Retrospective Radiographic Survey of Unconventional Ectopic Impacted Teeth in Al-Madinah Al-Munawwarah, Saudi Arabia

OBJECTIVES: Ectopic unconventional impacted teeth are rare. These teeth erupt in an unusual direction with limited unconventional access and have increased surgical risks. AIM: This study aimed to investigate and assess the prevalence and distribution of rare ectopic impacted teeth at the Taibah University Dental College and Hospital (TUDCH), Al-Madinah Al-Munawwarah, Saudi Arabia. METHODS: The study designed through a retrospective radiographic cross-sectional survey involving the review and examination of 9000 archived digital orthopantomograms of patients who visited the (TUDCH) in the period from January 2014 to December 2019 and to analyze any associated factors. RESULTS: There were 63 ectopically impacted teeth, with an incidence of 0.7%. The age of the patients ranged from 18 to 68 years, with a mean of 32.4 ± 13 years. Regarding patient nationality, 68.3% were Saudis. The most common ectopically impacted teeth were the extra impacted premolars, with an incidence of 0.2%, followed by the inverted molars, impacted first or second molars, and buccoversion or lingoversion third molars, with incidences of 0.16%, 0.13%, and 0.12%, respectively. The mandible was affected with ectopic impaction more than the maxilla, with an incidence of 55.6%. There was no difference between the right and left sides. Impacted teeth in the sinus were the least common. CONCLUSION: The prevalence of ectopic impacted teeth was 0.7% among the surveyed patients at TUDCH, Al-Madinah Al-Munawwarah, Saudi Arabia. Hence, the oral surgeon must have readiness for such a challenging, increasing situation

Tobacco Smoking, Secondhand Smoke Exposure and Cessation Perceptions by Dental Students in Al Madinah, a Conservative Saudi Society

Objective: To explore the prevalence of tobacco use and secondhand smoke (SHS) exposure in dental students and to investigate their perceptions on the role of dentists in tobacco cessation activities. Material and Methods:  A questionnaire-based study was conducted in a public university in Al Madinah, Saudi Arabia. The questionnaire investigated demographic factors, tobacco use practices, SHS exposure, and student perceptions of tobacco cessation activities. Descriptive statistics and statistical significance of differences between demographic groups were calculated. Results: A total of 228 students participated with 43.0% (n=98) males and 57.0% (n=130) females. A proportion of 30.7% (n=70) of the participants smoked tobacco, and these constituted 51 males (73%) and 19 females (27%). Only 39 students (15 females and 24 males) indicated their method of tobacco use, which was mainly cigarettes and waterpipes. One in two students was exposed to SHS. Non-smokers had better awareness of the health hazards of SHS (p<0.001), and were more likely to adopt tobacco cessation activities recommended by dentists (p<0.05). Conclusion:  A substantial proportion of dental students in a very conservative religious area smoke tobacco and are exposed to SHS. Their perceptions of the harms of SHS and attitudes on cessation need improvement. The influence of culture and religion in shaping health risk behaviors in conservative communities needs to be verified

Temporomandibular joint disorders prevalence and health-seeking preferences among Al-Madinah community: A prospective cross sectional study [version 4; peer review: 2 approved]

Background:  Painful temporomandibular joint disorders (TMDs) are of musculoskeletal origin and are considered the most common cause of non-odontogenic pain in the orofacial region.  The purpose of this study was to investigate the prevalence and awareness of temporomandibular joint (TMJ) disorders in Almadinah Almunawwarah community. Methods: A prospective observational cross-sectional study with convenience sampling was conducted. The patients were selected from the dental college and the hospital at Taibah University in Al-Madinah, Saudi Arabia.  A translated Arabic version of Fonseca's questionnaire was employed. The questionnaire asked about the participant's personal information, if they thought they had TMDs, and who to visit for therapy if necessary. These were followed by 10 items from Fonseca's questionnaire, each with a three-point scale. Results: The questionnaire was completed by 518 people. Females made up 57.1% of the participants. TMDs were present in 61% of the population, with varying degrees of severity. Males (44.3%) were less affected than females (55.7%). The difference, however, was not statistically significant (P = 0.354). Out of the 61% TMDs Positive patients, 74.1% had mild TMDs symptoms, while 20.8% and 5.1%, respectively, had moderate and severe TMDs symptoms (P = 0.05). The severity of the symptoms was unaffected by demographic data (P > 0.05). Only 40% seek care, with 64.6% selecting for a dentist or orofacial pain specialists for their management  and 24.6% preferring for an orthopaedic specialist (P= 0.008). Conclusions: Participants from Al-Madinah had a greater prevalence of mild TMDs. The majority of the participants had no idea who to go to for treatment. The findings of this study highlight the importance of educational activities to enhance public awarenes

Evaluation of Impacted Mandibular Third Molars with CBCT: A Cross-Sectional Study

Aim: The purpose of this study to evaluate and categorize the complexity of extracting impacted mandibular third molars (IMTMs) using cone beam computed tomography (CBCT).Materials and methods: CBCT used to analyze 315 lower third molars from 182 patients who met the inclusion criteria. CBCT scans were acquired with a CS 9300 Premium 3D machine. Patient demographics and IMTM details were recorded by two observers using CS 3D Imaging Software for image analysis. Descriptive statistics were applied to assess criteria for impaction and extraction difficulty. Differences in surgical risk indicators for IMTM extraction were statistically examined between age groups, gender, and ethnicities using Fisher’s exact test. Results: Patients aged 18-75 years showed that mesioangular impaction was most common at 41.90%, followed by horizontal at 30.79%, vertical at 25.72%, distoangular at 0.95%, and inverted at 0.63%. Class IA and IIA classifications were most prevalent at 27.30% and 23.49%, respectively, with Class IIIA being the least common at 1.58%. significantly higher surgical difficulty indicators seen in patients under 40 compared to older patients for right and left IMTMs (p = 0.026 and 0.011, respectively), but no statistically significant differences in these indicators were observed between genders or ethnicities.Conclusion: CBCT examination revealed that mesioangular impaction was the most frequent occurrence, followed by horizontal, vertical, distoangular, and inverted impactions. Class IA and IIA prevalent; Class IIIA least common. Surgical difficulty indication more in younger than 40 years old patients, no gender or ethnicity differences

Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region

Objective: To describe oral healthcare services administered during the lockdown in the Eastern Mediterranean region and to investigate the role of socio-professional characteristics of dental practitioners or their self-reported COVID-19 infection. Material and Methods: A questionnaire was distributed to dental practitioners in all healthcare sectors in Jordan, Egypt, and Saudi Arabia. Results: There was a total of 335 participants, with the majority being females (N=225, 67.2%) and general practitioners (N=202, 60.3%). Cellulitis was the most common emergency encountered (N=108). The most common urgent procedures were for pulpitis, abscesses, and pericoronitis (N=191, 130, and 95, respectively). Country-specific significant associations were pulpitis in Egypt and Jordan, broken symptomatic teeth in Jordan, and biopsy in Egypt (p<0.05). The Ministry of Health was significantly associated with the management of dental infections, avulsion, and orthodontic emergencies, while university hospitals were significantly associated with advanced restorative procedures (p<0.05). Male practitioners performed significantly more procedures, particularly surgical emergencies (p<0.05). Conclusion: Dental infections were the most common complaints among dental patients during lockdown. Country- and sector-specific dental procedures are detected. Male gender seems to play a determinant role in performing a higher number of procedures, particularly for surgical emergencies

Anticancer effects of punicalagin and 5-fluorouracil on laryngeal squamous cell carcinoma: an <i>in vitro</i> study

The purpose of this study was to assess the apoptotic effects of punicalagin alone and in combination with 5-fluorouracil (5-FU) on laryngeal squamous cell carcinoma (Hep-2) cell line. Hep-2 cells were cultured and divided into four groups: Group 1 received no therapy and served as control, Group 2 received 5-FU only, Group 3 received punicalagin only, and Group 4 received a combination of 5-FU and punicalagin. After 48 hours of incubation, cellular changes were examined under an inverted microscope. The methyl thiazolyl tetrazolium assay, caspase-3 gene level, and vascular endothelial growth factor (VEGF) level were assessed. The control group showed the highest mean value of cancer cell proliferation rate (1.595±0.58), followed by the punicalagin group (1.263±0.447), then the 5-FU group (0.827±0.256), while the combination group showed the lowest proliferation rate (0.253±0.111). The combination group showed the highest mean value of caspase-3 concentration (3.177±0.736), followed by the 5-FU group (1.830±0.646), and punicalagin group (0.741±0.302), while the control group showed the lowest mean value (0.359±0.117). Regarding VEGF levels, the control group had a statistically significant higher mean value, followed by the punicalagin and 5-FU groups, and finally, the combination group which showed the lowest value. Punicalagin exerts an anticancer effect through anti-proliferative action and induction of apoptosis on Hep-2 cell line. Combining punicalagin with 5-FU potentiates its anti-proliferative, apoptotic, and anti-angiogenic actions. It, further, helps in mitigating the putative side effects of 5-FU by reducing the dose required for its therapeutic effects

Oral Healthcare Services Delivered During COVID-19 Lockdown: A Report from Eastern Mediterranean Region

Objective: To describe oral healthcare services administered during the lockdown in the Eastern Mediterranean region and to investigate the role of socio-professional characteristics of dental practitioners or their self-reported COVID-19 infection. Material and Methods: A questionnaire was distributed to dental practitioners in all healthcare sectors in Jordan, Egypt, and Saudi Arabia. Results: There was a total of 335 participants, with the majority being females (N=225, 67.2%) and general practitioners (N=202, 60.3%). Cellulitis was the most common emergency encountered (N=108). The most common urgent procedures were for pulpitis, abscesses, and pericoronitis (N=191, 130, and 95, respectively). Country-specific significant associations were pulpitis in Egypt and Jordan, broken symptomatic teeth in Jordan, and biopsy in Egypt (p<0.05). The Ministry of Health was significantly associated with the management of dental infections, avulsion, and orthodontic emergencies, while university hospitals were significantly associated with advanced restorative procedures (p<0.05). Male practitioners performed significantly more procedures, particularly surgical emergencies (p<0.05). Conclusion: Dental infections were the most common complaints among dental patients during lockdown. Country- and sector-specific dental procedures are detected. Male gender seems to play a determinant role in performing a higher number of procedures, particularly for surgical emergencies

wound dehescence

the paper discuss causes and management of intraoral wound dehiscence after open reduction internal fixation of mandibular fracture </p

Unusual pattern of mandibular fracture displacement in a child: A case report

إن غالبية كسور الفك السفلي عند الأطفال هى من نوع كسر الغصن النضير مع وجود إزاحة بسيطة. نقوم هنا بتسجيل حالة كسر لقمي وإكليلاني للفك السفلي مع إزاحة شديدة، مع عرض مقدماتها السريرية وعلاماتها الإشعاعية والجراحية. أُزيحت اللقمة والإكليلاني اليُمنَيَان إلى الناحية الوحشية حتى استقرا بالكامل فوق الجانب الوحشي للقوس الوجني، مع إزاحة جزء من الإكليلاني إلى الناحية الإنسية. كان هناك تجمع دموي كبير في جدار البلعوم الوحشي امتد إلى الأسفل حتى الحد الأسفل للفك السفلية، مع إصابة شديدة للنسج الرخوة في المنطقة تحت الفك السفلي. ندرة مثل هذه الإصابة في الأطفال في منطقة الرأس والرقبة ومعالجتها تجعل هذه الحالة أكثر إثارة للاهتمام لجرَّاحي الوجه والفكين