Presence or absence of a minimal zone of keratinized tissue around dental implants has been a matter of controversy. However, a consensus exists that a thick zone of keratinized zone around implants provides a prosthetic friendly environment, facilitates precise prosthetic procedures, allows oral hygiene maintenance, resists recession, and enhances esthetic blending. The aim of the present case series was to increase the zone of keratinized soft tissue around dental implants supporting overdentures. Three different surgical techniques modified palatal roll technique with and without apical positioning and connective tissue graft (CTG) were used to achieve this goal. There was a significant gain of keratinized soft tissue with all the three techniques, which remained stable over a period of 6 months. Modified palatal roll technique with and without apical positioning and CTG are simpler surgical techniques, which can be successfully and predictably used for increasing the zone of keratinized tissue around implants.

Existing literature regarding the efficacy of Botulinum toxin A (BoNT-A) therapy in improving the clinical outcomes of temporomandibular disorders (TMDs) is ambiguous and lacks consistency. Thus, this study aimed to evaluate the efficacy of BoNT-A in reducing pain, occlusal force, electromyographic (EMG) changes, and maximum mouth opening compared with placebo and other interventions. An electronic database search was conducted using MEDLINE, PubMed, Google Scholar, the Cochrane Library, and ClinicalTrials.gov from January 2000 to June 2024 to identify randomized controlled trials (RCTs). A manual search complemented the electronic search. The Risk of Bias 2 (RoB 2) assessment was used to evaluate the internal validity of the included studies. A total of 1719 studies were identified, of which 23 fulfilled the inclusion criteria. Nineteen of these studies evaluated pain levels (primary outcome) after BoTN-A therapy, with six of them observing a decrease. In terms of secondary outcomes, seven of 10 studies noted an increase in maximum mouth opening, while all six reported a drop in EMG activity, and all four found a decrease in occlusal force following BoNT-A therapy. Muscle activity and biting force were significantly reduced in the therapeutic groups. Clinicians must consider these adverse events before treating patients with BoNT-A therapy. Additional regulatory guidelines and standardization of injection protocols are essential in improving therapeutic outcomes and patient safety. These findings suggest that BoNT-A may be a feasible option for TMD management but should be used with caution in clinical settings.

Introduction: To formulate an ideal treatment plan for edentulous patients, data collected from various diagnostic aids need to be structured and classified according to their treatment needs. The lack of structured diagnostic findings for edentulous patients has always been a barrier to effective care for patients. To address these issues, the American College of Prosthodontists (ACP) established the Prosthodontic Diagnostic Index (PDI) based on specific criteria. Aim: To screen and allot completely edentulous patients to students using PDI in a dental school, in Jeddah, Saudi Arabia. Materials and Methods: This cross-sectional study was conducted on 122 completely edentulous patients who visited the outpatient clinic of a dental school in Jeddah, Saudi Arabia. The edentulous patients based on PDI were classified into four classes (Class I–IV) according to the diagnostic findings based on the complexities. The parameters studied were: mandibular bone height measured on a panoramic radiograph, residual ridge morphology of the maxillary arch, muscle attachments in the mandibular arch, and maxillomandibular relationship. Statistical analyses were performed using counts and percentages. Results: In the overall classification of PDI maximum 52 (42.6%) patients were classified as Class IV. Among the different criteria of PDI, 48 (39.4%) patients exhibited Class III mandibular bone height of 11-15 mm, whereas 40 (32.8%) patients exhibited Class IV mandibular bone height of 10 mm or less. In the maxillary residual ridge morphology, 62 patients (50.8%) were classified as Class I. A large number of patients 84 (70%) had Type A mandibular muscle attachment criteria and were classified as Class I or II. In the maxillomandibular relationship, the maximum number of patients 74 (60.7%) was of Class I. Conclusion: The majority of patients in the study were categorised as Class IV (severely compromised). Edentulous patients must be classified according to PDI during the initial screening phase so that less complex cases (Class I and II) can be allotted to undergraduate students and more complex cases (Class IV) can be handled by prosthodontists or can be referred to specialist centers so that costly and time-consuming remake of complete dentures can be avoided.

The prevalence of total edentulism differs significantly between countries and between cities/regions within the same country. It can be affected by various factors, such as age, sex, and socioeconomic factors along with lifestyle and health behavior. Positive findings on panoramic radiographs are frequently observed in totally edentulous patients (TEP) during routine screening. This study aimed to retrospectively determine the prevalence of total edentulism and to evaluate the distribution and location of positive findings on panoramic radiographs of TEP at a dental school in Jeddah, Saudi Arabia. A total of 12,428 digital panoramic radiographs of patients aged ≥35 years seeking treatment at a dental school from January 2018 to December 2021 were evaluated to determine the prevalence of total edentulism. Retained root stumps, impacted teeth, radiolucent, and radiopaque lesions were detected on the panoramic radiographs of the TEP. Data were analyzed using descriptive statistics. Among the 12,428 patients, 521 (4.2%) showed total edentulism on their panoramic radiographs. The prevalence of edentulism was the highest among patients aged >65 years (n=305, 4.5%), men (n=246, 4.2%), and non-Saudi citizens (n=300, 4.4%). A total of 198 radiographic findings were identified in 150 patients. The frequency rates of retained root stumps and impacted teeth were 19.2% (n=100) and 4.6% (n=24), respectively. Radiolucent and radiopaque lesions each accounted for 2.5% (n=13) of the lesions. The prevalence of edentulism was higher in patients aged >65 years, male patients, and non-Saudi citizens. Retained root stumps were most often encountered among the four positive findings on panoramic radiographs. Considering the high frequency of positive radiographic findings in TEP, panoramic radiographs must be routinely obtained for TEP, but caution must be exercised to reduce the effects of radiation.