Aim: This study aims to determine the current trends in endodontic irrigation practice among general dental practitioners (GDPs) in Saudi Arabia. Methodology: An invitation to participate in a questionnaire was electronically sent to 500 affiliates of the Saudi dental association. The members were queried about the irrigation solution(s) they utilize, reasons affecting their selection of irrigant, the concentration of irrigant, the removal of smear layer, the use of an intracanal medicament, the depth of penetration and gauge of the needle used for irrigation, and participation in a course related to endodontic irrigation. Results: Two hundred and thirteen responses were obtained out of 500 questionnaires sent, 50 of the received questionnaires were answered by a non-GDP and were excluded from the study, leaving 163 responses (32.6%). Our result indicates that 92% of responders use sodium hypochlorite (NaOCl) as their primary irrigant. The main concentration of used NaOCl was 0.5%–1.5% used by 36.8% of responders. 68.7% of responders claimed that they are aiming routinely to eliminate smear layer during root canal treatment. More than half of the participants did not attend any seminars in the field of endodontic irrigation after their scale. Conclusion: Most of the responders are using NaOCl as a primary irrigant, routinely removing the smear layer, and are using intracanal interappointment medicament. However, the consequences of this survey revealed that there is a big need to enhance and monitor the approach utilized by the dentist in Saudi Arabia.

Pyogenic granuloma (PG) is a common reactive oral lesion predominantly involving the gingiva and rarely occurring on the dorsum of the tongue. It can develop at any age but more commonly in the second decade with a female predilection. Numerous factors are associated with its development, and surgical removal is the standard treatment. Various surgical modalities have been used to excise it. Herein, we report a case of a female patient in her late 60s who presented with an exophytic lesion involving the dorsum of the tongue, which was excised using a 940 nm diode laser. In addition, it discusses the advantages of diode laser as a surgical modality and describes this lesion's clinical features and pathogenesis.

Oral lichenoid mucositis (OLM) of the oral mucosa is a histological diagnosis mainly characterised by a band of inflammatory infiltrate in lamina propria and basal cell degeneration. These features describe oral lichen planus or oral lichenoid reaction. However, it could be seen in oral dysplasia. The study aimed to assess the demographics and clinicohistological characteristics of patients with OLM and their relevance to dysplastic changes in the oral mucosa. This was a cross-sectional and retrospective study of archived and electronic records of individuals with histological confirmation of OLM at King Saud University Medical City, Saudi Arabia. The descriptive and correlation assessments were used to describe the demographics and clinicohistological characteristics and their associations, respectively [p < 0.05]. The analysis included 140 records of patients with histological confirmation of OLM with a mean age of 47 (±13), and 57% (n = 81) were females. Notably, 40% of patients had at least one medical condition, mainly diabetes mellitus, 74% were asymptomatic, and 52% had lesions in the buccal mucosa. Dysplasia was seen in 18 (12%) of the 140 reviewed records. Regarding the associations between study variables, dysplastic changes were associated with the male gender [p = 0.024] and were of no significance with increased age [p = 0.594]. Moreover, having oral symptoms was associated with older age [p < 0.001], medical history of diabetes [p = 0.0132] and hypertension [p < 0.001]. The present study findings could help indicate the individuals with histologically confirmed OLM who suffer the most from the clinical disease and have an increased risk of dysplastic changes. Therefore, symptomatic management and long-term follow-up can be planned accordingly.

Plexiform neurofibroma is a benign peripheral nerve sheath tumor known to be pathognomonic for neurofibromatosis type 1. However, solitary plexiform neurofibroma in the oral cavity is extremely rare. Herein, we presented a 73-year-old Saudi male with solitary plexiform neurofibroma located on the maxillary alveolar ridge, which was excised successfully using a 940 nm diode laser. Microscopic examination revealed a multinodular arrangement of benign spindle cells in a haphazard pattern. Immunohistochemical analysis showed positive staining for S100 and CD34 in the tumor cells.

Angiosarcoma is a rare and highly aggressive soft tissue malignancy originating from vascular and lymphatic endothelial cells. Epithelioid angiosarcoma is the rarest subtype of angiosarcoma, characterized by the proliferation of large polygonal cells with an epithelioid feature. The occurrence of these tumors in the oral cavity is highly uncommon, and immunohistochemistry staining is essential to differentiate epithelioid angiosarcoma from mimicking lesions. To present a case of intraoral angiosarcoma with an unusual clinical presentation and behavior and to report, to the best of our knowledge, a first primary appendix epithelioid angiosarcoma with metastasis foci in the oral cavity. To discuss the clinical, histological, and immunochemical features of an unusual case of intraoral angiosarcoma. A 53-year-old Saudi female with an uncommon clinical presentation of intraoral angiosarcoma. The patient reported the lesion being painless, slowly growing, and of a six-month duration. The microscopic examination and immunohistochemical evaluation showed epithelioid angiosarcoma. The tumor cells were positive to ERG, FLI 1, and CD31 (focal) and negative to CK HMW, CD45, S100, HMB 45, D2-4, and CD 34. Due to the extremely rare occurrence and non-characteristic presentation of angiosarcoma in the oral cavity, many lesions maybe included in the differential diagnosis. Thus, making the diagnosis of intraoral angiosarcoma difficult.

An odontogenic keratocyst is a common oral lesion with high recurrence rates. There is an absence of a solid treatment consensus. Recurrence rates are reported to be higher in conservative treatment options. In this case report, we present a new method, utilizing a specially fabricated acrylic stent-obturator, aiding the conservative treatment methods in order to minimize lesion recurrence. A 42-year-old Saudi male with a 3.5 x 2.5 keratocyst on the right mandibular angle was treated successfully and conservatively in full abidance by medical community standards using the stent-obturator after lesion curettage alone, with no recurrence at three year follow up. KEYWORDS Odontogenic keratocyst, conservative management, obturator, re-curettage