Volumetric assessment of volume stable collagen matrix in maxillary single implant site development: A randomized controlled clinical trial.

INTRODUCTION: The stability of soft tissue volume around dental implants is an important factor for the final esthetic outcome. The main objective of this study was to compare volume stable collagen matrix (VCMX) versus connective tissue graft (CTG) in the augmentation of soft tissue profiles in single implant sites with a class I Siebert ridge defect. MATERIALS AND METHODS: Twenty patients (14 females and 6 males) were enrolled in the present study. After implant placement and augmentation of the buccal defect by VCMX or CTG, post-operative evaluation of the volumetric changes at the augmented implant site was carried out at 3, 6, and 9 months as primary outcome, clinical and radiographic soft tissue thickness were carried out at baseline and 9-month intervals, visual analog scale (VAS) and oral health impact profile-14 (OHIP14) were recorded 2 weeks after the surgery. RESULTS: A statistically significant difference in soft tissue volume was found between baseline and 3, 6, and 9 months postoperatively in both groups with the highest value at 9 months (136.33 ± 86.80) (mm3) in VCMX and (186.38 ± 57.52) (mm3) in CTG. Soft tissue thickness was significantly increased in both groups at 9 months in comparison to baseline. However, there was a significantly higher increase in soft tissue thickness at 9 months in CTG (3.87 ± 0.91) than in VCMX (2.94 ± 0.31). Regarding the radiographic soft tissue thickness, there was a statistically significant increase in both groups at 9 months in comparison to baseline. However, there was a statistically higher increase in the radiographic soft tissue thickness at 9 months in CTG (3.08 ± 0.97) than in VCMX (2.37 ± 0.29). VAS showed a statistically lower value in VCMX (0.4 ± 0.7) than CTG (2.8 ± 1.48). The OHIP recorded lower values in the VCMX group than the CTG group with no statistical significance. In addition, there was no difference in the PES between the two groups. CONCLUSION: The present study showed that CTG and VCMX were both effective in soft tissue augmentation around implants in the esthetic zone. However, CTG proved more efficient in increasing peri-implant soft tissue volume and mucosal thickness around single implants at a 9-month follow-up period. VCMX was associated with less pain or discomfort and reduced patient morbidity, as reflected by the significantly reduced VAS value in the VCMX group.

Double layer graft technique for horizontal alveolar ridge augmentation with staged implant placement: radiographic histological and implant stability analysis-a case report.

INTRODUCTION: Horizontal ridge augmentation of a deficient alveolar bone site is performed either simultaneously with implant placement or in a staged approach prior to implant insertion. There are several available strategies for the augmentation of alveolar ridge deficiencies, including guided bone regeneration (GBR) through the use of barrier membranes. The success of the GBR approach mainly depends on the exclusion of soft tissue cells during bone remodeling. CASE PRESENTATION: A healthy 25-year-old male patient presented with a missing upper left central incisor after clinical and radiographic examination, the site showed a class III defect horizontal atrophy. The procedure performed was the horizontal alveolar ridge augmentation using resorbable pericardium membrane with double layer graft technique (DLT) where autogenous bone placed as a first layer of the graft followed by xenograft as a second layer, the membrane was fixed with titanium pins. A cone beam computed tomography (CBCT) was performed before, immediately and 6 month following the surgery. After 6 months during implant placement, a core biopsy specimen was retrieved, stored and prepared for histological evaluation, with assessment of primary implant stability. The radiographic analysis showed a horizontal width gain of about 4 mm, at 6 month following implant placement, the implant was successfully osteointegrated with stability assessment also done after 6 months from placement. CONCLUSION: DLT was successfully used for horizontal alveolar ridge augmentation, thus allowing a prosthetically driven implant placement. More cases assessing implant survival and success are needed to confirm the results of this case report.

Treatment of class I Sibert alveolar ridge defects with volume stable collagen matrix. A case report.

INTRODUCTION AND IMPORTANCE: The soft tissue volume and its stability around dental implants are important for the final aesthetic outcome. CASE PRESENTATION: A 39-year-old female was referred for dental implant placement for her missing tooth. Following attachment of the cover screw VCMX was used to simultaneously augment buccal ridge defect. Patient was seen 2 weeks after surgery for follow up where sutures were removed. After 3 months, patient received her final crown and been on follow up for 9 months where a successful well-functioning restoration with clinically healthy soft tissue and optimal profilometric outcome were maintained. CLINICAL DISCUSSION: This approach is relatively simple, less invasive and time saving as it eliminates the need for another surgical donor site to manage the defect. CONCLUSIONS: The present report showed that VCMX was effective in soft tissue augmentation at implant sites in aesthetic zone. CLINICAL RELEVANCE: Within the limits of this study, the positive results suggest that the volume stable collagen matrix (VCMX) may be a reliable option in treatment of siebert class I ridge defects. VCMX was associated with less amount of pain or discomfort and reduced patient morbidity.

Injectable platelet rich fibrin effect on laser depigmented gingiva: a clinical randomized controlled split mouth trial with histological assessment.

OBJECTIVE: To determine whether intra-mucosal injection of injectable platelet-rich fibrin (i-PRF) can promote healing after Diode Laser Gingival Depigmentation (DLGD). METHODOLOGY: A total of 20 arch sites of hyperpigmented gingiva of 10 patients underwent DLGD. For each patient, two arch sites were randomly assigned for either intra-mucosal injection of i-PRF (G1-i-PRF) (n=10 sites) or no treatment (G2-Control): (n=10 sites). Wound Healing Score (WHS), patient satisfaction, and Pigmentation Index (DOPI) were measured at 1 week and 1 and 3 months postoperatively. Histological assessment of tissue specimens was performed at baseline and 1 week. RESULTS: The percentage change in WHS at 1 week was significantly higher in G1 (58.34±15.43) compared to G2 (37.50±11.79). At day 1, 50% of patients in G1 were pain free compared with 75% in G2, who had mild pain. Mean DOPI decreased significantly at 3 months in both groups (P-value <0.001), without significant differences between groups. G1 specimens showed significantly higher epithelial thickness (P-value <0.001), as well as a higher number of blood vessels and less percentage of inflammatory cells. CONCLUSIONS: i-PRF demonstrated better clinical and histological healing potential and less patient discomfort compared to sites without treatment after DLGD. Registered at https://clinicaltrials.gov/ as (NCT05283668).

Clinical and biochemical assessment of the effect of glutamine in management of radiation induced oral mucositis in patients with head and neck cancer: Randomized controlled clinical trial.

BACKGROUND: This study aimed to evaluate the effect of oral glutamine suspension on salivary levels of transforming growth factor beta 1 (TGF-ß1), a cytokine involved in inflammation and Tumor progression, and the severity of radiation-induced oral mucositis (RIOM) in head and neck cancer patients. This is the first study to investigate the impact of glutamine on TGF-ß1 levels in head and neck cancer patients with radiation induced oral mucositis (RIOM). METHODS: In this randomized controlled clinical trial, 50 HNC patients were enrolled and received either glutamine oral suspension or maltodextrin as a placebo from the baseline of RIOM to the end of radiotherapy. Salivary TGF-ß1 levels were measured at baseline and after treatment. Also, RIOM was assessed using the World Health Organization (WHO) Oral Toxicity Scale, the Oral Mucositis Assessment Scale (OMAS), the Pain Visual Analog Scale (Pain-VAS), the incidence of opioid use, and body mass index (BMI). RESULTS: Glutamine significantly reduced salivary TGF-ß1 levels and improved RIOM symptoms, such as pain, opioid use, and weight loss. The reduction of TGF-ß1 levels was associated with the improvement of RIOM severity. CONCLUSION: Glutamine may modulate the inflammatory response and enhance wound healing in RIOM by decreasing salivary TGF-ß1 levels. These findings support the use of glutamine as a potential intervention for RIOM and nutritional support for improving radiation sensitivity. TRIAL REGISTRATION: This study was registered on clinicalTrials.gov with identifier no. NCT05856188.

Injectable platelet rich fibrin effect on laser depigmented gingiva: a clinical randomized controlled split mouth trial with histological assessment

Abstract Objective To determine whether intra-mucosal injection of injectable platelet-rich fibrin (i-PRF) can promote healing after Diode Laser Gingival Depigmentation (DLGD). Methodology A total of 20 arch sites of hyperpigmented gingiva of 10 patients underwent DLGD. For each patient, two arch sites were randomly assigned for either intra-mucosal injection of i-PRF (G1-i-PRF) (n=10 sites) or no treatment (G2-Control): (n=10 sites). Wound Healing Score (WHS), patient satisfaction, and Pigmentation Index (DOPI) were measured at 1 week and 1 and 3 months postoperatively. Histological assessment of tissue specimens was performed at baseline and 1 week. Results The percentage change in WHS at 1 week was significantly higher in G1 (58.34±15.43) compared to G2 (37.50±11.79). At day 1, 50% of patients in G1 were pain free compared with 75% in G2, who had mild pain. Mean DOPI decreased significantly at 3 months in both groups (P-value <0.001), without significant differences between groups. G1 specimens showed significantly higher epithelial thickness (P-value <0.001), as well as a higher number of blood vessels and less percentage of inflammatory cells. Conclusions i-PRF demonstrated better clinical and histological healing potential and less patient discomfort compared to sites without treatment after DLGD. Registered at https://clinicaltrials.gov/ as (NCT05283668).

Effectiveness of thyme honey in the management of xerostomia in geriatric patients with end-stage renal disease: a randomized controlled clinical trial with a biochemical assessment.

BACKGROUND: Taking into consideration the value of the oral health condition in geriatric people with end-stage renal disease (ESRD) associated with xerostomia and believing that salivary stimulants or substitutes could potentially be used to manage this condition. This study aimed to evaluate the clinical effectiveness of thyme honey as oral rinse in geriatric patients with ESRD using the subjective dry mouth score as a primary objective and to assess the effect of thyme honey on the salivary nitric oxide level, salivary flow rate, and salivary ph in addition to objective dry mouth score as a secondary objective. METHODS: This was a single blinded randomized controlled trial with two equal arms, the interventional arm (thyme honey oral rinse) and the control arm (saline). Twenty-eight geriatric patients with ESRD undergoing hemodialysis complained of xerostomia were recruited from the renal dialysis center. Patients in both arms followed the same administration protocol either with thyme honey oral rinse or saline. The following clinical parameters (the subjective and objective dry mouth scores, salivary flow rate, salivary ph, and salivary nitric oxide (NO) levels) were evaluated for both groups at different intervals (baseline, 1 week, and 1 month). RESULTS: In the current study, it was found that both the subjective and objective dry mouth scores were significantly lower after one month of using thyme honey oral rinse (1.86 ± 0.66B) and (2.21 ± 0.43B) respectively, than the control group (3.07 ± 0.73B) and (3.07 ± 0.83B), respectively with a (p < 0.001). Also, the salivary flow rate was significantly higher after one month of using thyme honey oral rinse (1.56 ± 0.51A), than the control group (0.78 ± 0.27A) with a (p < 0.001). For the NO levels, there was a significant increase in measured value after 1 month in the intervention group (p < 0.001), while for the control group the change was not statistically significant (p = 0.166). CONCLUSIONS: The results of the current study have revealed the efficacy of Thyme honey oral rinse in the management of xerostomia in geriatric patients with ESRD. Trial registration The ClinicalTrials.gov Identifier for this study is NCT05247008.

Evaluation of muco-adhesive tacrolimus patch on caspase-3 induced apoptosis in oral lichen planus: a randomized clinical trial.

BACKGROUND: The study compared the clinical effectiveness of topical Tacrolimus (TAC) in patches or gel with Triamcinolone acetonide (TRI) gel for erosive/atrophic oral lichen planus (OLP) and investigated the influence of these therapies on Caspase-3 expression as a marker of apoptosis. METHODS: Thirty patients were randomly assigned into three equal groups to receive either topical TAC 0.1% patch twice daily, topical TAC 0.1% gel, or topical TRI 0.1% gel four times daily for 8 weeks. Each patient's clinical score (CS), visual analogue scale (VAS), and total atrophic area (TAA) of the marker lesion were measured at baseline, 2, 4, and 8 weeks of treatment, as well as after 4 weeks of treatment free period. Caspase-3 expression and lymphocytic counts (LC) were assessed in pre- and post-treatment biopsied stained sections. RESULTS: TAC patch resulted in a higher reduction in CS [- 14.00 (15.54%)] and VAS [- 70.21 (15.82%)] followed by TAC gel then TRI gel within the first two weeks. The reduction in VAS and TAA were significantly higher in TAC groups compared to TRI gel, although the difference between TAC treatment was not significant and this was observed throughout the treatment and follow-up periods. Caspase-3 expression increased in connective tissue in all groups. It decreased significantly within the epithelium in both TAC groups but increased in TRI gel. (LC) were significantly lowered with the TAC patch compared to other groups. The percentage change in Caspase-3 epithelial expression was significantly correlated to the CS, TAA, and LC. CONCLUSION: Both TAC patch and gel significantly decreased pain and lesion size than TRI gel, with a significant reduction in Caspase-3 expression within the epithelium in comparison to the increase seen with TRI gel. The study protocol was registered at www. CLINICALTRIALS: gov (NCT05139667) on 01/12/2021.

Outcome of Transplant Recipients Infected with Omicron BA.1 and BA.2: A Single-Center Retrospective Study in Saudi Arabia.

The outcome of transplant recipients is variable depending on the study population, vaccination status and COVID-19 variants. Our aim was to study the impact of Omicron subvariants on the mortality of transplant recipients. We reviewed the results of SARS-CoV-2 whole genome sequence of random isolates collected from 29 December 2021 until 17 May 2022 in King Faisal Specialist Hospital and Research center, Jeddah (KFSHRC-J), Saudi Arabia performed as hospital genomic surveillance program for COVID-19 variants. We included 25 transplant patients infected with confirmed Omicron variants.17 (68%) and 8 (32%) patients had Omicron BA.1 and BA.2, respectively. 12 (68%) patients had renal transplants. Only 36% of patients received three doses of COVID-19 vaccines. 23 (92%) patients required hospitalization. 20 (80%) patients survived and 6 (25%) required intensive care unit (ICU) admission. Among ICU patients, 66.7% were more than 50 years, 50% had two to three comorbidities and 5 out of 6 (83%) died. The mortality of transplant patients infected with Omicron variants in our cohort was higher than other centers as a limited number of patients received booster vaccines. Optimizing booster vaccination is the most efficient method to improve the mortality of COVID-19 in transplant recipients recognizing the inefficacy of monoclonal antibodies in the presence of SARS-CoV-2 emerging variants. We did not show a difference in mortality in transplant patients infected with Omicron BA.1 and BA.2 knowing the limitation of our sample size.

Awareness of medical emergencies among dental practitioners in three Egyptian dental schools: A cross-sectional study / Conscientização sobre emergências médicas entre dentistas em três Faculdades de Odontologia Egípcias: um estudo transversal

Objective: To evaluate the awareness of medical emergencies among dental practitioners in three dental schools. Material and methods: The study group included 384 dental practitioners, including dental staff members, post-graduate students, and dental interns. These professionals were attending three dental educational institutions in Egypt. Two of them were governmental and one was a private school. The educational model is almost the same in most Egyptian dental schools. Results: The response rate was 100%. Most of the participants worked in private academia (44.16%) or practice (42.34%) and 65.20% of them were females. The participants who recorded the medical history and filled a form (91.17%, 80.52 % respectively) while only 41.82% obtained the vital signs. Among the participants, 48.57 % were confident about handling medical emergency and 74.29 % reported their capability of intramuscular injection while only 25.71 % for intravenous injection and 49.35% knew about emergency kits. Management knowledge of airway obstruction and prosthetic heart valve patients was reported by 80.27 % and 71.94 % respectively, while less percentage for activation of EMS, chest compression, CPR ratio, and infant rescue breathing. The mean preparedness percent score was 54.57% and it was inversely correlated to the years of experiences and directly correlated to the degree of confidence in their ability to manage the dental emergency. Conclusion: The current study results reflected a deficiency in the dental practitioner awareness about the medical emergency especially the practical part. (AU)

Objetivo: Avaliar a consciência das emergências médicas entre os dentistas de três faculdades de odontologia. Material e Métodos: O grupo de estudo incluiu 384 dentistas, abrangendo membros da equipe odontológica, alunos de pós-graduação e estagiários de odontologia. Esses profissionais frequentavam três instituições de ensino de odontologia no Egito. Duas eram governamentais e uma era uma instituição particular. O modelo educacional é similar na maioria das escolas de odontologia egípcias. Resultados:A taxa de resposta foi de 100%. A maioria dos participantes trabalhava na área acadêmica (44,16%) ou clínica privadas (42,34%) e 65,20% deles eram do sexo feminino. Os participantes registraram o histórico médico e preencheram um formulário (91,17%, 80,52% respectivamente) enquanto apenas 41,82% obtiveram os sinais vitais. Entre os participantes, 48,57% estavam confiantes para lidar com emergências médicas e 74,29% relataram sua capacidade de injeção intramuscular, enquanto apenas 25,71% para injeção intravenosa e 49,35% sabiam sobre kits de emergência. O conhecimento do manejo de pacientes com obstrução das vias aéreas e válvula cardíaca protética foi relatado por 80,27% e 71,94%, respectivamente, enquanto menos porcentagem para a ativação do serviço de emergência médica (SEM), compressão torácica, índice de reanimação cardiorrespiratória (RCP) e respiração de resgate infantil. A pontuação percentual média de preparação foi de 54,57% e foi inversamente correlacionada aos anos de experiência e diretamente correlacionada ao grau de confiança em sua capacidade de gerenciar a emergência odontológica. Conclusão: Os resultados do presente estudo refletiram uma deficiência na conscientização do dentista sobre a emergência médica principalmente a parte prática (AU)

Corrosion Control of Carbon Steel in Water-Based Mud by Nanosized Metallo-Cationic Surfactant Complexes During Drilling Operations.

In this work, three nanometal complexes named cetyltrimethyammonium dibromodichloro zincate (CT-Zn), cetyltrimethyammonium dibromodichloro cuprate (CT-Cu), and cetyltrimethyammonium dibromodichloro manganesate (CT-Mn) were prepared, characterized, and evaluated as corrosion inhibitors for carbon steel in water-based mud (WBM). The chemical structure of the prepared complexes was confirmed by the use of Fourier transform infrared spectroscopy, Raman spectroscopy, elemental analysis, atomic absorption spectroscopy, dynamic light scattering, and thermogravimetric analysis techniques. The surface tension of the complexes was measured. The critical micelle concentrations and some of the surface properties were also determined. The compounds were evaluated as corrosion inhibitors for carbon steel in the prepared WBM using potentiodynamic polarization and weight loss methods during the static and dynamic conditions of the drilling operations. The results indicated that the prepared metal complexes showed high anticorrosion action as the inhibition efficiency increased gradually with the increase in the concentrations of the prepared complexes until it reached the maximum value (93.1%) at 300 ppm for CT-Cu. The order of inhibition efficiency of these inhibitors was as follows: CT-Cu > CT-Zn > CT-Mn. The polarization curves showed that these complexes acted as mixed-type inhibitors. According to the results, the adsorption of these compounds obeyed Langmuir adsorption isotherm. Surface analysis of the carbon steel samples was investigated using scanning electron microscopy, energy dispersive X-ray, and X-ray diffraction techniques. Rheological properties, gel strength, thixotropy, and filtration properties were also measured according to American Petroleum Institute specifications.

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.

Comparative Study between Direct and Pseudomorphic Transformation of Rice Husk Ash into MFI-Type Zeolite.

Pre-shaped mesoporous amorphous rice husk ash (RHA) and MCM-41 derived from RHA as a silica source were transformed into MFI-type zeolites using two different structure-directing agents. Tetrapropylammonium hydroxide (TPAOH) was utilized as an alkali source for silica dissolution and structure control during the direct transformation of RHA into zeolite. A monopropylamine (PA)-containing alkaline solution (NaOH) was used for the pseudomorphic transformation of RHA or MCM-41 into zeolite. The hydrothermal conversion of RHA or MCM-41 into MFI-type zeolites was investigated as a function of reaction time at 175 °C. With PA as template, the crystallization took place inside and on the outer surface of RHA or MCM-41 without losing the original shape of the initial silica sources, while TPAOH led to the formation of conventional MFI-type zeolite crystals due to the complete dissolution of RHA. The final products were characterized by X-ray diffraction, nitrogen adsorption, scanning electron microscopy, and optical emission spectroscopy.

Accuracy of rapid oral HCV diagnostic test among a Saudi sample.

OBJECTIVES: The objective of this study was to investigate the accuracy of the OraQuick® rapid diagnostic test in the detection of hepatitis C virus (HCV) antibodies in oral fluid among a Saudi population sample. DESIGN: A case-control cross-sectional study was conducted on 60 HCV-positive patients and 100 HCV-negative control subjects. PATIENTS AND METHODS: The HCV-positive patients were recruited from the Clinics of Infectious Diseases of King Abdulaziz University (KAU) Hospital, Jeddah, while the control group was collected from KAU, Faculty of Dentistry, including staff and students. The OraQuick® HCV rapid antibody test (OraSure Technologies, Inc. USA) utilized the oral fluid swab. Sensitivity and specificity for the test were calculated and correlated to the patients' viral load. RESULTS: Out of the 60 PCR + ve patients, 53 (88.33 %) revealed a positive OraQuick test, whereas 7 (11.67 %) patients showed negative test, revealing 88.33 % sensitivity and 100 % specificity for detection of salivary HCV antibodies. Only PCR level was valuable in predicting the outcome of OraQuick test. CONCLUSION: Using oral fluid for the detection of HCV antibodies could be a useful tool for epidemiological purposes and for field collection of samples in developing countries or in nonclinical settings by persons with minimal training. CLINICAL RELEVANCE: Millions of pilgrims visit Saudi Arabia during every year, many of whom are from countries where HCV infection is endemic; therefore, it will be very helpful to use a noninvasive, quick, simple, specific, and sensitive method for detection of HCV antibodies using oral fluid.

Effectiveness of the Microlux/DLTM chemiluminescence device in screening of potentially malignant and malignant oral lesions.

BACKGROUND: To evaluate the effectiveness of Microlux/DL with and without toluidine blue in screening of potentially malignant and malignant oral lesions. MATERIALS AND METHODS: In this diagnostic clinical trial clinical examination was carried out by two teams: 1) two oral medicine consultants, and 2) two general dentists. Participants were randomly and blindly allocated for each examining team. A total of 599 tobacco users were assessed through conventional oral examination (COE); the examination was then repeated using Microlux/DL device and toluidine blue. Biopsy of suspicious lesions was performed. Also clinicians opinions regarding the two tools were obtained. RESULTS: The sensitivity and, specificity and positive predictive value (PVP) of Microlux/DL for visualization of suspicious premalignant lesions considering COE as a gold standard (i.e screening device) were 94.3%, 99.6% and 96.2% respectively, while they were 100%, 32.4% and 17.9% when considering biopsy as a gold standard. Moreover, Microlux/DL enhanced detection of the lesion and uncovered new lesions compared to COE, whereas it did not alter the provisional clinical diagnosis, or alter the biopsy site. On the other hand, adding toluidine blue dye did not improve the effectiveness of the Microlux/DL system. CONCLUSIONS: The Microlux/DL seems to be a promising adjunctive screening device.

Prevalence of potentially malignant oral mucosal lesions among tobacco users in Jeddah, Saudi Arabia.

Smoking is recognized as a health problem worldwide and there is an established tobacco epidemic in Saudi Arabia as in many other countries, with tobacco users at increased risk of developing many diseases. This cross sectional study was conducted to assess the prevalence of oral mucosal, potentially malignant or malignant, lesions associated with tobacco use among a stratified cluster sample of adults in Jeddah, Saudi Arabia. A sample size of 599 was collected and each participant underwent clinical conventional oral examination and filled a questionnaire providing information on demographics, tobacco use and other relevant habits. The most common form of tobacco used was cigarette smoking (65.6 %) followed by Shisha or Moasel (38.1%), while chewing tobacco, betel nuts and gat accounted for 21-2%, 7.7%, and 5% respectively. A high prevalence (88.8%) of soft tissue lesions was found among the tobacco users examined, and a wide range of lesions were detected, about 50% having hairy tongue, 36% smoker's melanosis, 28.9% stomatitis nicotina, 27% frictional keratosis, 26.7% fissured tongue, 26% gingival or periodontal inflammation and finally 20% leukodema. Suspicious potentially malignant lesions affected 10.5% of the subjects, most prevalent being keratosis (6.3%), leukoplakia (2.3%), erythroplakia (0.7%), oral submucous fibrosis (0.5%) and lichenoid lesions (0.4%), these being associated with male gender, lower level of education, presence of diabetes and a chewing tobacco habit. It is concluded that smoking was associated with a wide range of oral mucosal lesions , those suspicious for malignancy being linked with chewable forms, indicating serious effects.

Trigeminal neuralgia: diagnostic criteria, clinical aspects and treatment outcomes. A retrospective study.

OBJECTIVE: The aim of this study was to investigate the diagnostic criteria and clinical presentations and compare the different treatment modalities in relation to prognosis in a sample of patients with the neuropathic disorder trigeminal neuralgia (TN). METHODS: A retrospective review study of clinical records was conducted of 92 patients diagnosed with TN. RESULTS: The mean age[±standard deviation (SD)] of the patients was 67.3±12.7 years with an average TN duration of 7.1±6 years and a female predominance (M:F=1:2.5). The maxillary branch was the most involved nerve (in 45% of patients). Twelve patients underwent CT scans, while thirty-six patients had MRIs. Carbamazepine used by 92.4% of patients was the most commonly used drug in the management of the disorder. Twenty-two patients had microvascular decompression (MVD). TN symptoms were completely relieved following surgery in 73% of patients who underwent neurosurgery. CONCLUSIONS: MRI is highly sensitive in the exclusion of central intracranial lesions and recommended as a routine consideration during the assessment of TN patients. Despite the side effects, carbamazepine is the drug therapy of choice. MVD produces satisfactory relief of TN symptoms in the majority of cases and should be offered to young healthy patients.

Topical pimecrolimus effect on Fas inducing apoptosis in oral lichen planus: a clinical immunohistochemical study.

OBJECTIVE: To investigate the effectiveness of pimecrolimus treatment in patients not responding to corticosteroid treatment and to investigate its effect on Fas expression on keratinocytes in oral lichen planus (OLP). SUBJECTS AND METHODS: Twenty patients with OLP were recruited from the Oral Medicine Clinic at the School of Dentistry, Ain Shams University, Egypt. Pimecrolimus 1% cream with a hydrophilic adhesive gel base was applied to the oral lesions, four times daily, for a total of 2 months. A marker lesion was identified and assessed by clinical scoring (CS). The symptomatology score was obtained using a visual analog scale (VAS). Pre-treatment and post-treatment specimens were immunohistochemically stained for detecting Fas. RESULTS: The results of clinical scores showed statistically high significant improvement (P = 0.0001). The mean VAS decreased significantly over time as well as the mean of Fas expression (P < 0.05). The overall percentage of reduction from baseline to week 8 was 87%, 93%, and 67% for clinical scores, visual analog score, and Fas expression, respectively. CONCLUSIONS: Topical pimecrolimus reduced Fas expression, and it appears to be a promising alternative treatment for OLP.