Oral and Maxillofacial Diagnostic Sciences

The exact frequency of the trigeminocardiac (TGC) reflex in temporomandibular joint (TMJ) surgery is still controversial. The purpose of the present report was to estimate the frequency of and identify the risk factors for TGC reflex among patients undergoing operative management of TMJ ankyloses.

The exact frequency of the trigeminocardiac (TGC) reflex in temporomandibular joint (TMJ) surgery is still controversial. The purpose of the present report was to estimate the frequency of and identify the risk factors for TGC reflex among patients undergoing operative management of TMJ ankyloses.

This study aimed to assess the clinical and radiographic findings obtained by using amniotic membrane (AM) to cover nano-hydroxyapatite (nHA) bone grafts coated with platelet-rich fibrin (PRF) and thereby evaluate the osseointegration of posterior mandibular implants inserted simultaneously during alveolar piezoelectric ridge splitting technique (RST). Methods: A prospective cohort study was implemented with thirty patients who had a narrow posterior mandibular alveolar ridge and required implant restoration. Patients were distributed randomly into three groups (group I treated by piezoelectric RST and immediate implant insertion, augmented by the nHA bone graft only; group II treated by piezoelectric RST augmented by nHA bone graft and covered by AM; while group III was treated by piezoelectric RST augmented with PRF and nHA graft and covered by AM). Patients were evaluated clinically to assess the implant stability quotient (ISQ) and radiographically to assess horizontal ridge dimension, crestal

Objectives: Hypercementosis (HC) is an asymptomatic excessive cementum deposition at the dental root apex. There is a lack of research that determines the pattern and associated factors of HC in Saudi Arabia. Materıals and Methods: A retrospective cross-sectional study was conducted on a random sample of 815 Orthopantomograms (OPGs) that was obtained from a total of 14003 female patients archived OPGs. The OPGs were retrieved from the Kodak Carestream-R4 database for the period between 2015 and 2017 at

Objectives: Maxillary sinus pneumatization (MSP), is linked worldwide to number of factors. MSP measurements and assessment alongside potential correlates in Al-Madinah Al-Munawwarah, Saudi Arabia (SA) awaits identification. Materials and methods: A retrospective cross-sectional study was conducted at Taibah University Dental-College and Hospital, Al-Madinah Al-Munawwarah; SA. The analysis included 700 female patients digital Orthopantomogram (OPG), of which 535 (76%) OPGs were usable. MSP was established according to the distance between the maxillary sinus floor and posterior teeth apices number 15, 16, 17, 18, 25, 26, 27 and 28. MSP categorized as followed: Sever MSP (Category I), Moderate MSP (Category II) and No MSP/normal (Category III). Descriptive statistics, and inferential analysis were carried out. Results: Mean age of the patients was 30.11 (±10.26) and 290 (54.5%) were Saudi nationals. Severe pneumatization (category I) was prominent in the right and left first and second molars, 16, 26, 17, 27 (66%, 64%, 63% and 62%, respectively). A statistically significant difference (P < 0.0005) was observed between pneumatization categories in all sites. Furthermore, the impact

Despite the feminization of dentistry in many areas of the world, female representation in the field of oral and maxillofacial surgery (OMFS) is poor. The purpose of this study was to identify factors perceived by female oral and maxillofacial surgeons in Egypt, Jordan, and Saudi Arabia as being obstacles to their career progression and to compare them to factors identified by their male colleagues. This was a cross-sectional questionnaire-based study. A Google Forms questionnaire was designed to collect data on socio-demographics and perceived career obstacles in OMFS. This was distributed to oral and maxillofacial surgeons in Egypt, Jordan, and Saudi Arabia. Statistically significant differences between the genders were evident in terms of marital status (P = 0.001), spouse's education (P = 0.005), and spouse's occupation (P < 0.001). When compared to male surgeons, female surgeons more often considered that their spouse's occupation hindered their career progression (P < 0.001). Female surgeons, but not male surgeons, perceived sexism and social factors such as marriage, children, and the attitudes of society to be major career obstacles (P < 0.005). In conclusion, female maxillofacial surgeons in some Middle Eastern countries were found to have different socio-demographic characteristics compared to their male colleagues and they considered sexism, marriage, children, and the attitudes of society to be major career obstacles.

The exact frequency of the trigeminocardiac (TGC) reflex in temporomandibular joint (TMJ) surgery is still controversial. The purpose of the present report was to estimate the frequency of and identify the risk factors for TGC reflex among patients undergoing operative management of TMJ ankyloses.

Objectives: Hypercementosis (HC) is an asymptomatic excessive cementum deposition at the dental root apex. There is a lack of research that determines the pattern and associated factors of HC in Saudi Arabia. Materıals and Methods: A retrospective cross-sectional study was conducted on a random sample of 815 Orthopantomograms (OPGs) that was obtained from a total of 14003 female patients archived OPGs. The OPGs were retrieved from the Kodak Carestream-R4 database for the period between 2015 and 2017 at

Despite the feminization of dentistry in many areas of the world, female representation in the field of oral and maxillofacial surgery (OMFS) is poor. The purpose of this study was to identify factors perceived by female oral and maxillofacial surgeons in Egypt, Jordan, and Saudi Arabia as being obstacles to their career progression and to compare them to factors identified by their male colleagues. This was a cross-sectional questionnaire-based study. A Google Forms questionnaire was designed to collect data on socio-demographics and perceived career obstacles in OMFS. This was distributed to oral and maxillofacial surgeons in Egypt, Jordan, and Saudi Arabia. Statistically significant differences between the genders were evident in terms of marital status (P = 0.001), spouse's education (P = 0.005), and spouse's occupation (P < 0.001). When compared to male surgeons, female surgeons more often considered that their spouse's occupation hindered their career progression (P < 0.001). Female surgeons, but not male surgeons, perceived sexism and social factors such as marriage, children, and the attitudes of society to be major career obstacles (P < 0.005). In conclusion, female maxillofacial surgeons in some Middle Eastern countries were found to have different socio-demographic characteristics compared to their male colleagues and they considered sexism, marriage, children, and the attitudes of society to be major career obstacles.

The present study was conducted to compare between extraoral and intraoral approach for botulinum toxin type A (BTX-A) injection into the lateral pterygoid muscle (LPM) in patients suffering from anterior disc displacement with reduction (ADDWR). Fourteen patients suffering from ADDWR were included in this prospective cohort study. Patients were enrolled randomly into 2 groups according to injection approach; where extraoral used in group I, while intraoral approach used in group II. The LPM was injected with 20 IU BTX-A under electromyography (EMG) guidance. Postoperative evaluation of the patients included: mouth opening assessment, LPM tenderness, temporomandibular joint TMJ (clicking), and tenderness. The LPM insertional EMG activity was assessed. Also, magnetic resonance imaging (MRI) was performed to evaluate disc position. Descriptive and inferential analysis was conducted to compare between groups. There was significant patient's convenience during injection and significant injection time reduction in group II. A slight decrease in mouth opening immediate post-injection followed by significant improvement from 8th weeks post-injection was reported in both approaches. There was a significant improvement in TMJ clicking from 1st-week post-injection with no group difference. The EMG assessment documented LPM hyperactivity pre-injection followed by significantly decreased muscle activity at 8 and 16 weeks post-injection without statistical difference. The MRI showed no change in disc position after injection. Conclusion: The BTX-A injection into LPM is a simple technique that can be used with high success and low complication rate for treatment of ADDWR. The intraoral approach was superior to the extraoral concerning patient convenience and injection duration with no statistical difference regarding other clinical outcomes.

Therefore, the purpose of the current report is to introduce this case of hypercementosis, review and update the recommended surgical techniques used for extraction, and to explore more avenues on the surgical treatment of hypercementosed teeth with the least complication. CASE REPORT A 38-year female was referred from the Restorative Department for extraction of an unrestorable tooth. The patient was referred to an oral and maxillofacial surgery clinic to complete the case rehabilitation. The patient's medical history was clear. On preoperative clinical examination, there were multiple attrited teeth with mild gingivitis with no other abnormal features. Upper left third molar was indicated for extraction due to chronic periodontitis and over-eruption as no opposing tooth was present. From the orthopantomogram radiograph, a generalised hypercementosis was noticed in almost all the maxillary

Objectives: Here, we present cases of mandibular fracture that were managed with the cortical lag screw fixation technique (CLSFT) in order to critically evaluate technique indications and limitations of application at various fracture sites. Materials and Methods: This was a retrospective cohort study. The study sample was composed of patients suffering from mandibular fractures that were treated by the CLSFT. The outcome variables were fracture type, duration of surgery, number of screws, and pattern of application. Other study categories included patient demographics and causes of injury. Chi-square tests were used to assess descriptive and inferential statistical differences, and the P-value was set at 0.05. Results: Thirty-three patients were included in the study sample, with a mean age of 30.9±11.5 years and a male predominance of 81.8%. The technique was applied more frequently in the anterior mandibular region (51.5%) than in other sites. Double CLSFT screws were required at the symphysis and parasymphysis, while single screws were used for body and angle regions. No intraoperative and postoperative variables were significantly different except for surgical duration, which was significantly different between the sites studied (P=0.035). Conclusion: We found that CLSFT is a rapid, cost-effective technique for the fixation of mandibular fractures yielding good treatment results and very limited complications. However, this technique is sensitive and requires surgical expertise to be applied to mandibular fractures that have specialized characteristics.

Aim Although partial extraction technique (PET) is an exciting emerging technique, there is still minimal evidence regarding its effectiveness in preserving the buccal cortical bone simultaneously with immediate implant insertion. The present study aimed to systematically evaluate the available clinical data concerning PET before immediate implantation. Material and methods A comprehensive systematic search was conducted which included a simple search strategy, using different electronic databases. Fourteen selected clinical human studies (7 clinical trials and 7 case series) out of 139 were included. The data retrieved from the selected studies included: study design, sample size, age, gender, study setting, site andside of technique application, author's names, journal title, year of publication, statistical tests used, and follow up prognostic results. Accuracy was confirmed by three researchers whom assessed all collected data. Results There were 619 implants inserted using the PET in the included studies ,96.6 % of them were performed on the maxillary anterior and premolars region. The patients' age ranged from 24 to 83 years. Follow up ranged from 12 to 60 months. Implant failure was reported in 1.6% of the cases, infection in 1% and 3.1% had shield exposure and resorption problems. Clinical esthetic parameters and other radiographic evaluations revealed comparable results in favor of PET over conventional post extraction implant placement techniques. Conclusion Based on the results of this review, the PET provided clinically acceptable results regarding ridge preservation in the esthetic zone of the maxillary anterior teeth. Future randomized controlled studies are needed to confirm the efficacy of this technique in different places of the jaw.

Introduction: The extraction of teeth is a common dental treatment. Healing complications have been reported to be influenced by patients' knowledge and compliance with postoperative instructions. Aim: The goal of the study was to define the influence of the way postoperative instructions delivering method on reducing morbidity and problems experienced after simple tooth extraction. Materials and Methods: A single-blind randomized clinical trial was designed at clinics of Oral Maxillofacial Surgery, Taibah University. Patients were distributed to two classes on a random basis. The first group was provided only with verbal instructions (VI) after dental extraction. The second group was given written and verbal (CVWI) instructions. Postoperative pain, swelling, sleep impairment, oral functions, and general activity were reported using an assessment tool for oral health life quality (OHQ). Results and Discussion: The mean OHQ scores were 14.28 ± 6.36 for VI and 13.46 ± 5.78 for CVWI, which did not indicate a statistical difference (P = 0.50). Of the 100 participants, 51% were mildly affected, whereas 22% were severely affected. Females constituted 51% of the study participants. There was a statistically significant difference between females' mean score values compared to males (15.78 ± 4.5-11.88 ± 6.5) with P = 0.001. About 56% of the participants were nonSaudis and 33% hold a high-school diploma. Conclusions: There was no difference between the two approaches used to present the postoperative instruction in the postextraction OHQ. Following tooth extraction, female patients experience a significantly greater decline in their OHQ. Translation of written postoperative instructions in more than one language should be available in our institution to improve OHQ during the postextraction period.

Purpose There is still no definitive consensus about the ideal technique in the treatment of anterior mandibular fractures. Therefore, this study aimed to determine clinical and radiographic outcomes of four different internal fixation devices used for this type of fractures. Methods This was a cohort study that included 64 fracture cases. Fractures were fixed using four types of open reduction internal fixation devices: single 2.0-mm mini-locking plates, double 2.0-mm miniplates, double lag screw and double microplates. Investigated variables were surgical duration, wound dehiscence, infection, occlusion, mouth opening, patient compliance, nerve damage and postoperative oedema. Results Male patients constituted 90.6% of the study sample. A proportion of 33% of the fractures were single symphysis and 67% were parasymphysis fractures. The most time-saving technique was the lag screw followed by microplate with mean/SD of 50.65 ± 4.152 min. Wound dehiscence occurred in 4.7% and 3.1% of the miniplate and the mini-locking groups respectively. Miniplate and microplate groups had small interfragmentary space at 1-month postoperative radiographs, while mini-locking and lag screw groups had no extra-callus formation. Conclusion The double lag screw and the single mini-locking plate are the most effective devices for primary bone healing of displaced mandibular symphysis/parasymphysis fractures which is attributed to their enhanced stability. Miniplates and microplates gave functionally well-balanced fixation and were also associated with higher patient convenience due to improved adaptability and relatively lower cost than locking plates. Cost-effectiveness of lag screws in comparison to bone plates is particularly beneficial in low-income countries.

In November 2002, a virus known as SARS-CoV was identified in Guangdong, China, and it was implicated as the etiology of severe acute respiratory syndrome. Seventeen years later, in the same month of November, a similar disease with more dramatic outcomes was identified in neighboring Wuhan. It has been six months since the identification of first cases of COVID-19 pandemic; however, unveiling clinical characteristics and modes of transmission of the disease are taking longer than expected. This overview aims to highlight some important points regarding the mode of transmission for which continuously surprising facts are being revealed every day. We also raise some vital questions to alert the scientific community to find the right answers and minimize the drastic fatal outcomes of this disease. It can be stated that SARS-CoV-2 could be transmitted as aerosol infection as well as through contacting infected surfaces. The possible role of abdominal gases as a route of spread of the virus should be considered and a fecal sample might be a useful diagnostic tool. Moreover, medical face masks are not protective from virus transmission during treating COVID-19 patients in settings where aerosol-generating procedures are performed. Doffing of PPE for healthcare workers needs more attention as this might be a source of infection unless additional measures of PPE disinfection are employed before doffing.

To implement and evaluate a simplified, rapid, single-day emergency management technique for pediatric mandibular fractures, the author applied the current technique of using combined lingual splint with Risdon wiring under sedation anesthesia as a cohort study in a group of preschool mandibular fracture children aged 4 to 6 years. Clinical outcome variables were fixation length and reduction simplicity, post-reduction occlusion, recovery of mouth opening, and degree of postoperative edema and pain. Age, gender, fracture site and the cause of injury were other study variables. The study involved 11 children suffering from a mandibular fracture in the dental bearing region. The majority of them were males with a proportion of 72.7%. The clinical results obtained from the combined technique were promising in terms of rapid surgical duration, simplicity of fracture reduction, decreased postoperative pain and edema, rapid recovery of mouth opening without a recorded complication. It could be concluded that combining Risdon wiring with lingual splint is a simple, fast, and reliable fixation technique for managing preschool mandibular pediatric fractures.

This study aimed to assess the clinical and radiographic findings obtained by using amniotic membrane (AM) to cover nano-hydroxyapatite (nHA) bone grafts coated with platelet-rich fibrin (PRF) and thereby evaluate the osseointegration of posterior mandibular implants inserted simultaneously during alveolar piezoelectric ridge splitting technique (RST). Methods: A prospective cohort study was implemented with thirty patients who had a narrow posterior mandibular alveolar ridge and required implant restoration. Patients were distributed randomly into three groups (group I treated by piezoelectric RST and immediate implant insertion, augmented by the nHA bone graft only; group II treated by piezoelectric RST augmented by nHA bone graft and covered by AM; while group III was treated by piezoelectric RST augmented with PRF and nHA graft and covered by AM). Patients were evaluated clinically to assess the implant stability quotient (ISQ) and radiographically to assess horizontal ridge dimension, crestal

Background/purpose: Several pharmacotherapeutic methods have been used for the treatment of COVID-19 with varying degrees of success. No definitive treatment or vaccine has been officially approved to-date. This review aimed to highlight COVID-19 pharmacotherapeutic agents that are relevant to dental practice in terms of their clinical indications in COVID-19 and dental practice, as well as their adverse effects as they impact the dental patient. Material and methods: Systematic search was performed using the following keywords combinations: Pharmacotherapy AND COVID-19 OR Pharmacotherapy AND SARS-CoV-2 OR Treatment AND COVID-19. Studies were categorized according to the type of pharmacotherapy used. Pharmacotherapeutic agents were extracted and only those relevant to dental practice were included for review. Results: For analysis, a total of 79 clinical trials research articles were included that included COVID-19 pharmacotherapeutic agents relevant to dental practice. Those were analgesics (paracetamol; non-steroidal anti-inflammatory agents); antibiotics (azithromycin, doxycycline, metronidazole); antivirals (penciclovir); and immunomodulatory agents (hydroxychloroquine, corticosteroids). While some COVID-19 drugs are less relevant to dental practice, as antivirals and hydroxychloroquine, their association with long-term adverse effects requires adequate knowledge among dental practitioners.