The relationship between bisphosphonates (BP) and dental implant failure has not been fully elucidated. The purpose of this retrospective radiographic study was to examine whether patients who take BP are at greater risk of implant failure than patients not using those agents. Treatment records of 362 consecutively treated patients receiving endosseous dental implants were reviewed. The patient population consisted of 227 women and 135 men with a mean age of 56 years (range: 17-87 years), treated in the University at Buffalo Postgraduate Clinic from 1997-2008. Demographic information collected included age, gender, smoking status, as well as systemic conditions and medication use. Implant characteristics reviewed included system, date of placement, date of follow-up radiographs, surgical complications, number of exposed threads, and implant failure. The relationship between BP and implant failure was analyzed using generalized estimating equation (GEE) analysis. Twenty-six patients using BP received a total of 51 dental implants. Three implants failed, yielding success rates of 94.11% and 88.46% for the implant-based and subject-based analyses, respectively. Using the GEE statistical method we found a statistically significant (P  =  .001; OR  =  3.25) association between the use of BP and implant thread exposure. None of the other variables studied were statistically associated with implant failure or thread exposure. In conclusion, patients taking BP may be at higher risk for implant thread exposure.

Aim: To evaluate the potential of advanced platelet-rich fibrin (A-PRF) as a regenerative biomaterial for bone regeneration and postoperative sequelae after impacted third molar extractions. Materials and methods: This was a split-mouth, randomized, double-blind clinical trial. A total of 10 female patients in King Abdulaziz University Dental Hospital with bilateral impacted third molars were recruited into the study. Surgical extractions were performed on both sides of the mandible. Randomization was done by a coin toss; A-PRF was placed on the one side while the other side did not receive any intervention. Each patient acted as their own control. Both the patients and the investigators were blinded about the A-PRF side. The outcome on periodontal regeneration was made measuring pocket depth (PD), gum recession (GR), and clinical attachment level (CAL) before and at 1-and 3-months postoperatively. Pain, swelling, and healing were assessed on the 7th postoperative day. p value less than 0.05 was considered statistically significant.Results: An estimated 10 patients completed the study. There were no significant differences in PD, CAL, and GR between the two groups at any time point, although the data obtained were slightly favoring the A-PRF. However, a statistically significant reduction in pain and swelling was observed in the A-PRF group compared to the controls (p < 0.05). Conclusion:The findings of this study demonstrate A-PRF as a potential biomaterial for lessening the severity of pain and swelling after third molar surgery. Long-term trials with a larger sample size and more methodically sound assessment tools are needed to obtain more meaningful results on periodontal regeneration. Clinical significance: Placement of A-PRF clot in the extraction socket could lessen postoperative pain and increase patient comfort after third molar extraction. Trial registration: NCT03703479. Registered

Objectives To compare the amount of en-masse retraction with or without piezocision corticotomy, to assess the type of tooth movement, to evaluate root integrity after retraction, and to record reported pain levels. Materials and Methods This randomized, controlled clinical trial included 26 orthodontic patients requiring premolar extraction. The patients were divided into two groups: (1) an extraction with piezocision corticotomy group (PCG) and (2) an extraction-only group, which served as the control group (CG). Cone-beam computed tomography images were acquired before and 4 months after the initiation of en-masse retraction utilizing miniscrews. The following variables were assessed: the amount of en-masse retraction, incisor inclination, incisor and canine root resorption, and patient-reported pain. Results Twelve and 11 participants completed the entire study in the PCG and CG, respectively. The amount of en-masse retraction was significantly greater in the PCG compared to the CG (mean = 4.8 ± 0.57 mm vs 2.4 ± 0.33 mm, respectively [P &lt; .001]). There was also significantly less tipping and root resorption of incisors in the PCG (P &lt; .05). The reported pain was significantly higher on the first day in the PCG compared to the CG (P &lt; .001); however, it became similar between the groups after 24 hours. Conclusions Piezocision corticotomy enhanced the amount of en-masse retraction two times more with less root resorption. However, future studies are required to assess the long-term effects of this technique.

This study aimed to evaluate the impact of two different oral health education approaches, a mobile application (the Brush DJ app) and conventional educational lectures, on the oral hygiene knowledge and behavior of high school children. Methods: The research was a cross-sectional study of 271 students from two public schools in Jeddah City, Saudi Arabia. An eighteen-item questionnaire was used for this purpose. Those who completed the baseline questionnaire were allocated to one of two groups: (1) mobile application and (2) educational lecture. A follow-up survey was later conducted at three months, which repeated eight of the eighteen questions asked in the baseline survey. The change in oral hygiene attitude and behaviors was compared across both groups. Results: The Brush DJ app was found to be equally effective compared to educational lectures in changing oral health knowledge, attitude and behavior. Both groups showed significant improvements in almost all aspects of oral health, except for the frequency and duration of tooth brushing in the app group. There was no change in twice daily tooth brushing of app users, and less than 40% reported brushing their teeth for 2 minutes. A statistically significant change, however, was noted among lecture group participants in these two areas of oral hygiene routine. The app was also found to be more difficult in usability than educational lectures (p = 0.037). Conclusion: The Brush DJ app may be a valuable tool to improve oral health knowledge, attitude and behavior. However, the app needs some improvements. The content and features of the app need to be structured in a way that it allows for personalization and is more interactive, practical and user-friendly.

Acquired tufted angioma is a rare, cutaneous and slow growing benign vascular neoplasm that usually affects pediatric populations. Only six cases of oral mucosal acquired tufted angioma have been reported in the English language literature. We present in this report the seventh case and discuss its clinical and pathological features.

Rapid and complete soft tissue healing after tooth extraction minimizes surgical complications and facilitates subsequent implant placement. We used four treatment methods and assessed changes in soft tissue socket closure following tooth extraction in humans. The effects of platelet-rich fibrin-calcium sulfate hemihydrate (PRF-CSH), platelet-rich plasma-calcium sulfate hemihydrate (PRP-CSH), a resorbable collagen dressing (RCD), and no grafting material were compared in a randomized, controlled pilot study with a blinded parallel design (N = 23). Patients with a hopeless tooth scheduled for extraction were randomly assigned to one of the four treatment groups. Socket measurements were obtained immediately after extraction and treatment, as well as after 21 days. There was a significant decrease in the total epithelialized external surface area of the extraction sockets in each group at all time points. However, there were no significant differences in soft tissue closure (p > 0.05) at any time point and PRF-CSH or PRP-CSH did not provide any additional benefit to enhance the soft tissue closure of extraction sockets compared with either RCD or sites without graft.

Purpose The study aimed to determine the types of periodontal services rendered by general dental practitioners (GDPs) in Saudi Arabia. Subjects and methods A cross-sectional survey was performed on a convenience sample of 340 licensed GDPs practicing within Saudi Arabia. GDPs were asked several questions regarding the types of periodontal services offered, the level of training and education received in periodontics and the periodontal referral processes. Results Two hundred and ninety GDPs responded to the survey. The most commonly rendered periodontal services by the GDPs were oral hygiene instructions (84.1%; 244/290), mouthwash prescribing (82.7%; 240/290) and scaling and root planing (72.4%; 210/290). Only 21% (59/282) of the GDPs surveyed reported providing periodontal surgical services. The most frequently rendered surgical procedures included gingivectomy, functional crown lengthening and single posterior implant. Also, 76% (220/290) of the GDPs had no continuing education (CE) credit relating to periodontics. The level of training received in the dental school seemed to be an important factor that influenced a GDP’s decision to provide periodontal services. Also, 64% (184/286) of the GDPs were not routinely performing periodontal screening exams. The most common reason for not referring patients to a periodontist was practice setting’s policy. Conclusion Periodontal services commonly rendered by the GDPs of this survey were mostly nonsurgical in nature. The results indicate a need for formal advanced training in periodontics. GDPs should be encouraged to take periodontic CE courses.

BackgroundSince the introduction of enamel matrix derivatives (EMD) (Emdogain®), it has not been allowed to be used in Saudi Arabia due to the religious restriction on porcine products. This study was conducted to determine the impact of the fatwas permitting the use of EMD and to assess the general perception of using bone-grafting materials in Jeddah, Saudi Arabia.Materials and methodsThis cross-sectional survey study included 213 patients seeking dental treatment at the Faculty of Dentistry Clinics of King Abdulaziz University, Jeddah, Saudi Arabia. They were recruited between September and November 2017. Subjects completed a questionnaire to assess their opinions before and after reading the fatwa about using EMD.ResultsMajority of the study subjects (70%) did not accept the use of bone-grafting materials and EMD in periodontal regeneration before reading the fatwas. The highest rate of acceptance was observed for the use of tissues from one’s own body (84%) while the biomaterials of porcine origin had the lowest acceptance rate (14.1%). Strong religious belief and low education level were the two key factors responsible for the initial refusal of EMD use before reading the fatwas. Around 45.1% of the participants changed their opinions in favor of EMD use after reading the fatwas and their interpretations. McNemar’s test found a statistically significant difference in opinions collected before and after reading the fatwas (P<0.001).ConclusionA significant impact of the fatwas was found on patients’ acceptance of EMD use for periodontal regeneration. We believe reliable interpretations of the fatwas may positively shift patients’ attitudes toward using new biomaterials.