Gender Variation, subject dispersion and citation impact in dental research: A bibliometric analysis of publications from 2009-2021.

Aim: This study probed into the gender variation, subject dispersion and citation impact of dental research with an objective to highlight the increasing influence of female authors in the field of dentistry. Methodology: The research employed bibliometric techniques to highlight gender variation in dental research as demonstrated in the Saudi Dental Journal (SDJ), over a period of thirteen years, 2009-2021. The examination comprised SDJ publications indexed in PubMed, with citation data extracted from Google Scholar on July 2023. The analysis encompassed the progressive growth of papers, authors, and citations, the gender distribution of authors, the co-authorship structure, subject dispersion, and collaboration patterns based on affiliation, both national and international. Results: 625 SDJ publications were identified in the PubMed database from 2009 to 2021. There was a notable rise in the volume of papers and the number of authors per year. The citation impact analysis revealed that these 625 papers achieved an average of 26 citations each. Remarkably, the representation of female authors increased from 0.47 to 2.23 authors per paper during the study period. The authorship pattern largely showed single-authorship, closely followed by a three-author pattern. Almost half the papers (48%) were a collaboration between male and female authors, with female authors solely producing about 15% of papers.The topological classification of papers revealed that the most considerable number of papers were on Periodontics, with the least number focusing on Oral and Maxillofacial Surgery. Female authors prominently contributed to Pediatric Dentistry and Periodontics papers. Conclusion: The study illustrates an encouraging trend of heightened female authorship in dental research over the years. Their increasing engagement not only enriches the academic diversity but also impacts the progressive evolution of dental science, contributing to a more inclusive and balanced society.

Association between mouth rinse use and changes in blood pressure: A systematic review and meta-analysis with trial sequential analysis.

INTRODUCTION: Previous randomized controlled trials have shown that the use of antiseptic mouth rinses not only eradicates oral bacteria but also disrupts their ability to convert nitrate to nitrite, which is the key molecule in regulating blood pressure (BP). OBJECTIVE: This study aimed to evaluate the association between the use of mouth rinses and changes in BP. METHODS: The PubMed, Web of Science, EMBASE, Scopus, and Cochrane Library databases were systematically searched from their respective inception dates to 18th December 2022 to identify potential interventional studies with information on the association between the use of mouth rinse and changes in BP. Five trials using a controlled, crossover design were identified for data analysis. RESULTS: The weighted mean difference was pooled using a random-effects model. The pooled results of five trials together showed that the use of mouth rinses did not result in a statistically or clinically significant increase in the systolic BP (SBP) (1.59 mmHg; 95% confidence interval [CI], -0.15 to 3.33) or diastolic BP (DBP) (0.46 mmHg; 95% CI, -0.72 to 1.64). The trial sequential analysis did not present conclusive evidence supporting the association between mouth rinse use and BP elevation. CONCLUSION: Within the limits of the available evidence, our review and meta-analysis showed that mouth rinse use did not result in a statistically significant increase in the SBP, DBP, or mean arterial pressure (MAP). Nevertheless, the results should be interpreted cautiously due to the high degree of inconsistency across the studies.

The efficacy of manual toothbrushes in patients with fixed orthodontic appliances: a randomized clinical trial.

OBJECTIVE: This study aims to evaluate three types of manual toothbrushes [Cross action (CA), Flat trim (FT), and orthodontic type (OT)] in terms of efficacy in plaque removal in patients undergoing fixed orthodontic treatment. BACKGROUND: Manual toothbrushes are an essential part of oral hygiene for primary prevention. Plaque control, however, can be influenced by a number of individual and material-related factors. Individual factors include the presence of fixed orthodontic appliances on tooth surfaces, such as brackets and bands, which create difficulties with oral hygiene and lead to plaque formation. The evidence for the effectiveness of advanced bristle designs (multilevel, criss-cross) of the manual toothbrush alone in removing plaque in patients undergoing orthodontic therapy is limited. METHODS: The experiment followed the Consolidated Standards of Reporting Trials (CONSORT) guidelines. This was a three treatment, three-period crossover clinical trial with a single brushing exercise. Thirty subjects were randomized to one of the three treatment sequences of different bristle designs: (CA, FT, and OT). The primary outcome measure was the difference in the plaque scores (baseline minus post-brushing) at each study period, as determined by the Turesky-Modified Quigley-Hein Plaque Index. RESULTS: Of the thirty-four subjects enrolled in the study, thirty of the subjects met the inclusion criteria and completed all three periods of the study. The mean age was 19.5 ± 1.52 years, with a range of 18-23 years. The differences between treatments in plaque score reduction after brushing were statistically significant (p-value < .001). The treatment differences were statistically significant (p-value < .001) favoring the FT toothbrush over the OT and CA types of toothbrush designs. On the contrary, the difference between the OT and CA types was not statistically significant. CONCLUSIONS: Plaque was significantly removed by the conventional FT toothbrush after a single brushing compared to the OT and CA types.

Accuracy and precision of using partial-mouth recordings to study the prevalence, extent and risk associations of untreated periodontitis.

To study the accuracy and precision of estimating the prevalence, extent and associated risks of untreated periodontitis using partial-mouth recording protocols (PRPs) Methods: A purposive sample of 431 individuals who had never been treated for periodontal disease was recruited from screening clinics at the King Saud bin Abdul-Aziz University for Health Sciences. Data were collected using questionnaires and clinical examinations. The prevalence, extent and risk associations of periodontitis were evaluated. Three PRPs were compared to full-mouth recordings (FRPs) in terms of the sensitivity, specificity, predictive values, and absolute bias. Results: The prevalence of periodontitis was estimated with the highest accuracy and precision by examinations of the full mouth at the mesiobuccal and distolingual sites (FM)MB-DL, followed by random half-mouth (RHM) recordings. The extent of periodontitis was estimated with high precision using all the PRPs, and the absolute bias ranged from -0.6 to -2.3. The absolute bias indicated by OR for risk associations was small for the three PRPs and ranged from -0.8 to 0.8. Conclusion: (FM)MB-DL and RHM were the PRPs with moderate to high levels of accuracy and precision for estimating the prevalence and risk associations of periodontitis. The extent of periodontitis was estimated with high precision using all three PRPs. The results of this study showed that the magnitude and direction of bias were associated with the severity of periodontitis, the selected PRPs and the magnitude of the risk associations.

Accuracy of Estimating Periodontitis and Its Risk Association Using Partial-Mouth Recordings for Surveillance Studies: A Systematic Review and Meta-Analysis.

Objectives: Our aim is to conduct an up-to-date systematic review and meta-analysis pertaining to the accuracy of using the partial-mouth recording protocol (PRP) in surveillance studies to estimate the periodontitis prevalence, extent, severity, and its risk associations. Methods: Medline and Embase databases were searched for studies which assessed the periodontitis prevalence, severity, extent, or its risk associations using PRPs versus full-mouth recording protocols (FRPs); searches were conducted up until May 26, 2021. The risk of bias and the applicability of the studies were assessed using the QUADAS-2 tool. Both qualitative data synthesis and quantitative data synthesis were performed, and comparisons were done for the accuracy and precision of PRPs for different periodontitis outcomes. The study's protocol was registered through the International Platform of Registered Systematic Review and Meta-analysis Protocols (registration number: INPLASY202160032). Results: A total of 14 studies were included. The studies had a considerable degree of heterogeneity, along with a moderate risk of bias and applicability concerns. Several factors influenced the accuracy or precision of using PRPs, including the age, distribution of periodontitis in the studied population, PRP selection, total PRP sites, the threshold for minimum sites with CAL, and the severity of periodontitis case definitions. Overall, the PRP with the highest accuracy and precision mainly included (1) a full-mouth protocol at the following partial sites: mesiobuccal-midbuccal-distolingual (MB-B-DL), mesiobuccal-distolingual (MB-DL), mesiobuccal-midbuccal-distobuccal (MB-B-DB), mesiobuccal-distobuccal (MB-DB), and 84 sites using the random site selection method (RSSM) and (2) random-half-mouth (RHM) protocols. Conclusions: The PRPs with the highest overall accuracy and precision in estimating the periodontitis prevalence, extent, severity, and risk associations included the full-mouth assessment at the following partial sites: MB-B-DL, MB-DL, MB-B-DB, MB-DB, and 84 sites using RSSM and RHM protocols.

Periodontal disease prevalence, extent, and risk associations in untreated individuals.

OBJECTIVES: to examine the prevalence, extent, and risk associations of untreated periodontitis. MATERIALS AND METHODS: A purposive sample of subjects who were never treated for periodontal conditions was clinically examined after collecting information about their sociodemographic characteristics, medical conditions, oral health behaviors, perceived stress, and perceived social support. RESULTS: A total of 431 subjects were recruited (response rate, 97.0%), and their mean age (SD) was 35.4 (13.3) years. Overall, high plaque levels were observed in all untreated individuals. The prevalence of periodontitis and severe (stage III/IV) periodontitis using the American Academy of Periodontology and European Federation of Periodontology (AAP/EFP) classification were 85.4% and 48.5%, respectively. The prevalence of moderate-severe and severe periodontitis using the definitions of the Centers for Disease Control and Prevention (CDC) and AAP were 78.4% and 31.1%, respectively. The extent of periodontitis expressed as mean% of clinical attachment loss (CAL) ≥ 3 mm and CAL ≥ 5 mm were 34.9% and 14.4%, respectively, while the mean% of a periodontal probing depth (PPD) ≥4 mm and PPD ≥6 mm were 22.0% and 9.2%, respectively. Risk determinants associated with AAP/EFP periodontitis after the adjustment for other variables were age ≥35 years (odds ratio [OR] = 11.5) and lower income (OR = 2.5). Adjusted risk associations with stage II/IV periodontitis included age ≥35 years (OR = 8.2), males (OR = 2.5), lower income (OR = 2.3), and lower perceived stress (OR = 2.0). Adjusted risk associations with CDC/AAP moderate-severe periodontitis included age ≥35 years (OR = 12.0), lower income (OR = 2.1), and current cigarette smoking (OR = 4.2). Adjusted risk associations with CDC/AAP severe periodontitis included age ≥35 years (OR = 4.5), males (OR = 1.9), lower education (OR = 2.0), lower income (OR = 1.7), uncontrolled diabetes mellitus (OR = 2.0), and current cigarette smoking (OR = 2.3). CONCLUSIONS: The prevalence and extent of periodontitis were high in untreated subjects. Risk associations with untreated periodontitis included age ≥35 years, males, lower income, lower education, current cigarette smoking, uncontrolled diabetes mellitus, and lower perceived stress.

The Posterior Extension of the Palatal Rugae as an Anatomical Constraint for Soft Tissue Grafts in a Saudi Arabian Population.

Background The purpose of this study was to investigate the distal extension of the palatal rugae area as an anatomical constraint on the harvesting of palatal soft tissue grafts in a Saudi Arabian population. Additionally, factors that could affect or predict the extension were considered. Methods Three hundred seventy-four (374) dental casts from Saudi nationals currently residing in Riyadh (170 males and 204 females) were included. Two independent observers used a standardized probe to measure the posterior extent of the rugae on each stone cast bilaterally on a horizontal base. A sharp graphite pencil was used to mark the measurements from the origin of the rugae to their terminal ends on the cast, and a magnification lens was used to identify them. Using this technique, the most posterior extension of the rugae was marked and then analyzed. The normal approximation test for binomial distribution was used to determine the proportion of the subjects with rugael extensions beyond the mesial end of the upper second premolar, and logistic regression was used to see the association of this extension with other factors. Results The asymptotic chi-squared (p = 0.0002) McNemar tests revealed that the posterior distal extension of the rugae was not the same on both sides. A normal approximation test for the left side with 95% confidence intervals (CIs) with the "rugael extension proximal to the mesial end of the upper second premolar" category considered "success" found that the proportion of upper second premolars with rugael extensions proximal to the mesial end was not significantly different to the proportion of rugael extensions beyond the mesial end of the upper second premolars (95% CI: 48.69%-58.79%, p = 0.147). Conversely, the proportion of the upper second premolars with rugael extensions proximal to the mesial end was significantly lower than that beyond the mesial end on the right (95% CI: 35.92%-45.89%, p = 0.00004). Gender, age, and palatal shape did not significantly affect the posterior extension of palatal rugae. Conclusions The palatal rugae on the left side of a sample of the Saudi Arabian population do not considerably extend beyond the upper second premolar mesial aspect, which may provide reliable soft tissue grafts for esthetic mucogingival surgery.

A Morphometric Analysis of Palatal Rugae Patterns in a Saudi Arabian Population.

Background Palatal rugae patterns are useful in the field of forensic dentistry. Ethnicity has a significant effect on the development and final morphological pattern of palatal rugae. This study focused on a morphological analysis of the palatal rugae in a Saudi population to determine if any differences based on age and gender could support identifying an individual. Materials and methods This cross-sectional study conducted at the College of Dentistry, King Saud bin Abdul Aziz University for Health Sciences, was undertaken to evaluate 496 dental casts from the participant database of Saudi nationals from Riyadh. The rugae were delineated using a sharp graphite pencil under adequate light and magnification. The rugae patterns were classified based on the length, shape, and direction of the rugae by two observers as per Thomas and Kotze's criteria. Results The asymptotic chi-square McNemar test indicated bilateral symmetry for all the characteristics of the palatal rugae, except for the backward and forward directions of the rugae. Two-way analysis of variance (ANOVA) revealed a statistically significant interaction between the effects of age group and gender on the primary rugae count (F(3, 488) = 7.466, p <0.05)). In addition, age had a statistically significant effect on the fragmentary rugae (p <0.05), and gender had a statistically significant effect on the circular and backward patterns of the rugae (p<0.05). The females had a higher incidence of backward-directed rugae and the males had more circular rugae. No other significant difference was evident, based on gender. The logistic regression analyses showed a significant association between the circular (OR=1.298; 95% CI= 1.061-1.588) and backward (OR= 0.898; 95% CI= 0.828-0.975) palatal rugae and gender. Also, there was a significant association of the fragmentary palatal rugae (PR) (OR=1.274; 95% CI= 1.084-1.498) with the age group younger than 16 years. Conclusion In a Saudi Arabian ethnic group, the varying type of length of the palatal rugae patterns can be used to identify the age group while the direction and shape can be used to determine gender, although with limited accuracy. Post-mortem identification may benefit from using them along with other reliable forensic tools. There is a need to conduct continued research on diverse populations and ethnic groups in order to evaluate the PR potential in forensic dentistry.

Risk of postoperative bleeding following dental extractions in patients on antithrombotic treatment.

INTRODUCTION: The risk of bleeding after dental extractions in patients taking antithrombotic medication is not well known. This study aims to investigate the incidence of postoperative bleeding following dental extractions in adult patients taking antithrombotic medication in Saudi Arabia. METHODS: This retrospective study included 539 patients aged 18-93 years who attended 840 appointments for dental extractions from January 2012 to June 2016 at a tertiary care hospital in Saudi Arabia. Patients who returned with a complaint of bleeding were treated with local hemostatic measures as outpatients.Results and Conclusion: Only 1.7% of extraction appointments were associated with postoperative bleeding. The highest risk of bleeding was noted in patients receiving warfarin (3.88%), whereas those on clopidogrel had no significant risk of bleeding. Women were found to have the highest rate of bleeding, particularly those on newer oral anticoagulant medications.Dental extractions can be safely done in adults receiving antithrombotic treatment, provided established guidelines are followed; therefore, dental professionals must exercise caution when planning invasive dental treatment for patients on continued antithrombotic therapy.

COVID-19 Pandemic: Oral Health Challenges and Recommendations.

The aim of this article is to shed light on coronavirus disease 2019 (COVID-19) and its oral effects and risk of nosocomial transmission to update the knowledge of dental health care workers. A thorough literature search of the PubMed/Embase/Web of Science/Cochrane central database was conducted to identify the impact of COVID-19 on oral health. We reviewed the recommendations on the recent guidelines set by the Centers for Disease Control and Prevention infection control practices for dentistry, American Dental Association, and the World Health Organization. According to the available evidence, COVID-19 may have a negative impact on the oral health due to the infection itself and due to various other consequences such as therapeutic measures, xerostomia, and other complications of the COVID-19. In light of the above facts, dentists should be wary of the disease, its identification, mode of spread and impacts on the oral health. The dental personnel have been identified as at the highest risk of getting COVID-19 due to cross infection from contact with their patients and aerosols generated in routine dental procedures. As such, they should be aware of the modifications that need to be made to the practice to prevent transmission of the disease. It is evident that COVID-19 has a negative impact on the oral health and at the same time a significant transmission risk to the dental personnel and patients who visit the clinic. If the recommendations issued by the regulatory authorities are meticulously followed, the risk of disease transmission can be lessened.

Proposal for a novel murine model of human periodontitis using Porphyromonas gingivalis and type II collagen antibody injections.

INTRODUCTION: Periodontitis is a chronic disease in humans induced by several pathogens including Porphyromonas gingivalis (P. gingivalis). Although mouse models of human periodontitis have been developed for study using an oral gavage of P. gingivalis, existing models take over a month to develop in order to ensure adequate periodontal destruction. The aim of the present study is to determine if using an injection of a cocktail of type II collagen antibodies along with an oral gavage of P. gingivalis in mice induces adequate periodontal destruction in a shorter time so as to potentially serve as a more useful mouse model of periodontitis. METHODS: Twenty-eight DBA1/BO male mice were placed in four groups: Group A (antibody injection plus gavage), Group B (gavage only), Group C (antibody injection only), and Group D (neither antibody injection nor gavage, control). Between six and eight weeks old, all mice underwent antibiotic administration, and at eight weeks old, were given antibody injection (Groups A and C) and oral P. gingivalis gavage (Groups A and B). Fifteen days after gavage Groups A and B received gavage, all mice were euthanized. Histomorphometric, morphometric, and cell counting analyses were conducted using analysis of variance (ANOVA) and Kruskal Wallis analysis followed by pairwise t-tests using Bonferroni correction. RESULTS: For histomorphometric analysis, mean distance from the cemento-enamel junction to the alveolar bone crest (CEJ-ABC) and the mean epithelial downgrowth (ED) in µm was statistically significantly highest for Group A (CEJ-ABC 1.49.81 vs. Group B 101.46, Group C 78.74, and Group D 66.23, p < 0.0083; ED 66.76 vs. Group B 25.92, Group C 9.21, and Group D 9.10, p < 0.0083). Morphometric analysis also showed that Group A had a significantly higher mean CEJ-ABC in µm compared to all other groups (265.50 vs. Group B 195.77, Group C 150.33, and Group D 133.93, p < 0.0083). A similar pattern was seen in cell counting, in which Group A had a significantly lower mean count of fibroblasts per 45 × 50 µm field (8.02 vs. Group B 9.56, Group C 12.09, and Group D 11.02, p < 0.0083), and a significantly higher mean count polymorphonuclear leukocytes per 45 × 50 µm (4.59 vs. Group B 1.74, Group C 0.83, and Group D 0.68, p < 0.0083). CONCLUSION: The results of this study provide proof-of-concept for a mouse model that can be quickly developed for human periodontitis using a type II collagen antibody cocktail injection coupled with oral gavage of P. gingivalis in DBA1/BO male mice. Future studies should verify the results of this proof-of-concept, compare this new model to existing models, and evaluate the extent of this model's usefulness.

Kava-241 reduced periodontal destruction in a collagen antibody primed Porphyromonas gingivalis model of periodontitis.

AIM: The aim of this study was to evaluate the effect of Kava-241, an optimized Piper methysticum Kava compound, on periodontal destruction in a collagen antibody primed oral gavage model of periodontitis. METHODS: Experimental periodontitis was induced by oral gavage of Porphyromonas gingivalis (P. gingivalis) + type II collagen antibody (AB) in mice during 15 days. Mice were treated with Kava-241 concomitantly or prior to P. gingivalis gavage and compared to untreated mice. Comprehensive histomorphometric analyses were performed. RESULTS: Oral gavage with P. gingivalis induced mild epithelial down-growth and alveolar bone loss, while oral gavage with additional AB priming had greater tissular destruction in comparison with gavage alone (p < .05). Kava-241 treatment significantly (p < .05) reduced epithelial down-growth (72%) and alveolar bone loss (36%) in P. gingivalis+AB group. This Kava-241 effect was associated to a reduction in inflammatory cell counts within soft tissues and an increase in fibroblasts (p < .05). CONCLUSION: Priming with type II collagen antibody with oral gavage is a fast and reproducible model of periodontal destruction adequate for the evaluation of novel therapeutics. The effect of Kava-241 shows promise in the prevention and treatment of inflammation and alveolar bone loss associated with periodontitis. Further experiments are required to determine molecular pathways targeted by this therapeutic agent.