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VOLUME 18 , ISSUE 3 ( March, 2017 ) > List of Articles


Patterns of Restorative Failure among Khat and Shammah Users in Jazan City, Kingdom of Saudi Arabia: A Cross-sectional Survey

Shilpa H Bhandi, Mohammed E Sayed, Razan A Bosly, Huda A Hakami, Maryam H Mugri

Citation Information : Bhandi SH, Sayed ME, Bosly RA, Hakami HA, Mugri MH. Patterns of Restorative Failure among Khat and Shammah Users in Jazan City, Kingdom of Saudi Arabia: A Cross-sectional Survey. J Contemp Dent Pract 2017; 18 (3):234-240.

DOI: 10.5005/jp-journals-10024-2023

Published Online: 00-03-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.



The effect of Khat and Shammah habits, with the parafunctional jaw activities that accompany them, on the integrity of the natural dentition, dental restorations, and prostheses has not yet been investigated. This study is the first attempt to identify the patterns of restorative failure among Khat chewers and Shammah users in Jazan City, Kingdom of Saudi Arabia.

Materials and methods

A cross-sectional study was conducted in 294 recruits among dental clinics in Jazan City, Kingdom of Saudi Arabia, from October 1, 2015, to April 30, 2016. The patients were surveyed and examined to identify the type of restorations/prosthesis they had and their failures. Bivariate analysis was conducted to investigate the association of the restorative failure with the demographic variables. General linear model was performed to investigate the association between restorations/prostheses failure and Khat/Shammah use with the controlling factors of age and gender as independent variables.


Khat/Shammah use was statistically significantly associated with restorative failure (p < 0.05) relative to amalgam, composite, crowns, fixed partial dentures, removable partial dentures, and complete dentures. In addition, a significant association of restorative failure was observed with gender, education, and brushing.


Consumption of Khat/Shammah may be attributed as one of the reasons associated with restorative failure among the Saudi population.

How to cite this article

Sayed ME, Bosly RA, Hakami HA, Mugri MH, Bhandi SH. Patterns of Restorative Failure among Khat and Shammah Users in Jazan City, Kingdom of Saudi Arabia: A Cross-sectional Survey. J Contemp Dent Pract 2017;18(3):234-240.

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  1. A review of amalgam and composite longevity of posterior restorations. Rev Port Estomatol Med Dent Cir Maxillofac 2010;51:155-164.
  2. Survival and reasons for failure of amalgam versus composite posterior restorations placed in a randomized clinical trial. J Am Dent Assoc 2007 Jun;138(6):775-783.
  3. The reasons for replacement and the age of failed restorations in general dental practice. Acta Odontol Scand 1997 Jan;55(1):58-63.
  4. [Despite all – do we have an appropriate substitute for amalgam?]. Refuat Hapeh Vehashinayim (1993) 2008 Apr;25(2):23-26,73.
  5. Longevity of restorations in posterior teeth and reasons for failure. J Adhes Dent 2001 Spring;3(1):45-64.
  6. Five-year study of Class II restorations in permanent teeth using amalgam, glass polyalkenoate (ionomer) cement and resin-based composite materials. J Dent 1993 Dec;21(6):338-343.
  7. Selection of restorative materials, reasons for replacement, and longevity of restorations in Florida. J Am Coll Dent 1998 Fall;65(3):27-33.
  8. Ten-year clinical assessment of three posterior resin composites and two amalgams. Quintessence Int 1998 Aug;29(8):483-490.
  9. Age of restorations at replacement in permanent teeth in general dental practice. Acta Odontol Scand 2000 Jun;58(3):97-101.
  10. Clinical performance of posterior composite resin restorations. Quintessence Int 1992 Oct;23(10):705-711.
  11. A 5-year study comparing a posterior composite resin and an amalgam. J Prosthet Dent 1990 Nov;64(5):523-529.
  12. A comparison of restoration longevity in maxillary and mandibular teeth. J Am Dent Assoc 1988 May;116(6):651-654.
  13. Teeth with large amalgam restorations and crowns: factors affecting the receipt of subsequent treatment after 10 years. J Am Dent Assoc 2005 Jun;136(6):738-748.
  14. Replacement reasons and service time of class-II amalgam restorations in relation to cavity design. Acta Odontol Scand 1991 Apr;49(2):109-126.
  15. Outcome of direct restorations placed within the general dental services in England and Wales (Part 1): variation by type of restoration and re-intervention. J Dent 2005 Nov;33(10):805-815.
  16. Prevalence of cusp fractures in teeth restored with amalgam and with resin-based composite. J Am Dent Assoc 2004 Aug;135(8):1127-1132.
  17. Influence of patient factors on age of restorations at failure and reasons for their placement and replacement. J Dent 2001 Jul;29(5):317-324.
  18. Catha edulis, a plant that has amphetamine effects. Pharm World Sci 1996 Apr;18(2):69-73.
  19. Effect of khat chewing on 14 selected periodontal bacteria in sub- and supragingival plaque of a young male population. Oral Microbiol Immunol 2005 Jun;20(3):141-146.
  20. Khat (Catha edulis) – an updated review. Addict Biol 2005 Dec;10(4):299-307.
  21. Validity and reliability of a Severity of Dependence Scale for khat (SDS-khat). J Ethnopharmacol 2010 Dec;132(3):570-577.
  22. Effect of khat chewing on periodontal pathogens in subgingival biofilm from chronic periodontitis patients. J Ethnopharmacol 2010 Dec;132(3):564-569.
  23. Qat habit in Yemen society: a causative factor for oral periodontal diseases. Int J Environ Res Public Health 2007 Sep;4(3):243-247.
  24. The association of khat (Catha edulis) chewing and orodental health: a systematic review and meta-analysis. S Afr Med J 2014 Nov;104(11):773-779.
  25. Influence of Khat chewing on periodontal tissues and oral hygiene status among Yemenis. Dent Res J (Isfahan) 2010 Winter;7(1):1-6.
  26. Oral manifestations of habitual khat chewing: a case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2010 Jun;109(6):e60-e66.
  27. Statistical analysis of the prevalence, severity and some possible etiologic factors of gingival recessions among the adult population of Thamar city, Yemen. RSBO 2011 Sep;8(3):305-313.
  28. Risk assessment of khat use in the Netherlands: a review based on adverse health effects, prevalence, criminal involvement and public order. Regul Toxicol Pharmacol 2008 Dec;52(3):199-207.
  29. Salivary caries parameters: comparative study among Yemeni khat chewers and nonchewers. J Dent Sci 2014 Dec 31;9(4):328-331.
  30. Qat chewing as an independent risk factor for periodontitis: a cross-sectional study. Int J Dent 2013 Feb 21;2013.
  31. Factors related to success and failure rates at 3-year follow-up in a multicenter study of overdentures supported by Brånemark implants. Int J Oral Maxillofac Implants 1995 Jan-Feb;10(1):33-42.
  32. Placement and replacement of restorations in general dental practice in Iceland. Oper Dent 2002 Mar 1;27(2):117-123.
  33. Oral health status in relation to socioeconomic and ethnic characteristics of urban adults in the U.S.A. Community Dent Oral Epidemiol 1977 Oct 1;5(5):200-206.
  34. Relationship between smoking and dental status in 35-, 50-, 65-, and 75-year-old individuals. J Clin Periodontol 1998 Apr 1;25(4):297-305.
  35. The flower of paradise: the institutionalized use of the drug qat in North Yemen. Dordrecht: D. Reidel Publications; 1987. p. 98-100.
  36. Frequency and costs of technical failures of clasp- and double crown-retained removable partial dentures. Clin Oral Investig 2002 Jun;6(2):104-108.
  37. An analysis of causes of fracture of acrylic resin dentures. J Prosthet Dent 1981 Sep;46(3):238-241.
  38. Evaluation of damage to removable dentures in two cities in Finland. Acta Odontol Scand 1993 Dec;51(6):363-369.
  39. Identification of complete denture problems: a summary. Br Dent J 2000 Aug 12;189(3):128-134.
  40. Khat: scientific knowledge and policy issues. Br J Addict 1987 Jan;82(1):47-53.
  41. Oral and paraoral lesion caused by Qat chewing [dissertation]. Sudan: University of Khartoum Faculty of Dentistry; 2002.
  42. Smokeless tobacco (Shammah) in Saudi Arabia: a review of its pattern of use, prevalence, and potential role in oral cancer. Asian Pac J Cancer Prev 2014;15(16):6477-6483.
  43. Smokeless tobacco (shamma) and oral cancer in Saudi Arabia. Community Dent Oral Epidemiol 1999 Dec;27(6):398-405.
  44. Characterization of Yemeni patients treated for oral and pharyngeal cancers in Saudi Arabia. Saudi Med J 2011 Nov;32(11):1177-1182.
  45. Genotoxicity of “shamma”, a chewing material suspected of causing oral cancer in Saudi Arabia. Mutat Res 1986 Jan-Feb;169(1-2):41-46.
  46. Leukoplakia and tobacco habits in Gizan, Saudi Arabia. Saudi Dent J 1992;4(2):50-54.
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