Periodontal status among adult cigarette smokers using Miswak (Salvadora persica) for oral hygiene: A crosssectional study from Asir Region of Saudi Arabia

Purpose: To compare the periodontal status of exclusive users of Miswak (Salvadora persica) with that of exclusive toothbrush users among adult smokers of cigarettes in Saudi Arabia.Methods: This educational-institutional study included one hundred and fifty adult patients (age and socioeconomic status matched, SES) between the ages of 18 and 75, and were listed as the group I, II, and III, with 50 participants each (participants with no oral hygiene, toothbrush users and miswak users respectively). Oral hygiene habits, the number of cigarettes smoked, and time since the habit began. Periodontal and radiographic parameters were reported.Results: All parameters related to periodontium (plaque index (PI), gingival index (GI), bleeding on probing (BOP), probing pocket depth (PPD), gingival recession (Rec), clinical attachment level (CAL) and bone loss (BL)) showed that the analysed groups exhibited differences (p < 0.001). Least amount of BL (anterior and posterior) was found in toothbrush users and Miswak users, while least amount of attachment loss (both anterior and posterior) was recorded among Miswak users (p > 0.05). Positive association was found for GI (r = 0.753) and recession (r = 0.436, p < 0.001) in terms of the number of cigarettes smoked in group I, and anterior PPD (r = 0.388, p < 0.001) in group III for the duration of smoking. A negative correlation was found for BOP in group III (r = - 0.339, p < 0.05) in terms of frequency of tooth cleaning and GI (r = - 0.381) (p < 0.001) in group II, in terms of time taken attain oral hygiene.Conclusion: This study indicates less severe periodontal damage among adult current cigarette smokers in miswak users than in toothbrush users. Thus, there some potentials for miswak use for promotion of oral hygiene. Keywords: Periodontal status, Adult cigarette smokers, Miswak, Oral hygien

Periodontal Treatment Practice and Referral Profile of General Dentists – A Cross-sectional Questionnaire Survey

BACKGROUND: Because of medical advancement, the mean age of the general population is increasing gradually. This increase in the mean age of patients has led to its implications on oral health. Hence, it is logical to assume an increase in the figure of referrals to specialists and the complexity of treatments provided. AIM: The aim of the survey was to assess the current status of periodontal treatment provided, awareness of referral profile, and criteria taken into consideration for the referral to the periodontist by general dentists. MATERIALS AND METHODS: This cross-sectional questionnaire study was conducted among 318 general dentists. The relevant work related to the status of periodontal procedures provided by dentists and their referral relationships were studied. The questionnaire consisting of six questions was designed. Descriptive statistics, including frequency distributions and measures of central tendency and Chi-square test, were used. RESULTS: The study showed that majority of the general dentists do non-surgical procedures by their own. However, around 85% of respondents did not provide surgical periodontal treatment by themselves. About 25% of the responding general dentists thought that they had inadequate education and experience in the field of periodontics which was a major reason for the referral to specialists. CONCLUSION: It was concluded that the general dentists are comfortable in carrying out the non-surgical procedures, but they had some reservations about the periodontal surgical procedures. Inadequate experience and facilities were the major reasons for the referral to periodontists. More of this type of study should be conducted to know the basic level of periodontal practices carried out among the general dentists and about the referral to the specialists

The role of physiotherapy interventions in the management of temporomandibular joint ankylosis: a systematic review and meta-analysis

Abstract Background The main aim of this systematic review and meta-analysis was to identify peer-reviewed scholarly journal articles reporting the significance of physiotherapy interventions in managing TMJ ankylosis. In addition, this study aimed to critically appraise the existing evidence on the prevalence and clinical presentation, physiotherapy intervention approaches, efficacy of physiotherapy interventions, adverse effects, and safety of physiotherapy interventions in TMJ ankylosis management. Methods An all-inclusive literature search was conducted using the PubMed, Google Scholar, and Scopus electronic databases. The researchers screened the potential articles and assessed for eligibility based on the reported inclusion and exclusion criteria. The quality evaluation tool for observational cohort and cross-sectional studies developed by the National Institutes of Health (NIH) and the Cochrane Collaboration's Risk of Bias Tool were used to assess the quality of the included studies. Researchers also comprehensively analyzed the data, reported the results, and discussed them according to the predominant themes. Results The primary electronic database search yielded 409 articles, of which 25 were included in this review. A secondary search was conducted from citations of the included studies, yielding 74 articles, of which six were included in the study. A significantly higher prevalence of bony ankylosis than fibrous ankylosis, with an overall effect size of p < 0.00001. In addition, there were significantly more unilateral than bilateral presentations with an overall effect size of p < 0.00001. Moreover, there were 78 reported complications out of 245 subjects according to five included studies demonstrating a significant effect size with p = 0.001 following the treatment protocols. Conclusion This study highlighted the prevalence of bony ankylosis in temporomandibular joint ankylosis, emphasizing its impact on patients' well-being. On the other hand, the results show that physiotherapy is essential to optimize postoperative outcomes and minimize adverse events such as re-ankylosis. Practitioners and healthcare professionals must monitor postoperative recovery and ensure strict adherence to physiotherapy protocols for optimal outcomes

Spectrophotometric Analysis of Dental Enamel Staining to Antiseptic and Dietary Agents: In Vitro Study

Background/Objectives. Use of antiseptics as an adjunct to a traditional mechanical tooth brushing method has limited their application for long duration because of their side effects such as staining and calculus formation. The objective of this in vitro study is to analyse the staining effects of antiseptic mouthwashes on dental enamel and compare it with those containing nanoparticles, dietary agents, and distilled water (control). Material and Methods. 105 intact premolars extracted for orthodontic reasons and without any caries or anatomical defects were selected for analysis. The samples were randomly divided into 7 different groups of fifteen teeth each for different solutions. A spectrophotometer was used to assess the colorimeter analysis of buccal dental enamel surface at R1 (baseline examination), R2 (24 hours after immersion in different solutions), and R3 (after brushing). Statistical analysis was done using the Kolmogorov–Smirnov test and Levene’s test (p<0.05), respectively. One-way ANOVA was used to compare the difference in color (∆E) between the readings, R1, R2, and R3. Results. The mouthwash containing titanium dioxide (TiO2) nanoparticles produced the greater enamel discoloration compared to that of chlorhexidine. Brushing had little effect on removal of stains induced by all mouthwashes except for dietary solutions (lemon with sodium bicarbonate and olive with laurel) and distilled water (control). Conclusion. The results from this study show that mouthwashes containing TiO2 nanoparticles and other antiseptic mouthwashes cause change in color of the teeth and lead to poor esthetic appearance when compared to dietary and control solutions. Thus, future in vivo studies have to be conducted to confirm these findings as in vitro studies may not provide a reliable simulation of the clinical situations