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Endodontic treatment of a permanent mandibular first molar is often difficult due to its related complex variations. The root cause of endodontic failure is the inability of a practitioner to recognize and manage an irregular root canal system. Knowledge of dental anatomy, thorough examination, and utilization of recent diagnostic tools are required for an effective root canal treatment. A 31-year-old Saudi male patient presented to the endodontic clinic for endodontic treatment of the mandibular left first molar (#36). Clinical examination using a dental operating microscope (DOM) followed by radiographic examination including cone-beam computed tomography (CBCT) revealed the diagnosis of asymptomatic apical periodontitis in a previously attempted root canal therapy which was incomplete. The periapical disease involved middle mesial canal (MMC) intermingling with the mesiobuccal (MB) in the mesial root. The root canal treatment was successfully carried out with no symptoms during 6 months of follow-up period. This case reports the presence of unusual presentation of MMC and MB canal in the mandibular first molar, which had resulted in postendodontic complications, which was diagnosed using CBCT and successfully managed with good prognosis. Dentists can use technical and imaging advancements including the DOM and CBCT to recognize anatomical variations in the root canal system, especially in cases of postendodontic failures or complications.

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Introduction: Oral health has been significantly associated with the wellness of an individual which includes physical and psychological wellbeing. In the recent past due to various reasons, depression has been noted to be evident in population. The patients visiting dental clinics are of no exclusion to have experienced depression. Aim: to determine the prevalence of depression among dental outpatients in an secondary health facility in Benin City using the Patient Health Questionnaire-9 (PHQ-9). Materials and Methods: This cross-sectional study mixed observational and clinical study using questionnaire and clinical oral examination was conducted among patients attending the dental outpatient clinic of Stella Obasanjo Hospital between December 2018 and January 2019. Results and Discussion: About one-quarter (28.6%) had depression of the mild severity. Depression was highest among the 31–40 years, females, those with primary education and those that earn less the 30,000 naira monthly and nonindigenous participants. Participants with mild depression presented more with acute apical periodontitis, dental caries, and periodontal disease than those without depression. Conclusion: Data from this study on screening for depression among patients attending a secondary facility revealed the low prevalence of depression which was mild in severity. Further studies on patients with symptomatic chronic dental condition are recommended.

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Introduction: Diet of an individual plays a remarkable role in maintaining health. Urbanization has had a great impact on the food habits of the society with the balance shifting to sweetened and refined food consumption. Dietary habits also has remarkable contribution to dental and overall health status. Aim: This study was designed to evaluate oral health awareness, practices, status, and the use of sugary products among urban and rural high school adolescents of Al-Ahsa, Saudi Arabia. Materials and methods: A cross-sectional mixed study was conducted using questionnaire and clinical examination among two female and two male urban and rural schools. Information on oral health awareness, practices, and use of sugar products were obtained using a self-reported structured questionnaire. Oral health status was assessed using decayed, missing, and filled teeth (DMFT) index, gingival index, Angle's classification at University dental clinics. The Chi-square test and t-test were performed using SPSS. Results and Discussion: Ninety-seven urban and one hundred and twenty-eight rural students with a median age of 17 years for males and 16 years for females completed the study. Eighty-five percent urban and 86% rural students demonstrated oral health awareness and practices, showing significant level for rural females (54%, P = 0.002) and urban females (72%, P = 0.006). Ninety-four percent urban and 89% of rural students used sugary products with a significant level for rural females (P = 0.001) for carbonated drinks only. Eighty-six percent of students had decayed, 22% missing and 38% filled teeth. Mean DMFT was 7.0 ± 4.7. Ninety-five (95%) participants showed mild-to-moderate gingivitis, 35% malocclusion, 11% other oral pathologies. Rural and urban difference for oral health parameters was significant only for filled teeth (P = 0.001) for urban and missing teeth (P = 0.019) among 15 years old for rural adolescents. Conclusion: This study demonstrates a good level of oral health awareness, but poor oral health status among both urban and rural students with an insignificant difference for most of the parameters studied.

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Introduction: Self-medication (SM) and purchase of over-the-counter medication have been in practice in medical fields. Dental students have the knowledge of pharmacological drugs and they have a higher chance than the population to indulge in SM. Aim: The aim of the study was to evaluate the practice, awareness, and attitude of undergraduate dental students toward SM and its relation with gender and to assess whether this practice differs among students of different years of study. Methods: A cross-sectional survey was conducted using simple random sampling among undergraduate dental students in a private dental college in Riyadh. A self-designed online questionnaire was used to collect data, which was validated and used for the research Results and Discussion: A total of 465 students (31% males and 69% females) responded to the survey. 60% of the students agreed to practice SM and it was significantly (P < 0.05) higher in females than males. With each successive year of study, there was significant decrease (P < 0.05) in the practice of SM and significant increase (P = 0.000) in the level of awareness toward SM. Body aches (57%) and mouth ulcers (35%) were the most common indications to practice SM regarding general and oral health, respectively. Most commonly used medicines were analgesics. Previous experience to treat the same illness was the most common reason for practicing SM, and the primary source of medicine was the medicine present at home. Conclusion: More than half of the respondents practiced SM for minor illnesses, and it was higher among females and students of preparatory years. There was less awareness among dental students relating to survey items such as importance of completing the course of medicine and adverse drug reactions. This study highlights the need to develop awareness and interventions to assess this health problem among dental undergraduates.

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Introduction: Atherosclerosis of the external division of the carotid artery contributes to approximately 20% among all the reasons leading to stroke. The strategies for the prevention of stroke remain underutilized despite the advancements in healthcare. Dentists can contribute in the prevention of stroke by identifying patients at risk from the details revealed in radiographic imaging. Aim: The aim of this study is to determine the prevalence of carotid artery calcifications (CACs) detected on digital panoramic radiographs in Riyadh and its relationship with cardiovascular disorders. Methodology: A retrospective cross-sectional study was conducted in Riyadh Elm University using digital panoramic radiographs. A total of 158 panoramic radiographs were analyzed with patients aged ≥18 years. The presence of CAC was determined and confirmed by an oral radiologist. Medical records were retrieved and collected from the digital data base after ethical approval. Chi-square test of independence was performed to examine the relationship between variables (age, gender, and medical problems) and the presence of calcification. Results and Discussion: From the data scrutinized, 158 panoramic radiographs were included for the study. 111 radiographs did not have any calcifications. 47 radiographs depicted the presence of soft tissue calcification, out of which 20 radiographs were of CAC and the remaining contributed to other soft tissue calcifications seen in the neck region. There was significant correlation between age and calcification, P = 0.003 with the highest prevalence in 40–69 years. Correlation between gender, CAC, and medically compromised conditions associated with cardiovascular systems was not significant. Conclusion: The prevalence of CAC in the Riyadh population was 1.12%. CAC comprised of 12.66% among all the soft tissue calcifications of the neck in this study. Patients are not aware of the underlying cardiovascular risk that CAC can pose. Dentists' diagnostic efficiency in analyzing CAC, which is a risk factor for cardiovascular events, can reduce further morbidities or mortality rates enhancing the quality of life and life span.

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Introduction: Emergency medicine department visits for odontalgia, related to traumatic and non traumatic dental events has seen a shift towards increase in cases. Emergency departments provide palliative care especially for the non traumatic dental injuries Aims: To explore the trends of emergency department (ED) visits for dental-related conditions in Saudi Arabia. The study also aimed to analyze visit management patterns, including procedures, prescriptions, and recall visits. Materials and Methods: A cross-sectional retrospective observational study was done using simple random sampling on dental emergency visit data to the ED at hospitals under renowned university of health sciences in Riyadh and Al-Ahsa between January 2016 and May 2019. Results and Discussion: A total of 5050 charts were included. An increase in dental emergency visits was observed between 2016 and 2017. Pulpal and periapical lesions were the most frequently diagnosed conditions every year (53.83% of all dental-related ED visits), and traumatic injuries were the least frequently (6.37%) diagnosed condition. Conclusion: Dental-related visits to EDs in Saudi Arabia increased remarkably from 2016 to 2019. Pulpal and periapical conditions were the most frequent cause of dental-related ED visits. To ensure better use of ED time and resources, it is imperative to raise public awareness of what types of urgent dental conditions require an ED visit, as well as to increase the number of public health unit dental clinics and their ease of access.

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Introduction: Sudden cardiac arrest is a life-threatening emergency and a leading cause of mortality worldwide. According to the World Health Organization, cardiovascular disease is the most common cause of death in Saudi Arabia. Aims: This study aims to evaluate the level of knowledge and awareness toward basic life support (BLS) among nonhealth-care professionals in Riyadh. Methods: This cross-sectional descriptive survey was done using random sampling during the time period of June 2020. Data were collected using self-administered online questionnaire which was adapted from a validated questionnaire that was used previously in a similar study. The questionnaire contained three parts: (i) demographic data, (ii) questions on awareness related to BLS, and (iii) questions on the level of BLS knowledge. Descriptive statistics were analyzed using IBM SPSS Version 25, and Chi-square test was used to find association between the level of knowledge and demographic factors. Results and Discussion: A total of 429 respondents completed the questionnaire: 80% were females and majority were 21–30 years old (39.4%). Our results demonstrated that only 22% had previous BLS training of which 43% had good knowledge and 56% had poor knowledge about BLS. There was a significant association between the level of BLS knowledge with gender (P = 0.007), education (P = 0.006), and occupation (P = 0.049). Nearly 84.4% of the respondents were aware that their knowledge in BLS was insufficient. Conclusions: Overall, the level of knowledge and awareness among nonhealth-care professionals in Riyadh are poor. Introduction of BLS courses in the education curriculum is highly recommended.

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Introduction: A successful root canal treatment ensures complete sealing of the root canal to abstain from re-infections. The efficiency of antimicrobial activity of the sealers is important for achieving long term success in root canal therapy. Aim: This study compared the antibacterial properties of three calcium silicate-based root canal sealers against Enterococcus faecalis at varying incubation time periods. Materials and Methods: This in vitro cross sectional experimental study was designed with three root canal sealers, namely, Endosequence/BC Sealer, CeraSeal, and BioRoot RCS. Freshly mixed selars were placed in agar plates infused with Enterococcus faecalis. Incubation at 37°C under anaerobic conditions was done for 1 week, during which measurements of the inhibition zones were recorded at 24 h, 48 h, 72 h, and 7 days. Data were compared using ANOVA, and Tukey's tests (P < 0.05). Results and Discussion: Bacterial growth inhibition was demonstrated by all the sealers tested, with antimicrobial activity being highest for BioRoot RCS and least for CeraSeal. An increase in duration of incubation, positively affected the antimicrobial properties. Conclusion: Significant difference (P < 0.05) of bacterial inhibition was observed among different time duration of 24 h compared to 48 h, 72 h, and 7 days, for all tested materials. Moreover, BioRoot RCS showed significant bacterial inhibition to tested microorganism.

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Introduction: Diabetes mellitus (DM) is a common metabolic disorder and a leading cause of mortality and morbidity worldwide. Dentists are increasingly encountered with patients affected by this chronic condition. Aim: To a review on updates in DM, dental management and emergencies. Methods: Database search was carried out in PubMed and Google scholar limited to articles of English language from 1998 to 2021 and pertaining to the keywords diabetes, orofacial manifestations , dental management diabetic emergency. A narrative review of this search is presented in this article. Results and Discussion: This article gives a concise update on DM and discuss the management of diabetic patients in a dental setting. Conclusion: Discussion of the possible orofacial manifestations of DM and management of diabetic emergencies is emphasized for efficicient dental practice.

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