Background: Periodontitis is defined as an inflammatory disease of the supporting tissues of the teeth caused by specific microorganisms, resulting in progressive destruction of the periodontal ligament and alveolar bone. Clinical manifestations of Persistent chronic periodontitis may mimic varied clinical manifestations, including those of apical abscess and systemic involvement. Case report: This report presents the management of an intraoral sinus mimicking a chronic apical abscess in the mandibular anterior region associated with deep periodontal pockets in two male patients in their early thirties. With careful clinical and radiological examination and ruling out of endodontic and systemic involvement, the diagnosis of primary periodontal infection was made. Results: The treatment plan involved initially phase 1 therapy and correction of occlusal discrepancies. After 2 weeks of periodontal surgical intervention that included open flap debridement, both patients reported marked symptomatic improvement, with complete resolution of pain and swelling, and sinus with no recurrence at 3 and 6 months. Conclusions: This case report emphasized careful periodontal examination and diagnosis of primary periodontal infection with intraoral draining sinus mimicking endodontic involvement, which can prevent unnecessary endodontic therapy and tooth extraction.
Background: Cell proliferation is essential for tissue repair and immunomodulation in regenerative dentistry. Adipose-derived stromal vascular fraction (AD-SVF) is a promising autologous source for tissue engineering. Its exosomes (AD-SVF Exo), as cell-free products stable under ischemic conditions, represent an ethical and attractive modalityfor dental tissue regeneration and broader regenerative applications. Prior study indicates that AD-SVF Exo can enhance human dental pulp stem cell (hDPSC) migration and proliferation, particularly at low concentrations, but their detailed time-and dose-dependent proliferative effects remain unclear. This study aimed to investigate the time-and dose-dependent effects of low-concentration AD-SVF Exo on hDPSC proliferation in vitro. Methods: AD-SVF exosomes were isolated by size-exclusion chromatography and characterized by flow cytometry and nanoparticle tracking analysis, then applied to hDPSCs at multiple concentrations. Proliferation was evaluated using the Cell Counting Kit-8 assay. One-way ANOVA with LSD post hoc testing was performed (alpha= 0.05). Results: AD-SVF exosomes (mean size 103 +/- 24 nm) expressed CD9 and CD63. All tested concentrations significantly increased hDPSC proliferation versus control in a time-and dose-dependent pattern, with lower doses generally producing the most favorable responses. Conclusions: AD-SVF exosomes enhance hDPSC proliferation in a time-and dose-dependent manner, supporting their potential as a cell-free adjunct in regenerative dentistry.
Background: Missed root canals are common and can cause persistent periapical disease, making the assessment of their prevalence essential for improving diagnostic accuracy and treatment outcomes. This study aimed to investigate the prevalence of missed canals and evaluate their association with periapical lesions in root canal-treated teeth in the Makkah population. Methods: This retrospective cross-sectional study analysed 815 cone-beam computed tomography scans obtained from Umm Al-Qura University between 2019 and 2024. Missed canals and their association with periapical lesions were assessed by two independent observers. Statistical analysis was performed using the chi-square test. Results: Missed canals were detected in 21% of maxillary and 14.2% of mandibular root canal-treated teeth. A highly significant association was observed among maxillary teeth (p < 0.001), whereas no statistically significant association was found for mandibular teeth (p = 0.25). Periapical lesions were present in 77.9% of maxillary teeth and 69.2% of mandibular teeth with missed canals. Conclusions: Missed canals are common in root canal-treated teeth in the Makkah diverse population and are strongly associated with a high prevalence of periapical lesions. Meticulous canal detection and consideration of population-specific anatomical variations are essential to reduce missed canals, prevent periapical pathology, and enhance endodontic treatment outcomes.
Background: Tooth extraction is a common dental procedure often complicated by postoperative infections, with Staphylococcus aureus as a key opportunistic pathogen. Rising antibiotic resistance and side effects of conventional antiseptics like chlorhexidine highlight the need for natural alternatives. This study evaluated the antibacterial and antibiofilm potential of 96% ethanol extract from Ziziphus mauritiana leaves against S. aureus. Methods: The extract was prepared by maceration and tested in vitro using microdilution for minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against S. aureus ATCC 25923. Antibiofilm activity was assessed via crystal violet staining on mature biofilms, with confirmation byqPCR-based absolute quantification of bacterial load using S. aureus-specific 16S rRNA primers. Statistical analysis included Shapiro-Wilk, ANOVA, and Tukey HSD tests. Results: The extract showed MIC between 125-250 mg/mL and MBC at 250 mg/mL. Concentrations of 1000, 500, and 250 mg/mL inhibited >80% biofilm biomass, comparable to 0.2% chlorhexidine. qPCR confirmed significant bacterial load reduction at 1000 and 500 mg/mL. Conclusions: Z. mauritiana leaf extract demonstrates promising antibacterial and antibiofilm activity against S. aureus, supporting its potential as a natural agent for managing post-extraction infections, though further studies on clinical isolates, cytotoxicity, and formulations are warranted.
Background: Children's oral health can be influenced by various factors, including health behaviors, dietary patterns, and oral health knowledge. This study aimed to determine the correlation between oral health behaviors and oral health status in elementary school children. Methods: This cross-sectional study involved 182 elementary school children in Bontang, East Kalimantan, taken by convenience sampling. Health behavior data were acquired by 12-item questionnaires based on the WHO guideline. Examination of dental and oral health status was done by using the DMFT Index and OHI-S. Chi-square was used to determine the correlation between oral health behaviors and oral health status. Results: Majority of children had DMFT score index less than or equal to 8 (86.3%) and OHI-S score more than or equal to 1 (54.4%). There was a significant difference between age (p = 0.012) and the dental caries status of children. There was also a significant difference between of biscuits = 0.018) and the dental caries status of children. Conclusions: Elementary school children in Bontang, East Kalimantan, still have poor oral health behaviors. Education on the importance of daily toothbrushing, regular dental visits, healthy eating habits, and the use of fluoride-containing toothpaste still needs to be improved.
