Sexual behaviours and head and neck cancer: A systematic review and meta-analysis.

Human papillomaviruses (HPV) are associated with head and neck cancers (H&NC). Transmission of HPV to the upper aerodigestive tract occurs plausibly through sexual contact, although epidemiologic evidence on the role of sexual behaviours in H&NC aetiology is inconsistent. We conducted a meta-analysis of studies examining the association between four indicators of sexual behaviours (number of sexual partners and oral sex partners, oral sex practice, and age at first intercourse) and H&NC. Summary odds ratios (OR) and 95% confidence intervals (CI) were estimated using fixed and random effects models for each indicator, contrasting 'highest' to 'lowest', 'ever' to 'never', or 'youngest' to 'oldest' categories. Twenty case-control studies were included out of 3838 identified publications. Using random effects models, summary ORs suggested an increased risk of H&NC for number of sexual partners [OR=1.29, 95% CI: 1.02-1.63] (19 studies) and number of oral sex partners [OR=1.69, 95% CI: 1.00-2.84] (5 studies), whereas no effect was observed with oral sex practice [OR=1.09, 95% CI: 0.88-1.35] (17 studies) and age at first intercourse [OR=1.40, 95% CI: 0.71-2.79] (6 studies). For number of sexual partners and oral sex practice, which were assessed in more studies, we further excluded studies contributing to heterogeneity and those not adjusted for age, sex, smoking, and alcohol consumption. The summary ORs were 0.95 (95% CI: 0.75-1.20) for number of sexual partners and 1.03 (95% CI: 0.84-1.26) for oral sex practice. Our findings highlight that observed associations might be partly attributed to confounding effects of sociodemographic and behavioural factors.

Treatment of oral ulcers in dogs using adipose tissue-derived mesenchymal stem cells.

AIM: Adipose tissue Derived Mesenchymal Stem cells (ADMSCs) represent a promising toolfor new clinical concepts in supporting cellular therapy. The goal of this study was to investigate the effects of ADMSCs transplantation on oral ulcer healing in dogs. STUDY DESIGN: Mesenchymal stem cells were isolated from adipose tissues of dogs obtained by suction-assisted lipectomy (liposuction), by dish adherence and were expanded in culture. Oral ulcers were induced by topical application of formocresol in the oral cavity of 18 dogs. The dogs were classified into 3 groups. Either autologous ADMSCs, Corticosteriod (Dexamethasone) or vehicle (saline) was injected. The healing process of the ulcer was monitored histopathologically. Gene expression of vascular endothelial growth factor (VEGF), platelets derived growth factor (PDGF), epidermal growth factor (EGF) and collagen was assessed in biopsies obtained from all ulcers "as healing markers'", by real time polymerase chain reaction (PCR). RESULTS: ADMSCs group showed significantly accelerated oral ulcer healing compared with the Dexamethasone and control groups. There was increased expression of VEGF PDGF EGF and collagen genes in ADMSCs-treated ulcers compared with Dexamethasone and controls. CONCLUSION: ADMSCs transplantation may help accelerate oral ulcer healing, possibly through the induction of angiogenesis by VEGF and PDGF as well as epithelial and connective tissue proliferation as evidenced by increased EGF and collagen gene expression.

Oral health knowledge, attitude and behaviour among Saudi school students in Jeddah city.

OBJECTIVES: To assess the knowledge, attitude and behaviour in relation to periodontal health status among Saudi intermediate and high school students living in Jeddah, Kingdom of Saudi Arabia. METHODS: A dental health questionnaire was distributed to a random sample of a total of 2586 Saudi students from intermediate and high school, aged 12-18 years residing in Jeddah. RESULTS: While about 87.1% knew that tooth brush helps prevent periodontal disease, only 33.1% knew that using dental floss helps in preventing periodontal disease. Females used brushing and flossing more than males, while males used miswak more than females. Tooth brushing (P<0.001) and dental floss (P<0.015) were used more frequently among private subjects, while miswak was utilized more frequently among governmental school students (P<0.005). Dental pain was found to be the main reason for visiting the dentist among the target group. CONCLUSIONS: It appears that knowledge, attitude, and behaviour concerning periodontal health among young Saudi school students living in Jeddah city are in need of improvement.

Symptoms and signs of temporomandibular disorders and oral parafunctions among Saudi children.

This study aimed to record the prevalence of signs and symptoms of temporomandibular disorders (TMD) and oral parafunctions among Saudi children. A questionnaire and a clinical examination of signs and symptoms of TMD were performed on 1940 stratified randomly selected schoolchildren. The sample was divided into three groups, 505 with primary, 737 with mixed and 734 with permanent dentition. The prevalence of TMD signs was found to be 20.7% and the most common sign of TMD was joint sounds (11.8%). The second most common sign was restricted mouth opening (5.3%). Muscle and temporomandibular joint (TMJ) pain as well as deviation upon jaw opening appeared infrequently. TMJ sounds were significantly increasing with age (P < 0.05). TMD symptoms as reported by the parents were evident in 24.2% of the returned questionnaires (1113). The most common symptoms were headache (13.6%) and pain on chewing (11.1%). The incidence of headache was found to be significantly increasing from primary to permanent dentition (P < 0.01). No sex difference in the prevalence of any symptom was reported. Nail biting was the most common oral parafunction (27.7%) while bruxism was the least common (8.4%). All parafunctions except bruxism were significantly related to age. Cheek biting and thumb sucking were reported more in females than in males. The importance of a screening examination for symptoms and signs of TMD should not be overlooked in the clinical assessment of the pediatric patient.

Sealing ability of a single bond adhesive in primary teeth. An in vivo study.

AIM: To compare the ability of a single bond adhesive to its preceding multiple step dentin bonding agent in reducing microleakage around class V composite resin in primary teeth. MATERIAL AND METHODS: Twelve children, between 9 and 11 years old, with non-carious primary canines indicated for extraction for orthodontic purposes, were selected for this study. Each child had facial surfaces of his or her upper and/or lower canines prepared for class V cavities. One canine was randomly selected for restoration using the Scotchbond Multi Purpose Plus System (group I) and its antimere for the Single Bond adhesive (group II). Thirty cavities were restored by Z-100 composite. Materials were handled according to the instructions of the manufacturer. All teeth were extracted one month later, immersed in 2% basic fuchsin then sectioned to evaluate dye penetration. RESULTS: No statistically significant difference was found in the degree of microleakage between the two materials. CONCLUSIONS: Neither of the two adhesive systems was able to completely prevent leakage of class V restorations. Additional preventive measures should be implemented whenever using composite resin restorations in children.

Relationship between premature loss of primary teeth and the development of temporomandibular disorders in children.

AIM: This study evaluated the prevalence of signs of temporomandibular disorders (TMD) in children with and without premature loss of primary teeth. SAMPLE: Fifty-eight children, aged 4-6 years, with missing primary molars, were compared with 58 age- and sex-matched control children with complete primary dentitions. METHOD: All the children underwent an examination that consisted of palpation and assessment of the joints and associated muscles for tenderness and joint sounds. Maximum vertical opening and deviation during jaw opening were also recorded. Children with any single anomalous finding were designated positive for TMD signs. RESULTS: There were no statistically significant differences in the prevalence of single or collective TMD signs between the two groups. CONCLUSION: The results of this study show that premature loss of primary teeth, uncomplicated by other factors, does not appear to be an aetiological factor for TMD development.

The effect of education upon dentists' knowledge and attitude toward fissure sealants.

Sealants are highly effective in preventing dental caries in the pits and fissures of teeth. It has been shown, however, that sealants are not widely used by dentists. This study aimed to educate dental professionals about sealants and to evaluate the effect of such education on dentists' knowledge, attitude and use of sealants. A total of 312 dentists were surveyed to determine their knowledge and attitude toward sealants. Respondents were randomly allocated to "Education" group, who received education materials; and "No Education" group, who received no material (until after the education phase). After 12 months, 105 dentists responded to the post-intervention survey. Comparison between the two surveys shows that dentists' knowledge increased significantly in the "Education" group. No difference was detected in dentists' knowledge in the "No Education" group. Dentists' attitude and sealant use did not significantly improve in any of the groups. It is therefore, concluded that continuing education were more likely to change dentists' knowledge than attitude and behaviour. Effort to encourage sealant use by dentists should continue, but with the recognition that changes in behaviour occur over a long time and that other external factors in the professional environment may affect the rate of change.

Temporomandibular disorders among school children.

A large volume of literature is available on the Temporomandibular Disorders (TMD) in adults. However, relatively little information is available on this condition in children. The present study is aimed at providing a comprehensive survey on Temporomandibular Joint Status in Saudi Arabian Children in the Western Region of the Kingdom. This is a report on the prevalence of TMDs in children. Five hundred and two children aged 3-7 years old were examined for signs and symptoms of TMDs in a classroom setting. Eighty-three (16.53%) presented with TMDs, with 34 (14.46%) males 49 (18.35%) female (This difference between sexes is significant P < 0.001); 39 (7.8%) of the children had TMJ sounds; 34 (6.77%) had associated muscle tenderness; 13 (2.59%) had pain during TMJ movement; 17 (3.39%) had deviation of the mandible during movement; and 9 (1.7%) had a restricted mouth opening. There is a general tendency for these signs and symptoms to be more significantly prevalent in females. None of the children had sought dental treatment for these conditions. The importance of TMJ examinations in the overall clinical assessment of the pediatric patient should not be overlooked. Identifying this subject early in life would allow us to follow up the patient and intervene in the appropriate time to avoid future problem in the TMJ apparatus.

Sucking habits in Saudi children: prevalence, contributing factors and effects on the primary dentition.

A review of the literature on the prevalence of sucking habits shows that it varies from one population to another. The purposes of this study were to: 1) determine the prevalence of sucking habits among preschool Saudi children living in Riyadh City, 2) assess the influence of some cultural factors on that prevalence, and 3) to study the effect these habits might have on the primary dentition. This cross-sectional study was conducted through a survey questionnaire and clinical examination of 583 Saudi children aged 3-5 years using a stratified cluster random sampling technique. The prevalence of sucking habits was 48.36% with the dummy-sucking as the dominant type. Most dummy-suckers had broken their habits in the first few years of life while more digit-suckers were still active at age 5 years. Sucking habits were only related to parents' education and the child feeding methods without significant effect of gender or birth rank or family income. Children with existing digit sucking habits had significantly (P < 0.05) more distal molar and class II canine relationships, larger overjet, and open bite than did children without sucking habits. These differences were even more significant (P < 0.01) when dummy-suckers were compared with nonsuckers. The only measurable effect of previous sucking habits was a more open bite. Posterior crossbite was no more common in children with sucking habits than in children without these habits.

Characteristics of primary dentition occlusion in a group of Saudi children.

Occlusal characteristics of the primary dentition vary among populations and ethnic groups. This cross-sectional study aimed to record various primary dentition parameters in 520 3-5-year-old randomly selected Saudi children and to observe the differences between the age groups. 80% of the children had a 'flush terminal plane' molar relationship. The proportion of the children with 'distal step' molar relationship was significantly lower at age 5 (7%) than at age 3 (16%). 86% of the children had Class I canine relationship, with no significant differences between the age groups. The degree of overbite was significantly less in the 5-year-olds than in the 3-year-olds. The majority of the children (76%) had an overjet of 0-2 mm, but the prevalence of 0-1 mm overjet was significantly higher, and that of 2-3 mm significantly lower, in the elder age group. The prevalence of anterior crossbite was 2% and of posterior crossbite 4%. The prevalence of malocclusion was lower in these subjects than in some Caucasian populations.

The Florence sextuplets. Report of a case. Part two: progression of pregnancy, the onset of labor and delivery.

The paper presents a successful case of sextuplet pregnancy after HMG-HCG induced ovulation. The pregnancy was brought to 34, 5 weeks of gestation with all six babies in good conditions and high birth weight (1200-1750 gr.). The effectiveness of early diagnosis, intensive follow-up, and elective caesarean section is discussed. Suggestions are made for the prenatal, intrapartum, and post natal problems connected with mulitple gestation of high fetal number.

Preliminary experience in the treatment of rebel ascites from ovarian cancer with the peritoneo-venous shunt of Leveen.

4 cases of rebel ascites from advanced ovarian cancer, considered lost to chemotherapy, are treated with Leveen's peritoneo-venous shunt. Deterioration of general conditions for the ascites and progressive unaffectiveness of chemotherapy induced the authors to find better conditions of life for these patients. By the peritoneo-venous shunt life condition improved significantly; the patients were able to continue chemotherapy with good results; 2 patients are living more than 2 years after the shunt.