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Background. Dental/oral diseases are one of the significant public health problems globally. Herbal medicines for managing oral diseases are considered an effective alternative to synthetic compounds due to their lower side effect. Azadirachta indica, Terminalia chebula, Camellia sinensis, and Piper nigrum are used to control and prevent oral inflammations in dentistry. In this study, we have evaluated the protease inhibition activity of these plant extracts, and further, the binding mode of the active ingredient of these plants with trypsin was studied using molecular docking. Methods. In this study, protease inhibition activity was carried out using aqueous extracts of the plant parts such as Azadirachta indica (neem) twig, Terminalia chebula (Haritaki) fruit, Camellia sinensis (green tea) powder, and Piper nigrum (kali miri) seed. Next, to explore the binding mode of active ingredients azadirachtin, chebuligenic acid, catechin, and piperine with trypsin, we employed a molecular docking study using AutoDock4.2. Results. The results revealed that the Azadirachta indica plant extract showed an IC50 value of 96.19 μg mL-1, Camellia sinensis IC50 value of 188.50 μg mL-1, Piper nigrum IC50 value of 371.20 μg mL-1, and Terminalia chebula IC50 value of 639.48 μg mL-1, when compared with standard drug diclofenac sodium, had IC50 value 93.00 μg mL-1. Further, the docking result reveals that all the main active ingredients of these plants have significant binding affinity and prefer the same binding pocket of trypsin. Conclusion. Hence, our results show the importance of traditional plants Azadirachta indica, Terminalia chebula, green tea, and Piper nigrum to control oral disease conditions. As they show significant protease inhibition activity, hence, the active ingredient could act as a potential anti-inflammatory agent and further help to prevent or control oral disease conditions such as gingivitis and periodontitis.

BACKGROUND: Molar incisor hypomineralization (MIH) is a frequently encountered oral condition that varies from mild opacities to posteruptive enamel breakdown. No previous published studies have investigated the frequency of MIH and associated risk factors among children with special health care needs (CSHCN) to our awareness. OBJECTIVES: Assess the frequency of MIH and associated risk factors among CSHCN. DESIGN: Cross-sectional. SETTING: Schools in provincial city of Saudi Arabia. PATIENTS AND METHODS: The study was conducted among 400 (180 boys and 220 girls) special needs children. Diagnosis of MIH was according to the European Academy of Paediatric Dentistry criteria. MAIN OUTCOME MEASURE: Result of logistic regression analysis that assessed the association between MIH prevalence and associated prenatal, perinatal, and postnatal factors. SAMPLE SIZE: 400 (180 boys and 220 girls) special needs children. RESULTS: Among 400 CSHCN, 98 (24.5%) presented with MIH. Children with multiple disabilities had a 3.89 times greater risk of MIH (95% CI: 1.91–6.19, P =.002). Children with positive prenatal factors had an adjusted odds ratio (aOR) of 2.31 times for MIH (95% CI: 1.22–4.73, P =.012). Children with a childhood infection history had an aOR of 2.43 times for MIH (95% CI: 1.31–5.85, P =.014). Children with a breastfeeding history >18 months had an aOR of 3.73 for MIH (95% CI: 1.62–8.60, P =.002). Permanent maxillary first molars were the most frequently affected teeth, and demarcated opacity was the most frequent MIH type. CONCLUSION: MIH should be recognized as one of the prevalent oral health problems among CSHCN to prevent tooth mortality. LIMITATIONS: A cross-sectional study cannot establish a causal relationship. CONFLICTS OF INTEREST: None.

BACKGROUND: Special needs children are at a higher risk of dental trauma because of neurological, physical, mental, and behavioral impairments. They are also at higher risk of developing obesity due to the side effects of medication. OBJECTIVE: Assess the association between traumatic dental injuries (TDIs) and obesity in children with special health care needs. DESIGN: Analytical cross-sectional study. SETTING: Schools for special needs children. STUDY POPULATION AND METHODS: Special needs children with a diagnosis of TDI according to the Andreasen criteria were included in the study. Data on the disability status were obtained from a national demographic survey in 2016. Demographic and dental variables were measured for analysis. Multivariable logistic regression was used to analyse any relationship between TDI prevalence and obesity. MAIN OUTCOME MEASURE: Relationship of body mass index (BMI) to TDI prevalence. SAMPLE SIZE: 350 (131 boys and 219 girls) special needs children with a median (interquartile range) age of 12.0 (2.0) years. RESULTS: Eighty-one (23.1%) children presented with TDIs. The mean (standard deviation) BMI for the entire study population was 24.7 (7.8). Children with obesity had a 30.3% TDI prevalence compared normal-weight children (20.6%) ( P =.035), but BMI category was not statistically significant in the regression analysis ( P =.541), which showed that children with an overjet of >3 mm were 4.82 times (CI: 2.55–9.09, P =.001) more likely to have TDI than children with an overjet of ≤3 mm. Those with inadequate lip coverage were 2.85 times (CI: 1.49–5.44, P =.002) more likely to have TDI. Children with cerebral palsy were 3.18 times (CI: 1.89–11.32, P =.024) more likely to have TDI than children with other disabilities. CONCLUSION: The study showed a significant association between TDI prevalence and increased overjet, inadequate lip coverage, and cerebral palsy. The prevalence of TDI among obese special needs children was statistically significant according to bivariate analysis, but not in a multivariate analysis that adjusted for other variables. LIMITATIONS: Causal relationship cannot be established with cross-sectional study. CONFLICT OF INTEREST: None.

The present systematic review was conducted to investigate the effect of the self-assembling peptide (SAP) – P11-4 in the remineralization of enamel caries. The systematic search for studies was co...

The prevalence of erosive tooth wear and obesity are high in psychiatric patients and soft drink consumption is a common risk factor associated with both diseases. This study aimed to assess the association between soft drink consumption, gastric reflux, erosive tooth wear, and obesity among resident patients at the Psychiatric Hospital, Taif, Saudi Arabia.This descriptive, cross-sectional study included 223 adult psychiatric inpatients (126 male, 97 female) with a mean age of 42.3 years (± 2.2). Dental erosion detection was performed according to World Health Organization criteria. The medical evaluation included assessment of the body mass index (BMI). With appropriate sample weighting, relationships between erosive tooth wear, gastric reflux, and obesity were assessed using multivariable logistic regression.Ninety eight patients (43.9%) presented with erosive tooth wear. The mean BMI for the entire study population was 27.7 ± 6.3 kg/m2. Regression analysis showed a strong association between erosive tooth wear and chronic vomiting or bulimia (adjusted odds ratio = 2.11; 95% confidence interval [CI] = 1.98-5.07, P .001), gastric reflux (adjusted odds ratio = 2.13; 95% CI = 1.34-6.23, P .001), consumption of soft drinks (adjusted odds ratio = 2.14; 95% CI = 1.03-6.08, P .001), and schizophrenia and delusional disorders (adjusted odds ratio = 2.07; 95% CI = 1.98-5.08, P .001).This study demonstrates a significant association between erosive tooth wear prevalence and chronic vomiting or bulimia, consumption of soft drinks, and gastric reflux among resident patients at psychiatric hospital.

Background and Objectives: There are no guidelines on the regenerative endodontic procedures that should be followed in dental treatment. Thus, it is essential to learn the knowledge, attitudes, and opinions about regenerative endodontics among dental practitioners, particularly endodontists, as they are the first providers of this type of dental treatment. Aim: This study aimed to assess the knowledge and attitudes among residents of the Saudi Board of Advanced Restorative Dentistry (SBARD) in Saudi Arabia. Methods & Materials: A questionnaire-based survey was conducted among 128 residents of endodontics, pedodontics, and the SBARD in Saudi Arabia. The questionnaire was distributed to participants using the available electronic measures such as emails and social media. The questionnaire was made by Google Forms, and responses were received directly in the excel sheet in the email. The data were exported as an excel file, coded, and analyzed, and the p-value < 0.05 was set as significant. Results: More than 50% (74 dentists) of the participants reported receiving continuing education in regenerative treatment, with a significant difference found among specialty (p = 0.023). No significant association was found between knowledge, gender, and type of postgraduate study. The vast majority (89.1%) of the participants believed regenerative endodontics should be incorporated into dentistry curricula. About two-thirds (78.2%) of the participants declared their ability to attend future training courses in a regenerative endodontic, whereas 10.9% did not, and 10.9% were unsure. Conclusions: The dental practitioners were enthusiastic and interested in regenerative and stem cell treatment. The results also suggested incorporating regenerative treatment into the dental curriculum and signaled the need for more continued training courses.

In Malaysia, oral cancer is very common and the reported 5-year survival of such patients is nearly 50% after treatment with surgery and radiotherapy, much lower than most of the developed countries. This study aimed to investigate the socio-demographic and clinicopathological parameters that influence the mortality rate of the patients suffering from oral squamous cell carcinoma (OSCC) in the Kelantanse population.In this retrospective study, data regarding socio-demographic, clinicopathological factors, and treatment outcome associated with OSCC were gathered from the archives of the medical records office of Hospital Universiti Sains Malaysia. For statistical analysis, simple and multiple logistic regression were performed. The significance level was set to P

The main purpose of the present systematic review was to evaluate the quantitative effects of the pendulum appliance and modified pendulum appliances for maxillary molar distalization in Class II malocclusion.Our systematic search included MEDLINE, EMBASE, CINAHL, PsychINFO, Scopus and key journals and review articles; the date of the last search was 30 January 2017. We graded the methodological quality of the studies by means of the Quality Assessment Tool for Quantitative Studies, developed for the Effective Public Health Practice Project (EPHPP).In total, 203 studies were identified for screening, and 25 studies were eligible. The quality assessment rated four (16%) of the study as being of strong quality and 21 (84%) of these studies as being of moderate quality. The pendulum appliances showed mean molar distalization of 2-6.4 mm, distal tipping of molars from 6.67° to 14.50° and anchorage loss with mean premolar and incisor mesial movement of 1.63-3.6 mm and 0.9-6.5 mm, respectively. The bone anchored pendulum appliances (BAPAs) showed mean molar distalization of 4.8-6.4 mm, distal tipping of molars from 9° to 11.3° and mean premolar distalization of 2.7-5.4 mm.Pendulum and modified pendulum appliances are effective in molar distalization. Pendulum appliance with K-loop modification, implant supported pendulum appliance and BAPA significantly reduced anchorage loss of the anterior teeth and distal tipping of the molar teeth.

The main purpose of the present systematic review was to evaluate the efficacy of enamel matrix derivative Emdogain in healing of replanted teeth in humans.This review conducted in adherence to PRISMA standards and was registered in PROSPERO with registration number CRD42017062736. We graded the methodological quality of the studies by means of Cochrane's tool of risk of bias in non-randomized studies - of interventions (ROBINS-I).In total, 65 studies were identified for screening, and five studies were eligible. The uneventful healing of replanted teeth was varied from 20% to 75%. Two controlled trials found Emdogain treatment significantly reduced resorption of replanted teeth and improved the healing of periodontal ligament compared with controls. Two studies showed high recurrent resorption in Emdogain treated teeth.To conclude, the number of publications that met all inclusion criteria were limited and did not allow for drawing evidence for Emdogain being effective in supporting healing of replanted teeth.

The main purpose of the present systematic review was to evaluate the efficacy of platelet concentrates in pulpotomy of human teeth. Our systematic search included Medline, Embase, CINAHL, PsycINFO, Scopus, key journals, and review articles; the date of the last search was July 30, 2017. We graded the methodological quality of the studies by Cochrane Risk of Bias tool. Four randomized controlled trails were included in the present systematic review. The number of study participants ranged from 28 to 50, with a mean of 45.5. The age of study participants ranged between 4 and 25 years. In three of the included studies, platelet-rich fibrin (autologous) was used and in one study lyophilized freeze-dried platelet (allogenic) was used as pulpotomy material. Calcium hydroxide and mineral trioxide aggregate were used in control groups. The quality assessment rated three studies as being of fair quality and one study as poor quality. Two of the included studies showed a 100% success of pulpotomy with platelet concentrates and two studies showed more than 80% of success, but the difference between control group and platelet concentrates group was not statistically significant. To conclude, the number of publications that met all inclusion criteria was found to be very limited and no significant difference was reported in the studies comparing platelet concentrates with other materials in pulpotomy. The present results point to the need for high-quality randomized controlled trials in further research.

A 12-year-old patient presented with a severe delay of eruption in permanent maxillary and mandibular incisors. On examination, there was over-retained primary teeth and delayed eruption of permanent teeth. Retained primary teeth showed light yellow discolouration whereas permanent teeth were distinct yellow with thin or little enamel. Subsequent imaging revealed all the premolars except maxillary left first premolar showed signs of intra-alveolar coronal resorption, nephrocalcinosis with bilateral multiple calculi and small papillary tip calcifications, marked increase in alkaline phosphatase. Subsequent dental treatment for restoring the functional and aesthetic requirement followed by appropriate treatment for renal problem was undertaken.

Context: Enamel hypoplasia is a defect caused by disturbances during enamel formation. These defects in the enamel present important clinical significance as they predispose a tooth to dental caries. Aim: The aim of this study was to assess the longitudinal relationships between enamel hypoplasia and caries experience of primary second molars and permanent first molars. Materials and Methods: The study sample consisted of 765 subjects who underwent dental examinations at both ages 6 and 9 by the calibrated examiner. Primary second molars and permanent first molars were scored for the presence of enamel hypoplasia for each participant. Caries presence and number of decayed and filled surfaces (dfs and DFS) were determined at ages 6 and 9. The relationships between enamel hypoplasia and caries experience were assessed using multivariable regression models. Results: At the tooth level, 2.8% and 3.5% of children had hypoplasia on primary second molars and permanent first molars respectively. Multivariable logistic regression analyses showed that children with enamel hypoplasia were at a significantly higher risk of caries at both ages 6 (odds ratio, OR = 5.27 for primary second molars and OR = 3.21 for permanent first molars) and age 9 (OR = 3.45 for primary second molars and OR = 4.57 for permanent first molars), and that a statistically significant association was seen with caries incidence (OR = 2.08 for primary second molars and OR = 2.87 for permanent first molars). Conclusion: Enamel hypoplasia appears to be a significant risk factor for caries in both primary second molars and permanent first molars and should be considered in caries risk assessment.