Re-epithelialization is an important part in mucosal wound healing. Surprisingly little is known about the impact of diabetes on the molecular events of mucosal healing. We examined the role of the transcription factor forkhead box O1 (Foxo1) in oral wounds of diabetic and normoglycemic mice with keratinocyte-specific Foxo1 deletion. Diabetic mucosal wounds had significantly delayed healing with reduced cell migration and proliferation. Foxo1 deletion rescued the negative impact of diabetes on healing but had the opposite effect in normoglycemic mice. Diabetes in vivo and in high glucose conditions in vitro enhanced expression of chemokine (C-C motif) ligand 20 (CCL20) and interleukin-36γ (IL-36γ) in a Foxo1-dependent manner. High glucose–stimulated Foxo1 binding to CCL20 and IL-36γ promoters and CCL20 and IL-36γ significantly inhibited migration of these cells in high glucose conditions. In normal healing, Foxo1 was needed for transforming growth factor-β1 (TGF-β1) expression, and in standard glucose conditions, TGF-β1 rescued the negative effect of Foxo1 silencing on migration in vitro. We propose that Foxo1 under diabetic or high glucose conditions impairs healing by promoting high levels of CCL20 and IL-36γ expression but under normal conditions, enhances it by inducing TGF-β1. This finding provides mechanistic insight into how Foxo1 mediates the impact of diabetes on mucosal wound healing.

PurposeTo study bone profile (facial bone thickness and height of alveolar bone crest) of anterior maxillary teeth in the aesthetic area among Saudi dentulous adults.MethodsThis retrospective study was conducted at Taibah University College of Dentistry and Hospital, AlMadinah; Saudi Arabia. The analysis included 490 adult patients’ Cone Beam Computed Tomography (CBCT) retrieved from Kodak Carestream-R4 database. Alveolar bone thicknesses and crest bone-height for maxillary anterior teeth were measured directly on CBCT images using built-in digital caliper. Descriptive statistics and comparative analysis were performed.ResultsOf the 490 CBCTs 186 were found useable for the study purpose. The mean age of the patients was 34.65 ± 11.57and 109 (59%) were males. Statistically significant (P < 0.001) differences were found between the mean ± SD facial plate thickness of the central incisors, lateral incisors, and canines (1.12 ± 0.28 mm, 1.14 ± 0.31 mm, and 1.03 ± 0.24 mm, respectively). In addition, facial plate height increased statistically significantly positively with age for the central incisors, lateral incisors, and canines (r = 0.543, n = 186, p = 0.001; r = 0.515, n = 186, p = 0.001; r = 0.474, n = 186, p = 0.001, respectively). Genderwise, males had statistically significantly (P < 0.00) higher facial bone thickness e.g. in central incisor (males 1.20 ± 0.29 VS females 1.04 ± 0.25, p = 0.001) and increased bone height (Males 2.62 ± 0.77VS females 2.09 ± 0.66, p = 0.001) compared to females.ConclusionIn this study, the significant differences in bone thickness and crest height between anterior maxillary teeth in the aesthetic area was highlighted. Notably, increases in facial plate crest height was linked to age and male and female differed on both facial bone thickness and bone height.

Background Screening for medical conditions (MCs) of public health importance is a first step in disease prevention and control. Prior studies in the United States found oral health care providers (OHCPS) embrace screening for increased risk of medical conditions in the dental setting. Our objectives were to assess Saudi Arabian (SA) dentist’s attitudes, willingness and perceived barriers towards implementing screening for MCs into their dental practices. Methods A self-administered, 5-point Likert Scale (1 = very important/willing to 5 = very unimportant/unwilling) questionnaire was given to a convenience sample of 190 practicing dentists. Friedman nonparametric analysis of variance was used to compare responses within each question. Results Of the 143 responding dentists the mean age was 31 years; 102 (71%) were men. The majority felt it was important for a dentist to screen for cardiovascular disease (98.6%), hypertension (97.9%), diabetes (97.9%), human immunodeficiency virus (HIV) (97.9%), and hepatitis C virus (98.6%). Respondents were willing to refer a patient to a physician (97.9%); send samples to an outside laboratory (96.1%); conduct screening that yields immediate results (96.2%); and discuss results immediately with the patient (93.7%). Respondents were willing to measure/collect blood pressure (67.2%); weight and height (63.7%); and finger stick blood (54.6%). The whole responding dentists (100%) reported time as an important barrier. Respondents were significantly more willing to refer a patient for consultation than send samples to an outside laboratory (mean ranks: 2.32, 2.81, P < 0.001); significantly more willing to measure blood pressure than take oral fluids for salivary diagnostics (mean ranks 2.22, 2.75, p = 0.003). Insurance was significantly ( P < 0.05) less important barrier than time, cost, patients’ willingness or liability (mean ranks 3.56, 2.63, 3.00, 2.79, 3.02, respectively). Conclusions The majority of dentists in this study reported positive attitudes towards and willingness to perform medical screenings in their practice. Time was an important factor.

To investigate the prevalence and contributing factors of antibiotic selfmedication for oral conditions in dental patients. Material and Methods: A questionnaire was distributed to 501 patients attending Taibah University Dental College and Hospital, Al Madinah, Saudi Arabia during late 2016. Questions were on socio-demographic characteristics, and pattern of antibiotic self-medication for oral disease. Statistical analysis was performed using IBM SPSS software version 21. Statistical significance level was set at p ≤.05. Results: Age range was 15-64 years (29.08±9.32 years) with 297 females (59.3%) and 204 males (40.7%). 135 patients (27%) self-medicated with antibiotics for oral disease. This practice was statistically significantly associated with the older adults (p=0.001), lack of medical or dental insurance (p=0.014 and 0.007, respectively), and poor dental attendance (p=0.021). A number of 26 (25.7%) perceived analgesics as antibiotics. Amoxicillin-clavulanic acid was the most commonly cited antibiotic by 18 patients (17.8%). Dental pain was the most frequently reported oral condition. Pharmacists were the most common source for antibiotic prescription cited by 58 (57.4%). Conclusion: Antibiotic self-medication for oral disease is associated with the use of broad-spectrum antibiotics for non-indicated clinical oral conditions. The practice was encouraged by lenient behavior of pharmacists, lack of health insurance, and poor dental attendance.

Background and aimRadiographic assessment is an important diagnostic tool in dental practice. Cone beam computed tomography (CBCT) is among the most important imaging examinations. By providing multiplanar visualization of the maxillofacial region, CBCT enables practitioners to assess various conditions threedimensionally. CBCT is utilized in different fields within dentistry, including oral and maxillofacial surgery, endodontics, orthodontics, periodontics, implant dentistry, and others. Having access to accurate 3D images is crucial in implant dentistry. This study aimed to measure the crestal bone height loss and facial alveolar bone thickness in the maxillary anterior teeth using CBCT to investigate its effect on surgical planning for dental implant placement in adult patients. Material and methodsCBCT scans (N = 119) of adults, aged 18-65 years, with bilateral permanent maxillary anterior teeth present were included in this retrospective study. The mean alveolar bone plate thickness and crest bone height loss adjacent to the maxillary anterior teeth were measured and differences were examined. ResultsThe results suggest that additional care and assessment of dental implant placement should be considered when replacing the permanent lateral incisors and canines. The frequency of fenestrations and dehiscence is higher in older adults. Possible management includes guided bone regeneration or "pink restorative solutions." ConclusionCBCT analysis to assess the bone morphology surrounding "hopeless" maxillary anterior teeth is important to ensure proper diagnosis and management, including the use of dental implants.