Abeer Almashraqi - Academia.edu (original) (raw)

Papers by Abeer Almashraqi

Clinical Oral Investigations

Objective This study evaluated the dimensional and positional osseous temporomandibular joint fea... more Objective This study evaluated the dimensional and positional osseous temporomandibular joint features in normodivergent facial patterns with and without temporomandibular disorders. Methods A total of 165 adult patients were divided into two groups: group 1 (n = 79 patients; 158 joints): temporomandibular disorders patients and group 2 (n = 86 patients; 172 joints): non-temporomandibular disorders patients. Three-dimensional positional and dimensional temporomandibular joint characteristics, including glenoid fossa, mandibular condyles, and joint spaces, were assessed by cone beam computed tomography. Results The glenoid fossa positions in the three orthogonal planes and height showed statistical significance between the two studied groups. The temporomandibular disorders patients showed higher horizontal and vertical condyle inclinations while anteroposterior inclination was less, and the condyle was positioned more superior, anterior, and lateral in the glenoid fossa. The condyle...

Clinical Oral Investigations

Clinical Oral Investigations

BMC Oral Health

BackgroundThree-dimensional (3D) detailed evaluations of the mandibular mediolateral position, ma... more BackgroundThree-dimensional (3D) detailed evaluations of the mandibular mediolateral position, mandibular condylar position, and temporomandibular joint (TMJ) spaces following stabilization splints (SS) therapy in patients with temporomandibular joint disorders (TMD) and mandibular deviation (MD) have not been reported in the available literature. Accordingly, this study aimed to three-dimensionally analyze the skeletal and bony temporomandibular joint changes following stabilization splint therapy in adult patients with temporomandibular joint disorders and mandibular deviation.MethodsThis study is a retrospective clinical study that enrolled 26 adult patients with TMD and MD with a mean age of 24.86 years. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was used to diagnose TMD. SS was adjusted weekly until occlusal contact stabilization occurred, and then adjusted monthly, patients were instructed to wear it at night for at least 10 h. The SS was removed after th...

Progress in Orthodontics

Background This study aimed to three-dimensionally evaluate the qualitative and quantitative maxi... more Background This study aimed to three-dimensionally evaluate the qualitative and quantitative maxillary basal, dentoalveolar, and dental dimensions in patients with unilateral or bilateral maxillary impacted canines relative to their normal peers. Materials and methods This is a retrospective comparative study. Cone-beam computed tomography images of one hundred and fifty adult patients were divided into three equal groups: unilateral, bilateral, and control groups. Each had 50 patients that were three-dimensionally analysed. The quantitative measurements involved three basal (molar basal width, premolar basal width, and arch depth), seven dentoalveolar (molar alveolar width, premolar alveolar width, inter-molar width, inter-premolar width, inter-canine width, arch length, and arch perimeter), and two dental (canine length and width) measurements. The qualitative measurements included four bone density areas (buccal, lingual, mesial, and distal) around the maxillary impacted canines....

BMC Oral Health

Background The goal of this systematic review was to assess the available evidence regarding the ... more Background The goal of this systematic review was to assess the available evidence regarding the skeletal and dentoalveolar effects of bi-maxillary skeletal anchorage devices (BMSADs) used in treating growing class II malocclusion patients. Methods A comprehensive search was conducted on PubMed, Scopus, Science Direct, Web of Science, Cochrane, and LILACS up to November 2021, which was augmented by a manual search. The studies included were clinical trials (RCTs) and/or follow-up observational studies (retrospective and prospective). The outcomes of interest were the skeletal, dentoalveolar, and occlusal treatment-induced changes obtained from pre- and post-cephalometric measurements. The risks of bias of the included studies were assessed using an assessment tool from previous publications. Results Out of 742 screened articles, only 4 were eligible and thus included in the qualitative synthesis. They showed a moderate overall risk of bias. The results are presented as mean changes ...

Advances in the Diagnosis of Coronary Atherosclerosis, 2011

X-rays are special types of electromagnetic radiation which can ionize matter. The interaction of... more X-rays are special types of electromagnetic radiation which can ionize matter. The interaction of radiation with tissue is dependent on the spectral distribution of the radiation as well as on the thickness, density, and atomic composition of the matter. Cardiac imaging systems use two forms of dynamic X-ray imaging: fluoroscopy and cineangiography. Fluoroscopy mode uses relatively low radiation dose levels and aids in the guidance and www.intechopen.com Advances in the Diagnosis of Coronary Atherosclerosis 346 positioning of medical devices within the patient. Cineangiography mode (shortly cine mode) is the acquisition of a series of high definition dynamic images. It is mainly used to image vessels injected with contrast media. The necessity of obtaining high contrast and sharp edge definition with low noise images requires higher radiation dose rates. The basic components of a fluoroscopic imaging chain are shown in Figure 1. The chain is composed by an X-ray tube and generator, which are capable to produce a stable X-ray output over long exposure times, a detector mounted opposite the X-ray tube, capable of dynamic imaging, digital image processing and storage facilities, and a display system capable for viewing real-time or recorded digital image series.

BMC Oral Health

Background This study aimed to evaluate three-dimensionally the factors associated with adjacent ... more Background This study aimed to evaluate three-dimensionally the factors associated with adjacent teeth root resorption of palatally impacted canines. Methods In this retrospective cross-sectional study, one-hundred and fourteen cone beam computed tomography scans with palatally impacted maxillary canines were evaluated for the presence of adjacent root resorption. Seven parameters were analyzed: alignment of maxillary incisors, presence of deciduous canines, first premolars’ roots configuration, impacted canines rotation, angulation of impacted canine to the midline, contact relationship, and area of contact with adjacent teeth. The association between dependent and independent qualitative and quantitative variables was analyzed using chi-square and independent student’s t-test, respectively. The multivariate analysis was performed using regression analysis. The significant value was set at P ≤ 0.05. Results The overall incidence of vertical, horizontal impaction and adjacent root r...

The Journal of Contemporary Dental Practice

Aim: This study sought to assess the fusion of spheno-occipital synchondrosis (SOS) in Chinese po... more Aim: This study sought to assess the fusion of spheno-occipital synchondrosis (SOS) in Chinese population using cone-beam computed tomography (CBCT). Materials and methods: This is a cross-sectional study in which data were randomly collected based on the pre-existing institutional records. Following selection criteria, the CBCT images of 500 patients aged 6-25 years (226 males and 274 females) were analyzed. Three-dimensional virtual models were oriented at a standardized position, then adjusted to the median sagittal plane (MSP) view. A four-stage scoring system was used; completely open, partially fused, semi-fused, or completely fused. The student's t-test, one-way ANOVA, Pearson correlation, and linear regression analysis were used and the significant level was set at ≤0.05.

Clinical Oral Investigations

OBJECTIVE Posterior teeth intrusion is one of the best treatment options for treatment of skeleta... more OBJECTIVE Posterior teeth intrusion is one of the best treatment options for treatment of skeletal open bite in adults; the surrounding anatomical landmarks are one of the restraining factors. This study aimed to assess the vertical relationship between the maxillary posterior teeth (MPT) and the maxillary sinus floor (MSF) in different facial growth patterns in the Chinese adult population. MATERIALS AND METHODS Cone beam computed tomography images of 298 patients, 145 males and 153 females aged between 20 and 45 years, were analyzed. Based on Jarabak ratio and the mandibular plane inclination, the sample was categorized into 94 hyperdivergent, 102 hypodivergent, and 102 normodivergent facial patterns subjects. The vertical relationship between the root-apex distances were classified as favorable, indicating no contact (type 1), or unfavorable, indicating roots in contact (type 2) for the posterior teeth intrusion. The relationship in the unfavorable group was subdivided into three subgroups (T2C, T2LC, and T2P). Comparative statistical tests were done related to age, gender, tooth side, and type of multiplanar view (sagittal and coronal). The significant level was set to be P < 0.05. RESULTS There was a statistically significant difference in the mean distance between both genders in the hyperdivergent group (P < 0.001). The measured distance increased with age in all tooth roots (P < 0.001). In both sagittal and coronal views, the most frequent root scores were type 1 and type 2p (54.2%, 27.5%) and (55.1%, 21.4%), respectively. The hyperdivergent group demonstrated a higher prevalence of type 2P (31.6% and 25.5%), whereas the hypodivergent group showed a lower prevalence (25.1% and 19.2%); furthermore, the second molar's mesiobuccal root in hyperdivergent patients showed the closest distance to the maxillary sinus in sagittal and coronal views, 0.3 ± 3.7 and 0.4 ± 3.1 mm, respectively. CONCLUSIONS Maxillary molars of hyperdivergent patients have the highest possible risk of root resorption due to the possible risk of cortical bone encroachment, while hypodivergent patients have the least possible risk. CLINICAL RELEVANCE Analysis of apex-sinus distances can be of great help for safe posterior teeth intrusion and providing correct and adequate treatment.

Clinical Oral Investigations

Head & Face Medicine

Background Understanding the anatomical relationship between the maxillary sinus floor (MSF) and ... more Background Understanding the anatomical relationship between the maxillary sinus floor (MSF) and the posterior maxillary teeth (PMT) is important when planning the orthodontic intrusion of the posterior teeth. This study aimed to determine the vertical relationship between posterior maxillary teeth and maxillary sinus floor in different skeletal classes in the Chinese adult population. Methods This is a retrospective cross-sectional study involved cone beam computed tomography images of 298 adult patients (145 males and 153 females) between 20 and 45 years old. The sample was categorized according to A point, Nasion, B point (ANB) angle into 102 Class I, 102 Class II, and 94 Class III malocclusion. Non-parametric Wilcoxon Mann–Whitney U and Kruskal–Wallis tests were used to compare the studied groups. The Intra-class Correlation Coefficient (ICC) was used to assess the intra- and inter-observer reliability analysis. Results Overall, there was a statistically significant difference i...

Obstructive sleep apnea (OSA) is a commonly seen disease characterized by apnea attacks during sl... more Obstructive sleep apnea (OSA) is a commonly seen disease characterized by apnea attacks during sleep due to chronic, repeated partial or complete obstruction of upper airway (1, 2). Apnea attacks, lasting more than 10 seconds, are usually spontaneously terminated by brief cortical arousals or awakenings which lead to excessive sleepiness during daytime (3). Impaired ventilatory control, low arousal threshold, hyporesponsive genioglossus muscle, anatomical abnormalities all contribute to the pathogenesis of the disease (4). The estimated incidence varies between 9-24% in females-males at ages between 30-50 years. However, it increases nearly to 50% in patients with severe obesity. Besides obesity and male gender; advanced age, chronic alcohol consumption and smoking are among the other factors that increase the risk (3). As a result, currently, more patients with diagnosed or undiagnosed OSA come to the operating theatre for several procedures. There are several screening tests such as ASA checklist, Belin questionnaire and STOP-Bang score. Polysomnography is the tool for definitive diagnosis and it also determines the severity of the disease. Apnea-hypopnea index (AHI=number of apnea/ hypopnea events per hour) 5-15 events/hour is defined as mild OSA, 15-30 events/hour as moderate OSA and AHI>30 events/hour as severe OSA (3). The lowest SpO 2 value, O 2 desaturation index, duration of O 2 desaturation, simultaneous cardiac changes could also give additional idea about severity of the disease (4). Perioperative safety of OSA patients is a matter of concern for anesthesiologists in many aspects. First of all, autonomic stimulation, due to chronic hypoxia and hypercarbia, leads to increased association with systemic and pulmonary hypertension, coronary artery disease, cerebrovascular accidents and type 2 diabetes mellitus (5, 6). Postoperative cardiopulmonary complications, such as atrial fibrillation, myocardial infarction, O 2 desaturation events, unplanned re-intubations, delirium and pneumonia are increased in OSA patients. Studies even relate OSA to the increased 30 days mortality (3). Higher prevalence of difficult airway is another major problem. Anesthesiologists should be aware of the risks, however delaying the surgery with complex and time-consuming tests for definitive diagnosis of OSA is not recommended due to insufficient evidence. STOP-Bang has been found as the most validated preoperative screening tool in surgical patients (7-9). STOP-Bang >4 or STOP ≥2 + BMI>35 kg/m 2 or male gender is associated with greater risk of OSA (3). Since it is an easy and fast applicable test, STOP-Bang should be considered for all possible cases during preoperative screening, and patients with suspected OSA should be approached with care as if they have diagnosed OSA. However, in case of uncontrolled or significant systemic disease or ventilation problems, the patients would benefit preoperative cardiopulmonary evaluation and optimization and CPAP therapy (3).

Diagnostics, 2021

The study sought to assess whether the soft tissue facial profile measurements of direct Cone Bea... more The study sought to assess whether the soft tissue facial profile measurements of direct Cone Beam Computed Tomography (CBCT) and wrapped CBCT images of non-standardized facial photographs are accurate compared to the standardized digital photographs. In this cross-sectional study, 60 patients with an age range of 18–30 years, who were indicated for CBCT, were enrolled. Two facial photographs were taken per patient: standardized and random (non-standardized). The non-standardized ones were wrapped with the CBCT images. The most used soft tissue facial profile landmarks/parameters (linear and angular) were measured on direct soft tissue three-dimensional (3D) images and on the photographs wrapped over the 3D-CBCT images, and then compared to the standardized photographs. The reliability analysis was performed using concordance correlation coefficients (CCC) and depicted graphically using Bland–Altman plots. Most of the linear and angular measurements showed high reliability (0.91 to ...

Journal of Oral Rehabilitation, 2020

BACKGROUND The social habit of chewing qat (also known as khat) is widely practiced in East Afric... more BACKGROUND The social habit of chewing qat (also known as khat) is widely practiced in East Africa and the Arabian Peninsula. It has been linked with various orofacial conditions, including temporomandibular joint disorders (TMD). OBJECTIVES This cross-sectional, comparative study sought to investigate the effects of qat chewing on temporomandibular joint (TMJ), using cone beam computerized tomography (CBCT). METHODS A total of 85 Yemeni males were included. The participants were divided into two groups: Qat chewers (QC; n= 41); and non-qat chewers (NQC; n= 44). Relevant data were obtained using a structured questionnaire and standardized clinical examination. Additionally, CBCT images of the TMJs were obtained, and then osteoarthritic changes and TMJ dimensions were analyzed. SPSS 21 was used for statistical analyses, with a significant level was set at 0.05. RESULTS Compared to NQC, a significantly higher proportion of QC presented with clinical signs of TMDs. The qualitative CBCT findings revealed significantly higher osteoarthritic changes in QC than in NQC: osteophyte (51.2% vs. 22.7%; P = 0.008), subcortical sclerosis (48.8% vs. 27.3%; P = 0.047), articular surface flattening (46.3% vs. 6.8%; P = 0.009), and subcortical cysts (43.9% vs. 4.5%; P < 0.001). However, CBCT quantitative findings (condylar dimensions) did not show significant differences between the two groups. The chewing side of the QC group showed slightly more changes compared to the non-chewing side. CONCLUSIONS The results demonstrate that qat chewing has detrimental effects on TMJ manifested mainly as osteoarthritic changes. Further large-scale studies are recommended.

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2020

OBJECTIVES This cross-sectional comparative study investigated the effects of qat chewing habit o... more OBJECTIVES This cross-sectional comparative study investigated the effects of qat chewing habit on the radiographic bone density (RBD) and trabecular microstructure of temporomandibular joint condyles using cone beam computed tomography (CBCT). STUDY DESIGN In total, 85 systemically healthy Yemeni males were included and divided into qat chewers (QCs; n = 41); and non-qat chewers (NQCs; n = 44). The participants responded to a structured questionnaire and underwent standardized clinical examination and CBCT scanning of the temporomandibular joint. Measurements of RBD and trabecular microstructure (trabecular thickness, trabecular separation, bone volume fraction, and fractal dimension) were performed. Statistical significance was established at P ≤ .05. RESULTS No statistically significant differences were found between QCs and NQCs in RBD or trabecular microstructure. The mean standard deviations and maximum values of trabecular separation on the nonchewing side for QCs were significantly lower compared to the corresponding values for NQCs (0.60 and 2.68 for QCs vs 0.72 and 3.05 for NQCs; P = .025 and .05, respectively). A comparison between chewing and nonchewing sides in QCs revealed no significant differences. CONCLUSIONS Qat chewing habit induces insignificant changes in condylar RBD and trabecular microstructure as detected by CBCT. Further studies using advanced radiographic techniques are warranted.

The Saudi Dental Journal, 2020

Objective To provide information on the prevalence and clinical features of impacted third molar ... more Objective To provide information on the prevalence and clinical features of impacted third molar teeth in the South-Western region of Saudi Arabia. Material and methods In this cross-sectional study, 1200 panoramic radiographs (50% males and 50% females) were retrieved from the electronic clinical records of patients at the College of Dentistry, Jazan University from December 2014 to December 2016, and impacted third molars were evaluated. Data on clinical and radiographic presentation were analyzed. Results Overall, there were 291 (24.3%) patients with impacted third molars among 1200 radiographs. The distribution of impacted third molars according to the number of impacted teeth was as follows: one impaction in 121 (41.6%); two impactions in 90 (30.9%); three impactions in 42 (14.4%); and four impactions in 38 (13.1%) patients. There was a high prevalence of all impaction types among females (54.5%). Maxillary vertical angulation was most common (50%) followed by mandibular mesioangular angulation (48.3%). The depth of impaction in maxillary teeth was higher than in mandibular teeth. Pain was uncommon (4.5% of patients). Discussion Clinically, vertical impaction in the maxilla was present in 50% of patients because of limited posterior space, and mesioangular angulation in the mandible was present in 48% of patients because of inadequate space between the ramus and the second molar. These findings are similar to other reports. Vertical impaction of the maxillary wisdom tooth is mostly related to the discrepancy between the mesiodistal size of the tooth crown and the limited retromolar space. Conclusion Noiseless presentation of an impacted third molar requires raising the population’s awareness about the need for diagnosis and treatment of the problem to avoid any further complications. The study can be to guide surgical procedures. This study documented the prevalence, pattern, and clinical features of impacted third molars in South Western region of Saudi Arabia.

CRANIO®, 2019

Objective: This study explored the effect of qat chewing (QC) on the lateral pterygoid muscle (LP... more Objective: This study explored the effect of qat chewing (QC) on the lateral pterygoid muscle (LPM), using magnetic resonance imaging (MRI).Methods: Forty qat chewers (QG), divided into three subgroups, according to duration of QC, and 20 non-qat chewers (NQG) were included. MRI sections were obtained to assess hypertrophy and atrophy of the superior belly (SB) and inferior belly (IB) of the LPM on the chewing and contralateral non-chewing side.Results: There was a significantly higher prevalence of atrophy of the IB (p < 0.001) and hypertrophy of the SB and IB (p = 0.002) in the QG. Hypertrophy of SB and IB was marked (p = 0.001) on the chewing side. Conversely, SB atrophy was marked on the non-chewing side (p = .003). MRI demonstrated a positive correlation between LPM alterations and the duration of QC in subgroup analysis.Conclusion: Unilateral QC might be a cause of LPM alterations.

Journal of Clinical and Experimental Dentistry, 2018

Background: The objective of this study was to assess the incidence, severity and orthodontic tre... more Background: The objective of this study was to assess the incidence, severity and orthodontic treatment difficulty of impacted maxillary canines in Saudi population. Material and Methods: This retrospective study included an investigation of panoramic radiographs for patients

Clinical Oral Investigations

Objective This study evaluated the dimensional and positional osseous temporomandibular joint fea... more Objective This study evaluated the dimensional and positional osseous temporomandibular joint features in normodivergent facial patterns with and without temporomandibular disorders. Methods A total of 165 adult patients were divided into two groups: group 1 (n = 79 patients; 158 joints): temporomandibular disorders patients and group 2 (n = 86 patients; 172 joints): non-temporomandibular disorders patients. Three-dimensional positional and dimensional temporomandibular joint characteristics, including glenoid fossa, mandibular condyles, and joint spaces, were assessed by cone beam computed tomography. Results The glenoid fossa positions in the three orthogonal planes and height showed statistical significance between the two studied groups. The temporomandibular disorders patients showed higher horizontal and vertical condyle inclinations while anteroposterior inclination was less, and the condyle was positioned more superior, anterior, and lateral in the glenoid fossa. The condyle...

Clinical Oral Investigations

Clinical Oral Investigations

BMC Oral Health

BackgroundThree-dimensional (3D) detailed evaluations of the mandibular mediolateral position, ma... more BackgroundThree-dimensional (3D) detailed evaluations of the mandibular mediolateral position, mandibular condylar position, and temporomandibular joint (TMJ) spaces following stabilization splints (SS) therapy in patients with temporomandibular joint disorders (TMD) and mandibular deviation (MD) have not been reported in the available literature. Accordingly, this study aimed to three-dimensionally analyze the skeletal and bony temporomandibular joint changes following stabilization splint therapy in adult patients with temporomandibular joint disorders and mandibular deviation.MethodsThis study is a retrospective clinical study that enrolled 26 adult patients with TMD and MD with a mean age of 24.86 years. The Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) was used to diagnose TMD. SS was adjusted weekly until occlusal contact stabilization occurred, and then adjusted monthly, patients were instructed to wear it at night for at least 10 h. The SS was removed after th...

Progress in Orthodontics

Background This study aimed to three-dimensionally evaluate the qualitative and quantitative maxi... more Background This study aimed to three-dimensionally evaluate the qualitative and quantitative maxillary basal, dentoalveolar, and dental dimensions in patients with unilateral or bilateral maxillary impacted canines relative to their normal peers. Materials and methods This is a retrospective comparative study. Cone-beam computed tomography images of one hundred and fifty adult patients were divided into three equal groups: unilateral, bilateral, and control groups. Each had 50 patients that were three-dimensionally analysed. The quantitative measurements involved three basal (molar basal width, premolar basal width, and arch depth), seven dentoalveolar (molar alveolar width, premolar alveolar width, inter-molar width, inter-premolar width, inter-canine width, arch length, and arch perimeter), and two dental (canine length and width) measurements. The qualitative measurements included four bone density areas (buccal, lingual, mesial, and distal) around the maxillary impacted canines....

BMC Oral Health

Background The goal of this systematic review was to assess the available evidence regarding the ... more Background The goal of this systematic review was to assess the available evidence regarding the skeletal and dentoalveolar effects of bi-maxillary skeletal anchorage devices (BMSADs) used in treating growing class II malocclusion patients. Methods A comprehensive search was conducted on PubMed, Scopus, Science Direct, Web of Science, Cochrane, and LILACS up to November 2021, which was augmented by a manual search. The studies included were clinical trials (RCTs) and/or follow-up observational studies (retrospective and prospective). The outcomes of interest were the skeletal, dentoalveolar, and occlusal treatment-induced changes obtained from pre- and post-cephalometric measurements. The risks of bias of the included studies were assessed using an assessment tool from previous publications. Results Out of 742 screened articles, only 4 were eligible and thus included in the qualitative synthesis. They showed a moderate overall risk of bias. The results are presented as mean changes ...

Advances in the Diagnosis of Coronary Atherosclerosis, 2011

X-rays are special types of electromagnetic radiation which can ionize matter. The interaction of... more X-rays are special types of electromagnetic radiation which can ionize matter. The interaction of radiation with tissue is dependent on the spectral distribution of the radiation as well as on the thickness, density, and atomic composition of the matter. Cardiac imaging systems use two forms of dynamic X-ray imaging: fluoroscopy and cineangiography. Fluoroscopy mode uses relatively low radiation dose levels and aids in the guidance and www.intechopen.com Advances in the Diagnosis of Coronary Atherosclerosis 346 positioning of medical devices within the patient. Cineangiography mode (shortly cine mode) is the acquisition of a series of high definition dynamic images. It is mainly used to image vessels injected with contrast media. The necessity of obtaining high contrast and sharp edge definition with low noise images requires higher radiation dose rates. The basic components of a fluoroscopic imaging chain are shown in Figure 1. The chain is composed by an X-ray tube and generator, which are capable to produce a stable X-ray output over long exposure times, a detector mounted opposite the X-ray tube, capable of dynamic imaging, digital image processing and storage facilities, and a display system capable for viewing real-time or recorded digital image series.

BMC Oral Health

Background This study aimed to evaluate three-dimensionally the factors associated with adjacent ... more Background This study aimed to evaluate three-dimensionally the factors associated with adjacent teeth root resorption of palatally impacted canines. Methods In this retrospective cross-sectional study, one-hundred and fourteen cone beam computed tomography scans with palatally impacted maxillary canines were evaluated for the presence of adjacent root resorption. Seven parameters were analyzed: alignment of maxillary incisors, presence of deciduous canines, first premolars’ roots configuration, impacted canines rotation, angulation of impacted canine to the midline, contact relationship, and area of contact with adjacent teeth. The association between dependent and independent qualitative and quantitative variables was analyzed using chi-square and independent student’s t-test, respectively. The multivariate analysis was performed using regression analysis. The significant value was set at P ≤ 0.05. Results The overall incidence of vertical, horizontal impaction and adjacent root r...

The Journal of Contemporary Dental Practice

Aim: This study sought to assess the fusion of spheno-occipital synchondrosis (SOS) in Chinese po... more Aim: This study sought to assess the fusion of spheno-occipital synchondrosis (SOS) in Chinese population using cone-beam computed tomography (CBCT). Materials and methods: This is a cross-sectional study in which data were randomly collected based on the pre-existing institutional records. Following selection criteria, the CBCT images of 500 patients aged 6-25 years (226 males and 274 females) were analyzed. Three-dimensional virtual models were oriented at a standardized position, then adjusted to the median sagittal plane (MSP) view. A four-stage scoring system was used; completely open, partially fused, semi-fused, or completely fused. The student's t-test, one-way ANOVA, Pearson correlation, and linear regression analysis were used and the significant level was set at ≤0.05.

Clinical Oral Investigations

OBJECTIVE Posterior teeth intrusion is one of the best treatment options for treatment of skeleta... more OBJECTIVE Posterior teeth intrusion is one of the best treatment options for treatment of skeletal open bite in adults; the surrounding anatomical landmarks are one of the restraining factors. This study aimed to assess the vertical relationship between the maxillary posterior teeth (MPT) and the maxillary sinus floor (MSF) in different facial growth patterns in the Chinese adult population. MATERIALS AND METHODS Cone beam computed tomography images of 298 patients, 145 males and 153 females aged between 20 and 45 years, were analyzed. Based on Jarabak ratio and the mandibular plane inclination, the sample was categorized into 94 hyperdivergent, 102 hypodivergent, and 102 normodivergent facial patterns subjects. The vertical relationship between the root-apex distances were classified as favorable, indicating no contact (type 1), or unfavorable, indicating roots in contact (type 2) for the posterior teeth intrusion. The relationship in the unfavorable group was subdivided into three subgroups (T2C, T2LC, and T2P). Comparative statistical tests were done related to age, gender, tooth side, and type of multiplanar view (sagittal and coronal). The significant level was set to be P < 0.05. RESULTS There was a statistically significant difference in the mean distance between both genders in the hyperdivergent group (P < 0.001). The measured distance increased with age in all tooth roots (P < 0.001). In both sagittal and coronal views, the most frequent root scores were type 1 and type 2p (54.2%, 27.5%) and (55.1%, 21.4%), respectively. The hyperdivergent group demonstrated a higher prevalence of type 2P (31.6% and 25.5%), whereas the hypodivergent group showed a lower prevalence (25.1% and 19.2%); furthermore, the second molar's mesiobuccal root in hyperdivergent patients showed the closest distance to the maxillary sinus in sagittal and coronal views, 0.3 ± 3.7 and 0.4 ± 3.1 mm, respectively. CONCLUSIONS Maxillary molars of hyperdivergent patients have the highest possible risk of root resorption due to the possible risk of cortical bone encroachment, while hypodivergent patients have the least possible risk. CLINICAL RELEVANCE Analysis of apex-sinus distances can be of great help for safe posterior teeth intrusion and providing correct and adequate treatment.

Clinical Oral Investigations

Head & Face Medicine

Background Understanding the anatomical relationship between the maxillary sinus floor (MSF) and ... more Background Understanding the anatomical relationship between the maxillary sinus floor (MSF) and the posterior maxillary teeth (PMT) is important when planning the orthodontic intrusion of the posterior teeth. This study aimed to determine the vertical relationship between posterior maxillary teeth and maxillary sinus floor in different skeletal classes in the Chinese adult population. Methods This is a retrospective cross-sectional study involved cone beam computed tomography images of 298 adult patients (145 males and 153 females) between 20 and 45 years old. The sample was categorized according to A point, Nasion, B point (ANB) angle into 102 Class I, 102 Class II, and 94 Class III malocclusion. Non-parametric Wilcoxon Mann–Whitney U and Kruskal–Wallis tests were used to compare the studied groups. The Intra-class Correlation Coefficient (ICC) was used to assess the intra- and inter-observer reliability analysis. Results Overall, there was a statistically significant difference i...

Obstructive sleep apnea (OSA) is a commonly seen disease characterized by apnea attacks during sl... more Obstructive sleep apnea (OSA) is a commonly seen disease characterized by apnea attacks during sleep due to chronic, repeated partial or complete obstruction of upper airway (1, 2). Apnea attacks, lasting more than 10 seconds, are usually spontaneously terminated by brief cortical arousals or awakenings which lead to excessive sleepiness during daytime (3). Impaired ventilatory control, low arousal threshold, hyporesponsive genioglossus muscle, anatomical abnormalities all contribute to the pathogenesis of the disease (4). The estimated incidence varies between 9-24% in females-males at ages between 30-50 years. However, it increases nearly to 50% in patients with severe obesity. Besides obesity and male gender; advanced age, chronic alcohol consumption and smoking are among the other factors that increase the risk (3). As a result, currently, more patients with diagnosed or undiagnosed OSA come to the operating theatre for several procedures. There are several screening tests such as ASA checklist, Belin questionnaire and STOP-Bang score. Polysomnography is the tool for definitive diagnosis and it also determines the severity of the disease. Apnea-hypopnea index (AHI=number of apnea/ hypopnea events per hour) 5-15 events/hour is defined as mild OSA, 15-30 events/hour as moderate OSA and AHI>30 events/hour as severe OSA (3). The lowest SpO 2 value, O 2 desaturation index, duration of O 2 desaturation, simultaneous cardiac changes could also give additional idea about severity of the disease (4). Perioperative safety of OSA patients is a matter of concern for anesthesiologists in many aspects. First of all, autonomic stimulation, due to chronic hypoxia and hypercarbia, leads to increased association with systemic and pulmonary hypertension, coronary artery disease, cerebrovascular accidents and type 2 diabetes mellitus (5, 6). Postoperative cardiopulmonary complications, such as atrial fibrillation, myocardial infarction, O 2 desaturation events, unplanned re-intubations, delirium and pneumonia are increased in OSA patients. Studies even relate OSA to the increased 30 days mortality (3). Higher prevalence of difficult airway is another major problem. Anesthesiologists should be aware of the risks, however delaying the surgery with complex and time-consuming tests for definitive diagnosis of OSA is not recommended due to insufficient evidence. STOP-Bang has been found as the most validated preoperative screening tool in surgical patients (7-9). STOP-Bang >4 or STOP ≥2 + BMI>35 kg/m 2 or male gender is associated with greater risk of OSA (3). Since it is an easy and fast applicable test, STOP-Bang should be considered for all possible cases during preoperative screening, and patients with suspected OSA should be approached with care as if they have diagnosed OSA. However, in case of uncontrolled or significant systemic disease or ventilation problems, the patients would benefit preoperative cardiopulmonary evaluation and optimization and CPAP therapy (3).

Diagnostics, 2021

The study sought to assess whether the soft tissue facial profile measurements of direct Cone Bea... more The study sought to assess whether the soft tissue facial profile measurements of direct Cone Beam Computed Tomography (CBCT) and wrapped CBCT images of non-standardized facial photographs are accurate compared to the standardized digital photographs. In this cross-sectional study, 60 patients with an age range of 18–30 years, who were indicated for CBCT, were enrolled. Two facial photographs were taken per patient: standardized and random (non-standardized). The non-standardized ones were wrapped with the CBCT images. The most used soft tissue facial profile landmarks/parameters (linear and angular) were measured on direct soft tissue three-dimensional (3D) images and on the photographs wrapped over the 3D-CBCT images, and then compared to the standardized photographs. The reliability analysis was performed using concordance correlation coefficients (CCC) and depicted graphically using Bland–Altman plots. Most of the linear and angular measurements showed high reliability (0.91 to ...

Journal of Oral Rehabilitation, 2020

BACKGROUND The social habit of chewing qat (also known as khat) is widely practiced in East Afric... more BACKGROUND The social habit of chewing qat (also known as khat) is widely practiced in East Africa and the Arabian Peninsula. It has been linked with various orofacial conditions, including temporomandibular joint disorders (TMD). OBJECTIVES This cross-sectional, comparative study sought to investigate the effects of qat chewing on temporomandibular joint (TMJ), using cone beam computerized tomography (CBCT). METHODS A total of 85 Yemeni males were included. The participants were divided into two groups: Qat chewers (QC; n= 41); and non-qat chewers (NQC; n= 44). Relevant data were obtained using a structured questionnaire and standardized clinical examination. Additionally, CBCT images of the TMJs were obtained, and then osteoarthritic changes and TMJ dimensions were analyzed. SPSS 21 was used for statistical analyses, with a significant level was set at 0.05. RESULTS Compared to NQC, a significantly higher proportion of QC presented with clinical signs of TMDs. The qualitative CBCT findings revealed significantly higher osteoarthritic changes in QC than in NQC: osteophyte (51.2% vs. 22.7%; P = 0.008), subcortical sclerosis (48.8% vs. 27.3%; P = 0.047), articular surface flattening (46.3% vs. 6.8%; P = 0.009), and subcortical cysts (43.9% vs. 4.5%; P < 0.001). However, CBCT quantitative findings (condylar dimensions) did not show significant differences between the two groups. The chewing side of the QC group showed slightly more changes compared to the non-chewing side. CONCLUSIONS The results demonstrate that qat chewing has detrimental effects on TMJ manifested mainly as osteoarthritic changes. Further large-scale studies are recommended.

Oral Surgery, Oral Medicine, Oral Pathology and Oral Radiology, 2020

OBJECTIVES This cross-sectional comparative study investigated the effects of qat chewing habit o... more OBJECTIVES This cross-sectional comparative study investigated the effects of qat chewing habit on the radiographic bone density (RBD) and trabecular microstructure of temporomandibular joint condyles using cone beam computed tomography (CBCT). STUDY DESIGN In total, 85 systemically healthy Yemeni males were included and divided into qat chewers (QCs; n = 41); and non-qat chewers (NQCs; n = 44). The participants responded to a structured questionnaire and underwent standardized clinical examination and CBCT scanning of the temporomandibular joint. Measurements of RBD and trabecular microstructure (trabecular thickness, trabecular separation, bone volume fraction, and fractal dimension) were performed. Statistical significance was established at P ≤ .05. RESULTS No statistically significant differences were found between QCs and NQCs in RBD or trabecular microstructure. The mean standard deviations and maximum values of trabecular separation on the nonchewing side for QCs were significantly lower compared to the corresponding values for NQCs (0.60 and 2.68 for QCs vs 0.72 and 3.05 for NQCs; P = .025 and .05, respectively). A comparison between chewing and nonchewing sides in QCs revealed no significant differences. CONCLUSIONS Qat chewing habit induces insignificant changes in condylar RBD and trabecular microstructure as detected by CBCT. Further studies using advanced radiographic techniques are warranted.

The Saudi Dental Journal, 2020

Objective To provide information on the prevalence and clinical features of impacted third molar ... more Objective To provide information on the prevalence and clinical features of impacted third molar teeth in the South-Western region of Saudi Arabia. Material and methods In this cross-sectional study, 1200 panoramic radiographs (50% males and 50% females) were retrieved from the electronic clinical records of patients at the College of Dentistry, Jazan University from December 2014 to December 2016, and impacted third molars were evaluated. Data on clinical and radiographic presentation were analyzed. Results Overall, there were 291 (24.3%) patients with impacted third molars among 1200 radiographs. The distribution of impacted third molars according to the number of impacted teeth was as follows: one impaction in 121 (41.6%); two impactions in 90 (30.9%); three impactions in 42 (14.4%); and four impactions in 38 (13.1%) patients. There was a high prevalence of all impaction types among females (54.5%). Maxillary vertical angulation was most common (50%) followed by mandibular mesioangular angulation (48.3%). The depth of impaction in maxillary teeth was higher than in mandibular teeth. Pain was uncommon (4.5% of patients). Discussion Clinically, vertical impaction in the maxilla was present in 50% of patients because of limited posterior space, and mesioangular angulation in the mandible was present in 48% of patients because of inadequate space between the ramus and the second molar. These findings are similar to other reports. Vertical impaction of the maxillary wisdom tooth is mostly related to the discrepancy between the mesiodistal size of the tooth crown and the limited retromolar space. Conclusion Noiseless presentation of an impacted third molar requires raising the population’s awareness about the need for diagnosis and treatment of the problem to avoid any further complications. The study can be to guide surgical procedures. This study documented the prevalence, pattern, and clinical features of impacted third molars in South Western region of Saudi Arabia.

CRANIO®, 2019

Objective: This study explored the effect of qat chewing (QC) on the lateral pterygoid muscle (LP... more Objective: This study explored the effect of qat chewing (QC) on the lateral pterygoid muscle (LPM), using magnetic resonance imaging (MRI).Methods: Forty qat chewers (QG), divided into three subgroups, according to duration of QC, and 20 non-qat chewers (NQG) were included. MRI sections were obtained to assess hypertrophy and atrophy of the superior belly (SB) and inferior belly (IB) of the LPM on the chewing and contralateral non-chewing side.Results: There was a significantly higher prevalence of atrophy of the IB (p < 0.001) and hypertrophy of the SB and IB (p = 0.002) in the QG. Hypertrophy of SB and IB was marked (p = 0.001) on the chewing side. Conversely, SB atrophy was marked on the non-chewing side (p = .003). MRI demonstrated a positive correlation between LPM alterations and the duration of QC in subgroup analysis.Conclusion: Unilateral QC might be a cause of LPM alterations.

Journal of Clinical and Experimental Dentistry, 2018

Background: The objective of this study was to assess the incidence, severity and orthodontic tre... more Background: The objective of this study was to assess the incidence, severity and orthodontic treatment difficulty of impacted maxillary canines in Saudi population. Material and Methods: This retrospective study included an investigation of panoramic radiographs for patients