Aim: This study aimed to compare the best restorative approach for the conservative class I cavity by comparing flowable and nanohybrid composites versus the placement technique regarding surface microhardness, porosity, and presence of interface gaps. Materials and methods: Forty human molars were divided into four groups (n = 10). Standardized class I cavities were prepared and restored using one of the following materials: Group I – Flowable composite placed by incremental technique; group II – Flowable composite placed in one increment; group III – Nanohybrid composite placed by incremental technique; and group IV – Nano-hybrid composite placed in one increment. After finishing and polishing, specimens were sectioned into two halves. One section was chosen randomly for the Vickers microhardness (HV) evaluation and the other section was used for the assessment of porosities and interfacial adaptation (IA). Results: The surface microhardness range was 28.5–76.2 (p < 0.05), mean pulpal microhardness range was 27.6–74.4 (p < 0.05). Flowable composites had lower HV than conventional counterparts. The mean pulpal HV of all materials exceeded 80% of occlusal HV. Restorative approaches did not statistically differ in porosities. However, IA percentages were higher in flowable materials compared to nanocomposites. Conclusion: Flowable resin composite materials have lower microhardness than Nanohybrid composites. In small class I cavities, the number of porosities was similar between the different placement techniques and the interfacial gaps were highest in the flowable composites. Clinical significance: The use of nanohybrid resin composite to restore class I cavities will result in better hardness and less interfacial gaps compared to flowable composites.

Aim: The goal of this research was to compare radiographically the outcomes of hydraulic transcrestal sinus lifting with platelet-rich fibrin (PRF) or normal saline filling on implant survival rates, negative outcomes, and variations in the height of residual alveolar ridge (HARB). Materials and methods: There were 80 study participants included and 90 dental implants were placed. The study participants were divided into two categories: Category A and Category B. Each category consists of 40 study participants. Category A: Normal saline was placed in the maxillary sinus. Category B: PRF was placed in the maxillary sinus. Implant survival, complications, and HARB alterations were the outcome metrics. Radiographic images through Cone-beam computed tomography (CBCT) were retrieved and compared prior to surgery (T0), immediately following surgery (T1), three months later (T2), 6 months later (T3), and 12 months later (T4). Results: There are 90 implants having an average length of 10.5 ± 0.7 mm were inserted into the posterior portion of the maxilla of 80 patients with an average HARB of 6.9 ± 1.2 mm. At T1, elevation in HARB peaked, and the sinus membrane continued to droop but steadied while observed at T3. The steady increment of areas of radiopacities was noticed below the elevated membrane of the maxillary antrum. A radiographic intrasinus bone increase of 2.9 ± 1.4 mm was caused by the PRF filling, compared to 1.8 ± 1.1 mm by the saline filling at T4 (p < 0.05). Over the course of the one-year follow-up period, all of the implants were operating normally with no major issues. Conclusion: Platelet-rich fibrin when used as a filling medium alone without bone graft can cause significant ascend in height of the residual alveolar bone (HRAB). Clinical significance: The degradation of the alveolar bone under the maxillary sinus following tooth loss frequently restricts the placement of the implant in the edentulous region of posterior maxilla. Numerous sinus-lifting surgery procedures and tools have been developed to address these problems. It has been a topic of debate regarding the benefits of bone grafts placed at the apical region of the implant. The sharp protrusions of the granules of bone graft may also provide a danger of membrane puncture. Recently, it was shown that regular bone gain might occur inside the maxillary antrum without the use of any bone transplant material. Additionally, if there were substances that filled the gap between the floor of the sinus and the raised sinus membrane, then the membrane of the maxillary sinus could be raised greater and for a longer period of time during the phase of formation of new bone formation.

Aim: The goal of this research was to compare the stress distribution in the bone adjacent to the implant where three different angled abutments were loaded in both the axial and oblique directions. Materials and methods: The premaxilla region was digitally recreated in 3-dimension (3D) using a finite element model, with a solid 4.2 mm by 13 mm implant and abutments at 0°, 15°, and 25° of rotation. Axial load (100 N) and oblique load were also applied to the abutments (178 N). Six models were made and used with a fixed bases. The coefficient of friction was set at a constant value of 0.02. The CITIA program was used for the stress analysis. In this investigation, we employed linear static analysis. Each abutment and crown in the model has subjected to an arbitrary vertical load as well as the oblique load. Results: The cortical bone around the implant with a 25° angled abutment experienced a maximum von Mises stress of 187.692 Mpa under oblique load. This stress was increased with the degree of abutment angulation. Conclusion: As abutment angulation was increased, axial and oblique burdens were also increased. In both cases, we were able to identify the source of the observed growth. When we looked at the effect of stress on angulation, we found that the peaks were seen in the area of abutment and cortical bone. Since it was difficult to predict the stress distribution around implants with varying abutment angles in a clinical setting, finite element analysis (FEA) was chosen for this investigation as a more cutting-edge approach. Clinical significance: It is a herculean task calculating the prompted forces clinically, FEA has opted for this study as it's a progressively wielded tool to prognosticate the stress allocation in the region of the implants with different angled abutments.

Aim: This retrospective study aimed to compare and evaluate the pattern of maxillary canine impaction and its association with other anomalies using cone–beam computed tomography (CBCT). Methods: A total of 59 CBCT records of patients (ages 12 and up) were divided into two groups: A total of 35 subjects with unilateral canine impactions and 24 subjects with bilateral canine impactions. The CBCT data were analyzed for the measurement of qualitative and quantitative variables. Results: In unilateral canine impaction, the mesiodistal (MD) width of the central incisors and the nasal cavity (NC) width were wider (p < 0.05). The canine–palatal plane (U3-PP) distance was significantly longer in bilateral canine impaction (p < 0.05). The distance of the impacted canines from the palatal and mid-sagittal planes, the anterior dental arch width, and the maxillary skeletal width changed significantly with the position of the impacted canines (p < 0.05). Males had 0.185 odds of presenting with a bilateral canine impaction as compared to females (p = 0.025). The odds of having bilateral canine impaction with a longer canine-midsagittal plane (U3-MSP) distance was 1.30 (p = 0.003). Conclusion: The findings indicate a gender predilection with females showing a greater prevalence of bilateral canine impaction. Supernumerary teeth were associated with unilateral impacted canines and lower canine impaction with bilaterally impacted canines. Clinical significance: Anomalies in the form of the maxillary central and lateral incisors, distance from the maxillary canine to the palatal plane and the mid-sagittal plane, NC width, maxillary skeletal width, and gender, are the best discriminating parameters between unilateral and bilateral canine impactions.

Aim: The aim of the current study was to compare the esthetic results for subjects with Miller Class I and II gingival recession (GR) abnormalities using platelet-rich fibrin (PRF) membrane with coronal advanced flaps (CAFs) with and without vertical releasing incisions (VRIs; the envelope-type flap and the flap with VRIs). Materials and methods: Seven defects from each of the test and control groups made up of fourteen defects total. In the test group, PRF + CAF was performed without VRI, while in the control group, VRI was used. Gain in root coverage was the main result, with secondary results including papillary bleeding index (PBI), plaque index (PI), relative gingival margin level, relative attachment level, probing pocket depth, recession depth, width of keratinized gingiva (WKG), and gingival thickness. After 3 months of therapy, a clinical evaluation was conducted. Results: No significant difference was observed between the two groups in terms of recession reduction (2.08 ± 0.5 vs 1.91 ± 0.66 mm), clinical attachment level (CAL) gain (2.08 ± 0.5 vs 1.91 ± 0.66 mm), and increase in WKG (2.66 ± 0.88 vs 2.58 ± 0.51 mm) for test and control groups, respectively. Conclusion: For the treatment of GR, both groups are efficient. However, the CAF + PRF without VRI group showed higher patient compliance and lower postoperative morbidity. Clinical relevance: The PRF membrane with CAF with or without VRI provide effective treatment option for GR. CAF + PRF without VRI is easy to perform and has less postoperative complications.

Aim: This study aimed to evaluate the root canal anatomy of maxillary second premolars, and its relation to the maxillary sinus in a Saudi Arabian population using cone-beam computed tomography. Materials and methods: Records of 301 patients (602 Teeth) were obtained from a Cone-beam Computed Tomography Database of the College of Dentistry, Jazan University from February 2020 to January 2022. The number of roots, root canals, and the relationship between the root apices of maxillary second premolars and the floor of the maxillary sinuses were studied. The data was recorded, tabulated, and statistically analyzed. Results: A majority of maxillary second premolars were single-rooted (78.74%), followed by double-rooted (20.76%) and three-rooted (0.5%). Two canals (59.1%) were seen in the majority of the examined teeth, followed by one canal (40.4%) and three canals (0.5%). The roots of the maxillary second premolars were predominantly (69.17%) outside the sinus. Nineteen percent of roots were in contact with the floor of the maxillary sinus with no significant difference between buccal and palatal roots, and around twelve percent (11.73%) of roots were inside the maxillary sinus. Conclusions: The root canal system morphology of maxillary second premolars showed a wide range of anatomical variations in the Saudi Arabian population with a predominance of single roots. Most of the roots were located outside the sinus followed by in contact and then inside the sinus. Three-rooted second premolars were exceedingly rare. Clinical significance: The cognizance of maxillary second premolar root canal anatomy and its relation to maxillary sinus would be a valuable affirmation for dentists of different nationalities treating the Saudi Arabian population to ensure a successful endodontic treatment.

Aim: The aim of this web-based questionnaire was to survey dental students to obtain their perception and knowledge of oral and facial piercings. Materials and methods: The participants comprised 240 students enrolled in the dental school who were asked to complete 20 close-ended, yes/no, yes/no/do not know, and multiple responses questions. The questionnaire covers general information concerning oral/facial piercing, triggers why youths and early adults get it, probable complications, their appreciation of the possibility of related health conditions, and their knowledge and perception. The survey was distributed to the students by email. The results were tabulated and statistically analyzed. Results: Dental first year (D1) and dental second year (D2) were substantially more likely to indicate that orofacial piercings as unacceptable and are less expected to have an orofacial piercing compared to D3 and D4 (p < 0.01). About 16.8% of the students reported previous orofacial piercings. There was a definite correlation between previous orofacial piercings and thinking that is appropriate in society (p < 0.05). Males were significantly more likely to have an orofacial piercing (p < 0.01). The Internet was reported as the most common source of information. The most popular cause for piercings is to be unique and different. Conclusions: Orofacial piercings are relatively frequently used by students in dental school and few students intend on getting one in the future. Knowledge of the hazards of orofacial piercing correlated with the requirement for parental approval. The majority of students think piercings are appropriate in society and know their complications and risks. Clinical significance: Orofacial piercing has been gaining popularity but its risks/complications may not be known by practitioners. There is a need for research to assist dental/medical practitioners in advising, educating, and safeguarding patients by evaluating of the perception and knowledge of students about orofacial piercings.

Aim: Since there is a lack of data on dentofacial esthetic perception in Saudi Arabia, the present research was conducted to study children's and their parent's perceptions of smiles with different dental alignments and dental appearances. In addition, we aimed to determine whether facial attractiveness or dental esthetic dominates the overall esthetic perception. Finally, we aimed to investigate the influence of gender on the judgment of a dental smile. Materials and methods: Six digitally altered photographs and two dynamic videos of smiling faces of boys and girls with different dental alignments and appearances were shown to 183 children and their parents in malls in Saudi Arabia's Qassim Province. Following the parent's acceptance of the interview, the child was interviewed first, followed by the parent. Their responses were measured using a smile perception questionnaire (SPQ) for children aged 8–10 years. Data were analyzed using the Kruskal–Wallis one-way analysis of variance (ANOVA) and the Wilcoxon signed-rank test. Results: The results demonstrated that whole-face smiles of both boys and girls with different poor dentofacial esthetics had a significantly lower rating score than lower third-face smiles scores among children and their parents (p ≤ 0.05). Except for a few views, there were no significant differences between children's and their parents’ dentofacial esthetic judgments. Moreover, the answers to the smile perception questionnaire 8–10 for the smiling face dynamic videos of boys and girls were not significantly different. Conclusion: Children agreed with their parents in judging the smiles of different dentofacial esthetic perceptions. Overall, esthetics was more influenced by facial esthetics than dental esthetics. Background attractiveness and sexual characteristics do not affect smile perception. Clinical significance: The smile is considered one of the major determinants of how the overall esthetic of children will appear. Thus, the comprehensive diagnosis involving the analysis of malocclusion and poor dental appearance psychological effect can be used for patient care improvement. Consequently, dental treatment to improve the dental smile will enhance the children's quality of life and social interaction.

Aim: The aim of this study is to evaluate and compare the impact strength of conventional acrylic resin, high-impact acrylic resin, high-impact acrylic resin reinforced with silver nanoparticles, and high-impact acrylic resin reinforced with a zirconium oxide powder. Materials and methods: A total of 60 samples were prepared of dimensions 60 mm length × 7 mm width × 4 mm thickness to test impact strength. Machined stainless steel dies of the same dimension were used to form molds for the fabrication of these samples. Of 60 samples, 15 samples were prepared each from conventional acrylic resin (Group A1), high-impact acrylic resin (Group A2), acrylic resin reinforced with silver nanoparticles (Group A3), and acrylic resin reinforced with zirconium oxide powder (Group A4). Izod-Charpy pendulum impact testing machine was used. Results: The impact strength of group A1 was in the range of 2.83–3.30 kJ/m² (M = 3.12 kJ/m², SD = 0.16), group A2 was in range of 5.10– 5.78 kJ/m² (M = 5.51 kJ/m², SD = 0.18), group A3 was in range 3.18–3.56 kJ/m² (M = 3.37 kJ/m², SD = 0.11), and group A4 was in range 7.18– 7.78 kJ/m² (M = 7.5 kJ/m², SD = 0.18). Statistical analysis using one-way ANOVA and t-test revealed significant differences (p < 0.001). Conclusion: High-impact acrylic resin reinforced with zirconium oxide powder has the highest impact strength. Clinical significance: This research sheds light on the usefulness of novel filler materials in clinical prosthodontics.

Aim: To understand the role of Artificial intelligence (AI) in oral radiology and its applications. Background: Over the last two decades, the field of AI has undergone phenomenal progression and expansion. Artificial intelligence applications have taken up new roles in dentistry like digitized data acquisition and machine learning and diagnostic applications. Materials and methods: All research papers outlining the population, intervention, control, and outcomes (PICO) questions were searched for in PubMed, ERIC, Embase, CINAHL, database from the last 10 years on first January 2023. Two authors independently reviewed the titles and abstracts of the selected studies, and any discrepancy between the two review authors was handled by a third reviewer. Two independent investigators evaluated all the included studies for the quality assessment using the modified tool for the quality assessment of diagnostic accuracy studies (QUADAS- 2). Review results: After the removal of duplicates and screening of titles and abstracts, 18 full texts were agreed upon for further evaluation, of which 14 that met the inclusion criteria were included in this review. The application of artificial intelligence models has primarily been reported on osteoporosis diagnosis, classification/segmentation of maxillofacial cysts and/or tumors, and alveolar bone resorption. Overall study quality was deemed to be high for two (14%) studies, moderate for six (43%) studies, and low for another six (43%) studies. Conclusion: The use of AI for patient diagnosis and clinical decision-making can be accomplished with relative ease, and the technology should be regarded as a reliable modality for potential future applications in oral diagnosis.