Environmental tobacco smoke exposure and non-syndromic orofacial cleft: Systematic review and meta-analysis.

INTRODUCTION: Environmental tobacco smoke (ETS) is associated with several congenital anomalies, including non-syndromic orofacial clefts (NSOFCs). This systematic review aimed to update the literature on the association between ETS and NSOFCs. METHODS: Four databases were searched up to March 2022, and studies that evaluated the association between ETS and NSOFCs were selected. Two authors selected the studies, extracted the data, and evaluated the risk of bias. Comparing the association of maternal exposure to ETS and active parental smoking with NSOFCs allowed for the creation of pooled effect estimates for the included studies. RESULTS: Twenty-six studies were deemed eligible for this review, of which 14 were reported in a previous systematic review. Twenty five were case-control studies, and one was a cohort study. In total, these studies included 2142 NSOFC cases compared to 118129 controls. All meta-analyses showed an association between ETS and the risk of having a child with NSOFC, based on the cleft phenotype, risk of bias, and year of publication, with a pooled increased odds ratio of 1.80 (95% CI: 1.51-2.15). These studies had a marked heterogeneity, which decreased upon subgrouping based on the recent year of publication and the risk of bias. CONCLUSIONS: ETS exposure was associated with more than a 1.5-fold increase in the risk of having a child with NSOFC, showing a higher odds ratio than paternal and maternal active smoking. TRIAL REGISTRATION: The study is registered on the International Prospective Register of Systematic Reviews database # CRD42021272909.

Oral and Dental Health Status among Adolescents with Limited Access to Dental Care Services in Jeddah.

The purpose of this study was to assess the prevalence and associated factors of dental caries and periodontal diseases among 14⁻19-year-old schoolchildren with limited access to dental care services. A cross sectional study design was conducted during field visits to seven governmental schools in Al-Khomrah district, South Jeddah, over the period from September 2015 to May 2016. Clinical examinations and administered questionnaires were carried out in mobile dental clinics. The dentists carried out oral examinations using the dental caries index (DMFT), the simplified oral hygiene index (OHI-S), and the community periodontal index for treatment needs (CPITN). Statistical analyses were performed using SPSS 20. A total of 734 schoolchildren were examined. The prevalence of decayed teeth was 79.7% and was significantly higher among boys (88.9%) than girls (69.0%). About 11% of students had missing teeth, with a significantly higher figure among females than males (15.9% versus 7.3%); 19.8% of students had filled teeth. Moreover, a DMFT of seven or more was significantly more prevalent among males (43.3%) than females (26.8%), while the percentage of females with sound teeth was significantly higher than for males (20.4% and 9.6% respectively). The CPITN revealed 0, 1 and 2 scores among 14.6%, 78.2%, and 41.6% respectively. Males had a significantly higher percentage of healthy periodontal condition (23.8%) than females (3.8%). Dental caries prevalence was moderate to high, calculus and gingival bleeding were widespread among schoolchildren, and were more prevalent among students with low socioeconomic status.

Comparison Between Dexamethasone and Ibuprofen for Postoperative Pain Prevention and Control After Surgical Implant Placement: A Double-Masked, Parallel-Group, Placebo-Controlled Randomized Clinical Trial.

BACKGROUND: Postoperative pain is a potential adverse side effect of oral surgeries, and attempts should be made to prevent or minimize it. This study compares efficacy of preemptive ibuprofen and dexamethasone protocols for pain prevention or control after surgical implant placement. METHODS: This prospective, double-masked, parallel-group, placebo-controlled, randomized clinical trial included 117 patients with planned dental implant placement. Patients were assigned to receive one of three different protocols: 1) 600 mg ibuprofen 1 hour before surgery and another 600 mg 6 hours after the first dose; 2) 4 mg dexamethasone 1 hour before surgery and another 4 mg 6 hours after the first dose; or 3) placebo. Rescue medication (1,000 mg acetaminophen) was made available to each patient, and they were instructed to take it as necessary. Pain intensity was evaluated via a 101-point numeric rating scale and a visual analog scale, and discomfort was evaluated using a four-point verbal rating scale hourly for the first 8 hours after surgery and three times daily for the following 3 days. RESULTS: Ibuprofen and dexamethasone significantly reduced pain (Kruskal-Wallis; P <0.05) up to 3 days after surgery and discomfort (P <0.05) up to 2 days after surgery compared with placebo treatment. Both treatments reduced the number of painkillers taken and increased time before the first painkiller was taken (P <0.01). CONCLUSION: Steroidal dexamethasone is as effective as non-steroidal ibuprofen for preventing or controlling postoperative pain and discomfort after surgical implant placement.

Can Multiple Mini-Interviews Predict Academic Performance of Dental Students? A Two-Year Follow-Up.

Prior research has shown that students' previous grade point average (GPA) is the best predictor for future academic success. However, it can only partly predict the variability in dental school performance. The aim of this study was to assess the predictive value of multiple mini-interviews (MMI) as an admission criterion by comparing them with the academic performance of dental students over a two-year period. All incoming undergraduate dental students at the King Abdulaziz University Faculty of Dentistry (KAUFD) during academic year 2013-14 were invited to participate in MMI. Students rotated through six objective structured clinical exam (OSCE)-like stations for 30 minutes total and were interviewed by two trained faculty interviewers at each station. The stations were focused on noncognitive skills thought to be essential to academic performance at KAUFD. The academic performance of these students was then followed for two years and linked to their MMI scores. A total of 146 students (71 males and 75 females) participated in an interview (response rate=92.9%). Most students scored in the acceptable range at each MMI station. Students' total MMI score, ambitions, and motives were significant predictors of GPA during the two years of follow-up (p<0.038 and p<0.001, respectively). In this study, MMI was found to be able to predict future academic performance of undergraduate dental students.

Gathering validity evidence in the use of multiple mini-interviews as an admission tool for dental students: Preliminary evidence from Saudi Arabia.

AIMS: This study examined the validity evidence of noncognitive skills of incoming students in the Faculty of Dentistry at King Abdulaziz University using multiple mini-interviews (MMI). Validity evidence in response process, internal structure and relationship to other variables was investigated. METHODS: A total of 146 students were interviewed by faculty members over a two-day period. The interviews took the form of an MMI, which consisted of six objective structure clinical examination (OSCE) stations with two faculty interviewers per station. Each student rotated through the six stations and were asked 4-5 structured questions per station. Each student was rated on a three-point rating scale. RESULTS: The majority of dental students were rated to be acceptable. The inter-rater reliability was 0.91 which was significantly high (range: 0.87-0.94). The total MMI score for all stations was 73.47 (SD = 8.49) with female students scoring significantly higher than males did (p < 0.001). Generalizability study results indicated good reliability (Φ-coefficient = 0.73; G-coefficient = 0.75). Moderate association was found between total MMI score and foundation year GPA (r = 0.30, p ≤ 0.001). CONCLUSIONS: Preliminary validity evidence supports the use of MMI scores as an admission tool for dental students, with respect to its response process, internal structure and relationship to other variables.

Validity and reliability of an Arabic version of the modified dental anxiety scale in Saudi adults.

OBJECTIVES: To test the reliability and validity of an Arabic version of the modified dental anxiety scale (MDAS), and to correlate it with other demographic data. METHODS: The original English version of the MDAS was translated into Arabic, and then translated back into English by experienced bilingual professionals. Four hundred and seventy-four patients referred to dental clinics for treatment at the Faculty of Dentistry Hospital, Jeddah, Kingdom of Saudi Arabia from November 2012 to June 2013 participated in the study. The assessment tool included questions regarding demographic characteristics, frequency of dental visits, the Arabic version of the MDAS, and the patient's rating of their current level of anxiety using a visual analogue scale (VAS). RESULTS: The Arabic version of the MDAS had excellent internal consistency and reliability (Alpha coefficients >0.90). The scale was unidimensional, and the percentage of patients with dental anxiety was 48.3% (using a cutoff total score of >15) and with dental phobia was 2.5% (using a cutoff total score of >16). Younger patients, females, and infrequent visitors to the dentist were more anxious than those who were older, male, and frequent visitors. Visual analogue scale scores correlated significantly with individual items on the MDAS questionnaire and total anxiety score, supporting the criterion validity. CONCLUSION: The Arabic version of the MDAS presented adequate internal consistency reliability, allowing its safe use to assess levels of dental anxiety in Arabic-speaking populations.

Skeletal and dental characteristics of subjects with incompetent lips.

OBJECTIVES: To evaluate the cephalometric features of subjects with incompetent lips, and to find the most discriminant variables for lip incompetence among the following: dental protrusion and proclination, antero-posterior and vertical skeletal relationships, and lip dimensions. METHODS: This retrospective study was conducted at King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia, between 2011 and 2012. Cephalograms of 84 subjects (22 males and 62 females, aged 20.18+/-3.65 years) diagnosed as having incompetent lips were collected (incompetent group [IG]) and compared with the control group (CG), matching in age and gender distribution. Thirty-five measurements were compared between the 2 groups using independent t-test. Stepwise discriminant analysis of lip incompetence was performed. RESULTS: Compared to the CG, subjects in the IG had thinner upper lips, shorter upper and lower lips, more retrognathic facial types, greater angle between nasion-point A and nasion-point B, shorter anterior and posterior cranial bases, shorter palatal length, shorter mandibular body length, shorter ramal length, steeper mandibular plane, less prominent chin, bimaxillary dental protrusion, and smaller inter-incisal angle. The significant discriminant variables, in order, were inter-incisor angle, inclination of upper incisors, ramal height, anterior cranial base,  palatal plane to Frankfort horizontal plane angle, lower and then upper anterior dental height, upper lip thickness, and length. CONCLUSIONS: The presence of incompetent lips can be attributed to more than one factor and not only bimaxillary protrusion. This should be considered during the treatment planning of such problem. 

Oral health-related quality of life in partially edentulous patients treated with removable, fixed, fixed-removable, and implant-supported prostheses.

PURPOSE: This study investigated changes in oral health-related quality of life (OHRQoL) in partially edentulous patients treated with removable dental prostheses (RDPs), fixed dental prostheses (FDPs), fixed-removable (combined) restorations (COMBs), and implant-supported fixed prostheses (ISFPs). MATERIALS AND METHODS: A total of 200 patients (30 to 50 years old) were enrolled: 45 received RDPs, 32 received FDPs, 66 received COMBs, and 57 received ISFPs. OHRQoL was measured using the shortened version of the Oral Health Impact Profile (OHIP-14) before treatment and 6 weeks and 6 months after treatment. Treatment groups were sex-neutral; however, significant differences were found relative to age and Kennedy classification. A general linear model was used to explore the interaction of age and Kennedy classification with treatment modality. RESULTS: Pretreatment analysis revealed that the psychologic discomfort domain showed the greatest negative impact on OHRQoL, while functional limitation had the smallest effect. Within-group comparison revealed a significant decrease in OHIP scores throughout the study in all groups except the younger age group treated with RDPs after 6 weeks. Between-group comparison revealed significant differences among the treatment groups. The least amount of OHRQoL improvement was recorded for RDPs for both age groups at 6 weeks and for the younger age group at 6 months. There were no significant differences between FDPs and ISFPs. CONCLUSIONS: All treatments produced significant improvement in OHRQoL. The least amount of improvement was observed in patients with RDPs. OHRQoL changes in patients treated with FDPs and ISFPs were comparable. The same treatment can have different impacts on the OHRQoL of partially edentulous individuals depending on their age and Kennedy classification.

Risk factors of perinatal and neonatal mortality in Alexandria, Egypt.

BACKGROUND: Egypt has already achieved the goal of reducing the under-five mortality rate (U5MR) by two-thirds. However, one of the challenges that Egypt currently faces is how to reduce the perinatal and neonatal mortality (PM, NM). This study aimed to identify the social and biomedical risk factors contributing toward PM and NM in Alexandria, Egypt. PARTICIPANTS AND METHODS: A case-control design was used. Cases were 150 mothers whose index pregnancy terminated in perinatal (from the 28th week of pregnancy to less than 7 days after birth) and neonatal deaths (from the seventh day to less than the 28th day after birth). They were selected from the antenatal clinic and neonatal care unit of ElShatby University hospital for Obstetrics and gynecology. Controls were 150 mothers with live births ranging in age from 28 days up to 2 months selected from the outpatient clinics of ElShatby University Hospital for Pediatrics. RESULTS: Stepwise logistic regression analysis indicated a higher risk of PM/NM among very young or very old mothers (OR=4.1 and 6.46, respectively), those who had previous PM/NM [odds ratio (OR)=12.7; 95% confidence interval (CI): 5.04-29.54], grand multiparous (OR=2.23; 95% CI: 1.50-5.42), those with infrequent antenatal visits (OR=3.88; 95% CI: 2.26-6.65), and mothers with complications during the index pregnancy (OR=9.21; 95% CI: 3.40-24.95). CONCLUSION: This study confirms the evidence of a positive association between PM/NM and maternal age, obstetric history, and utilization of healthcare services. Appropriate age at marriage and pregnancy, spacing of and limiting the number of births, and improving antenatal, natal, and postnatal care are priority actions that can reduce PM/NM in Alexandria.