faculty for both groups. RESULTS: The mean students' scores in the fabrication of the Adam's clasp were 6.69 and 6.78 for the live demonstration (group A) and the procedural video (group B), respectively. No significant difference was detected between the two groups (P = 0.864). Statistically significant difference was found in the mean response between the two groups for statement 6 on the questionnaire, "The steps in the teaching method were presented in a clear fashion and were easy to understand". A higher mean response for group B was found compared to group A (P = 0.049). No significant differences were found between the two groups for the other statements (P > 0.05). CONCLUSION: Procedural video is equally as effective as a live demonstration. Both methods should be considered in teaching undergraduate orthodontic courses in order to improve the learning experience and to match different learning preferences of students.

Influence of bimaxillary protrusion on the perception of smile esthetics.

OBJECTIVES: To evaluate the impact of bimaxillary protrusion on smile esthetics as perceived by dental professionals and laypersons. METHODS: One hundred and fifty evaluators, equally distributed into their respective panels (orthodontists, general dentists, and laypersons), participated in this cross-sectional study conducted in April to December 2012 in Riyadh, Saudi Arabia. The patient sample consisted of 14 female patients divided equally into 2 groups: bimaxillary protrusion patients, and patients who have had 4-premolar extraction treatment. Two standardized photographs (frontal and three-quarter close-up smile views), and a lateral cephalogram were taken for each patient. The evaluators were asked to rate the attractiveness of each photo according to a 100-mm visual analog scale. These esthetic ratings were correlated with the patients' cephalometric measurements. RESULTS: The bimaxillary protrusion group was rated significantly as less attractive than the treatment group by each evaluator panel. Panel comparison showed that laypeople were less receptive of bimaxillary protrusion than dental professionals. Frontal and three-quarter views of the same smiles were not similarly rated for esthetic perceptions. Correlational analysis revealed that the dentoalveolar measurement with the highest significant negative correlation to the smile esthetics was the upper incisors to palatal plane (U1-PP) angle. CONCLUSION: Patients with bimaxillary protrusion were found to be less attractive than patients who were treated for the condition. This was especially evident among the laypersons. An increase in the upper incisor inclination, as well as a decrease in the interincisal angle compounds the bimaxillary effect. 

Validity of moyers mixed dentition analysis for Saudi population.

OBJECTIVES: To evaluate the applicability of Moyers probability tables and to formulate more accurate mixed dentition prediction tables in the Saudi population. METHODS: A cross-sectional study was conducted at the College of Dentistry, Kind Saud University, Saudi Arabia. The data were collected from 410 (203 males and 207 females) orthodontic study models, which had erupted mandibular permanent incisors, maxillary, mandibular canines and premolars. The mesiodistal widths were measured using a digital caliper with an accuracy of 0.01 mm. Student's paired t-test was used to compare the mean width values derived from this study with the values derived using the Moyers table. Simple linear regression was used to evaluate the linear relationship between the combined mesiodistal widths of the mandibular permanent incisors and the canine-premolar segments in each dental arch. RESULTS: The regression equations for the maxillary canine-premolar segment (males: Y=10.27+0.48X; females: Y=11.71 + 0.39X) and the mandibular canine-premolar segment (males: Y=9.71 + 0.40X; females: 11.28 + 0.39X) were used to formulate new probability tables on the Moyers pattern. Statistically significant differences were observed between predicted widths in our subjects and the widths obtained using Moyers tables. CONCLUSIONS: The new prediction tables derived in this study provided a more precise mixed dentition space analysis than Moyers prediction tables in estimating tooth dimensions in the Saudi population.

Is Tanaka-Johnston mixed dentition analysis an applicable method for a Saudi population?

OBJECTIVES: To test the applicability of the Tanaka and Johnston prediction method in a Saudi population. METHODS: The current study was conducted at the College of Dentistry, King Saud University, Riyadh, Saudi Arabia from September 2013 to January 2014, on a sample of 409 pairs of orthodontic study models. The mesiodistal width of the mandibular permanent incisors, permanent canines, and permanent premolars were measured using an electronic digital caliper with an accuracy of 0.01mm. The predicted widths derived from the Tanaka and Johnston equation were compared with the actual measured widths. RESULTS: Gender differences were observed in the sum of the mesiodistal width of canine and premolars in both arches as indicated by t-test (p<0.001). The sum of the actual mesiodistal widths of canines and premolars were compared with the predicted widths derived from the Tanaka and Johnston equation and significant differences were found (p<0.001). The regression analysis indicated that the sum of the mesiodistal width of the mandibular permanent incisors is a good predictor for those of unerupted canines and premolars, with the correlation coefficients ranging from 0.51 to 0.61. Accordingly, 2 linear regression equations were developed for tooth width prediction for Saudi males and females. CONCLUSION: The Tanaka and Johnston prediction equation overestimated the sum of mesiodistal widths of permanent canines and premolars in Saudis. New regression equations were formulated for the prediction of tooth width in the Saudi population.

Perception of pain and discomfort from elastomeric separators in Saudi adolescents.

OBJECTIVE: To examine the patient's perception of pain and discomfort following the placement of elastomeric separators in Saudi adolescents. METHODS: The study was conducted on 38 adolescent patients who received fixed orthodontic treatment. The data was collected through the use of a self-administrated questionnaire that was distributed to the patients by one investigator in a non-clinical setting. The evaluation of pain started from the fourth hour after placement of elastomeric separators, and continued until the fifth day. RESULTS: The data showed that after 4 hours from separator placement, 94.7% of patients reported pain. There was a daily decrease in these percentages starting from the third day. The type of pain during the first 2 days was continuous, then continued to be intermittent pain. Most of the patients reported pain during eating and chewing, changed their food habit, and used analgesics. No statistical differences were observed between male and female patients in pain perception, type of pain, analgesic consumption, and influences on chewing and food consistency. CONCLUSION: The pain associated with orthodontic separation starts and peaks within 4-48 hours from separator placement, then starts to decline to reach the lowest level on fifth day.

Career characteristics and postgraduate education of female dentist graduates of the College of Dentistry at King Saud University, Saudi Arabia.

OBJECTIVES: The aims of this study were to investigate the number of female bachelor of dental surgery graduates who earned postgraduate education degrees from King Saud University, their specialties, degrees of qualification, and countries of graduation. METHODS: A questionnaire survey was conducted through face-to-face or phone interview among 677 female dentists who graduated from the College of Dentistry at King Saud University between 1984 and 2006. RESULTS: Five hundred forty-five (81%) graduate female dentists responded, of whom 54% had completed postgraduate dental education. In the Saudi Board, 17% had obtained degrees in advanced restorative dentistry, 15% in pediatric dentistry, 14% in advanced general dentistry, 11% in orthodontics, 10% in prosthodontics, 8% in operative dentistry, 5% in endodontics, 5% in periodontics, 3% in oral and maxillofacial surgery, and 11% in other specialties. Fifty-nine percent had master's degrees, 7% had doctorates, 32% had board certificates, and 2% had fellowship certificates. CONCLUSION: More than half (54%) the female dentists surveyed had pursued postgraduate education. This investigation highlighted the different specialties enrolled by female dentists. Orthodontic post graduate program displayed the highest percentage of interest. Understanding the unavoidable social family needs and the demand for higher education by female dentists provides ideas as more programs should be planned to accommodate the needs of Saudi female dentists. This type of study should be repeated due to the increasing interest of female dentists in higher education.

Soft tissue facial profile of adult Saudis. Lateral cephalometric analysis.

OBJECTIVE: To develop cephalometric measurements of soft tissue facial profile for a sample of adult Saudi males and females and compare it with European-Americans` norms for any significant differences. METHODS: Sixty-one lateral cephalometric radiographs (31 males and 30 females; mean age 23 years) were selected from the archives of cephalometric radiograph files at College of Dentistry, King Saud University, Riyadh, Kingdom of Saudi Arabia between June 2009 and June 2010. Thirteen cephalometric parameters were analyzed electronically using the Dolphin version 10 software according to Legan and Burstone analysis. Descriptive statistics and p-values were calculated for the group comparisons using SPSS program. The statistical significance was determined at the 0.05 level of confidence. RESULTS: Adult Saudis generally had increased facial convexity associated with retruded mandible, more obtuse lower face-throat angle, increased bimaxillary lip protrusion, greater mentolabial sulcus, decreased vertical lip-chin ratio, and increased maxillary incisor exposure than European-Americans. Saudi females had more obtuse nasolabial angle and decreased lower vertical height-depth ratio than European-American females. Comparisons between the males and females indicated that Saudi females had a reduced lower vertical height-depth ratio, smaller lower lip distance more obtuse nasolabial angle and decreased interlabial gap than males. CONCLUSION: The significant differences in facial structures of Saudis, European-Americans and between the genders should be of a great help for diagnosis of orthodontic and orthognathic surgical cases in Saudi adults.

Orthognathic surgical norms for a sample of Saudi adults: Hard tissue measurements.

OBJECTIVE: The aim of the study is to establish hard tissue cephalometric norms for orthognathic surgery for a sample of Saudi adults. MATERIALS AND METHODS: Sixty-two lateral cephalometric radiographs for 31 females and 31 males, age range of 22-24 years, were analysed. The mean values of the hard and dental measurements were compared with those of European-American adults using Burstone analysis, as well as comparison between Saudi males and females. RESULTS: Saudi males had an increased cranial base length, the mandible lied more posterior to maxilla, increased mandibular plane angle and backward rotation of the mandible with less prominent chin, shorter maxillary length, and also less proclination of lower incisors compared to those of European Americans. Saudi females had similar cranial base length and shorter maxillary length than European Americans. In both gender; lower anterior and posterior dental heights were smaller when compared with the European-Americans' values. A significant difference between Saudi males and females was found. Saudi males showed longer cranial base length, larger vertical skeletal proportion, increased dental values, longer maxillary and mandibular length than the female group. CONCLUSION: This study may be useful in providing racially specific cephalometric norms for diagnosis and treatment planning for orthognathic surgery for a sample of Saudi adults.

Appointments failure among female patients at a dental school clinic in Saudi Arabia.

The aim of the study was to assess the factors and reasons responsible for failed appointments among female patients attending a dental school clinic. A cross-sectional survey was conducted at the College of Dentistry in Riyadh city on 200 patients who failed to keep their appointments at least one time. The data were collected using a structured, pretested questionnaire through a telephone interview method from January through May 2007. The selected sample was in the age group of fourteen years and older. The response rate was 86 percent. The results illustrated that most of the patients who broke their appointments were married, housewives, above forty years in age, and of low to middle socioeconomic status. It was found that the most common reasons for failed appointments were fasting in the Holy Month of Ramadan (79.1 percent) followed by transportation difficulty (76.2 percent), inconvenient appointment time (65.1 percent), and dissatisfaction of communication with booking area (54.1 percent).