Islam Saad

Background: It is necessary for dental students and freshly graduated dentists to apply their education and practice to different clinical and preclinical procedures. The implant success rate and durability are high. Therefore, this study was designed to assess the level of knowledge, awareness and perception of dental students, interns and freshly graduated students regarding dental implant complications in Saudi Arabia. Methods: A cross-sectional study design using a web-based method was conducted at different dental institutions in Saudi Arabia from December 2019 to March 2020. Data were collected from all (n = 288) undergraduate students, interns and freshly graduated dentists using a pretested standardized self-administered web-based questionnaire that was prepared and circulated using a template provided by Google Forms (Google, Inc., USA). Descriptive statistics and chi-square tests were performed to analyse the data using SPSS (version 20). Results: A total of 288 participants completed the questionnaire, with a response rate of 83.4%. Of the total participants, 37.5% showed a good level of knowledge regarding dental implant procedures, and 38.9% showed the same level of knowledge regarding implant complications. The most important cause of complications associated with dental implants was case selection, which accounted for 54.17%. Most participants (58.33%) chose massive bone loss related to implant failure as the most common late dental complication, while 26.39% chose postoperative infection as the most common early dental complication. In addition, 30.56% of the participants selected screw loosening as the most frequent mechanical complication. However, lack of implant primary stability was the most common hard-tissue implant complication. Based on aesthetic and reversible complications, restorations that were too buccal or too palatal and prosthetic-related, respectively, were the least common dental implant complications. Conclusions: The level of knowledge among participants regarding dental implant complications differed among the institutions participating in this study. This difference reflects a significant variation that necessitates reviewing and standardizing dental implant curricula among these institutions.

To evaluate the effectiveness of photobiomodulation (PBM) of low-level laser therapy (LLLT) as a palliative treatment of symptomatic geographic tongue. This randomized double-blinded controlled clinical trial was performed on 50 patients with symptomatic geographic tongue (GT). Participants were allocated randomly into study and control groups. A 660-nm diode laser was applied on randomly selected patients of the study group (n = 25) over the complained site for 2 minutes with continuous laser beam application. For the control group (n = 25), no application of 660-nm diode laser was performed. None of the participants were aware if they received the LLLT or placebo treatment. Patients were assessed for the level of pain, burning sensation, and size of the lesion before starting LLLT "T0" and during recall visit "T1, T2, and T3." The study group showed a low level of pain, burning sensation, and better healing with statistically significant differences at T2 and T3 of the follow-up period, with a level of significance was set at p < 0.05. Low-level laser therapy can be used to adequately relieve significant discomforts associated with GT and accelerate healing and restoring of the patient's quality of life. To develop a framework based on the results regarding the photobiomodulation effect of a 660-nm diode laser to relieve pain and burning sensation associated with symptomatic GT, which increases patients' perception toward the services provided to them.

A 28-year-old female patient came to the outpatient dental clinic for multiple teeth extractions and full mouth rehabilitation suffer from myasthenia gravis (MG) primary presentation as tongue atrophy and facial muscles weakness and the symptoms became worries, the patient unable to speak as well and change her voice and complaining of dysphagia and dysarthria. Oral symptoms, treatment schedule and protocol, the selection, prescription and impacts of medications, and prevention of myasthenic crisis are all important; aspects should be considered by dentists and oral health care providers. Weakness of facial and oropharyngeal muscle is considered very popular at disease onset and therefore oral health providers are often the first medical professionals to observe these patients. Myasthenic patients seek particular approach and consultation in order to ensure ideal and proper dental management.

The current study will attempt to throw light on the role of desmoglein 1 and desmoglein 3 in the pathogenesis of erosive lichen planus and their response to topical application of tacrolimus. Twenty patients with erosive oral lichen planus received tacrolimus ointment three times daily for eight weeks. Assessments using the clinical score and a visual analog scale were recorded at each visit. Serum concentrations of circulating autoantibodies to desmoglein 1 and desmoglein 3 will be determined by enzyme-linked immunosorbent assay (ELISA) at baseline, four weeks and eight weeks after treatment. Statistical software SPSS v.17.0 was used for statistical analysis. All patients showed significant improvement in all outcomes within the follow-up periods when compared with the baseline (p < 0.05). The mean value of the visual analog scale were 8.30 ± 1.49, 4.15 ± 1.14, 2.10 ± 0.91, 0.90 ± 0.79, and 0.0 ± 0.0 starting from baseline to the end of follow up period. The mean value of the clinical score were 4.7 ± 0.48, 2.9 ± 1.29, 1.8 ± 1.32, 1.31 ± 0.69, and 0.69 ± 0.09 starting from baseline to the end of follow-up period. There was a significant decrease in the levels of anti-Dsg1 and anti-Dsg3, during the follow-up period (p < 0.05). The concluded data suggest that antibodies against desmoglein 1 and desmoglein 3 seem to play a key role in the pathogenesis of oral lichen planus. Also, there is a significant decrease in the level of anti-Dsgl and anti-Dsg3 autoantibodies with topical tacrolimus 0.1% ointment. Monitoring the serum level of antibodies against keratinocyte cadherins Dsg 1 and Dsg 3 can be used to evaluate the effect of topical application of tacrolimus on Erosive Oral lichen planus.

Aims: This study was aimed to develop a framework based on the existing knowledge among interns and dental students of their awareness of anesthesia technique which may help improve the treatment services provided to the community. Study Design: Randomized clinical trial. Place and Duration of Study: College of Dentistry, Taibah University, Madinah, Saudi Arabia between March 2017 and September 2017. Methodology: The knowledge of Periodontal ligament (PDL) injection as a substitute technique for inferior alveolar nerve block (IANB) used by interns and dental students when performing tooth extraction. This was investigated using a questionnaire consisting of 10 questions and was distributed among 4^th, 5^th year students and interns at the college of dentistry, Taibah University, Saudi Arabia. Survey participants were asked about commonly administered injection techniques for extraction, awareness of periodontal ligament injection, periodontal injection technique, its point of entry, patient response, its effectiveness and the most common indication. Statistical software SPSS® for mac .20, Chicago, IL, USA was used for statistical analysis. Results: Injection technique commonly used for tooth extraction was 58.2%, 35.8% and 6% for nerve block, infiltration and PDL injection 6% respectively, significant difference at P- value (P≤0.05) was found between different academic level. Awareness of the PDL injection technique was 76.1% while 23.9% wasn’t aware, significant difference at P- value (P≤0.05) was found between different academic levels. Points of entry of PDL injection was 74.6%, 19.4% and 6% for gingival sulcus, attached gingiva and alveolar mucosa respectively, significant difference at P- value (P≤0.05) was found between different academic level. Participants using PDL injection for extraction and endodontic treatment was 44% while 56% not using it, significant difference at P- value (P≤0.05) was found between different academic levels. Patient response for periodontal injection was good for 50.7% of participants, significant difference at P- value (P≤0.05) was found between different academic level. Conclusion: Most students know about PDL injection, but they only used it when routine IANB fails, they are also familiar with the technique, but need to increase their knowledge regarding indications and limitations of PDL injection.

Aims: The purpose of this study was to compare the effectiveness of blood banked platelet glue and blood banked fibrin glue as a local hemostatic agent after tooth extraction in patients diagnosed with acute leukemia with concomitant thrombocytopenia. Study Design: Randomized clinical trial. Place and Duration of Study: Hematology Unit, Internal Medicine Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt between June 2015 and July 2016. Methodology: 21 patients who underwent 60 dental extractions diagnosed with acute leukemia with concomitant thrombocytopenia; age between 25-45 years were included in this study. Patients were randomly allocated into three groups: Group I (control group) patients had underwent platelet transfusion before tooth extraction and was continued after the extraction if re-bleeding occurred, Group II (Fibrin Group) Fibrin glue used as a local hemostatic agent after tooth extraction; and Group III (Platelet group) platelet glue used as a local hemostatic agent after tooth extraction. Immediate and delayed evaluation by monitoring time to hemostasis (secs), postoperative complications; fever, localized gingival inflammation, disintegrated blood clot, wound dehiscence, wound infection and time in days for healing. Statistical software SPSS v.17.0 was used for statistical analysis. Results: Time to hemostasis (secs) was 12.57 ± 1.51 sec, 9.57 ± 2.57 sec, and 9.43 ± 2.44 sec for group I, II and III respectively, significant difference at P- value (P≤0.05) was found between three groups. Wound healing time was 16.00 ± 3.51 days, 10.00 ± 1.00 days and 7.29 ± 0.95 days in Group I, Group II and Group III respectively, significant difference at P- value (P≤0.05) was found between three groups. Conclusion: Blood banked platelet glue has excellent hemostatic action and can be used successfully as a local hemostasis after tooth extraction.