Mohammed Sultan Al-Ak’hAli

Background Stomatognathic movement disorders (SMDs) are uncommon but clinically significant neurological conditions that frequently present with orofacial manifestations. Because affected patients may initially seek care from dental practitioners, limited awareness of these disorders could contribute to diagnostic confusion with temporomandibular disorders (TMDs) and may have implications for timely referral and appropriate patient management. This study evaluated dental practitioners’ knowledge, diagnostic confidence, and educational preparedness regarding SMDs. Methods A cross-sectional survey was conducted among dental practitioners using a validated self-administered online questionnaire. Knowledge scores were calculated out of 25 points and expressed as percentages. Comparative analyses were performed across educational levels using one-way ANOVA, chi-square tests, and multivariable logistic regression. Results A total of 156 dental practitioners participated. Mean knowledge scores differed significantly across academic level (Bachelor: 44.05%, Master: 48.95%, Doctorate: 63.71%; p < 0.001). Doctoral-level education independently predicted adequate knowledge (OR = 8.54, 95% CI: 2.09–34.97; p = 0.003), whereas master’s-level showed no significant effect. Knowledge gaps were observed in several domains, particularly in distinguishing SMDs from TMDs and in the management of oromandibular dystonia. Only a minority of participants correctly recognized that temporomandibular joint radiographs are not routinely required prior to treatment. Self-reported clinical confidence was generally low, with only 1.1% of general dentists reporting the ability to independently manage suspected SMD cases. Nevertheless, 94.9% of participants supported integrating SMD-related content into dental curricula. Conclusion The surveyed dental practitioners demonstrated important knowledge gaps regarding SMDs. These findings highlight opportunities to strengthen undergraduate and continuing dental education in the recognition, differentiation from TMDs, and appropriate referral of patients with suspected SMDs.

Despite the widespread availability of online information about dental veneers, there is a lack of data on the quality and readability of these resources. The aim of this study was to assess the quality and readability of patient-oriented online information on dental veneers. This study conducted a thorough web search utilizing Google, Yahoo, and Bing search engines to identify English-language websites offering information on dental veneers. The quality of the websites was assessed using DISCERN, Journal of the American Medical Association (JAMA) benchmarks, and Health on the Net Code (HONcode) tools. The readability of the websites was evaluated using the Flesch-Kincaid Grade Level (FKGL), Simplified Measure of Gobbledygook (SMOG), and Flesch Reading Ease (FRE) metrics. Out of a total of 195 websites included in the study, only 8 websites obtained a high overall DISCERN score, representing 2.4% of dental clinic (DC) and 14.8% of nonprofit organization (NPO) websites. The median [interquartile range (IQR)] of the overall score of DISCERN was significantly higher for NPO websites [55.5 (13)] compared to DC websites [42 (13)] and commercial entity (CE) websites [36.25 (5.5); p < 0.001]. Up to 15, 63, and 70% of NPO, DC, and CE websites, respectively, did not report any of the four JAMA criteria. Only seven websites (all NPOs) showed an active Health on the Net (HONs) Code certificate. All readability indicators confirmed easier texts on the NPO websites. The quality of the English web-based health information on dental veneers seems suboptimal. Nonprofit organization websites offer higher quality, more reliable, and readable content compared to DC and CE websites. Online dental veneer information is generally of poor quality, with NPO websites offering the most reliable and readable content. Clinicians should direct patients to trustworthy NPO resources for accurate information. How to cite this article: Alqutaibi AY, Alharbi AT, Alassaf MS, et al. Assessment of Quality and Readability of Online Patient-centered Information on Dental Veneers: An Infodemiological Study. J Contemp Dent Pract 2025;26(11):1060-1066.

This meta-analysis aims to systematically assess the association between periodontitis and stress in relation to salivary cortisol levels. Four major databases, the MEDLINE-PubMed, Google Scholar, EMBASE, and CENTRAL databases, were searched from January 2005 to August 2023 for prospective and retrospective clinical studies. The PECO guidelines followed were as follows: Population: Patients with periodontal disease; Exposure: depression, stress, or anxiety; comparison: No periodontal disease and no depression, stress, or anxiety; outcome: salivary cortisol level. The following variables were extracted from each study: author, study design, sample size, saliva cortisol level (mean), periodontal parameters, method of stress evaluation, and the outcome of the study. The risk of bias was evaluated using the Newcastle-Ottawa Scale. The statistical analysis involved calculating standardized mean differences (SMD) and their corresponding 95% confidence intervals (CI). The meta-analysis was conducted using comprehensive meta-analysis version 2. A total of 101 articles were identified, of which 73 articles were excluded after the first round of screening of titles and abstracts and 17 articles were excluded after full-text examination. Finally, 11 clinical studies comprising of 1,565 participants that satisfied the inclusion criteria for the systematic review were considered. While eight studies were included for meta-analysis in the first comparison group and seven studies were considered for analysis in the second comparison group. Of the 11 studies included in the present systematic review, seven were cross-sectional studies, three were case-control studies, and one was randomized double-blinded prospective study. The meta-analysis findings indicated a statistically significant increase in cortisol levels among patients with periodontitis compared to those without periodontitis (SMD = -1.424, CI: -2.107 to -0.740, p = 0.001, low-quality evidence). Moreover, a statistically significant increase in cortisol levels was observed in patients with periodontitis who experienced stress. Overall studies included in the review demonstrate and confirm a positive association between elevated salivary cortisol levels and periodontitis with stress. The results of this study suggest that treatment for periodontitis patients could be tailored to consider both the clinical aspects of the condition and the patient's stress levels. Thus, clinicians should pay attention to stress management as part of comprehensive periodontal care. How to cite this article: Al‑Ak'hali MS, Al-Moraissi EA, Fageeh HN, et al. Are Salivary Cortisol Levels Elevated in Periodontitis Patients Experiencing Stress Compared to Those without Stress? A Systematic Review and Meta-analysis. J Contemp Dent Pract 2025;26(2):206-216.

Background: In the era of the internet, patients seek health information ahead of getting the required treatment. Dental implant, which is among the most sought dental treatments, is not an exception. Incorrect health related information may lead to harmful deeds, so this study sought to assess the quality of web-based Arabic health information on dental implants. Methods: The following engines were searched: Google (http://www.google.com), Yahoo! (http://www.yahoo.com), and Bing (http://www.bing.com) on 13 January 2022 for specific Arabic terms on “dental implants”. The first 100 consecutive websites from each engine were analyzed for eligibility. The eligible websites were assessed using JAMA benchmarks tool, DISCERN tool, and HONcode. An online tool (including FKGL, SMOG and FRE) was used to assess readability of the websites. Results: There were 65 eligible websites, of which only one (1.5%) was HONcode certified. Only 3 (4.5%) websites attained a high score (> 65 out of 80) based on DISCERN tool: The mean DISCERN score was 41.14 ± 12.64. The mean JAMA score was 1.69 ± 1.13; however, only five (7.6%) met all JAMA criteria. The main shortcomings were attributed to not meeting the “Attribution” (54 [83.1%]) and “Authorship” (43 [66.2%]) criteria. The mean grade level of FKGL score was 7.0 ± 4.5. The majority of the websites (60%) scored less than 7, indicating easy content to understand. The mean grade level of SMOG score required to understand a website’s text was 3.2 ± 0.6. Around 91% of the websites had reading ease scores ≥ 80, suggesting that the website’s content was easy to read. Conclusion: Unfortunately, although readable, most of the easily accessible web-based Arabic health information on dental implants does not meet the recognized quality standards.

Background: This study aimed to investigate the effect of vertical facial patterns on the developmental relationship between the nasal bone and maxillary central incisors.Methods: In this retrospective comparative study, the lateral cephalograms of 213 subjects (51 Males, 162 Females) with skeletal Class I malocclusion (aged 18–32 years) were classified into three equal groups: (1) hyperdivergent, (2) normodivergent, and (3) hypodivergent facial patterns based on the mandibular plane inclination (S–N/Go-Me). Several sets of measurements were extracted: (1) gradient and length of the nasal bone and maxillary central incisor, (2) the distance from apex and root of the nasal bone, and (3) maxillary central incisor to the true perpendicular from the digitized lateral cephalograms. The significance level was considered atP < 0.05.Results: The inclination angle and length between nasal bone and maxillary central incisor were positively correlated independent of vertical facial type. The inclination angle of the nasal bone in the hypodivergent group was significantly larger than the other two vertical facial patterns. The inclination angle of the maxillary central incisor increased successively in the hyperdivergent, normodivergent, and hypodivergent groups. The length of the nasal bone in the hyperdivergent group was significantly longer than that in the hypodivergent and normodivergent groups. The maxillary central incisor length in the hyperdivergent group was significantly longer than in the hypodivergent group.Conclusion: A correlation between nasal bone and maxillary central incisors during the growth and development of the maxillofacial region was found. In Class I malocclusion subjects, hypodivergent patients were more likely to have a prominent and relatively short nasal bone and maxillary central incisors and vice versa.

This study aimed to investigate the knowledge and practices among dental practitioners in Saudi Arabia regarding the use of antimicrobials for periodontal diseases. An online questionnaire was sent to senior dental students and dental practitioners including interns, general dental practitioners (GDP), and periodontists in Saudi Arabia. Two hundred and twenty-three dental practitioners responded and participated in the study. The potential associations between the use of antimicrobials and different variables were assessed by a chi-square test. The majority of the participants (84.3%) reported prescribing systemic antimicrobials for a periodontal abscess or acute necrotizing periodontal disease. Surprisingly, 31% of participants reported prescribing systemic antimicrobials for deep localized periodontal pockets or for acute gingivitis associated with herpes simplex in children. Noteworthy is that 66% of the participants thought that mechanical periodontal treatment alone, without adjunctive antimicrobial therapy, is adequate to resolve the clinical condition in most cases of periodontal diseases. Almost half of the participants recommended the use of local antimicrobials for a periodontal pocket (45.3%), a recurrent periodontal pocket (45.4%), and refractory periodontitis (43.7%). The barriers against the use of local antimicrobials were a lack of knowledge and a lack of continuous education after graduation, as reported by 64% of the participants. In conclusion, knowledge and practices regarding antimicrobial use for periodontal diseases were inadequate, especially among practitioners other than periodontists.

Objective: the aim of this study was to evaluate the efficacy of ultrasonography in diagnosis of tempromandibular joint soft tissue injury after mandibular osteosynthesis. Material and Methods: ten male patients (20 joint) with age ranged between 20-28 years were collected from those attending the outpatient clinic of Oral and Maxillofacial Surgery Department, Al-Kuwait Hospital, Sana’a University. Patients were divided into two groups according to the number of fracture line in the mandible. All patients were randomly assigned to diagnosis of the soft tissue changes of temporomandibular joint by either ultrasonography or magnetic resonance image preoperatively, after 2 weeks and 3 months postoperatively. Results: preoperatively, there was moderate agreement between ultrasonography and magnetic resonance image in the diagnosis of abnormal findings in both groups, the difference was not statistically significant. In group I, ultrasonography of the temporomandibular joint didn’t detect any abnormal findings after mandibular osteosynthesis, meanwhile, magnetic resonance image recorded abnormal findings 40% and 20% after 2 weeks and 3 months respectively. In group II, the diagnosis of abnormal findings was the same (80%) pre and postoperatively by using magnetic resonance image however, the percent of abnormal findings was reduced from 60% preoperatively to 40% postoperatively by using ultrasonography. Conclusion: the ultrasonographic image was not able to identify or diagnosis the disc position changes after indirect trauma. However, it had to some extent a role in the identification and diagnosis of effusion in temporomandibular joint. KEYWORDS Magnetic resonance imaging; Temporomandibular joint; Ultrasonography; Mandibular fractures; Injury.

Purpose: The present meta-analysis aimed to answer the following research question: In endodontically treated teeth (ETT), what is the effect of partial ferrule (PF) on fracture resistance compared to complete ferrule (CF) and/or no ferrule (NF)?Study selection: PubMed, Scopus, Web of Science, and Google Scholar were searched for relevant studies published until May 20, 2022. In vitro studies that compared the effect of partial ferrule with that of complete ferrule and/or no ferrule on fracture resistance of ETT were included. The studies were assessed for risk of bias, and a meta-analysis was performed.Results: Seventeen in vitro studies comprising 807 teeth were included. Nine studies were at a high risk of bias and eight presented a moderate risk of bias. Overall, the results showed that CF was superior to PF in increasing fracture resistance (SMD= 0.93, CI95%= 0.57-1.29, P< 0.0001), with no change in the effect based on the type of teeth (P< 0.001). However, the subgroup analysis found that PF 2 mm buccal, lingual, and buccal and lingual ferrule were comparable to CF (P= 0.06). Additionally, the PF group showed significantly higher fracture resistance than the NF group (SMD= 2.02, CI95%= 1.54-2.49, P< 0.00001).Conclusions: Although CF design provided the highest fracture resistance to restored ETT, PF can still be a viable option for restoring ETT in cases where CF is not feasible.