Faculty development programs (FDPs) have proven to be successful for improving teaching skills in higher education. This review article summarizes literature reviews and resource books on faculty development. It tackled why FDP is important, history of FDP in the past years, and questioned whether FDP produced any positive effect on students' academic achievement as well as the different methods to assess FDPs effectiveness. The review also discussed how to establish FDP, presented its ideal structure, features that make FDP effective, and outlined the barriers to its successful implementation as well as the future vision. This report also highlighted the situation of FDP in Saudi Arabia. Finally, the review concluded that professional FDPs produce promising outcomes in the learning and teaching practices and recommended that teachers in higher education should attend FDP training activities on regular basis and that the scope of planned FDPs should extend beyond the health professions discipline, to include social skills necessary for collaboration, professional growth as well as management, and leadership abilities.

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Aim: Children under 5 years of age generally spend most of their time with parents or guardians, especially mothers. Parents play a central role in giving children the information and encouragement needed for healthy lives. Parental oral health knowledge, belief and attitudes influence the oral health maintenance, dietary habits and healthy behavior of their children. The aim of this study was to assess the mothers oral health care knowledge and to assess the oral health status of their child. Materials and Methods: A total of 386 mothers along with their child of 1-6 years were randomly selected for the study. A 22-point questionnaire including parent's literacy levels, socioeconomic status, dietary practices and oral hygiene practices, was designed to assess the knowledge of the mothers regarding oral health of their child. Oral examination of the children was done by World Health Organization criteria for recording children's oral health status. Results: About 87% of the mothers agreed that intake of food with excessive sugars can cause cavities, and 95.8% admitted that chocolates cause the most decay. 80.5% agreed to the fact that leaving a milk bottle all night increases the risk for tooth decay, however, 59.3% mothers were of the opinion that dental visit is must only in the presence of decay. 59.3% mothers were unaware about the optimal fluoride content. 71.7% mothers agreed that caries in deciduous teeth are a matter of concern. The average decayed score of the children was 2.9 and 77.9% of the children had a fair to good oral hygiene status. Conclusion: Instead of the fact that most of the health care knowledge that the mothers had was primarily from the family elders, they were aware of caries risk factors, tooth brushes and amount of toothpaste and bacteria from mother's cavities can infect child. This could be observed by less number of decayed teeth and good oral hygiene status of the children. However, parents knowledge, attitudes and few beliefs regarding dental care need to be improved.

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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.

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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.

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Context: Anxious patients are difficult to manage and tend to avoid dental treatment. Aim: The aim of this study is to explore dental anxiety (DA) among patients visiting Riyadh Elm University (REU) clinics. Materials and Methods: Dental patients were first oriented about the purpose of the study and then signed consent before filling a ten-item quantitative DA questionnaire that included demographic variables of age, gender, and educational level. Responses were scored on a scale of 1–4 for each question, and an overall questionnaire score of 40 was obtained. Low anxiety was considered with at or below 15, moderate anxiety between 16 and 27, and high anxiety at or above 28. Statistical analysis was performed with frequencies and cross-tabulation by Chi-square and Student's t-test. Results: Of 365 respondents, the majority (50.1%, n = 183) showed moderate anxiety followed by 104 participants (28.5%) showing high anxiety while only 78 participants (21.4%) exhibited low DA. Among the high DA group, 81% were female (n = 84) while 19% were male (n = 20) and this difference was statistically significant. High DA was recorded in patients aged 13–18 (25%) and 19–25 years (27%) compared to other age groups; however, the difference was statistically insignificant. Furthermore, schoolchildren demonstrated high DA (53%) compared to other educational levels, yet the difference was not statistically significant. Conclusion: A considerable number of patients attending REU dental clinics exhibited DA that was more intense among female patients, younger age groups, and the less educated individuals.

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Background: The effectiveness of school-based dental health programs has been vastly reported. The objective of the present study was to assess the oral health knowledge and attitudes of primary school teachers in Saudi Arabia and to identify any barriers in implementing school oral health programs. Methodology: A pretested self-administered questionnaire was used to assess the oral health knowledge and attitudes of primary school teachers including barriers in implementing school oral health programs. Results: A total of 61 primary schools were included in the present study with responses from 1186 teachers. The mean oral health knowledge score among primary school teacher of Abha-Khamis was found to be 16 ± 2.7. The overall attitude of primary school teachers regarding implementing school-based oral health program was found to be positive on Likert scale. The responses for barriers in implementing school oral health program were almost equally distributed: lack of material resources (21%), lack of professional training (25%), lack of availability of time (25%), lack of support from school administration (22%), and teacher's attitude was least perceived as a barriers (7%). Conclusions: The oral health knowledge among primary school teachers was found to be good with positive attitudes toward school-based oral health programs. The most significant barriers in implementing a school oral health program were administrative barriers. There is a need for concerned school authorities and health policy makers to address these barriers and to promote oral health in the community.

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Bioactive glass (BAG) is a benevolent biocompatible material used as an adjunct to various materials used in dentistry. BAG is proved to have a beneficent effect in promoting material–tissue bond. The objective is to analyze significant information available in the literature regarding application of BAG in dentistry. A literature search of electronic databases, including PubMed, Google Scholar, and ResearchGate using the keywords: (Dentifrice OR Dentifrices) OR (Toothpaste OR Toothpastes) AND (Treatment) AND (Dentin OR Dentine OR Tooth) AND (Hypersensitivity OR Sensitivity) AND (Dentifrício OR Dentifrícios) AND (Tratamento OR Tratamentos) AND (Dentinária OR Dentina OR Dente) AND (Hipersensibilidade OR Sensibilidade). The papers found were analyzed regarding title and abstract contents to eliminate the ones that were out of context and not relevant to the review. After this first filter, 31 papers were selected, in which the full-text available was considered of good quality and relevant to the context. The languages of the papers were predominantly English and articles published before 1999 were excluded. The material BAGs are currently used for implant coating, bone grafting, dentin desensitizer, and restorative materials. The current paper reviews the significant developments of BAGs in clinical application, especially dentistry.

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Introduction: This research aimed to evaluate and compare the oral health status and treatment required for visually impaired children and normal healthy school-going children in New Delhi and to investigate the factors that influence oral health. Subjects and Methods: The study was conducted in 420 children who were equally divided into visually impaired children and normal healthy children. Oral health status was recorded, which includes dental caries, plaque, debris, and gingival status in both groups. The Chi-square test was used, and statistical significance was fixed at (P < 0.05). Results: The total caries experience (Decayed, Missing, and Filled Surface + decayed, missing, filled surface) was found to be more in normal healthy children 2.72 than the visually impaired children 2.22 and it was found to be statistically significant (P < 0.05). Oral hygiene simplified index of normal healthy children and visually impaired children were 0.74 and 1.33, respectively, and found to be statistically significant (P < 0.05). The gingival index of normal healthy children was 0.10 found to be greater than visually impaired children 0.08. Visually impaired children required more treatment needs than normal healthy children. Conclusions: Visual impairment can actively limit these children maintaining good oral hygiene, and hence, it is important to create awareness, proper oral health guidance, and periodically screening to avoid complicated treatment needs in these children.

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Background: Awareness of available treatment devices and methods influences the seeking of appropriate treatment. With the lack of prior orthodontic awareness baseline, the present study aims to measure awareness level of various orthodontic treatment options along with ranking available orthodontic appliances and payment options. Materials and Methods: A total of 350 Saudi participants have completed a survey listing various orthodontic modalities next to its images, as well as payment plan options. Likert awareness scale was used to assess the awareness of nine orthodontic modalities and participants were asked to rank the most preferred orthodontic appliance and payment method options. Results: Stainless steel and ceramic brackets, along with clear aligners displayed moderate-to-high awareness levels. However, statistically significant lower recognition of early treatment tools, namely, expander, headgear, and functional appliances was evident (P < 0.01). The studied group has ranked ceramic brackets as first and lingual brackets as least preferred orthodontic appliance (P < 0.01). Conclusions: Community awareness program along with dental practitioners should aim toward improving population's knowledge on dentofacial orthopedic treatments in specific, as per the study findings.

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Background: Cancrum oris is a debilitating and rapidly progressive gangrenous disease. It is life-threatening and results in severe devastation. Tissue loss constitutes a formidable cause of morbidity in patients and also poses an enormous challenge to a reconstructive surgeon. This study aims to describe the pattern of tissue loss among patients with cancrum oris at our center. Methods: A review of the data of patients treated for cancrum oris at Noma Children Hospital, Sokoto, Nigeria, from December 1999 to 2011, was done. Data on the age, gender, and pattern of tissue loss were retrieved. The pattern of tissue loss was assessed anatomically and clinically. Analysis of data was done using SPSS (IBM SPSS Statistics for Windows Version 20 [Armonk, NY: IBM Corp]). Results: A total of 159 cases of cancrum oris were included in this study. The age range was 1–33 years with a mean (± standard deviation) of 3.5 (3.23) years. A male/female ratio of 1:1.2 was observed. A total of 425 sites were affected in 159 patients. In 109 (68.6%) patients, only soft tissue involvement was seen, while a combination of soft and hard tissue destructions was observed in 50 (31.4%) patients. The most frequently affected site was the cheek, 268 (63.1%), followed by the lips, 106 (66.7%). The nose was affected in 40 (25.2%) patients. Osseous involvement was observed in 50 (7.6%) patients. Conclusion: Cancrum oris, though considered to be a rare disease, continues to constitute a grievous cause of orofacial tissue loss and consequent morbidity in our environment.

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Introduction: Prevalence studies on oral lesions in children are scarce, and none of them was conducted in Jordan. Objectives: To determine the prevalence of oral mucosal lesions among Jordanian children. Materials and Methods: A stratified cluster random sampling technique was used to select a sample of first and sixth-grade school children. Systematic oral examination was performed using natural light, and lesions were diagnosed based on the clinical diagnostic criteria proposed by the WHO. Statistical analysis was performed using Statistical Package for Social Sciences (SPSS) version 20 (SPSS Inc., Chicago, IL, USA), and P < 0.05 was considered statistically significant. Data were analyzed using Chi-squared test or Fisher's exact test where appropriate. Results: The study included 1366 school children (639 [46.8%] males and 727 [53.2%] females) of whom 620 (45.4%) were 6-year-old and 746 (54.6%) were 12-year-old. The prevalence of oral lesions among children was 47.4%, without a significant difference in prevalence between males (46.6%) and females (47%). Prevalence was significantly higher in 12-year-old children (50%) compared to 6-year-old children (44.2%; P = 0.032). The most commonly diagnosed lesions were racial pigmentation (16.8%), fissured tongue (14.6%), and hematoma (5.3%). Discussion: Oral mucosal lesions are common in children in general, with no overall preference to gender, but the prevalence increases significantly with age. General dental practitioners and pediatric dentists should be aware of the common oral mucosal lesions in their communities for optimum diagnosis, management, and possible prevention. Conclusions: Oral lesions are common among Jordanian children and dentists should be aware of their diagnosis and management.

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Background: The restorative materials used in dentistry are required to have long-term durability in the oral cavity. Effect of various fluids in the oral environment can affect the hardness of these restorations. This study was carried out to evaluate the effect of different mouth rinses on the hardness of Silorane and Nano-hybrid resin composites. Materials and Methods: Thirty specimens were prepared from each type of composite and stored in artificial saliva for 24 h at 37°C. They were then divided into six experimental groups based on the test solution and were immersed and stored for 24 h at 37°C. Thereafter, the specimens were washed, dried and the hardness was measured for each specimen by Vickers microhardness tester. Results: Nano-hybrid resin composite showed higher Vickers hardness number (VHN) than Silorane composite in any test solution. There was only a mildly significant difference in the mean VHN of Silorane composite immersed in alcohol-containing mouthwash compared with artificial saliva. However, there was a significant difference in the mean VHN of Nano-hybrid composite when immersed in different mouthwashes. Conclusion: The microhardness values of Silorane-based and Nano-hybrid resin composites were decreased after immersion in the mouthwashes. The hardness of Nano-hybrid composite immersed in artificial saliva showed the highest VHN and was significantly affected when immersed in other test solutions. Silorane-based composite is more resistant to alcohol-containing mouthwash than Nano-hybrid composite.

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Background and Aim: This study was conducted to assess the periodontal knowledge, orientations of Saudi medical interns and the medical curriculum. Study Population and Methodology: Questionnaires were distributed to 221 medical interns chosen randomly from two major educational institutions in Saudi Arabia. Questions were developed from literature reviews. The questionnaire had five true/false knowledge items, and eight Likert-scale questions. Data were analyzed by computerized SPSS (version 20). Level of significance was set at P < 0.05. Results: Of the 221 respondents, 66% were male and 34% were female. Most of the participants were 24 years old (48%). About 40% of the interns answered all five true/false general knowledge questions correctly, nearly half of the respondents (49.8%) reported they never asked patients if they were diagnosed with periodontal disease, 93.2% reported not receiving any training about periodontal disease in medical school, 23.5% reported they would feel absolutely uncomfortable performing a simple periodontal examination, about one-third of interns (29.4%) agreed that patients expect physicians to discuss/screen for periodontal disease, 43.9% felt that discussing/evaluating the periodontal status of their patients was peripheral to their role as physicians, nearly half of interns (48.4%) reported never screening patients for periodontal disease, and 33% stated they never referred patients to dentists. Conclusion: Medical interns were not prepared nor trained to screen patients for periodontal disease. They had limited knowledge about the association between periodontal health and general health. Oral health training as part of the medical curriculum is strongly recommended.

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Background and Objectives: Evidence has accumulated linking the effects of licorice for the treatment of many diseases. The objectives of this study were to evaluate the antibacterial action of licorice root extract against Staphylococcus aureus and to study its healing potential on the experimentally induced oral wounds in the rabbit's cheek mucosa. Materials and Methods: Different concentrations of licorice root extract were prepared and their antibacterial activities against S. aureus determined by disk diffusion method. The wound had been created using of biopsy punch at the right cheek mucosa of the rabbit. In the study group, these wounds were irrigated with 1 ml of 60 g/100 ml of licorice root extract twice daily. Seven rabbits from the control and the study group were sacrificed in the 3 ^rd and 6 ^th day of the experiment, and biopsies were taken for histological observations of the wounds. Results: There was no sensitivity of S. Aureus to different concentrations of licorice extract. The histological features of oral wounds in the study group showed satisfactory healing potential after twice daily irrigation with 60 g/100 ml of licorice root extract in comparison to control group. Conclusions: Different concentrations of licorice root extract has no antibacterial action against S. aureus, but licorice can shorten the healing time of the induced oral mucosal wounds in rabbits.

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Background: Traumatic dental injuries (TDIs) have been reported to be a low priority of emergency room (ER) personnel; however there have been increased calls from across the world to train ER personnel in the provision of dental trauma first aid (DTFA). Aim: The aim was to measure the knowledge and attitude of a sample of ER physicians, nurses and emergency medical technicians (EMTs) from across Saudi Arabia regarding DTFA. Materials and Methods: A structured questionnaire was modified from previously existing questionnaires on the topic. A stratified, cluster sample was designed by randomly selecting hospitals across four regions of Saudi Arabia. A total of 150 questionnaires was distributed to all the ER personnel of these hospitals of which 146 completed responses were received. Results: The overall knowledge scores ranged from 0 to 6 out of 7 (mean score 2.88 ± 0.55). Surgeons had the best knowledge about DTFA while EMTs had the lowest knowledge. Nurses had the most positive attitude toward the management of DTFA. Regression models showed that specialty of the personnel and previous education about DTFA significantly influenced knowledge while witnessing a TDI was the only factor that significantly influenced attitude. Conclusion: Overall knowledge of DTFA among ER personnel across the sampled regions of Saudi Arabia is low.

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Aim: The purpose of this interview-based questionnaire study is to evaluate the patients' and parents' perspectives on orthodontic treatment and parent's willingness to pay (WTP) for orthodontic treatment of their child in Riyadh City. Research Hypothesis: The higher the socioeconomic status and the severity of the child's malocclusion, the more willing the parents are to pay. Materials and Methods: Data were collected from 171 patients and their parents who were personally surveyed from several dental centers. Two different questionnaires were used: one was for the patients who rated their satisfaction with their occlusion and the other was for the parents who were asked to approximate the amount of Saudi Riyal (SR) they would be willing to invest for the treatment of their children's malocclusion. The WTP was calculated using the competitive bidding process, with a median price of 10,000 SR. Results: A total of 171 families and their children with malocclusion were interviewed, of which 71.6% of the parents disagreed to a statement that 10,000 SR/- is a fair amount for the orthodontic treatment. Approximately 47% have responded that their child needed orthodontic treatment. However, a high proportion of parents, i.e., 71.4% were willing to pay more amounts for advanced kind of treatment for their children. Conclusion: The median price used in this study was unacceptable to many parents; however, those parents who found it acceptable were willing to pay more for advanced treatment procedures. Orthodontists in Saudi Arabia should educate the public to what it entitles to achieve a healthy, functional, and esthetically pleasing occlusion.

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Background and Aim: Oral tori are bony growth present in the oral cavity and are not considered as pathological lesions. Smaller tori do not cause any problems, but larger sized tori can result in significant problems. The aim of this study was to determine the prevalence of torus palatinus (TP) and torus mandibularis (TM) in the Indian population. Study Design: A total of 3087 patients were examined between August, 2010 and October, 2012 for the presence of TP and TM by inspection and palpation. The data were collected and analyzed using SPSS 12.0 (SPSS Inc., Chicago, USA). Results: A total of 36 patients (1.3%) presented with TP, while 214 patients (6.9%) presented with TM. Tori were more frequent in males and this difference was statistically significant (P < 0.05). TP was more common in 31-40 years age group (13 patients, 36.1%), whereas TM was more in the 41-50 years age group (81 patients, 37.9%). The most commonly observed type of TP was flat shaped, whereas bilateral solitary types were the most common TM. Conclusion: The results of this study showed a significantly higher prevalence of tori in males. No difference in the prevalence of TP and TM was noted regarding the age groups. Although, not pathologically significant, these bony overgrowths very often need surgical removal, especially when prosthesis are indicated.

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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.

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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.

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Introduction and Aim: The anterior lingual foramen is an anatomic structure in the symphysis region of the mandible. There is little research on the incidence and prevalence of this structure. The aim of this study was to evaluate the prevalence and the location of the mandibular lingual foramen seen in CBCTs of a sample of the Saudi population. Methodology: 160 CBCTs images of the mandible of Saudi individuals taken at the Riyadh dental center were evaluated (45 male and 112 female) on the axial, coronal and curved sections for the presence and the number of lingual foramina for each patient. The distance between each foramen and the inferior border of the mandible, and the distance between the foramen and the genial tubercle were measured. Results: There was no statistically significant difference between male and females in the presence of the foramen. All CBCT scans showed presence of at least one lingual foramen in the mandible. Conclusion: The prevalence of the mandibular lingual foramen seems to be nearly universal in the Saudi population. Surgeons looking to place implants in the mandibular anterior region should take cognizance of this fact in order to minimize the chance of complications.

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Objectives: To compare the cytological findings of preoperative buccal smears with their histopathological types in oral cavity tumors. Materials and Methods: This study investigated 45 patients with oral tumors who had undergone preoperative buccal smears of oral lesions and were diagnosed by postoperative histopathological examination. Two samples were taken from patients that were clinically diagnosed with oral squamous cell carcinoma (OSCC): smears for cytological examination and biopsies for histopathological diagnosis. Results: Of the 45 cases studied, histopathology showed the presence of OSCC (n = 39 [86.7%]), verrucous carcinoma (n = 2 [4.4%]), and hyperkeratosis (n = 4 [8.9%]). OSCC cases predominantly occurred in males, with a ratio of 3.8:1 (P = 0.000); the majority of OSCC cases, in both males (27; 87%) and females (6; 75%), were older than 50 years. Most OSCC cases, 32 (82.1%), were toombak dippers, and 28 out of the 32 were males (87.5%). In addition, the labiogingival, a common site of toombak dipping, was a prevalent lesion site of OSCC (13 patients, 33.3%) (P = 0.004). The cytological findings showed good diagnostic concordance with the histopathological findings; in 39 cases of OSCC, 31 patients had positive smears and biopsies and eight patients had negative smears but positive biopsies, for an overall sensitivity of 79.5% and specificity of 100%. Conclusion: Despite the small number of cases in this study, we realized that the diagnostic accuracy of preoperative buccal smear cytology for oral lesions was high and that it is a safe, easy-to-perform, and clinically useful diagnostic procedure.

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Background: The nature of collagen in the oral potentially malignant disorder of oral submucous fibrosis (OSF) has always been a subject of interest to researchers studying the condition. The type, constitution, and morphology of the collagen has been studied to understand the pathogenesis of the disorder. Aim: The present review attempts to collate literature to assess the changes reported on the nature of collagen in OSF. Materials and Methods: A systematic analysis of literature based on the PRISMA protocol was carried out on studies that analyzed the nature of collagen in OSF. A total of 30 articles were found acceptable for analysis. The reported literature was categorized into histological, immuno-histochemistry (IHC), electron microscopic (EM)/scanning electron microscopic (SEM), biochemical, culture, and genetic studies. Results: Light microscopic studies revealed increased collagen with compaction and condensation as the disease advanced. Polarising microscopy revealed presence of greenish yellow (type I) thick fibers replacing the yellowish orange (type III) thin fibers in the submucosa. Fibrosis originated in the submucosa and subsequently involved the lamina propria as the disease advanced. EM/SEM investigations revealed frayed ends, degeneration of collagen cores. Increased expression of collagen antibodies and total collagen content were observed in IHC and biochemical studies, respectively. Cultured fibroblasts from OSF tend to produce more collagen in comparison to normal fibroblasts indicating a phenotypic change. Increased expression and upregulation of collagen genes were consistent in OSF cases. Conclusion: The collagen deposition in OSF is biochemically normal but quantitatively more. Fibroblast phenotypic change, upregulation of collagen genes, and selective remodeling due to decreased degradation seem to contribute to the increased fibrosis in the disorder.

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