Assessment of Mental Foramen Characteristics in Syrian Population Using Cone Beam Computed Tomography: A Pilot Study.

Background Knowledge of the mental foramen (MF) characteristics is crucial for avoiding iatrogenic injuries during dental implant placement, root canal treatment, orthognathic surgery, and other dental and surgical interventions. Cone beam computed tomography (CBCT) offers a valuable tool for evaluating the MF characteristics with its precise anatomical details. The current study investigates the horizontal and vertical position variations in addition to the exit angle of MF within the Syrian adult population. Materials and methods The sample included CBCT scans of 42 subjects with an equal number of males and females (21 males, 21 females), with no underlying pathology in the investigated region, mean age was 24.7 years (SD: 7.2 years). CBCT scans were retrospectively analyzed in terms of the vertical, horizontal, and exit angle direction of MF. The chi-square test was conducted to investigate statistical differences in terms of MF horizontal and vertical positions. A T-test was conducted to investigate statistical differences in terms of exit angle direction. Comparisons were conducted between males and females groups, and between the left and right sides in the total sample group. Results The most frequent horizontal position was position 3 (MF between the first and second premolars) on the right side (n=20, 47.61%), and on the left side (n=21, 50%). The most frequent vertical position was position 3 (MF below the apices of the premolars) on the right side (n=29, 69.04%), and on the left side (n=27, 64.28%). The exit angle of the MF was in a backward direction, with a mean value of 118.42° (SD: 6.45 degrees), and 115.97° (SD: 7.29 degrees) on the right and left side, respectively. Statistically significant differences were found in terms of the right vertical position between males and females (P value < 0.05). Conclusion Variations in MF characteristics exist in the Syrian population. Statistically significant differences were found in the right vertical position of MF. The current study findings necessitate precise preoperative three-dimensional imaging for dental interventions among this population. By establishing normative values for the Syrian population, the results can contribute to improved surgical planning and patient care, and can be used for comparative studies for more understanding of the human anatomical variations.

Evaluation of the efficacy of using dental pulp graft in the healing of the alveolar bone after impacted canine extraction: a prospective cohort study.

Summary: The purpose of this study was to evaluate the radiographic density of the alveolar bone of the maxilla after extraction of the impacted canines and using the pulp tissue as an autogenous graft. Materials and methods: This prospective cohort study recruited 14 patients (8 females and 6 males) between 2021 and 2023, with an average age of 35 years. All participants had palatally impacted maxillary canines. The impacted teeth were extracted surgically. The extracted teeth were then used for autogenous grafting. The pulp tissue was removed, cut into small pieces, and placed on an absorbable gelatin sponge before being inserted into the extraction socket. The wound was subsequently closed meticulously. After 4 months, the bone density was assessed radiographically using the Hounsfield Scale on cone beam computed tomography scans. Results: After 4 months, the mean radiographic bone density value in the extraction area was (652.77 ± 56.13 HU), while the average density of the original bone was (659.7 ± 39.6 HU). Conclusions: Within the limits of this study, dental pulp tissue can be used to restore bony defects of the alveolar bone in the maxilla. However, further research is needed to confirm these findings.

A clinical dimple on facial skin related to dental origin: A case report.

INTRODUCTION AND IMPORTANCE: Facial skin may experience many clinical manifestations which are numerous and need accurate diagnosis to reach the best treatment immediately and effectively. Dimpling of the skin may be diagnosed improperly due to lack of information related to diseases of dental origin. The objective of this study is to provide clarity on dental diagnosis and treatment options for extraoral dimpling caused by odontogenic infections. CASE PRESENTATION: A 19-year-old girl presented with a dimple on her facial skin developed during the last month before her consultation. The dimple was located where a vertical line from the distal canthus crosses a horizontal line from the nasal alar. No systemic disease was discovered, and the dental history revealed recurrent failure of root canal treatment in the upper first molar. CLINICAL DISCUSSION: Cutaneous sinuses originating from dental issues are characterized by a connection between the skin surface and a periapical dental abscess, which is caused by a long-dated tooth infection. Due to the patient's previous dental abscess in close proximity to the skin defect, a clinical diagnosis of an odontogenic cutaneous sinus was established. CONCLUSION: It is crucial to recognize that skin lesions in the face and neck area can be a result of odontogenic infections. Careful clinical and radiographic examinations should be conducted to accurately diagnose and differentiate these conditions. By identifying the tooth associated with the lesion, unnecessary medications and incorrect interventions can be avoided, ensuring the implementation of appropriate treatment.

Tent-pole technique for alveolar ridge width preservation with a compromised buccal plate: a prospective cohort study.

Objectives: The aim of this study was to assess the effectiveness of the tent-pole technique for alveolar ridge preservation of compromised alveolar socket following the surgical extraction of incurable single root premolars. Materials and methods: This study was conducted on 12 patients who presented to the department of oral and maxillofacial surgery and had alveolar ridge preservation using tent-pole technique between August 2021 and February 2022. The alveolar ridge width was analyzed using cone beam computed tomography scans taken preoperative and 6 months postoperative. Statistical analysis was performed to assess the alveolar ridge width at different levels. The alveolar ridge width differences between periods were assessed with paired t-test. The comparison of alveolar ridge width loss according to jaw, sex, and different levels were done with unpaired t-test. The level of significance considered was 5% (α=0.05). Results: The mean alveolar ridge width before surgery was 10.03 mm. After 6 months, the mean alveolar ridge width was 8.4 mm. The range of alveolar ridge width loss was between 0.6 and 3.22 mm with a mean of 1.63 (16.25%). There was no statistically significant difference in width loss between the maxilla and mandibular whether in males or females. Alveolar bone width loss was the greatest at W1 level (26.8%). Conclusion: According to the results of this study, the authors conclude that the tent-pole technique could preserve the alveolar bone ridge width without bone graft materials.

Assessment of the efficacy of auricular conchal cartilage graft in repairing orbital floor fractures and its effect on diplopia: a nonrandomized clinical trial.

Orbital fractures are a common sequela of maxillofacial zone trauma. Rapid assessment and management are essential for successful reconstruction. The selected treatment method depends on fracture types, accompanied injuries, and intervention time. Implantable grafts used to be from autologous materials. The study aimed to evaluate the effectiveness of using the auricular conchal cartilage taken from the ear to repair orbital floor fractures in cases of minimal bone loss, less than (2×2) cm. Material and Methods: A prospective single-arm, nonrandomised clinical trial was conducted during the past 4 years (from 2018 to 2022). A total of 15 cases, who had visited the department of oral and maxillofacial surgery department with orbital floor fractures, were enrolled. The participants underwent conchal cartilage grafting for orbital floor fracture reconstruction. The time factor to perform the surgery after trauma had been considered. Patients were closely monitored for the development of double vision (diplopia) at 15 days, 1 month, and 3 months postsurgery. Results: The results showed statistically significant differences during the follow-up period following the surgical procedure. They appeared to have complete restoration of eye movements, restoration of the normal positioning of the eyeball affected by the orbital floor fracture compared to the healthy eyeball, and regression of double vision (diplopia) throughout the follow-up period. Conclusion: Using the auricular conchal cartilage graft in repairing fractures of the orbital floor resulted in the improvement of the functional aspect of the eyeball and the restoration of the esthetic aspect.

Pseudoaneurysm of the external carotid artery following parotitis: a case report.

Pseudoaneurysms of the external carotid artery of nontraumatic causes are very rare; those of infectious causes in adults are also quite unusual and are often preceded by bacteremia. Infection-related cases such as the one described here are scarce in the literature since the complication is not often calculated or expected. We present a case report of an elderly female patient who, after dental treatment and parotitis, noticed a mass behind the right mandible. After examination, the case was diagnosed as a pseudoaneurysm of the external carotid artery of an infectious cause. Management could be by surgical intervention, but the high positioning of the pseudoaneurysm and the age of the patient were contraindications. The choice was made to avoid surgery and keep the patient under long-term follow-up; no increase in its mass was observed after 3 years of follow-up.

Effect of partial ferrule on fracture resistance of endodontically treated teeth: A meta-analysis of in-vitro studies.

PURPOSE: The present meta-analysis aimed to answer the following research question: In endodontically treated teeth (ETT), what is the effect of partial ferrule (PF) on fracture resistance compared to complete ferrule (CF) and/or no ferrule (NF)? STUDY SELECTION: PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published until May 20, 2022. In vitro studies that compared the effect of partial ferrule with that of complete ferrule and/or no ferrule on fracture resistance of ETT were included. The studies were assessed for risk of bias, and a meta-analysis was performed. RESULTS: Seventeen in vitro studies comprising 807 teeth were included. Nine studies were at a high risk of bias and eight presented a moderate risk of bias. Overall, the results showed that CF was superior to PF in increasing fracture resistance (SMD= 0.93, CI95%= 0.57-1.29, P< 0.0001), with no change in the effect based on the type of teeth (P< 0.001). However, the subgroup analysis found that PF 2 mm buccal, lingual, and buccal and lingual ferrule were comparable to CF (P= 0.06). Additionally, the PF group showed significantly higher fracture resistance than the NF group (SMD= 2.02, CI95%= 1.54-2.49, P< 0.00001). CONCLUSIONS: Although CF design provided the highest fracture resistance to restored ETT, PF can still be a viable option for restoring ETT in cases where CF is not feasible.

Happiness among dentists: a multi-scale, multi-national study from 21 countries.

OBJECTIVES: The extent to which dentists are happy with their profession and their life has not been well studied. The present study aimed to explore the level of happiness, satisfaction with life and psychological well-being among a sample of dental professionals from 21 countries. MATERIALS AND METHODS: The sample comprised 2,200 dentists from 21 countries. Three scales - Subjective Happiness Scale (SHS), Satisfaction With Life Scale (SWLS), and Affect Balance Scale (ABS) - were used to measure the subjective responses. Data related to demographic and social characteristics were recorded. Mann-Whitney and Kruskal-Wallis tests were used as appropriate. Scales were correlated, and multiple linear regression analyses were employed to identify the independent determinants of SHS, SWLS and ABS. Data were analysed using the SPSS software program; a value of P <0.05 was considered significant. RESULTS: The overall mean scores of SHS, SWLS and ABS were 18.53 ± 5.06, 23.06 ± 6.25 and 1.26 ± 2.40, respectively, with significant differences found across countries: dentists working in Croatia, Peru and Serbia recorded the highest scores, unlike dentists practicing in Yemen, Syria, and Iraq, who recorded the lowest scores. There were significant, moderately positive correlations between the various scales: SHS and SWLS: r = 0.535, P < 0.001; SHS and ABS: r = 0.58, P < 0.001; and SWLS and ABS: r = 0.533, P < 0.001. Country of practice, age, qualification and monthly income were the significant independent predictors of SHS, SWLS and ABS. CONCLUSION: Country of residence and social characteristics were associated with dentists' responses regarding their feelings and subjective well-being.

Translation and validation of the Arabic version of the 5-item Oral health impact profile: OHIP5-Ar.

PURPOSE: The aim of this study was to translate and validate an Arabic version of the 5-item Oral Health Impact Profile (OHIP). METHODS: A total of 320 subjects (aged 18 years and above) were consecutively recruited from dental clinics. The self-administered OHIP5-Ar was distributed and the data were collected and analyzed. The dimensionality of the instrument was investigated using confirmatory factor analyses (CFA). Reliability was assessed as the instruments internal consistency using Cronbach's alpha and test-retest-reliability using intraclass correlation coefficient (ICC). Convergent validity was tested by correlation between perceived global oral and general health questions with the latent factor (OHRQoL) using structural equation modelling analysis and with OHIP5-Ar total score using spearman's correlation coefficient. Known-groups validity was tested among groups with known differences and sensitivity to change was also investigated after dental treatments. RESULTS: The OHIP5-Ar was fitted well in the unidimensional model as indicated by the CFA with fit indices (RMSEA: 0.00, SRMR: 0.010, GFI: 0.998, TLI: 1). Cronbach's alpha was 0.78 and the ICC agreement was 0.88. The validity tests indicated satisfactory validity of the instrument and the sensitivity to change of the instrument revealed significant change in the OHIP5-Ar total score after the provision of dental treatments (effect sizes: 0.55-1.49). CONCLUSION: The OHIP5-Ar showed satisfactory psychometric properties among Arabic-speaking population. This instrument is sensitive to the changes of oral health and can be used to measure the OHRQoL with one total score.

Evaluation of a New Surgical Technique for Closing Oroantral Fistula Using Auto-transplanted Upper Third Molar: A 1-Year Follow-Up Study.

BACKGROUND: Oroantral fistula (OAF) is considered a frequent complication in dental practice. Many surgical techniques/methods have been proposed to close it. The aim of this study was to evaluate the auto-transplantation of upper third molar for closing OAF. MATERIALS AND METHODS: Twenty patients participated in this study aged between 20 and 40 years old. The OAF was closed by auto-transplantation of upper third molar placed directly in the socket of the extracted tooth. Results were evaluated clinically and radiographically through the period of observation which lasted for 1 year. RESULTS: Final results showed that the success rate of closing OAF was 95% while the success rate of upper third molar auto-transplantation was 90%. CONCLUSION: This technique is simple, applicable, provides immediate replacement of the missing tooth, and does not require complicated instruments or procedures.

Closure of Oroantral Communication Using Platelet-rich Fibrin: A Report of Two Cases.

Oroantral communication (OAC) is an abnormal connection between the maxillary sinus and oral cavity. It is mostly formed after the extraction of the first and second upper molars. Platelet-rich fibrin (PRF) created by Choukroun's protocol concentrates most platelets and leukocytes from a blood harvest to a single autologous fibrin biomaterial. It has been used widely in oral and maxillofacial surgery. However, no data are available concerning the use of PRF alone as a clot and a membrane for the closure of OACs. Two clinical cases presented with OAC, created after extraction of tooth #16 in two patients, were closed with PRF as a clot and a membrane and monitored until the epithelization of the sockets was ended successfully. Two months postclosure, the sockets were evaluated clinically and on waters' view radiography. The results of these case reports showed that PRF can be successfully applied for the closure of OACs.