Objective: The aim of the current study was to investigate awareness, general attitudes and perspectives of a sample of dentists from Saudi Arabia, Egypt, and Jordan regarding their knowledge and future expectations of cone-beam computed tomography. Materials and Methods: The study included a convenience sample of dentists from different specialties throughout the three regions. They were contacted through E-mail and dental social discussion groups and completed an online questionnaire. The data were collected, sorted, cross-tabulated, and analyzed in view of the objectives of the study, using descriptive analysis and Chi-square tests of significance. Results: Age, sex, and years of experience had no effect on cone-beam computed tomography (CBCT) knowledge, whereas education level and place of work had a significant effect (P = 0.001 and P = 0.05, respectively). A change in diagnosis or treatment plan was also significantly related to the need for CBCT (P = 0.01 and P = 0.015, respectively). Requesting a dentomaxillofacial radiology (DMFR) board program was significantly related to the dentist's concern about medicolegal issues but not to the decision to refer the patient to a radiologist. Conclusions: This study showed that having a higher education level and being in a tertiary workplace improved CBCT knowledge, and better knowledge about CBCT increased the number of patient referrals when the indications justified it. With the increasing demand for CBCT, there have been more changes in diagnoses and treatment plans, and thus, more dentists are requesting DMFR board programs in the region to avoid medicolegal issues.

Introduction: Bite force is one of the indicators of the functional state of mastication and loading of teeth. Bite force measurement is a reliable method of assessing the biomechanical properties of the masticatory system. Aim: To evaluate the occlusal bite force of children in different stages of dentition and to relate the occlusal bite force to body mass index (BMI). Methodology: One hundred and twenty children (60 boys and 60 girls) aged 3–13 years were selected and divided into three groups of forty children each matched for age and gender. The children were divided according to the teeth present into primary, mixed, and permanent dentition. BMI was calculated using the formula, weight/height². The height was measured using a portable height measuring unit. Body weight of each child was measured using a portable glass electronic personal scale. Occlusal bite force was measured using a portable occlusal bite force gauge. The bite force was measured in triplicate, alternately on the right and left sides of the mouth. Data obtained were subjected to statistical analysis. Results: Mean occlusal bite force was highest in children with permanent dentition (269.7 N). Males showed a higher bite force than females in all three groups. The highest occlusal bite force recorded was in males with permanent dentition (326.6 N), which was statistically significant (P ≤ 0.05). The mean BMI of males was significantly higher than that of females in children with primary dentition. In children with primary and mixed dentition, bite force showed an inverse relationship with BMI. A positive but weak association was found between occlusal bite force and BMI in children with permanent dentition. Conclusions: There was a difference in the occlusal bite force at different dentition stages. It was significantly higher in males and in the permanent dentition stage. Height and weight can be considered as predictors of occlusal bite force in older children with permanent dentition.

Background: Despite increasing success rates, dental implants remain susceptible to multiple inflammatory and noninflammatory complications. Given the increased usage of dental implants in Saudi Arabia, it is reasonable to assume that a general practitioner (GP) will come across a case of peri-implantitis in his/her routine practice. Aim of the Study: The primary aim of this study is to assess the knowledge and awareness of general dental practitioners in Riyadh, using a radiographic- and clinical visual-based questionnaire in the management of implant complications. Materials and Methods: The study was conducted using a Google form questionnaire that was distributed to the GP database of the Saudi Dental Society. The questionnaire comprised of three parts. The first part of the questionnaire included the demographic data of the respondents, the second part contained visual radiographic and clinical pictures that were aimed to assess the knowledge and awareness of the participants toward the commonly occurring peri-implant complications and their management, the third part tested the attitudes of the participants toward the management of these complications. Statistical Analysis: The frequencies of the submitted data were measured using the mode and median for the nominal and ordinal variables, respectively. The Chi-square test was used to test the significance of differences while a logistic regression model was developed to assess the impact of variables such as age, year of graduation, and the extent of knowledge. Statistical analyses were done using SPSS V.22. Results: Two hundred and four responses were collected, 190 (93.1%) consented on participating in the study. The majority of the respondents were graduates before the year 2012 (47.5%). Most of the respondents (71.6%) had received a dental implantology didactic course during their undergraduate studies. There was no significant difference in the answers of the dentists who were given didactic courses in their undergraduate studies or not (P > 0.05). Most of the participants were able to identify problems related to the anatomical structures and implant-supported prosthesis, but not the surgical components of the implant itself. Conclusion: Dentists who participated in dental implantology workshops had a higher tendency to answer correctly compared to dentists who were given didactic courses in their undergraduate studies in issues associated with hands-on training. This shows that hands-on training in the undergraduate studies would result in a better understanding of dental implants, its complications, and management.

Aim: The aim of the study is to assess the prevalence and the related factors of parafunctional oral habits among preschool children in Riyadh, Saudi Arabia. Materials and Methods: The study sample included 435 children (3–6 years) randomly selected from public and private preschools in the different regions of Riyadh. Questionnaires were distributed to be filled by children's parents. The questionnaire included questions concerning child's feeding method during infancy, number of the child siblings, and his/her order among them. The other part of the questionnaire included questions concerning the types of parafunctional habits that the child might suffer from. The last part inquired if the child suffered from psychological, social, medical, or sleeping problems. Descriptive statistics were performed and Pearson's Chi-square test was used to observe the relations between categorical study and outcome variables. Results: Nail-biting habit was highly prevalent among the study samples (27.2%), followed by mouth breathing during sleeping (13.8%), thumb sucking (7.4%), and teeth clenching (6.0%). A statistically significant relation was found between the age groups and teeth clenching and lip sucking habits (P = 0.001).There was a highly statistically significant relation between malocclusion and the habits of thumb sucking and pacifier sucking (P = 0.001 and 0.01, respectively). Protrusion of anterior teeth was statistically significantly related to thumb sucking (P < 0.0001). Respiratory and tonsils problems were related to mouth breathing (P = 0.004 and < 0.0001, respectively). The presence of dental caries was statistically significantly related to the habit of teeth clenching (P = 0.03). Conclusion: Nail-biting habit was highly prevalent among preschool children in Riyadh, followed by mouth breathing, thumb sucking, and teeth clenching. Malocclusion was the main factor related to the habits of thumb sucking and pacifier sucking. Respiratory and tonsils problems were related to mouth breathing. Teeth clenching was highly related to the presence of carious teeth.

Introduction: Mothers play a key role in adoption of preventive strategies for an improved oral health in the first few crucial years of life of infants and young children. The purpose of the study is 2 folds: (1) to evaluate and compare the awareness and attitude (Aw-At) levels between expectant and lactating mothers toward infant oral health care and (2) to analyze the influence of maternal sociodemographic variables on their Aw-At levels toward infant oral health care. Materials and Methods: A total of 500 expectant and lactating mothers visiting the outpatient department of the government hospital in Rohtak, India, were randomly selected and interviewed through a 27-item self-designed, structured questionnaire. Mann–Whitney, Kruskal–Wallis, and Chi-square tests were applied for assessment and comparison. Results: Lactating mothers scored significantly higher than expectant mothers (P = 0.004) in awareness levels. Awareness score of mothers (26–35 years old) was also significantly higher than the younger ones (P = 0.002). Urban group had a higher attitude score than rural group mothers (P = 0.002). Working mothers scored more in both Aw-At scores (P < 0.001). The awareness scores also increased significantly with increase in educational qualification (P < 0.001) and parity of mothers. Conclusion: The study had found low awareness levels toward infant oral health care but a positive attitude among mothers. Hence, it is suggested to increase this to ensure optimal dental health for themselves and their children by educating and motivating the mothers, providing prenatal counseling, anticipatory guidance, referral by the medical personnel, and most importantly, establishing the concept of dental home.

Background: Fluoride varnishes have been the standard of practice for the professional application of fluoride. The primary reason for wide acceptance of fluoride varnish is that the procedure is easy, safe, convenient, and well-accepted by patients. Aim: The aim of this study is to evaluate and compare the remineralizing potential of varnish containing casein phosphopeptides-amorphous calcium phosphate (CPP-ACP) and fluoride (MI Varnish^®), with that of varnish containing only fluoride (Fluor Protector^®). Materials and Methods: Fifty premolar teeth samples were used for this part of the study. They were divided into two Groups (1 and 2), consisting of 25 samples each. Two windows on the buccal surface of these samples were made and assigned randomly as control and experimental window. Initial depth of carious lesions of both windows was measured in all the samples. No varnish was applied on control windows. On the experimental window of Subgroup 1, varnish containing CPP-ACP with fluoride was applied, and on samples of Group 2, varnish containing only fluoride was applied. After varnish application, all the samples were subjected to pH-cycling. Following, the final depth of carious lesion was calculated using polarized light microscope. The data obtained were tabulated and subjected to statistical analysis. Results: The final depths of artificial carious lesion of experimental window of Group 1 and 2 were 131.26 ± 7.01 μm and 134.11 ± 5.95 μm, respectively. Conclusion: There was no significant difference in the remineralizing potential of varnish containing CPP-ACP and fluoride and varnish containing only fluoride.

Introduction: Diet plays a major role in the etiology of dental caries. The physical properties of food can affect its retention on tooth surfaces, and its oral clearance. Aim: The aim is to determine the physical properties of foods that are commonly consumed in India by children aged 3–6 years and to ascertain the frequency of their consumption. Materials and Methods: Texture profile analysis of solid foods and viscosity of liquid food samples was performed. A questionnaire was used to assess the frequency of consumption of these foods. Results: Among the solid food samples, cheese had the highest hardness (157 ± 20.8 N), chewiness (82 ± 10.4 N), gumminess (82 ± 10.4 N), and adhesiveness (11.2 ± 2.4 Nmm). Noodles had the least hardness, cohesiveness, gumminess, and chewiness. Among the liquid food samples, peanut butter was the most viscous (21 Pas) and milk was the least viscous. Milk had the highest pH (6.3) and fruit juice (3.5) had the lowest pH. Conclusion: The physical properties and texture of food can be considered to be a risk factor for evaluating the relationship between food retention and dental caries. This information can further be used as an educative tool to parents and caregivers for effective modification of diet.

Introduction: Chronic periodontitis is an oral disease and having multiple etiologies. The coinfection between herpesviruses and periodontopathic bacteria might play a crucial role in the increasing severity of the disease. The present study was conducted to find out any specific coinfection which is contributing in increase in the severity of the disease. Materials and Methods: It was a prospective case–control study. A total of 300 cases with chronic periodontitis (100 each from mild, moderate, and severe chronic periodontitis) and 300 age- and sex-matched controls were included. After fulfilling the inclusion and exclusion criteria, a subgingival plaque specimen was collected and processed for detection of herpesviruses and periodontopathic microbiota. Results: Herpesviruses were significantly associated with anaerobes and yeasts as compared to aerobes. In severe chronic periodontitis, association of anaerobes and herpesviruses was found to be statistically significant in the present study. All four studied herpesviruses have shown strong association with Porphyromonas gingivalis. Conclusion: Coinfection helps in the increasing severity of chronic periodontitis when a particular combination of herpesviruses and periodontopathic microbiota is detected from the cases of chronic periodontitis. Herpes simplex virus-2 and P. gingivalis seem to play a crucial role in the increasing severity of chronic periodontitis as compared to other coinfection combinations in the studied populations.

Aim: The aim of the present study was to evaluate and compare the influence of different surface treatments and their cumulative effects on the biaxial flexural properties and phase transformation of yttria-stabilized zirconia ceramics. Materials and Methods: A total of fifty specimens were fabricated by computer-aided design/computer-aided manufacturing machining from Cercon^®. The samples were divided into five groups following different surface treatments as control (C), air particle abrasion (Si), mechanical loading (ML), low-temperature degradation (LTD), and cumulative treatment (CT) groups. Statistical Analysis Used: The results were analyzed by two-way ANOVA and Tukey's honestly significant difference (HSD) test. Two-way ANOVA was used to find significance between the test and the control groups. Tukey's HSD test was carried out to determine any significant difference among the groups. Results: The highest biaxial flexural strength was observed in the Si group (950.2 ± 126.7 MPa) followed by the LTD group (861.3 ± 166.8 MPa), CT group (851.2 ± 126.5 MPa), and the least with the ML group (820 ± 110 MPa). Significant difference was observed in two-way ANOVA test. Tukey's HSD test showed that there was a significant difference (P ≤ 0.05) between the C and Si groups and C and LTD groups; however, no significant difference was observed (P ≥ 0.05) between the C and ML groups and C and CT groups. X-ray diffraction analysis showed that the control group consisted of 100% tetragonal zirconia while the maximum amount of monoclinic phase was obtained after the LTD treatment. Conclusions: Air particle abrasion with CoJet Sand, LTD, and CTs had no negative impact on biaxial flexural strength indeed it increased the biaxial flexural strength. Hence, these surface treatments can be done in routine clinical practice to improve the performance of ceramic restorations.

Bifid mandibular condyle is characterized by the duplicity of the head of the mandibular condyle, so the name double-headed condyle. It is usually diagnosed on routine radiographic examination and is described as a rare entity. Usually, bifid condyle is an incidental finding and its etiology is controversial, with no predilection for sex or ethnic background. Herein, we report a case of bilateral bifid condyles.

Early orthodontic treatment remains controversial in literature. Delayed eruption and impaction of the canine are the common phenomena. However, a unerupted mandibular canine causing mobility of the permanent lateral incisor is a relatively rare case. An 11-year-old Saudi girl presented with a complaint of mobility of the lower left permanent lateral incisor. An ectopically erupted permanent left mandibular canine and a narrow maxilla were evident upon examination. Rapid palatal expansion was started to expand the maxilla for 2 weeks and it was retained for 6 months, after which the patient was followed for a year. At the end of a year, the lower permanent left canine erupted and there was a reduction in anterior crowding. At the end of 2 years, the child demonstrated no relapse of crowding. Expansion of the maxilla can be a useful technique to facilitate the expansion of the mandible.