Validity of Cone-beam Computed Tomography in Assessment of Morphological Bony Changes of Temporomandibular Joints.

AIM: The aim of the current study was to correlate the clinical symptoms that are associated with temporomandibular disorder (TMD) to the osseous changes occurring in the affected temporomandibular joint (TMJ), as detected by cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The clinical data of patients that presented with TMJ symptoms was collected and correlated with the CBCT findings for the same patients. Patient recruitment took place over a 1-year period in the Oral and Maxillofacial Surgery and Oral and Maxillofacial Radiology department of the same academic institution. RESULTS: There was a limited mouth opening (MO) (<3 cm). More importantly, there was a statistically significant positive relation between pain and loss of cortication. CONCLUSION: There was no significant correlation between CBCT findings consistent with TMJ degeneration and clinical symptoms. CLINICAL SIGNIFICANCE: Cone-beam computed tomography evaluation of the TMJ is important for providing information about the state and level of TMJ degeneration if any. However, clinical findings should be the most important factor when considering management options for symptomatic TMJ.

Comparing Dental Stress in New Child Patients and Returning Patients Using Salivary Cortisol, Immunoglobulin-A and Alpha- Amylase.

OBJECTIVES: this study was aimed at comparing dental stress in children having their first dental visit to those returning for dental treatment using salivary biomarkers of stress including salivary cortisol (s-cortisol), Immunoglobulin-A (s-IgA) and alpha-amylase (s-α-amylase). Additionally, the study was aimed at monitoring the change in stress in new patients as they progressed from the waiting to the clinical areas. STUDY DESIGN: salivary samples were collected from 40 children who had not been to a dentist before and similar samples were collected from 40 children who were returning for completion of dental treatment. Salivary cortisol, s-IgA and s-α-amylase concentrations were obtained by Enzyme-linked Immunosorbent Assay (ELISA). RESULTS: salivary cortisol levels were higher for new patients at the waiting area compared to that at the dental chair (p=0.05). Salivary alpha-amylase significantly increased in new patients while being seated in the dental chair. Returning patients had higher s-α-amylase (p=0.001) and s-IgA (p=0.016) compared to new patients. Returning patients had the lowest level of s-cortisol when providers were faculty pediatric dentists than with students and interns (p=0.035). CONCLUSIONS: children coming in for their first dental visit may experience dental stress at the waiting area before being seated for dental examination. Returning children may experience higher levels of stress compared to new child patients possibly due to previous dental exposure.

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.

Clinical efficacy of new aloe vera- and myrrh-based oral mucoadhesive gels in the management of minor recurrent aphthous stomatitis: a randomized, double-blind, vehicle-controlled study.

OBJECTIVE: To evaluate the clinical efficacy, and safety of newly customized natural oral mucoadhesive gels, containing either aloe vera or myrrh as active ingredients, in the management of minor recurrent aphthous stomatitis (MiRAS). SUBJECTS AND METHODS: Ninety subjects with MiRAS were recruited from Oral Medicine Clinic, at Faculty of Dentistry, King Abdulaziz University, Saudi Arabia, for this randomized, double-blind, placebo-controlled study. Two new natural gels, containing aloe vera and myrrh, were prepared in a concentration of (0.5% w/w), in addition to a plain mucoadhesive gel used as a placebo. Patients with fresh ulcers (<48-h duration) were instructed to apply either one of the three gels four times a day for a period of 5 days. Clinical efficacy was investigated in the form of changes in ulcer size, pain intensity, erythema, and exudation at days 4 and 6 of study entry. Participants were interviewed for the emergence of any side effects. RESULTS: 76.6% of patients using aloe gel showed complete ulcer healing, 86.7%, and 80% of them revealed subsidence of erythema and exudation, respectively, especially at day 6 visit, whereas 76.7% of myrrh-treated patients revealed almost absence of pain at day 6. No side effects were encountered with the use of any of the three gels. CONCLUSION: The new formulated aloe- and myrrh-based gels proved to be effective in topical management of MiRAS. Aloe was superior in decreasing ulcer size, erythema, and exudation; whereas myrrh resulted in more pain reduction.

Genetic and dental study of patients with celiac disease.

OBJECTIVES: The aim of this work was to study the pattern of inheritance of celiac disease in a group of Saudi patients and to compare oral mucosal and dental clinical findings in these patients to those of healthy controls. STUDY DESIGN: Fifty patients suffering from celiac disease were screened for dental evaluation. They were subjected to clinical genetic examination, pedigree construction, oral mucosal and dental clinical evaluation. RESULTS: An autosomal recessive mode of inheritance was evident in some of the studied cases, while others showed sporadic occurrence. Oral mucosal and dental clinical examinations revealed recurrent oral ulcerations, enamel hypoplasia in most of the celiac disease patients. CONCLUSIONS: Pedigree analysis of families is important to identify the mode of inheritance. Oral mucosal and dental clinical examinations are important in diagnosing and monitoring cases of celiac disease.