Objectives: The purpose of the present study was to systematically review literature relating to the quality of life (QoL) in adult individuals with cleft lip and/or palate (CLP) and identify which aspect of QoL adults with CLP find to be the most problematic, in comparison to a general non-cleft population. Design: Different databases were searched for this review including the Cochrane Central Register of Controlled Trials, Ovid MEDLINE and Embase. Five domains of QoL were identified to evaluate the overall results of these QoL measures. These domains were; physical function, physical pain, psychological implications and self-esteem, self-perception in relation to facial aesthetics, and social function. The studies included underwent critical appraisal and different types of bias were assessed based on the Cochrane handbook for systematic reviews of interventions. Results: Ten studies were included in this review. The total number of participants was 541. The most common QoL measure for adults with CLP was Short-Form (SF-36). Seven studies out of 10 reported statistically significantly worse scores (P < 0.05) in the psychological implications and self-esteem domains of QoL in adults with CLP, indicating lower QoL in terms of these domains. The least affected QoL domain was physical function. A high heterogeneity was found among the studies, including variation in the QoL measures, types of orofacial clefts, types of treatment and comparison groups. Conclusion: The presence of CLP did seem to negatively affect the QoL for adults with CLP, mainly in terms of psychological implications and self-esteem.

In order to improve the understanding of dental fluorosis prevalence in Saudi Arabia and have a good idea of the quality of the studies that have been conducted, a systematic review was conducted to evaluate the prevalence of dental fluorosis among people who live in Saudi Arabia. Online databases EMBASE and MEDLINE and the Cochrane Library were searched, without any restriction regarding age. In addition, there were no study design filters applied to the search engine. Study selection and data extraction were conducted in duplicate. Studies were included if they were conducted in Saudi Arabia on any population (adults and children) and collected dental fluorosis data. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the studies. A narrative synthesis was conducted. Seven cross-sectional studies were identified. Areas of weakness in study design/conduct were low response rates, and identification and handling of confounding factors. Statistical pooling of data was not appropriate due to substantial heterogeneity, due in part to variation in sample size, variation of water fluoridation concentration, index used, targeted population and age group. Seven studies present dental fluorosis at any level. The proportion of dental fluorosis prevalence at any level ranged from 0.00 to 0.91. Six studies explored the prevalence of dental fluorosis of aesthetic-only level of concern. The proportion of dental fluorosis in this category ranged from 0.07 to 0.76. The proportion of dental fluorosis at any level ranged from 0.00 to 0.91 and fluorosis at aesthetics level ranged from 0.07 to 0.76. However, current data does not provide a complete assessment of dental fluorosis across Saudi Arabia. Existing studies are limited in terms of the population covered. The included studies had methodological flaws.

Objectives: Medication-related osteonecrosis of the jaw (MRONJ) is a significant complication associated with bisphosphonates, impacting jaw osteoclasts, and causing altered bone remodelling. Prevention involves stabilizing systemic pathology, considering antiresorptive therapies, and exploring platelet-rich fibrin (PRF) for wound healing and tissue regeneration. The study aims to assess the efficacy of PRF in MRONJ treatment and highlight research gaps for more robust investigations. Methods: Following PRISMA and MOOSE guidelines, this systematic review and meta-analysis included English publications from 2013 to 2023, employing a systematic search in databases such as MEDLINE, Scopus, and Web of Science. Quality assessment used the Cochrane Collaboration’s tool and the NOS, with the main meta-analysis concentrating on PRF-treated MRONJ cases, assessing resolution rates, and prioritizing healing outcomes and infection absence as primary endpoints. Results: The study, encompassing 11 articles and 480 participants with MRONJ, demonstrated that in stage 1 procedures, PRF significantly outperformed conventional medical treatments (OR: 2.93, 95% CI: 1.54–5.59, P=0.001), particularly at the mandible site (OR: 1.65, 95% CI: 0.86–3.17, P=0.13). PRF also exhibited significantly superior healing outcomes compared with conventional medical treatments (OR: 4.45, 95% CI: 1.58–12.53, P=0.005), supporting its consideration as a valuable alternative in specific MRONJ management scenarios. Conclusion: This study highlights PRF’s effectiveness in early MRONJ interventions and specific anatomic sites, despite acknowledged limitations, emphasizing the need for further research, and supporting its consideration in MRONJ surgical management.

This study aimed to investigate dental anxiety levels among adults with cleft lip and/or palate (CL/P) and compare to adults with no orofacial cleft. The study also intended to find out the impact of cleft severity, gender and age on the perceived dental anxiety. The study was composed of a sample of 70 adult participants who received and completed dental treatments. After sending self-addressed envelopes with consent forms and Modified Dental Anxiety Scale (MDAS) to 192 potential participants, 35 participants with CL/P (CL/P group) and 35 participants with no CL/P (control group), agreed to participate. Data were analysed using Mann–Whitney U test. A two-tailed P-value < 0.05 was considered as statistically significant. 54.3% of adults with CL/P (23 females and 12 males, age range from 16 to 72 years) reported normal dental anxiety, while the remaining 45.7% reported moderate dental anxiety. No extreme dental anxiety were recorded in the CL/P group. These results were similar to the control group and there were no significant differences between groups (p > 0.05). Female participants recorded higher median anxiety scores than male participants in the CL/P group, and participants with cleft lip had higher median scores than participants with cleft lip and palate. However, these were not statistically significant. The results suggest that CL/P did not affect dental anxiety levels for participants with the CL/P as there were no extreme cases and their results were comparable to a general non-cleft sample.

J Int Soc Prevent Communit Dent, Official publication of International Society of Preventive and Community Dentistry (ISPCD)

Objective: To investigate the effectiveness of the microsurgical treatment in restoring full sensory recovery following trigeminal nerve injuries caused by iatrogenic oral and maxillofacial surgical interventions. Methods: A detailed search was conducted on the Cochrane central register of controlled trials, Medline and Embase. Clinical studies with at least twelve months of follow up were included and assessment of risks of bias was made using the Robbin I assessment tool. Results: Six studies were identified in the searches which include 227 patients. The lingual nerve was the most common injured nerve, followed by the inferior alveolar nerve. Third molar removal was the most frequent cause of nerve injury, followed by root canal treatment, pathology excision, coronectomy, orthognathic surgery, dental implants and then local anaesthetic injections. Overall, surgical interventions for nerve injuries showed neurosensory improvement postoperatively in the majority of patients. Conclusion: Direct neurorrhaphy is still the gold-standard technique when the tension at the surgical site is minimal. Promising results have been noted on conduit applications following traditional repair or grafting. Further research is needed on the efficacy of allografting and conduit applications in nerve repair.