The incidence of periodontal diseases is associated with multiple comorbidities that influence a patient’s treatment planning. This study evaluates the relation between periodontal disease and multiple comorbidities reported in the Saudi population from the Eastern province. This study was conducted on 190 patients, who visited the periodontology clinics at Imam Abdulrahman Bin Faisal University, Saudi Arabia. Demographic data, smoking habits, past medical and dental histories, blood pressure, random blood glucose, and recent haemoglobin A1c were recorded. A comprehensive periodontal examination included the number of missing teeth, pocket depth (PD), clinical attachment level (CAL), bleeding on probing (BOP), and mobility of all teeth except third molars. Radiographic bone loss was measured on standardized full‐mouth periapical radiographs. Multivariable regression models were calculated aiming to see the association between different comorbidities and alveolar bone loss with confounders controlled. Out of 190 periodontitis patients, 56 (29.5%) were males and 134 (70.5%) were females. More than half of the patients (60%) were between 26 and 50 years, 30% of them had diabetes, and 18% were smokers. The risk of alveolar bone loss was higher in persons who had diabetes and those who had both diabetes and coronary heart disease than those who did not, although the association was not statistically significant (B = 1.26, 95%CI = −0.30, 2.82, and B = 2.86, 95%CI = −1.25, 6.96, respectively). The risk of alveolar bone loss was significantly higher among persons with diabetes and hypertension (B = 2.82 and 95%CI = 0.89, 4.75). Collectively, the risk of alveolar bone loss in periodontitis patients increases with diabetes in the presence of other comorbidities regardless of smoking or gender.

Background: Early childhood caries (ECC) is a public health problem, especially in developing countries like Egypt which has an ECC prevalence of 74%. This research aimed to assess the risk indicators associated with ECC in a rural, socially-disadvantaged population in Alexandria, Egypt.Methods: A case-control study was conducted in 8 nurseries of preschool children aged 3 to 5 years in rural, deprived areas in Alexandria, Egypt, from October 2019 till January 2020. Two groups, 93 with ECC and 93 without ECC. A validated questionnaire was used to collect sociodemographic data including age, sex, number of siblings, socioeconomic status, oral health practices including toothbrushing frequency, pattern of dental visits, daily frequency of sugary snacks. Also, salivary pH and buffering capacity were assessed. A trained and calibrated dentist assessed caries status clinically according to the World Health Organization (WHO) criteria using the dmft index and oral hygiene status using Silness and Loe Plaque Index. Chi-squared test, followed by multivariable logistic regression were performed to assess the relation between independent variables and ECC,P < 0.05 was considered to be statistically significant.Results: Bivariate analysis showed that age, mother’s education, dental visits, dietary habits, Plaque index, salivary pH and buffering capacity were significantly associated with ECC. The significant risk indicators for ECC in multivariable regression were age (AOR = 4.73, 95% CI: 2.76–7.83), mother’s education (illiterate vs. university educated, AOR = 28.36, 95% CI: 8.51-112.92), frequency of daily sugary snacks (twice vs. once, AOR = 2.00, 95% CI: 1.29–3.49, and three or more vs. once, AOR = 2.67, 95% CI: 1.72–3.27), night feeding (AOR = 1.89, 95% CI: 1.38–10.21), Plaque index (AOR = 21.34, 95% CI: 5.56–81.99), and salivary pH (AOR = 0.16, 95% CI: 0.05–0.58).Conclusion: This study suggests that sociodemographic indicators, dietary habits, plaque accumulation and salivary pH are risk indicators for ECC in the studied population.

(1) Background: In this study, the impact of odontogenic risk factors with nasal septum deviation on maxillary sinus mucosal thickening was assessed using Cone-beam computed tomography CBCT. (2) Methods: A total of 328 maxillary sinus regions from 164 patients (85 males and 79 females) were examined. Images were interpreted by dental specialists and Otolaryngologists. Coronal and sagittal sections were examined to assess the proximity of the root tips of posterior maxillary teeth (RPMT) to the maxillary sinus. The periodontal bone loss for all maxillary posterior teeth was also assessed. Consequently, maxillary sinus mucosal thickening (MT) was further classified into three gradings. Multilevel modeling regression analysis was used due to the hierarchical structuring of the data. Four models were developed, a null model with no factors, a model with tooth-level factors (RPMT, PBL, tooth condition, and root length), a model with patient-level factors (gender and nasal septum deviation), and a model with combined patient- and tooth-level factors. Regression estimates (AOR) and 95% confidence intervals (CIs) of individual and tooth factors were calculated. (3) Results: Multilevel regression analysis showed that RPMT was significantly associated with MT of maxillary sinus (p < 0.001), where patients who had RPMT > 0 had higher odds of MT of maxillary sinus. Tooth condition was also found to be significantly associated with MT of maxillary sinus, where teeth with failed RCT (p < 0.001) and teeth with restorations (p < 0.008) had higher odds of MT of maxillary sinus (AOR = 2.87, 95%CI 1.65, 4.42, AOR = 1.64, 95%CI 1.14, 2.36, respectively). (4) Conclusions: In order to plan preoperative treatment for maxillary posterior teeth, it is important to assess the anatomical relationship between the sinus floor and the root tips of the maxillary posterior teeth. Additionally, we establish a better understanding of the clinician before surgical intervention is conducted.

Background Odontogenic maxillary sinusitis arises mainly from dental origins, emphasizing the connection between dental health and sinus issues. Understanding these relationships is crucial for implant planning, sinus augmentation procedures, and managing post-extraction complications. This knowledge can help clinicians make informed decisions about treatment timing and approach. In this study, the influence of tooth periapical and periodontal conditions on maxillary sinus mucous membrane thickening using cone-beam computed tomography (CBCT) imaging was evaluated. Methods In this retrospective cross-sectional study, 124 patients who underwent CBCT for dental treatment covering 248 maxillary sinuses and 992 teeth were examined. Coronal and sagittal sections were examined to assess the maxillary sinus mucosal thickening (MT), the periodontal bone loss for maxillary posterior teeth, and their proximity to the maxillary sinus (RPMS). The mean ± standard deviation of quantitative variables was compared using a one-way ANOVA test. Multivariable logistic regression analysis was used to assess the relation between the different independent variables and MT of the maxillary sinus. P < 0.05 was considered to be statistically significant. Results MT was detected in 90 (72.6%) patients. We found 42 (33.9%) patients bilaterally. Grade 1 mucosal thickness was the most prevalent grade (72.5%), followed by Grade 2 (19.2%). Almost half the teeth examined were not in contact with the cortical borders of the sinus (56.0%). Most of the teeth showed mild to moderate periodontal bone loss (80.2%). Logistic regression analysis showed that the variables significantly associated with higher odds of MT of maxillary sinus occurrence were tooth location (second molar vs. first premolar AOR = 2.30, 95% CI: 1.29-2.79, first molar vs. first premolar AOR = 3.79, 95% CI: 1.82- 3.10, and second premolar vs. first premolar AOR = 1.57, 95% CI: 1.27-2.84), the relation of roots of posterior maxillary teeth to the sinus floor (Type 2 vs. Type 0 AOR = 2.27, 95% CI: 1.38-3.34, and Type 1 vs. Type 0 AOR = 2.24, 95% CI: 1.54-3.26), periodontal bone loss (severe vs. non-periodontitis AOR = 2.75, 95%CI: 1.29-5.86, and mild-moderate periodontitis vs. non-periodontitis AOR = 1.68, 95%CI: 1.19-4.93), and periapical and periodontal tooth condition (periapical lesion vs. extracted AOR = 32.7, 95% CI: 4.53-83.61, and no periapical lesion vs. extracted AOR = 19.8, 95% CI: 8.18-74.23). Conclusions Second molars, severe periodontal bone loss, and periapical lesions were associated with increased sinus MT risk, highlighting the need for dental health consideration in maxillary sinus management.

Objectives: The objective of this study was to assess the level of knowledge and attitude about the etiology, diagnosis, and management of peri-implantitis among dental practitioners. Methods: An online cross-sectional study on 303 dentists in Saudi Arabia was conducted. A closed-ended survey consisting of 28 questions was designed. Three sections were created, i.e., (1) participants’ characteristics; (2) knowledge of peri-implantitis etiology, risk factors, diagnosis, and complications; and (3) the use of antibiotics to manage peri-implantitis and methods used for diagnosis and treatment. The data were analyzed using mean and percentages. Results: A total of 303 dentists participated in this study with a 78.8% response rate, comprising 80% general dentists and 20% specialists. The majority of dentists demonstrated knowledge about peri-implantitis, with 85.5% identifying bacterial plaque as an etiologic factor and 83.8% recognizing it as an inflammatory reaction. Regarding risk factors, 88.1% identified smoking and 86.1% recognized periodontitis as contributors to peri-implant disease development. In terms of clinical decision making, 63% of participants considered implant mobility as a definitive indication for implant removal, and more than half reported using crater-like bone defects surrounding implants as a diagnostic criterion for peri-implantitis. For antimicrobial therapy, amoxicillin alone (30%) was the most commonly prescribed antibiotic, followed by the combination of amoxicillin with metronidazole (29%). Despite these treatment approaches, it is important to note that currently there are no established, predictable protocols for treating any phase of peri-implant disease. Conclusion: While participating dentists demonstrated a strong understanding of peri-implantitis etiology and risk factors, particularly regarding bacterial plaque and smoking as major contributors, there was considerable variation in antibiotic selection and usage patterns. These findings suggest the need for standardized guidelines and further research to establish evidence-based protocols for managing peri-implant diseases.

Background: Refugees oral health remains underexplored despite high disease prevalence. This study assessed oral health, access to care, and factors associated with dental caries and periodontal disease among refugees in Alexandria, Egypt. Methods: A cross-sectional study was conducted at Caritas office from June-September 2024. Arabic-speaking refugees aged ≥18 years, residing in Alexandria for ≥6 months were included. Data were collected via a questionnaire and oral examination using Silness and Loe Plaque Index, Decayed, Missing, and Filled Teeth (DMFT) index, and Community Periodontal Index (CPI). Negative binomial regression identified factors associated with DMFT, and binary logistic regression identified factors for periodontal pockets. Results: A total of 510 refugees participated (64.1% females, mean age 46.7 ± 14.2 years, 79.0% Sudanese). Mean DMFT was 9.25 ± 5.82 (DT = 5.01, MT = 3.34, FT = 1.02), and mean Plaque Index was 1.49 ± 0.68. Gingivitis was found in 64.51% and periodontal pockets in 12.16%. In multivariable analysis, increased caries prevalence was associated with age (PRR = 1.16, 95% CI: 1.03–2.34), education (illiterate vs. university educated, PRR = 1.32, 95% CI: 1.08–3.49; secondary vs. university educated, PRR = 1.19, 95% CI: 1.05–4.32), low income (PRR = 1.06, 95% CI: 1.01–1.63), sugary snacks (PRR = 1.39, 95% CI: 1.29–3.51), and Plaque Index (PRR = 1.46, 95% CI: 1.20–3.53). Shorter residence (≤5 years) (PRR = 0.90, 95% CI: 0.71–0.93) and access to oral healthcare (PRR = 0.88, 95% CI: 0.56–0.98) were associated with lower DMFT count. Periodontal pockets were associated with male gender (AOR = 1.87, 95% CI: 1.34–5.17), older age (AOR = 4.48, 95% CI: 2.68–10.62), education (illiterate AOR = 5.15, 95% CI: 1.28–17.64; secondary AOR = 2.61, 95% CI: 1.92–14.32), sugary snacks (AOR = 2.47, 95% CI: 1.20–6.09), smoking (AOR = 3.18, 95% CI: 1.56–9.12), Plaque Index (AOR = 3.60, 95% CI: 1.92–8.30), and DMFT (AOR = 2.78, 95% CI: 1.09–6.98). Conclusions: Refugees had a high burden of oral disease, with significant sociodemographic, behavioral, and clinical factors. Tailored oral health promotion programs are needed for this vulnerable group.