An Unusual Presentation of Osteomyelitis Complicated by Pathological Fracture of the Mandible: A Case Report and Literature Review.

Osteomyelitis is mainly caused by pyogenic organisms that spread through fractures, the bloodstream, or surgeries. It is a serious bone infection that can be either acute or chronic. It involves an inflammatory process affecting the bone and its surrounding structures. Management of osteomyelitis mainly depends on the nature of the lesion. In pathological fracture, the usual treatment is resection of the lesion with affected margins. However, the reconstruction is usually delayed until the infected bone is completely removed. In this case report, we demonstrate a case of an unusual presentation of osteomyelitis in the right body of the mandible which caused a pathological fracture following the extraction of the lower right first molar. The patient was further treated by segmental resection, coronoidectomy, and reconstruction of the defective site using a recon plate with inferior alveolar nerve preservation using the lateralization technique.

Trigeminal Cardiac Reflux During Le Fort I Osteotomy: A Case Report.

The trigeminocardiac reflex (TCR) is marked by significant cardiovascular reactions, such as bradycardia and asystole, triggered by trigeminal nerve stimulation. It is described as a brief episode of bradycardia, hypotension, or even cardiac arrest resulting from trigeminal nerve stimulation. The exact cause of TCR is not yet fully understood, but it is believed to involve the release of neurotransmitters, including acetylcholine, and the involvement of central neuronal integration. In this case report, we present an occurrence of trigeminal cardiac reflux during a Le Fort I osteotomy procedure in a patient with no medical issues.

An Unusual Case of Tongue Entrapped in an Electronic Nail Clipper: A Case Report.

Children with entrapped foreign objects in their tongues require a careful and knowledgeable approach to calm their anxiety, as not all patients may be appropriate for moderate sedation. Deciding the best treatment approach is often challenging due to conflicting advice and unclear guidelines. Recently, the emergency department has started favoring natural healing over suturing, especially for small tongue lacerations not involving the tip of the tongue. However, in cases of large lacerations or involvement of the tip of the tongue, suturing is usually recommended. This case report presents a rare incident of a tongue trapped in an electronic nail device in a pediatric patient.

Modifications in the Free Gingival Graft Technique: A Systematic Review.

Free gingival grafts (FGGs) have developed beyond covering exposed roots to improve the width and thickness of gingival tissue. While traditional FGGs have shown a high success rate and are easy to apply, they have some drawbacks, such as potential aesthetic concerns and bulky appearance. Recent advancements in FGGs have been explored, with different modifications proposed to overcome these limitations, including partly epithelialized FGGs (PE-FGG), gingival unit grafts, and epithelialized subepithelial connective tissue grafts. This systematic review aims to evaluate published case reports that discuss the utilization of modified approaches to FGG treatment and their outcome.

Irritational Fibroma Mimicking an Odontogenic Infection: A Case Report of a Misdiagnosed Extraoral Fibroma.

Fibroma is a benign fibrous tissue growth that develops in response to injury or irritation. It is usually firm, painless, nodular, and merging in color with the surrounding tissue. Commonly located in areas such as the buccal mucosa, tongue, and lip, the usual treatment involves surgical removal. In this case report, we present a rare instance of misdiagnosed extraoral irritational fibroma that emerged following the surgical extractions of the lower left third molar.

Maxillary Odontoma Associated With Noonan Syndrome: A Case Report.

Noonan syndrome (NS) is a common congenital syndrome characterized by multiple anomalies commonly observed in children. In this article, we describe a case of a patient with congenital heart disease, severe mitral regurgitation, and Nonaan syndrome presented with left maxillary swelling and pain, which was treated by complete surgical excision of the left maxillary odontoma. Based on this case, we conclude that numerous oral abnormalities may be related to NS and thus necessitate interdisciplinary treatment planning and prompt therapy. The importance of including oral manifestations as a scoring criterion in diagnosing NS cannot be overstated, as the significance of oral findings in NS has largely been overlooked.

Dental management of patients with renal diseases or undergoing renal transplant.

BACKGROUND: The kidneys carry out many essential processes. A reduced glomerular filtration rate is the primary cause of renal failure. Patients with chronic kidney disease are significantly increasing all around the world. Patients with varying degrees of renal disease will be seen on the dental chair, and the dentist must be aware of dental considerations when treating such patient. Dental clinicians should carefully evaluate the oral findings and general condition of the renal disease patient. OBJECTIVE: To increase the awareness of dentists in the dental management of patients with renal diseases or undergoing renal transplant. METHODS: This study reviews 56 articles searched on two databases PubMed and Google Scholar with English language. CONCLUSION: Every dentist should be well-informed regarding dental considerations and oral manifestations when treating a patient with any renal disease. Simple treatment plan modification can prevent the evolution of mild to critical medical or dental complications in renal disease patients.

Facial Paralysis Treatment Using Selective Neurectomy: A Comprehensive Review.

Facial paralysis can affect patients undergoing full mouth rehabilitation, regardless of what caused their paralysis. A procedure known as modified selective neurectomy of the facial nerve can enhance the movement of facial muscles in individuals with facial synkinesis safely and effectively. This approach is proposed as an alternative to more invasive surgical options when used independently as a treatment for incomplete facial palsy. Selective neurectomy offers a promising surgical option for managing nonflaccid facial paralysis and synkinesis, enhancing patients' quality of life. However, treatment plans should be individually tailored considering the complexity of facial paralysis and the unique needs of each patient, taking into account the timing and type of treatment. The objective of this review is to explore the use of selective neurectomy as a treatment for facial paralysis based on previously published papers.

Survival of Dental Implants Placed in Iliac, Fibula, and Radial Forearm Flaps: A Comprehensive Review.

Various donor sites have been extensively documented in the literature for bone free flaps in head and neck reconstruction. These include the radius, scapula, rib, ilium, femur, fibula, and metatarsal bone. Among them, the fibula, ilium, and scapula are the most commonly used and studied for placing endosseous implants and for rehabilitation purposes. Each donor site has its own advantages and disadvantages, which depend on factors such as whether the reconstruction is for the maxilla or mandible, the required volume and length of the bone and soft tissue, and the location, extent, and type of defect that needs to be reconstructed. The aim of this current review is to comprehensively assess the existing literature on the survival of implants in fibula, radial, and iliac flaps.

Knowledge, Attitude, and Practice Regarding Periodontal and Dental Diseases During Pregnancy Among Obstetricians and Dentists in King Saud University Medical City.

BACKGROUND: Providing effective dental treatment during pregnancy is related to controlling oral diseases and helps maintain a healthy oral cavity. One of the possible treatment options for endodontic disease is to treat the odontogenic infection, maintain a healthy oral environment, and minimize the expected complications that can occur later in pregnancy or during the postpartum period. Sufficient awareness among obstetricians and dentists is essential to delivering appropriate preventive and curative care to pregnant patients. OBJECTIVE: The aim of this cross-sectional study is to assess knowledge, attitudes, and behaviors regarding oral health care and providing dental treatment among King Saud University Medical City obstetricians and dentists during pregnancy and the association of dental and periodontal disease with adverse pregnancy outcomes. METHODS: This study was conducted in Saudi Arabia, Riyadh, from December 2022 to June 2023 (six months). The data were collected from 381 participants in Riyadh, Saudi Arabia, from January 2023 to June 2023. The study targeted male and female general dentists and obstetricians living in Riyadh, Saudi Arabia, and excluded those who are not dentists and obstetricians or not living in Riyadh, Saudi Arabia. RESULT: Out of a total of 381 completed responses, 281 (73.8%) of the participants were dentists, while 100 (26.2%) were obstetricians. It was observed that the majority of the participants agreed that oral health is a part of prenatal care, while the minority did not agree (0.3%). Of the 281 (73.8%) respondents, most of them reported periodontal disease can cause preterm birth, low birth weight, and gestational diabetes (73.2%), while only 0.5% answered no. Two hundred and seventy-eight of the participants answered that it is essential to consult with an obstetrician before treating pregnant patients. CONCLUSION: The overall knowledge of dentists and obstetricians was adequate regarding dental disease during pregnancy. However, more education should be assessed and continuously improved regarding the treatment options, as well as future recommendations regarding the medications used in dental clinics and awareness programs promoting dental health care in pregnant patients.

Facial Reconstruction Using Facial Artery Myomucosal Flap: A Comprehensive Review.

The facial artery myomucosal (FAMM) flap is a type of facial flap that is constructed with the buccal mucosa and submucosa along with a portion of the buccinator muscle, which is connected to nearby blood vessels to maintain its blood supply. It is a versatile and reliable option for head and neck reconstruction, particularly in oral cavity defects. This flap is employed in the reconstruction of the floor of the mouth, alveolar cleft surgery, and tongue defect repair. Previous studies have discussed the use of FAMM flaps for facial reconstructions. However, there are no current and updated comprehensive reviews discussing the use of FAMM flaps in facial reconstruction. In light of this, this study aimed to review all relevant studies that discuss the use of FAMM flaps in facial reconstruction.

Knowledge and Awareness of Oral and Perioral Piercing and Its Complications Among the Population in Riyadh.

Background and objective Body piercing was a cultural custom associated with religious or ceremonial rites in antiquity. Currently, it has grown in popularity among teenagers and young people as a form of self-expression. Young adults are now frequently seen with body and oral piercings, which can cause several complications. Patients with intraoral piercing often present with poor dental and periodontal health, as well as various complications and side effects. The general public is often poorly informed about the risks they are exposed to after intraoral piercing and the strategies for minimizing them, and even healthcare professionals often have limited knowledge of the risks and complications that may arise after this procedure. To the best of our knowledge, no published data assessing the knowledge of oral and perioral piercing among the population living in Riyadh City, Saudi Arabia are currently available. In light of this, we conducted this study to assess the level of awareness and knowledge of oral piercing and its complications among the population living in Riyadh city and evaluate the correlation of nationality, sex, age, and socioeconomic status (educational level, area of residence, and income) with the level of individual knowledge. Methods This was a cross-sectional observational study with a sample size of 1,099. A confidence interval (CI) of 95%, a standard deviation of 0.5, and a margin of error of 5% were employed to determine the sample size. A structured questionnaire was used as the study tool and was distributed in several residential areas in Riyadh, such as North, South, Middle, Eastern, and Western Riyadh City. The data collection was performed using simple random sampling via electronic questionnaires distributed to participants living in Riyadh. Results A total of 1,054 individuals completed the survey. Of these, 95.6% were Saudi nationals. Approximately 85.5% of the participants (n = 901) were women, 52.4% were aged 20-29 years (n = 552), and most participants (62.9%, n = 663) had a low monthly income (<5,000 Saudi Riyals); in terms of residence, the highest number of participants were from the northern region of Riyadh (37.1%, n = 391). Most participants had heard of or seen an oral or perioral piercing (89.1%, n = 939). However, very few of them had received an oral piercing themselves (10.7%, n = 113) or had a family member with an oral piercing (18.7%, n = 197). Participants reported that the most commonly observed site for oral piercing was the lip (29.8%, n = 314), and teenagers were the most common age group with oral piercings (76.3%, n = 804). Regarding the adverse effects, most participants reported being aware of the negative consequences of oral piercing in the mouth (72.2%, n = 761). Sex and age were the only factors that showed a significant association with participants' level of knowledge. Women were significantly more knowledgeable and had higher scores (ß: 0.41; 95% CI: 0.13, 0.69) than men (p<0.05). Additionally, participants aged 20-29 years had significantly higher knowledge scores (ß: 0.39; 95% CI: 0.15, 0.63) than younger participants (p<0.05). Conclusions Based on our findings, participants' knowledge and awareness about oral piercing is adequate in general. However, there should be more efforts to educate the people of Riyadh about the complications of these piercings as well as raise awareness about proper oral hygiene methods.

Periapical Cemento-Osseous Dysplasia in a Medically Compromised Patient: A Case Report.

A fibro-osseous lesion is a condition where the regular bone is changed with a fibrous connective tissue matrix that includes an abnormal bone or cementum. These lesions are divided into three groups: ossifying fibroma, cemento-osseous dysplasia (COD), and fibrous dysplasia. COD is the most recurring benign fibro-osseous lesion. These lesions are usually not detected unless infected and are commonly noted accidentally on an X-ray. In this report, we demonstrate a case of periapical cemento-osseous dysplasia in a medically compromised patient with multiple systemic diseases.

Factors Affecting the Choice of Implant Specialists Among the Saudi Population: A Cross-Sectional Study.

Background Patients are frequently exposed to misleading information about dental implants on social media or from dental marketing businesses. Patients' selection of an implant specialist for placing dental implants may vary due to several factors, including cost, social media, dentist qualification, and previous patient experience. Objective This study aims to assess and evaluate the factors that influence the choice of implant specialist in the Saudi population. Materials and methods The data were collected from 625 participants in Riyadh, Saudi Arabia, from January 2023 to April 2023. The study targeted males and females over 20 years old living in Riyadh, Saudi Arabia, and excluded those under 20 years old or not living in Riyadh, Saudi Arabia. Results The dentist's qualification (80.2%), dental implant cost (77.3%), and clinic or hospital (68.2%) were the most frequently agreed-upon factors for selecting an implant specialist. The study found that 13.7% of respondents disagreed or strongly disagreed that social media could influence the choice of an implant specialist. Among females, those with higher educational levels, middle-income groups, and those who had ever replaced a missing tooth, the importance of a dentist's specialty to perform a dental implant increased significantly. Conclusion Different factors contributed to the selection of an implant specialist among the population, with dentist qualification followed by dental implant cost being the most commonly discussed factors in the study.

ChatGPT in Dentistry: A Comprehensive Review.

Chat generative pre-trained transformer (ChatGPT) is an artificial intelligence chatbot that uses natural language processing that can respond to human input in a conversational manner. ChatGPT has numerous applications in the health care system including dentistry; it is used in diagnoses and for assessing disease risk and scheduling appointments. It also has a role in scientific research. In the dental field, it has provided many benefits such as detecting dental and maxillofacial abnormalities on panoramic radiographs and identifying different dental restorations. Therefore, it helps in decreasing the workload. But even with these benefits, one should take into consideration the risks and limitations of this chatbot. Few articles mentioned the use of ChatGPT in dentistry. This comprehensive review represents data collected from 66 relevant articles using PubMed and Google Scholar as databases. This review aims to discuss all relevant published articles on the use of ChatGPT in dentistry.

ChatGPT for Future Medical and Dental Research.

ChatGPT is an artificial intelligence (AI) chatbot developed by OpenAI and it first became available to the public in November 2022. ChatGPT can assist in finding academic papers on the web and summarizing them. This chatbot has the potential to be applied in scientific writing, it has the ability to generate automated drafts, summarize articles, and translate content from several languages. This in turn can make academic writing faster and less challenging. However, due to ethical considerations, its use in scientific writing should be regulated and carefully monitored. Few papers have discussed the use of ChatGPT in scientific research writing. This review aims to discuss all the relevant published papers that discuss the use of ChatGPT in medical and dental research.

Comprehensive Dental Management of a Rolandic Epilepsy Patient Under Local Anesthesia: A Case Report.

Dental treatment of epilepsy patients is often challenging and requires careful consideration of their sudden movements. Epilepsy patients often require sedation (e.g., nitrous oxide or intravenous sedation) to receive their required dental treatments. Rolandic epilepsy (RE) is a specific type of epilepsy in children with certain electroencephalogram (EEG) abnormalities and motor focal seizures with no signs of neurological deficits. This report discusses a case of an RE patient who was treated comprehensively under local anesthesia with careful evaluation of the patient's medical conditions.

Radial Forearm Free Flap for Head and Neck Defect Reconstruction: An Up-to-date Review of the Literature.

The radial forearm free flap has emerged as the mainstay of free flaps for oral cavity soft tissue reconstructions because of its versatility and ability to be used in the reconstruction of large and medium-sized defects. This flap is commonly used to restore head and neck defects, including full-thickness lip and oral cavity defects. This flap offers the opportunity to cover severe defects of the facial region due to its long vascular pedicle and elasticity. In addition to its ease of being harvested, the radial forearm free flap provides a sensate, pliable, and thin skin paddle with a long vascular pedicle. However, it can cause severe morbidity at the donor site, mainly due to exposure of the flexor tendon that results from a failed harvesting of the skin graft, changed sensation in the radial nerve, aesthetic deformity, and reduced range of motion and grip strength. This article aims to review all the up-to-date studies discussing the use of radial forearm free flap in head and neck reconstruction.

Facial Reconstruction Using Sternocleidomastoid (SCM) Flap: A Review of the Literature.

The sternocleidomastoid (SCM) flap has been used for a long time in protective coverage of major vessels, reconstruction of intraoral pharyngeal, closure of pharyngo-cutaneous fistulas, and augmentation of soft tissue defects in the oral and maxillofacial region. However, this flap is not yet commonly used due to doubtful blood supply to the flap. This flap offers favorable esthetic results, combined flap, rich vascularization, and the possibility of shifting the two heads of the muscle. Thus, this flap has been used broadly in the maxillofacial region to reconstruct the defects of the post-parotidectomy, mandible, pharynx, and floor of the mouth defects. Previous studies discussed the use of a SCM flap following parotidectomy. However, few studies explained the use of SCMs in facial reconstruction. This study aims to review published articles discussing the use of SCMs for facial reconstruction.

Behavioral Changes in Patients With Diabetes During the COVID-19 Pandemic in Saudi Arabia: A Cross-Sectional Study.

On March 2, 2020, the first case of coronavirus disease 2019 (COVID-19) was dedicated in Saudi Arabia. The government established partial quarantine, and all precautions were mandatory on March 23, 2020. This in turn forced people to spend more time at home, leading to changes in the physical activity and dietary habits of individuals. In this study, we aimed to assess the behavioral changes of Saudi diabetic individuals during the COVID-19 pandemic and measure the effectiveness of the behavioral changes of Saudi diabetic individuals during the COVID-19 pandemic on the control of the glucose level. A cross-sectional study was conducted through an online questionnaire sent to diabetic patients in Riyadh, Saudi Arabia. Participants ranging from 18 years old and above of both genders were selected. Diabetic patients (type 1 and 2) were included. All collected data for this study were analyzed using Stata 17 (StataCorp LLC, College Station, Texas, USA). A total of 223 people responded. For 45% of individuals, doctor visits significantly decreased (p<0.05), and the percentage of doctor visits also decreased for individuals who previously visited their doctor more regularly. Furthermore, the number of hours spent on tablets increased significantly during COVID-19 (p<0.05). Our findings demonstrate that there are no significant changes in lifestyle factors or glycemic control during the pandemic compared with the pre-pandemic year in individuals with diabetes. However, the rate of patient visits to the doctor was lower than pre-pandemic, with an increase in the rate of physical activity.