Introduction: Dentin hypersensitivity (DH) is a common and painful clinical occurrence that can negatively impact patients' quality of life. An arsenal of different desensitizing molecules is available on the market, but no gold standard has yet to be set.Aim: The aim of this study was to perform a review on the potential of nano-hydroxyapatite (n-HA) as a desensitizing toothpaste agent as opposed to placebo or other desensitizing molecules. Materials and Methods: Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses, an electronic search of the PubMed database was conducted from inception up until May 2021. Seven English written randomized controlled trials about the use of n-HA toothpaste in treating adults with DH were assessed for quality via the modified Jadad scale, and included in the review. Non-English studies, publications involving lasers, and studies researching the effect of n-HA on gingival inflammation or postwhitening sensitivity were all excluded. Results and Discussion: Available evidence suggests that n-HA is a promising addition to the growing arsenal of desensitizing treatments available on the market. Conclusion: n-HA remains a viable everyday option that dentists should strongly consider for their patients' pain relief. However, due to the heterogeneity of pain studies and the lack of standardization in trial protocols, no evidence of superiority to other desensitizing agents can be ascertained, thus far.

Introduction: Variability in the size and shape of mandibular condyles among individuals of different sexes and ages may appear as a remodeling process to accommodate malocclusion. Hence, the aim of this study was to assess whether or not associations exist between different types of malocclusions and morphological modifications of the mandibular condyle. Materials and Methods: A systematic literature search was conducted on the Medline database via PubMed interface and supplemented by a manual search via Google Scholar to identify more articles reporting the subject of the review. A combination of controlled vocabulary was used in the search strategy and the final update was stopped on January 2021. The risk of bias was assessed based on the Newcastle–Ottawa Scale. Results and Discussion: Considering the preestablished inclusion and exclusion criteria, 20 articles were retained with 2607 human subjects (967 males/1299 females and 341 not specified, age: 4–60 years). Eighty percent of the selected articles reported associations between malocclusion and morphological changes of the condylar head. Sagittal plane malocclusions produce more changes to the temporomandibular joint components (head of condyle and joint space) (71.93%), while vertical malocclusions lead to the most severe manifestations. Conclusions: Cone-beam computed tomography is the most useful tool for the assessment of osseous morphology of mandibular head condyles and detection of cortical erosion (21.7%). Associations between morphological changes of the condylar head and specific types of malocclusions were proven. However, there is still a need for more clinical studies.

Introduction: Undergraduate oral and maxillofacial radiology curricula are currently undergoing a reform process that is moving toward digital-based radiology that requires dedicated resources to train dental students to the field experience. It is not known if the time is appropriate to totally shift from training students on conventional analog film-based radiology to training them on digital images and the choice of digital system in intraoral and extraoral radiography. Aim: The aim of this study is to assess availability and utilization of the digital radiographic techniques by dental clinics in Riyadh, Saudi Arabia, using a cross-sectional descriptive, epidemiological survey. Materials and Methods: The study included dental departments of nine main governmental hospitals, six dental schools in Riyadh and a representative selected sample of the private dental clinics in Riyadh that included 40 dental clinics. A self-administered e-survey regarding the use of analog or digital radiographic intraoral and extraoral techniques was made. Descriptive statistics are reported in forms of means and range. Results and Discussion: For intraoral radiographic examinations, most clinics (90.9%) used digital systems. Solid-state detectors such as charge-coupled device (CCD) and complementary metal oxide semiconductor sensors were the most popular type digital intraoral sensors (94%) and only 13 locations (26%) used digital photostimulable phosphors plates. For panoramic radiography, almost all (98.1%) used digital systems. Again, the solid-state detectors were the most common digital panoramic system (96.4%). Most respondents had a digital information system to store, retrieve, and display digital radiographs (92.7%), whereas only four locations (5.9%) used hard-copy films or paper prints. Conclusion: Digital imagining is more common than film-based imaging in intraoral radiography in and panoramic radiography in the different dental care delivery sites in Riyadh, Saudi Arabia.

Introduction: The extraction of teeth is a common dental treatment. Healing complications have been reported to be influenced by patients' knowledge and compliance with postoperative instructions. Aim : The goal of the study was to define the influence of the way postoperative instructions delivering method on reducing morbidity and problems experienced after simple tooth extraction. Materials and Methods: A single-blind randomized clinical trial was designed at clinics of Oral Maxillofacial Surgery, Taibah University. Patients were distributed to two classes on a random basis. The first group was provided only with verbal instructions (VI) after dental extraction. The second group was given written and verbal (CVWI) instructions. Postoperative pain, swelling, sleep impairment, oral functions, and general activity were reported using an assessment tool for oral health life quality (OHQ). Results and Discussion: The mean OHQ scores were 14.28 ± 6.36 for VI and 13.46 ± 5.78 for CVWI, which did not indicate a statistical difference (P = 0.50). Of the 100 participants, 51% were mildly affected, whereas 22% were severely affected. Females constituted 51% of the study participants. There was a statistically significant difference between females' mean score values compared to males (15.78 ± 4.5–11.88 ± 6.5) with P = 0.001. About 56% of the participants were nonSaudis and 33% hold a high-school diploma. Conclusions : There was no difference between the two approaches used to present the postoperative instruction in the postextraction OHQ. Following tooth extraction, female patients experience a significantly greater decline in their OHQ. Translation of written postoperative instructions in more than one language should be available in our institution to improve OHQ during the postextraction period.

Introduction: Periodontal diseases (gingivitis and periodontitis) are one of the main concerns for oral health affecting around 20%–50% of the world population. Aims: The aim of this study was to formulate a predictive model for periodontal diseases in a selected population. Materials and Methods: A hospital-based analytical study was carried out. Seven hundred male patients having different forms of periodontal diseases were included to explore the common features and possible risk factors related to periodontal diseases. Chi-squared test and t-test were performed for univariate analysis, and binary logistic regression model was adapted for multivariate analysis using SPSS v23. Results and Discussion: Four hundred and seventy (67%) and 230 (33%) patients suffered from gingivitis and periodontitis, respectively. The mean age of patients with periodontitis (37.17 ± 11.52 years) was significantly higher than those with gingivitis (26.04 ± 10.83 years). Univariate analysis showed that plaque and calculus had statistically significant relationship with gingivitis 451 (72%). Systemic diseases 18 (72%) and patients' habits 39 (76%) had statistically significant relationship with periodontitis (P < 0.05). A logistic regression model was formulated including age, risk factors, and nationality. The model was tested, and its sensitivity, specificity, and accuracy for detecting periodontal diseases were equal to 83.3%, 67.2%, and 78.0%, respectively. Conclusions: This model had a good fit and explained a significant proportion of variance in the outcome variable (periodontitis) R² = 0.40, (χ² (9) = 238.32, P < 0.001).

Introduction : Patients treated with orthodontics show short root due to apical root resorption. Aim: The aim of the study was to compare the external apical root resorption (EARR) of endodontically treated teeth before and after orthodontic movements using clear aligner therapy. Materials and Methods: The study group comprised 22 class I adult healthy patients with a mean age of (28 ± 8.2) years treated with clear aligner therapy. Thirty-four endodontically treated teeth (maxillary incisors and molars) were measured for the extent of the EARR in panoramic radiographs at the beginning and at the end of clear aligner therapy. Root resorption was measured using an electrical digital caliper (Mitutoyo Manufacturing Co. Ltd., Tokyo, Japan) on the dental panoramic radiographs from the mesial cusps of the first molar tooth to the apex of the root, and from the incisal edge to the apex of the root for the central incisors. Results and Discussion: All the endodontically treated teeth demonstrated reduction in pretreatment root length. Less than one percent of EARR was found in 4 teeth, and 1%–4.9% of the EARR was observed in 23 teeth. Six teeth showed EARR of 5–7.9 while only one tooth EARR in the range of 8–10. A pretreatment versus posttreatment comparison of median root lengths of #16, #26, #36, and #46 showed a statistically significant difference (P < 0.05). The mean differences of root lengths after clear aligner therapy among different teeth showed no significant difference (P = 0.981). Conclusion: All the endodontically treated teeth showed minimal external root resorption after orthodontic treatment with a clear aligner.

Introduction: Dental education quality is reflected by assessing graduating students' professional preparedness. Coronavirus disease 2019 (COVID-19) has had many challenges for dentistry some of which may have further long-term impacts on clinical practice, dental education, and dental research. Impact on education can be directly reflected on graduates' preparedness. Aim: The aim of this study is to study self-perceived preparedness of dental school graduates and the impact of COVID-19 on their preparedness. Materials and Methods: An online survey was designed and sent electronically to 5^th year students who were graduating in 2020, dentists who graduated in 2019 and were doing their prelicensure training, and dentists who graduated before 2019. The survey was self-designed and validated by an experienced professor in the school then tested by couple of participants. The survey composed of multiple sections. Four-point Likert scale was used to assess participants' perception in all the survey sections. Results and Discussion: A total of 209 participants responded to the online questionnaire. The mean total preparedness score (TPS) for the 209 participants was 97.6 (standard deviation ± 9.7) with a range of 69–120. The mean TPS of the different classes of participants was 99.5 for the class graduated before 2019, 98.1 for the 2020 class, and 95.1 for the 2019 class. Participants felt they are confident and extremely confident doing most of the required competencies. Weakness was mainly reported in surgical extraction for 2020 graduates due to the 8 weeks loss of their training. COVID-19 had considerable impact on 59.7% of the participants and marginal to no impact on 40.3%. The highest prevalence of those who thought it had some to severe impact on their confidence was those who graduated in year 2019 (73.4%). Conclusions: The graduates who participated in the survey felt confident in performing the majority of general dentistry procedures. COVID-19 pandemic negatively impacted the confidence of all the classes of participants even those graduated before 2019.

Introduction: The classical skeletal divisions of orthodontic patients are the Angle's classification of Classes I, II, and III and of mandibular inclination into normo-, hypo-, or hyperdivergent. Of these classifications, Class III and hyperdivergent are the least studied. This study aimed to investigate the prevalence and relationship between Class III and hyperdivergency. Materials and Methods: Lateral cephalometric radiographs of Class III patients were collected from Riyadh Elm University and were traced by WebCeph^TM software and measured for 16 linear and angular measurements to determine anteroposterior, vertical, and dental associations. To determine the anteroposterior relationships, Sella-Nasion to A point Angle, Sella-Nasion to B point Angle, A point to B point Angle, and Wits appraisal were used. Class III status was determined by utilizing (A point to B point Angle <1) and (Wits appraisal <−2.5). The vertical divergency pattern was considered according to normal Frankfort horizontal plane and mandibular plane (FMA) (22°–28°) and SN-GoMe: Sella-Nasion to Mandibular plane (27°–36°) measurements. The dental correlation was considered according to upper incisor to maxillary plane (U1-Mx) and lower incisor to mandibular plane angle. Statistical analysis was performed with SPSS (version 25) software. Results and Conclusions: One hundred and twenty-five Class III patients were included in the final analysis of this study. A significant correlation at 0.650 was discovered between ANB and Wits analyses (<0.001). Subjects data was grouped, based on their mandibular divergency, into hypodivergent, normodivergent, and hyperdivergent. The distribution, regardless of measurement used, was significantly higher in the prevalence of hyperdivergents (FMA 46.4% and SNGoMe 56%) over hypo- and normodivergents. Although FMA and SNGoMe were positively correlated at 0.887, there were significant differences in their classification of divergency with higher levels of hyperdivergency with SNGoMe.

Introduction: The quarantine, due to the COVID-19 pandemic, forced dental schools globally to change to distant learning methods which include viewing previously recorded lectures or attending online virtual classes. Aims: The aim of this study was to assess the impact of three methods of teaching: Online interactive virtual classes, recorded lectures, and real-life classroom lectures on the academic performance of dental students. The second aim was to evaluate the students' perceptions of the two remote teaching methods as a substitute for traditional classroom lectures. Materials and Methods: The cross-sectional study was conducted with the second-year dental students at the College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, during the spring semester of 2020. The last six lectures of a Preclinical Fixed Prosthodontics course were delivered remotely due to the COVID-19 pandemic. The students' performance in these lectures was compared to their performance in the first nine lectures of the course delivered traditionally before the quarantine period. An online survey was distributed to the students at the end of the course with questions about their perceptions regarding the different teaching methods used to deliver the didactic component of the course. Results and Discussion: The performance of 104 students (56 males and 48 females) was assessed through the number of correct responses for each teaching method. The percentage of students who responded correctly to all the questions was 44% for the classroom lecture format, 75% in the interactive virtual class format, and 78% in the recorded lecture format. The response rate to the online survey was 87.5%. The majority of the students (78%) indicated that the interactive virtual classes were an effective learning method. The perception about viewing recorded material was also positive as 83% of the students agreed that it is an adequate learning method when the classroom lectures were canceled. Nevertheless, only 43% indicated that recorded material could be used as a substitute for classroom attendance. Conclusion: The students' performance in the lectures taught remotely in interactive virtual classes or by viewing recorded lectures was both effective and comparable to traditional classroom lectures. The dental students were generally satisfied with the remote online education.

Genetic disorders of the dentin are known for several years, and reviews have been published mainly in the form of case reports. Dentinogenesis imperfecta (DI) is a disease characterized by an abnormal formation and abnormal structure of the dentin, generally affecting both primary and permanent dentition. The only epidemiological data available were published in 1975 by Witkop, who estimated the incidence of dentinogenesis imperfecta to be between 1/6000 and 1/8000. We present a case of DI III with an unusual presentation of rhizomegaly, dilacerations of the root, and taurodontism, seldom reported in the English literature for any genetic disorder of dentin. Clinical management is challenging in such cases, as the literature mentions that only an early diagnosis and early treatment with periodic follow-up can help improve the quality of life. Psychological and genetic counseling along with a multidisciplinary approach is mandatory for the cases such as the one presented here. Patient education and motivation had a paramount role in making the patient accept the treatment.

Odontogenic keratocyst (OKC) is a locally aggressive intraosseous tumor of odontogenic origin, associated with syndromes such as nevoid basal cell carcinoma syndrome. Also known as Gorlin syndrome, it is an autosomal dominant inherited condition. The disease is characterized by multiple basal cell carcinomas of the skin, multiple keratocystic odontogenic tumors, rib anomalies, and palmar and plantar pits. This article reviews a 3-year follow-up case that we have reported in the Dental University Hospital OMFS clinic at King Saud University, Riyadh, Saudi Arabia. The patient was a 13-year-old female that has been diagnosed with Gorlin–Goltz syndrome in 2018. She had multiple radiolucent lesions, two mandibular OKC, and maxillary dentigerous cyst. The extensive left OKC was treated with marsupialization followed by enucleation. Optimal results with low recurrence rate have been shown after using the marsupialization followed by enucleation and curettage, which agree with the present case results. Unfortunately, there is no gold standard or concrete recommendations that emphasize particular treatment modality. Nevertheless, this approach is considered effective and less invasive in treating OKCs, reducing the lesion size by drainage and decompression up to 47% of the initial size, allowing the preservation of critical anatomical structures. Furthermore, marsupialization prior to enucleation is an appropriate approach in young patients because it is the least treatment modality that interferes with the developmental process of jaws.