Purpose The aim of this study was to assess the learning approaches of undergraduate dental students in Saudi Arabia. Methods This was a cross-sectional study in which an electronic questionnaire using the Biggs Revised two-factor Study Process Questionnaire (R-SPQ-2F) was completed by 222 undergraduate dental students from 1st year to 5th year. R-SPQ-2F contains 20 items to measure learning approaches through a structural model contrasting deep and surface learning. Results The mean value of the deep approach was higher among 4th- and 5th-year students than among 1st-, 2nd-, and 3rd-year students. The mean values of the surface approach in male subjects and subjects with lower grade point averages were statistically significant higher than those of the deep approach. Conclusion This study highlights that dental students have a greater tendency to adopt the surface approach when they are in preclinical years and in the 3rd year, when they experience a transition to clinical training. A deep approach to learning was mostly adopted among 4th- and 5th-year dental students. The surface approach was higher among male than female students. Students who used a deep approach had higher academic achievement than students who used a surface approach.

Aim The present randomized controlled trial assessed the postoperative anti‐inflammatory efficacy of 2% saline rinses (SR) and a herbal‐ mouthwash (HMW) after non‐surgical periodontal therapy (NSPT) for the management of periodontal inflammation in patients with chlorhexidine (CHX) allergy. Materials and Methods Patients with periodontal inflammation with and without self‐reported CHX allergy were included. All patients underwent non‐surgical periodontal therapy (NSPT). Patients were randomly divided into three groups. In the SR and HMW groups, 2% SR and a HMW, respectively, were prescribed. In Group 3 (CHX‐group), patients without CHX allergy were included and were prescribed 0.12% CHX. In all groups, plaque index (PI), gingival index (GI), probing depth (PD), clinical attachment loss (AL), and marginal bone loss were measured at baseline. Clinical periodontal parameters were re‐assessed at 6‐weeks’ follow‐up. p < 0.01 were considered statistically significant. Results Thirteen, 12, and 12 patients were included in the SR, HMW, and CHX groups, respectively. At baseline, clinical and radiographic periodontal parameters were comparable in all groups. In all groups, PI (p < 0.01), GI (p < 0.01), and PD (p < 0.01) were significantly higher at baseline than their respective values at 6 weeks of follow‐up. There was no significant difference in clinical AL at all time intervals in all groups. There was no significant correlation between periodontal parameters and age, gender, and daily toothbrushing/flossing in all groups. Conclusion In young adults with self‐reported CHX allergy, herbal mouthwashes and/or 2% SR are suitable post‐operative prescriptions after NSPT.

This meta-analysis was to systematically investigate all preclinical researches on the possible benefits of antiosteoporotic drugs on titanium implants. Also, we performed a subgroup analysis to examine if the methods of drug delivery (systemic vs. local vs. surface coatings) or the types of antiosteoporotic drug (anticatabolic vs. anabolic) have more effect on bone-to-implant regeneration. A total of 116 articles (animal studies) were included. Poor reporting was assessed in the majority of the included studies. Then, results of meta-analysis showed that the use of osteoporotic medications significantly increased the overall values of micro-CT bone volume (BV) (mean differences [MD]: 21.7%, confidence interval [CI]: 17.8-25.7), bone-to-implant contact (BIC) (MD: 12.1%, CI: 10.6-13.7), torque-out (MD: 5.7N.cm, CI: 4.6-6.8), and push-out (MD: 67.3N, CI: 54.6-79.9) compared with the values of implants without osteoporotic medications. Also, implants coated with drugs showed higher values of BIC (MD: 16.8%, CI: 12.4-21.3) compared with implants received drugs through systemic administration (MD: 12.2%, CI: 10.1-14.3) or local administration (MD: 8.6%, CI: 5.8-11.4). A positive effect of local delivery of antiosteoporotic drugs was significant on push-out testing (MD: 169.8N, CI: 120.1-219.6) compared with the use of drugs through systemic route (MD: 51.6N, CI: 38.7-64.6) or as surface coatings (MD: 24.1N, CI: 15.4-32.7). Finally, anabolic drugs showed a significant effect on push-out forces (MD: 125.5N, CI: 95.5-155.5) compared with the use of anticatabolic drugs (MD: 51.9N, CI: 39.5-64.5). In conclusion, the positive effect of antiosteoporotic drugs on osseointegration is observed in the present meta-analysis. Mainly, antiosteoporotic drug-coated implant surfaces showed an increase of BIC% compared with implants received drugs through local routes, but not with systemic routes. Also, the positive effect of anabolic drugs seems beyond the effect of anticatabolic drugs in terms of mechanical stability of implants as tested by push-out.

Guided bone regeneration (GBR) using a porcine-derived collagen matrix (Mucograft [MG], Geistlich) has not yet been reported. The aim of this histologic and biomechanical study was to compare the efficacy of MG versus resorbable collagen membranes (RCMs) in facilitating GBR around standardized rat calvarial defects. Forty female Wistar albino rats with a mean age and weight of 6 to 9 weeks and 250 to 300 g, respectively, were used. With the rats under general anesthesia, the skin over the calvaria was exposed using a full-thickness flap. A 4.6-mm-diameter standardized calvarial defect was created in the left parietal bone. For treatment, the rats were randomly divided into four groups (n = 10 per group): (1) MG group: the defect was covered with MG; (2) RCM group: the defect was covered with an RCM; (3) MG + bone group: the defect was filled with bone graft particles and covered by MG; and (4) RCM + bone group: the defect was filled with bone graft particles and covered by an RCM. Primary closure was achieved using interrupted resorbable sutures. The animals were sacrificed at 8 weeks after the surgical procedures. Qualitative histologic analysis and biomechanical assessment to identify hardness and elastic modulus of newly formed bone (NFB) were performed. Collected data were statistically analyzed using one-way analysis of variance. Histologic findings revealed NFB with fibrous connective tissue in all groups. The quantity of NFB was highest in the RCM + bone group. Statistically significant differences in the hardness (F = 567.69, dfN = 3, dfD = 36, P < .001) and elastic modulus (F = 294.19, dfN = 3, dfD = 36, P < .001) of NFB were found between the groups. Although the RCM + bone group had the highest mean ± standard deviation (SD) hardness of NFB (531.4 ± 24.9 MPa), the RCM group had the highest mean ± SD elastic modulus of NFB (18.63 ± 1.89 GPa). The present study demonstrated that RCMs are better than MG at enhancing new bone formation in standardized rat calvarial defects when used along with mineralized particulate graft material.

The aim of this review was to systematically assess bone regeneration by using antiosteoporotic drugs in adjunction with bone grafting compared with controls (bone grafting without the administration of antiosteoporotic drugs). The review also evaluated statistical differences in the effect between systemic and local routes of drugs. Also, the effect of type of drugs (anticatabolic vs. anabolic) was subevaluated. PubMed and EMBASE (via OvidSP) resulted in inclusion of 60 animal studies. The studies were assessed for reporting quality and risk of bias. Outcome data from selected studies were categorized as either experimental (bone grafting with the administration of antiosteoporotic drugs) or control. Meta-analysis of selected studies was done for these outcomes: histomorphometrical bone area (BA%) and micro-CT bone volume (BV%). In this review, several animal models (52 healthy, 6 osteoporotic, and 2 both conditions) were subjected to examine the effect of antiosteoporotic drugs on bone grafting, with a predominant use of rodent species. Assessment indicates poor reporting quality and unclear risk of bias in the majority of studies. Random-effects metaanalysis revealed a significant increase in overall BA% (mean difference [MD]: 2.6, confidence interval [CI]: 2.25 to 2.92) and BV% (MD: 0.12, CI: 0.05 to 0.19) due to osteoporotic drug treatment compared with controls. For subgroups, both routes of antiosteoporotic drug administration showed similar effects on BA%. In contrast, systemic antiosteoporotic drug administration led to significantly higher BV% (MD: 6.75, CI: 5.30 to 8.19) compared with local administration (MD: 0.02, CI: -0.03 to 0.08). Further, administration of anabolic drugs significantly increased BA% (MD: 5.75, CI: 4.62 to 6.87) compared with anticatabolic drugs (MD: 1.86, CI: 1.47 to 2.26). In conclusion, both histomorphometrical and micro-CT scan analysis indicated an overall effect of using the antiosteoporotic drugs toward bone regeneration in adjunction with grafting. However, not all studies showed a positive effect and the present results need to be applied with care, as the included papers showed experimental heterogeneity for animal models. Further (pre)clinical research is warranted to explore whether drug-based strategies can be an effective adjunctive with bone grafting.The aim of this meta-analysis was to assess whether antiosteoporotic drugs can promote bone regeneration in adjunction with bone grafting by using preclinical animal models. Although the majority of included studies indicated poor reporting quality and unclear risk of bias, an overall positive effect of the antiosteoporotic drugs toward bone regeneration related to bone grafts can be highlighted.

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The aim of this in vivo microcomputed tomographic (μCT) study was to compare the efficacy of Mucograft (MG) vs resorbable collagen membranes (RCMs) in facilitating guided bone regeneration (GBR) around standardized calvarial defects in rats. Forty female Wistar albino rats with a mean age and weight of 6 to 9 weeks and 250 to 300 g, respectively, were used. With the rats under general anesthesia, the skin over the calvaria was exposed using a full-thickness flap. A standardized calvarial defect with a 4.6-mm diameter was created in the left parietal bone. For treatment, the rats were randomly divided into four groups (n = 10 per group): (1) defects covered with MG (MG group); (2) defects covered with an RCM (RCM group); (3) defects filled with xenograft bone particles and covered by MG (MG + bone group); and (4) defects filled with xenograft bone particles and covered by an RCM (RCM + bone group). Primary closure was achieved using interrupted resorbable sutures. The animals underwent high-resolution, three-dimensional μCT scans at baseline and at 2, 4, 6, and 8 weeks after the surgical procedures. Data regarding volume and bone mineral density (BMD) of newly formed bone (NFB) and bone particles revealed an increase in the volume of NFB in all the groups from baseline to 8 weeks. The MG group had the lowest volume of NFB (mean ± standard deviation [SD], 1.32 ± 0.22 mm(3)). No significant differences in mean ± SD values for volume of NFB were observed between the RCM (3.50 ± 0.24 mm(3)) and MG + bone (3.87 ± 0.36 mm(3)) groups, but their values were significantly lower than that of the RCM + bone group (2.95 ± 0.15 mm(3), F = 131.91, dfN = 2, dfD = 27, P < .001). Significant differences in BMD of NFB between the groups (F = 332.46, dfN = 3, dfD = 36, P < .001) and during different data collection periods (F = 97.04, dfN = 3, dfD = 36, P < .01) were observed, with the RCM group having the highest mean ± SD BMD of NFB (0.42 ± 0.05 g/mm(3)). Significant differences in the bone particle volume between the RCM + bone and MG + bone groups (F = 91.04, dfN = 1, dfD = 18, P < .05) and at different data collection periods (F = 314.12, P < .01) were observed, with the RCM + bone group displaying greater reduction in both volume (36.8%) and BMD (19.7%) of bone particles. The present in vivo μCT study demonstrated that RCM is better than MG in enhancing new bone formation in rat calvarial standardized defects when used in combination with mineralized particulate graft material.