Publications by authors named "Hytham N Fageeh"

18 Publications

  • Page 1 of 1

miRNA-146a and miRNA-126 as Potential Biomarkers in Patients with Coronary Artery Disease and Generalized Periodontitis.

Materials (Basel) 2021 Aug 20;14(16). Epub 2021 Aug 20.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

The present study aims to compare the levels of micro-RNA-146a and micro-RNA-126 in oral subgingival plaque and coronary plaque from artery walls in patients with coronary artery disease who suffer from generalized periodontitis. A total of 75 participants were selected and grouped into three categories of 25 patients each: GP+CAD, GP, and HP groups. GP+CAD consisted of patients diagnosed with generalized periodontitis (GP) and coronary artery disease (CAD). The GP+CAD group was further divided into two groups-GP+CADa: where subgingival plaque samples were collected; GP+CADb group: where coronary plaque samples were collected while the patient underwent a coronary artery bypass grafting surgery. The GP group consisted of 25 patients diagnosed with only generalized periodontitis. The HP group consisted of 25 systemically and periodontally healthy controls. miRNA-146a and miRNA126 levels were assessed in subgingival plaque (SP) samples from all groups. Results revealed that miRNA-146a was expressed at higher levels and miRNA-126 was downregulated in the GP+CAD group. microRNAs in subgingival plaque samples showed a significant correlation with the coronary plaque samples in the GP+CAD group. miRNA-146a and miRNA-126 were present in coronary artery disease patients with periodontitis. These micro-RNAs may serve as risk biomarkers for coronary artery disease and generalized periodontitis.
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http://dx.doi.org/10.3390/ma14164692DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8398247PMC
August 2021

Preliminary Evaluation of Proliferation, Wound Healing Properties, Osteogenic and Chondrogenic Potential of Dental Pulp Stem Cells Obtained from Healthy and Periodontitis Affected Teeth.

Authors:
Hytham N Fageeh

Cells 2021 Aug 18;10(8). Epub 2021 Aug 18.

Department of Preventive Dental Science, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Background: Dental pulp tissue within the central cavity of the tooth is composed of dental pulp stem cells (DPSC). These mesenchymal stem cells have good proliferative as well as differentiation potential. DPSC has been isolated even from teeth with inflamed pulps and is found to retain their proliferative and differentiation potential. Little research is available about the viability and differentiation potential of DPSC obtained from teeth with periodontitis. In the present study, the aim was to compare the morphological features, stem cell marker (MSC) expression, proliferation rate, migratory and wound healing properties, osteogenic and chondrogenic differentiation potential of DPSCs obtained from periodontally healthy teeth (hDPSCs) and periodontitis affected teeth (pDPSCs).

Methods: Dental pulp tissue was obtained from periodontally healthy volunteers ( = 3) and patients with periodontitis undergoing extraction of mobile teeth ( = 3). DPSC were isolated using the explant technique and cultured. All the experiments were performed at early passage (Passage 2), late passage (Passage 6) and after cryopreservation. Morphological features of the hDPSCs and pDPSCs were ascertained using microscopy. The expression of cell surface stem cell markers was assessed by the flow cytometry method. The proliferation and growth rate of the cells were assayed by plotting a growth curve from 0-13 days of culture. The migratory characteristics were assessed by wound scratch assay. Osteogenic and chondrogenic differentiation of the cells was assessed using standard protocols with and without induction.

Results: DPSCs were successfully obtained from periodontally healthy teeth (hDPSC) and periodontitis-affected teeth (pDPSCs). The data suggests that there were no morphological differences observed in early passage cells between the two cohorts. Cryopreservation did change the morphology of pDSPCs. There was no significant difference in the positive expression of mesenchymal markers CD73, CD90 and CD105 in early passage cells. However, serial passaging and cryopreservation affected the marker expression in pDPSCs. A faint expression of hematopoietic stem cell markers CD34, CD45 and MHC class II antigen HLA-DR was observed in both the cell types. The expression of HLA-DR is upregulated in pDPSCs compared to hDPSC. A significantly slower growth rate and slower wound healing properties was observed in pDPSCs compared to hDPSC. In late passage and after cryopreservation, the migratory ability of pDPSCs was found to be increased drastically. There was no significant difference in osteogenic potential between the two cell types. However, the chondrogenic potential of pDPSCs was significantly lower compared to hDPSc. Yet, pDPSCs showed enhanced osteogenesis and chondrogenesis at late passage as well as after cryopreservation.

Conclusion: The results of this novel study shed light on the isolation of viable DPSC from periodontitis-affected teeth. These cells exhibit a slower growth rate and migratory characteristics compared to their healthy counterparts. There was no difference in osteogenic potential but a reduction in chondrogenic potential was seen in pDPSCs compared to hDPSC. The findings reveal that DPSC from periodontitis-affected teeth presents an easy and viable option for regenerative medicine application. Some additional nutritive factors and protocols may be required to attain better regenerative benefits while using pDPSCs.
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http://dx.doi.org/10.3390/cells10082118DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8393753PMC
August 2021

The Role of Applied Behavior Analysis to Improve Knowledge on Oral Hygiene Practices among Cooperative Autistic Children: A Cross-Sectional Study from Jazan, Saudi Arabia.

Int J Dent 2021 20;2021:9491496. Epub 2021 Jul 20.

College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia.

Objective: To assess the effectiveness of Applied Behavior Analysis (ABA) to improve knowledge regarding oral hygiene practices among cooperative autistic children.

Materials And Methods: A cross-sectional study was conducted among 15 children between the age group of 6-12 years and their parents who were randomly chosen from a special care autistic school in Jazan, Saudi Arabia. A mobile application was custom designed and programmed with videos on oral hygiene. A close-ended questionnaire comprising 14 questions for the cooperative autistic children and 21 questions for their parents was designed to assess their knowledge in relation to oral health and hygiene. After four weeks, a questionnaire-based knowledge assessment was conducted. The mean knowledge score was then calculated for children and their parents and compared using paired sample -test.

Results: Poor knowledge regarding oral hygiene practices was revealed among the study participants. The estimated mean score among the children was 4.73 before the intervention, which significantly increased to 9.0. The estimated mean score for the parents was 9.3 before intervention and 14.6 after four weeks' period ( < 0.0001).

Conclusion: The application of ABA using avatars and delivered through videos can significantly improve knowledge regarding oral health hygiene among cooperative autistic children.
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http://dx.doi.org/10.1155/2021/9491496DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8315859PMC
July 2021

Monocyte Differentiation into Destructive Macrophages on In Vitro Administration of Gingival Crevicular Fluid from Periodontitis Patients.

J Pers Med 2021 Jun 15;11(6). Epub 2021 Jun 15.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45412, Saudi Arabia.

Background: Periodontitis is an inflammatory condition of the tooth-supporting structures initiated and perpetuated by pathogenic bacteria present in the dental plaque biofilm. In periodontitis, immune cells infiltrate the periodontium to prevent bacterial insult. Macrophages derived from monocytes play an important role in antigen presentation to lymphocytes. However, they are also implicated in causing periodontal destruction and bystander damage to the host tissues.

Objectives: The objective of the present study was to quantify the cytokine profile of gingival crevicular fluid (GCF) samples obtained from patients with periodontitis. The study further aimed to assess if GCF of periodontitis patients could convert CD14+ monocytes into macrophages of destructive phenotype in an in vitro setting. The secondary objectives of the study were to assess if macrophages that resulted from GCF treatment of monocytes could affect the synthetic properties, stemness, expression of extracellular matrix proteins, adhesion molecules expressed by gingival stem cells, gingival mesenchymal stromal cells, and osteoblasts.

Methods: GCF, blood, and gingival tissue samples were obtained from periodontitis subjects and healthy individuals based on specific protocols. Cytokine profiles of the GCF samples were analyzed. CD14+ monocytes were isolated from whole blood, cultured, and treated with the GCF of periodontitis patients to observe if they differentiated into macrophages. Further, the macrophages were assessed for a phenotype by surface marker analysis and cytokine assays. These macrophages were co-cultured with gingival stem cells, epithelial, stromal cells, and osteoblasts to assess the effects of the macrophages on the synthetic activity of the cells.

Results: The GCF samples of periodontitis patients had significantly higher levels of IFN gamma, M-CSF, and GM-CSF. Administration of the GCF samples to CD14+ monocytes resulted in their conversion to macrophages that tested positive for CD80, CD86, and CD206. These macrophages produced increased levels of IL-1β, TNF-α, and IL-6. Co-culture of the macrophages with gingival stem cells, epithelial cells, and stromal cells resulted in increased cytotoxicity and apoptotic rates to the gingival cells. A reduced expression of markers related to stemness, extracellular matrix, and adhesion namely OCT4, NANOG, KRT5, POSTN, COL3A1, CDH1, and CDH3 were seen. The macrophages profoundly affected the production of mineralized nodules by osteoblasts and significantly reduced the expression of , , and genes.

Conclusion: In periodontitis patients, blood-derived monocytes transform into macrophages of a destructive phenotype due to the characteristic cytokine environment of their GCF. Further, the macrophages affect the genotype and phenotype of the resident cells of the periodontium, aggravate periodontal destruction, as well as jeopardize periodontal healing and resolution of inflammation.
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http://dx.doi.org/10.3390/jpm11060555DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8232302PMC
June 2021

Genetic Polymorphisms of NLRP3 (rs4612666) and CARD8 (rs2043211) in Periodontitis and Cardiovascular Diseases.

Biology (Basel) 2021 Jun 27;10(7). Epub 2021 Jun 27.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Background: The existing data show that inflammasomes play a role in periodontal disease pathogenesis. However, their role in the pathogenesis of periodontitis and coronary heart disease remains unclear. This study had the objective of assessing NLRP3 (rs4612666) and CARD8 (rs2043211) gene polymorphisms in dental plaque and blood of generalized chronic periodontitis (CP) patients in the presence and absence of coronary heart disease (CHD).

Methods: A total of 70 subjects were divided into two groups, including CP and CP + CHD subjects. Demographic variables, periodontal, and cardiac parameters were recorded from both groups. Subgingival plaque and blood samples were obtained from both groups and were subjected to further molecular analysis for NLRP3 (rs4612666) and CARD8 (rs2043211) expression and allele change using conventional polymerase chain reaction (PCR) and gene sequencing (Sanger's method).

Results: Amongst the demographic variables, age, and monthly income were statistically significant between the two groups. Plaque index (PI), clinical attachment level (CAL), high-density lipoprotein (HDL), and low density-lipoprotein (LDL) exhibited statistically significant levels between the two groups. NLRP3 (rs4612666) and CARD8 (rs2043211) genes showed a statistically significant association of allele change (frequency) among the groups. In general, when all of the parameters were compared to the allele change of the genes, statistically significant relationships were found between the two groups.

Conclusions: The present study expressed an allele change of the investigated genes which could profoundly affect the pathobiology of the two diseases under investigation.
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http://dx.doi.org/10.3390/biology10070592DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8301148PMC
June 2021

Viability of Quercetin-Induced Dental Pulp Stem Cells in Forming Living Cellular Constructs for Soft Tissue Augmentation.

J Pers Med 2021 May 18;11(5). Epub 2021 May 18.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan 45142, Saudi Arabia.

Autogenous gingival grafts used for root coverage or gingival augmentation procedures often result in donor site morbidity. Living cellular constructs as an exogenous alternative have been proven to be associated with lower morbidity. With the available background information, the present study aims to assess if quercetin-induced living cell constructs, derived from dental pulp stem cells, have the potential to be applied as a tool for soft tissue augmentation. The characterized dental pulp stem cells (positive for CD73, CD90, and negative for CD34, HLA-DR) were expanded in Dulbecco's Modified Eagle's medium (DMEM) supplemented with 10 mM quercetin. The handling properties of the quercetin-induced dental pulp stem cell constructs were assessed by visual, and tactile sensation. A microscopic characterization using hematoxylin and eosin staining, and qRT-PCR-based analysis for stemness-associated genes (OCT4, NANOG, SOX2, and cMyc) was also performed. Dental pulp stem cells without quercetin administration were used as the control. Dental pulp stem cell constructs induced by quercetin easily detached from the surface of the plate, whereas there was no formation in the control cells. It was also simple to transfer the induced cellular construct on the flattened surface. Microscopic characterization of the constructs showed cells embedded in a tissue matrix. Quercetin also increased the expression of stemness-related genes. The use of quercetin-induced DPSC living constructs for soft tissue augmentation could provide an alternative to autogenous soft tissue grafts to lower patient morbidity and improve esthetic outcomes.
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http://dx.doi.org/10.3390/jpm11050430DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8158115PMC
May 2021

Melatonin as a Topical/Systemic Formulation for the Management of Periodontitis: A Systematic Review.

Materials (Basel) 2021 May 6;14(9). Epub 2021 May 6.

Department of Oral and Maxillofacial Sciences, Sapienza University of Rome, 00161 Rome, Italy.

Objectives: To qualitatively and quantitatively review the use of melatonin as a topical/systemic formulation for the management of periodontitis.

Materials And Methods: PubMed; Scopus; and Web of Science databases were searched using the MesH terms "melatonin" and "periodontitis". Title and abstracts were screened to eliminate irrelevant and duplicate articles. The full text data of the screened articles were assessed using the selection criteria.

Results: Of 176 identified articles (PubMed-66; Scopus-56; Web of Science-52; Cross-reference-2), only 12 studies qualified to be included in the systematic review. Four studies assessed the independent effect of 1% topical melatonin formulation while 8 articles assessed the adjunctive use of systemic melatonin formulation (1-10 mg) following scaling and root planing (SRP). All studies showed an improvement in periodontal parameters such as pocket depth, clinical attachment loss, periodontal disease index, community periodontal index, gingival bleeding scores, and prognostic marker levels in saliva and serum. A meta-analysis of data from 2 studies revealed that 1-2 mg (systemic) melatonin supplementation reduced pocket depth; although the difference was not statistically significant and hence cannot be interpreted or used for conclusive evidence. Risk of Bias Assessment tool (RoBANS) and Cochrane Collaboration RoB tool elicited a high risk of bias in the included studies. GRADE (recommendation assessment, development, and evaluation) inferred a weak recommendation for the use of melatonin in periodontitis management.

Conclusions: Melatonin supplementation (topical and systemic) in periodontitis patients improved key periodontal parameters including pocket depth and clinical attachment loss.

Clinical Relevance: Melatonin could be a potential host modulatory agent for periodontitis management; although the data from the present review should be interpreted carefully due to the associated high risk of bias.
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http://dx.doi.org/10.3390/ma14092417DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8124881PMC
May 2021

Third molar impaction in the Jazan Region: Evaluation of the prevalence and clinical presentation.

Saudi Dent J 2021 May 4;33(4):194-200. Epub 2020 Mar 4.

Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia.

Objective: To provide information on the prevalence and clinical features of impacted third molar teeth in the South-Western region of Saudi Arabia.

Material And Methods: In this cross-sectional study, 1200 panoramic radiographs (50% males and 50% females) were retrieved from the electronic clinical records of patients at the College of Dentistry, Jazan University from December 2014 to December 2016, and impacted third molars were evaluated. Data on clinical and radiographic presentation were analyzed.

Results: Overall, there were 291 (24.3%) patients with impacted third molars among 1200 radiographs. The distribution of impacted third molars according to the number of impacted teeth was as follows: one impaction in 121 (41.6%); two impactions in 90 (30.9%); three impactions in 42 (14.4%); and four impactions in 38 (13.1%) patients. There was a high prevalence of all impaction types among females (54.5%). Maxillary vertical angulation was most common (50%) followed by mandibular mesioangular angulation (48.3%). The depth of impaction in maxillary teeth was higher than in mandibular teeth. Pain was uncommon (4.5% of patients).

Discussion: Clinically, vertical impaction in the maxilla was present in 50% of patients because of limited posterior space, and mesioangular angulation in the mandible was present in 48% of patients because of inadequate space between the ramus and the second molar. These findings are similar to other reports. Vertical impaction of the maxillary wisdom tooth is mostly related to the discrepancy between the mesiodistal size of the tooth crown and the limited retromolar space.

Conclusion: Noiseless presentation of an impacted third molar requires raising the population's awareness about the need for diagnosis and treatment of the problem to avoid any further complications. The study can be to guide surgical procedures. This study documented the prevalence, pattern, and clinical features of impacted third molars in South Western region of Saudi Arabia.
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http://dx.doi.org/10.1016/j.sdentj.2020.02.004DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8117367PMC
May 2021

Gingival crevicular fluid infiltrating CD14+ monocytes promote inflammation in periodontitis.

Saudi J Biol Sci 2021 May 21;28(5):3069-3075. Epub 2021 Feb 21.

Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry Jazan University, Jazan 45412, Saudi Arabia.

Periodontitis is a condition that occurs because of inflammation-mediated tissue degeneration. Many studies have been conducted to identify inflammatory molecules in periodontitis, but the well-defined role of cells from the immune system in the progression of periodontitis as well as in gingival tissue degeneration has not been appropriately established. The objective of the present study was to characterize the monocytes isolated from the gingival crevicular fluid (GCF) in patients with periodontitis. GCF was obtained from periodontitis patients and healthy controls. Cytokine levels of CCL2 were evaluated by ELISA in GCF samples. CD14+ monocytes were separated using magnetic sorting from GCF. RT-qPCR was performed to assess the gene expression. Cytometric bead array analysis was performed to analyze the levels of cytokines and chemokines in the secretome of cells. CD14+ monocytes from GCF secreted higher levels of CCL2 and showed elevated expression of genes responsible for monocyte migration. Additionally, upon lipopolysaccharide stimulation, these monocytes secreted higher levels of inflammatory cytokines and chemokines. This investigation aids in understanding the inflammatory microenvironment of periodontitis by characterizing GCF in terms of infiltrated CD14+ monocytes, cytokines, and molecules secreted by these monocytes, which are specific for cellular differentiation.
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http://dx.doi.org/10.1016/j.sjbs.2021.02.049DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8116999PMC
May 2021

Necrotizing periodontal diseases in human immunodeficiency virus-infected patients receiving highly active antiretroviral therapy: A review.

Dis Mon 2021 Sep 24;67(9):101168. Epub 2021 Feb 24.

College of Dental Medicine, Roseman University of Health Sciences, Utah, United States. Electronic address:

Human immunodeficiency virus-infected patients have depleted CD4 lymphocyte counts and are susceptible to a plethora of infections of bacterial, viral, and fungal etiology. In addition to a wide range of systemic manifestations, human immunodeficiency virus-infected patients also display several characteristic oral manifestations. Studies have shown a correlation between some of the oral manifestations and CD4 lymphocyte counts which in turn is an independent prognostic indicator. To tackle the human immunodeficiency virus numerous drugs have been discovered and implemented. To overcome any potential resistance, human immunodeficiency virus patients are prescribed highly active antiretroviral therapy, wherein a combination of antiretroviral regimens are used. Studies have shown that in addition to controlling the viral activity, the treatment regimen, has a significant effect on the oral manifestations of the human immunodeficiency virus-infected patients. The present paper highlights the effects of highly active antiretroviral therapy on periodontal diseases in human immunodeficiency virus-infected individuals.
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http://dx.doi.org/10.1016/j.disamonth.2021.101168DOI Listing
September 2021

Quality and readability of web-based Arabic health information on periodontal disease.

BMC Med Inform Decis Mak 2021 02 4;21(1):41. Epub 2021 Feb 4.

Prosthodontics Unit, School of Dental Sciences, Health Campus, Universiti Sains Malaysia, 16150 Kubang Kerian, Kelantan, Malaysia.

Background: Currently, the Internet seems to be a helpful tool for obtaining information about everything that we think about, including diseases, their prevention and treatment approaches. However, doubts exist regarding the quality and readability of such information. This study sought to assess the quality and readability of web-based Arabic information on periodontal disease.

Methods: In this infodemiological study, the Google, Yahoo!, and Bing search engines were searched using specific Arabic terms on periodontal disease. The first 100 consecutive websites from each engine were obtained. The eligible websites were categorized as commercial, health/professional, journalism, and other. The following tools were applied to assess the quality of the information on the included websites: the Health on the Net Foundation Code of Conduct (HONcode), the Journal of the American Medical Association (JAMA) benchmarks, and the DISCERN tool. The readability was assessed using an online readability tool.

Results: Of the 300 websites, 89 were eligible for quality and readability analyses. Only two websites (2.3%) were HONcode certified. Based on the DISCERN tool, 43 (48.3%) websites had low scores. The mean score of the JAMA benchmarks was 1.6 ± 1.0, but only 3 (3.4%) websites achieved "yes" responses for all four JAMA criteria. Based on the DISCERN tool, health/professional websites revealed the highest quality of information compared to other website categories. Most of the health/professional websites revealed moderate-quality information, while 55% of the commercial websites, 66% of journalism websites, and 43% of other websites showed poor quality information. Regarding readability, most of the analyzed websites presented simple and readable written content.

Conclusions: Aside from readable content, Arabic health information on the analyzed websites on periodontal disease is below the required level of quality.
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http://dx.doi.org/10.1186/s12911-021-01413-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7863442PMC
February 2021

Efficacy of vitamin C supplementation as an adjunct in the non-surgical management of periodontitis: a systematic review.

Syst Rev 2021 01 4;10(1). Epub 2021 Jan 4.

Department of Maxillofacial Surgery & Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.

Background And Objective: The antioxidant potential of vitamin C is useful in reducing oxidative stress, free radicals, and reactive oxygen species, which may assist in the improved outcomes of periodontal therapy. This systematic review was aimed to evaluate the effectiveness of vitamin C supplementation as an adjunct to non-surgical periodontal therapy, in the management of periodontitis.

Data Sources: PubMed, EMBASE, Cochrane Library, and Web of Science.

Study Eligibility Criteria: Randomized controlled trials published between January 1990 and March 2020.

Participants: People 18 years and older with periodontitis.

Study Appraisal And Synthesis Methods: The Critical Appraisal Skills Programme (CASP) quality appraisal tool.

Results: The initial search yielded 441 articles out of which six studies fulfilled the inclusion criteria. Vitamin C supplementation helped improve bleeding indices in gingivitis but did not significantly lead to reduction of probing depths or clinical attachment gain for periodontitis.

Conclusion: Administration of vitamin C as an adjunct to non-surgical periodontal therapy did not result in clinically significant improvements in pocket probing depths at 3 months in periodontitis patients. With the limited evidence available, no recommendation can be made for supplementation of vitamin C in conjunction with initial periodontal therapy for subjects with periodontitis to improve primary treatment outcome measures.
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http://dx.doi.org/10.1186/s13643-020-01554-9DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7780401PMC
January 2021

Melatonin levels in periodontitis vs. the healthy state: A systematic review and meta-analysis.

Oral Dis 2020 Oct 15. Epub 2020 Oct 15.

Department of Preventive Dental Science, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

The aim was to provide a comprehensive qualitative and quantitative assessment of any potential differences in melatonin levels in periodontitis vs. the healthy state. The keyword combination "melatonin" AND "periodontitis" was searched in Web of Science, PubMed, and Scopus. Qualitative analysis and quantitative analysis were performed on articles satisfying the inclusion criteria. Only 14 studies were included in the systematic review, out of which only 10 had quantitative data compatible with a meta-analysis. Ten studies demonstrated low melatonin in periodontitis, three studies demonstrated an initial reduction in melatonin levels followed by elevation with worsening of periodontitis, and one study showed an elevation in melatonin levels in the transition from a healthy state to periodontitis. Grading of recommendations assessment, development, and evaluation revealed that all the included studies had low to very low overall evidence. The meta-analysis revealed a significant reduction (p < .0001) in salivary melatonin levels in chronic periodontitis (3.26 ± 3.44 pg/ml) compared with healthy controls (5.27 ± 5.39 pg/ml), with a mean difference of 2.65 ± 7.84 and a confidence interval of 1.94-3.36. The significantly lower salivary melatonin levels in periodontitis must be inferred with caution given the low quality of the included studies.
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http://dx.doi.org/10.1111/odi.13679DOI Listing
October 2020

Advanced diagnostic aids for oral cancer.

Dis Mon 2020 Dec 25;66(12):101034. Epub 2020 Jun 25.

College of Dental Medicine, Roseman University of Health Sciences, South Jordan, Utah 84095, United States. Electronic address:

Oral cancer, a universal malady, has become a stumbling block over the years due to its significant morbidity and mortality rates. The greater morbidity associated with this deadly disease is attributed to delay in its diagnosis / its presentation in advanced stage. Being multifactorial, Oral squamous cell carcinoma (OSCC) is the outcome of genetic and epigenetic instability. However, in many instances, oral cancer is preceded by precursor lesions named as oral potentially malignant disorders (OPMDs), the early detection of which makes it beneficial for patients with the possible increase in the productive longevity. Many diagnostic tools / aids have been explored with the aim of early detection of oral precancer and cancer. The basic chair-side procedures or relatively advanced aids come with a set of limitations along with subjectivity as one of the setbacks. The advent and exploitation of molecular techniques in the field of health diagnostics, is demanding the molecular typing of the OPMDs and also of oral cancer. The saga of various diagnostic aids for OSCC has witnessed the so-called latest trends such as lab-on-chip, microfluidics, nano diagnostics, liquid biopsy, omics technology and synthetic biology in early detection of oral precancer and cancer. Oral cancer being multifactorial in origin with the chief participation of altered genetics and epigenetics would demand high-end diagnostics for designing personalized therapy. Hence, the present paper highlights the role of various advanced diagnostic aids including 'omics' technology and synthetic biology in oral precancer and cancer.
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http://dx.doi.org/10.1016/j.disamonth.2020.101034DOI Listing
December 2020

The effectiveness of oral hygiene instructions in sign language among hearing impaired adults in Saudi Arabia.

Spec Care Dentist 2020 Jan 6;40(1):41-48. Epub 2019 Nov 6.

Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Jazan, Saudi Arabia.

Objective: To improve knowledge of oral health among the hearing impaired in Saudi Arabia using videos with detailed oral hygiene instructions in Arabic sign language.

Methods: Videos of oral hygiene instructions in Arabic sign language were produced under the supervision of a periodontist. Fifty male subjects above 18 years of age were chosen randomly from different deaf schools in Jazan, Saudi Arabia and divided into two groups as follows: Group 1 received printed booklets with oral hygiene instructions, and Group 2 received videos of the same instructions in Arabic sign language. Knowledge regarding oral health and hygiene practice was evaluated with the aid of a questionnaire before and after 4 weeks.

Results: The estimated marginal mean of the knowledge regarding oral hygiene in Group 1 was 3.37, which was slightly increased to 4.40 after 4 weeks of general instructions. The estimated marginal mean in Group 2 was 3.70 before the distribution of the videos, which was significantly increased to 11 after 4 weeks (P < .001).

Conclusion: Videos of oral hygiene instructions in Arabic sign language had immensely improved knowledge regarding oral health and hygiene practices in the deaf/hearing impaired patients in this study.
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http://dx.doi.org/10.1111/scd.12428DOI Listing
January 2020

Correction to: The accuracy and reliability of digital measurements of gingival recession versus conventional methods.

BMC Oral Health 2019 Aug 30;19(1):199. Epub 2019 Aug 30.

Division of Periodontics, College of Dentistry, Jazan University, P.O.Box 114, Jazan, 45142, Saudi Arabia.

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http://dx.doi.org/10.1186/s12903-019-0876-4DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6716887PMC
August 2019

The accuracy and reliability of digital measurements of gingival recession versus conventional methods.

BMC Oral Health 2019 07 16;19(1):154. Epub 2019 Jul 16.

Division of Periodontics, College of Dentistry, Jazan University, P.O.Box 114, Jazan, 45142, Saudi Arabia.

Background: An apical shift in the position of the gingiva beyond the cemento-enamel junction leads to gingival recession. This study aimed to evaluate the reproducibility of digital measurements of gingival recession when compared to conventional measurements taken clinically using periodontal probes.

Methods: Gingival recession was measured at 97 sites in the oral cavity by four examiners using the following methods: CP, direct measurement of gingival recession using William's periodontal probe intraorally; CC, measurements on cast models using a caliper; DP, digital measurement on virtual models obtained by intraoral scanning, and DC, digital measurements on virtual models of dental casts. Intra-class and inter-rater correlations were analyzed. Bland Altman plots were drawn to visually determine the magnitude of differences in any given pair-wise measurements.

Results: In this study, good inter-methods reliability was observed for almost all the examiners ranging from 0.907 to 0.918, except for one examiner (0.837). The greatest disagreements between the raters were observed for methods; CP (0.631) followed by CC (0.85), while the best agreements were observed for methods DP (0.9) followed by DC (0.872).

Conclusion: Variations in measurements between examiners can be reduced by using digital technologies when compared to conventional methods. Improved reproducibility of measurements obtained via intraoral scanning will increase the validity and reliability of future studies that compare different treatment modalities for root coverage.
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http://dx.doi.org/10.1186/s12903-019-0851-0DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6636111PMC
July 2019

Papillon-Lefèvre Syndrome: A Rare Case Report of Two Brothers and Review of the Literature.

Authors:
Hytham N Fageeh

Int J Clin Pediatr Dent 2018 Jul-Aug;11(4):352-355. Epub 2018 Aug 1.

Diplomate and Vice Dean, Division of Periodontics, Department of Preventive Dental Sciences, College of Dentistry, Jazan University, Jazan, Kingdom of Saudi Arabia.

Papillon-Lefèvre is an autosomal recessive syndrome that starts in early periods of childhood. Characteristic features include palmar plantar hyperkeratosis, aggressive periodontal disease, and a tendency for dry and chopped skin, thin and sparse hair. Patients show signs of premature tooth loss at the age of 2 to 4 years, which is then followed by the loss of permanent dentition during adolescence. The presence of both skin and oral lesions in this syndrome differentiates this unusual genodermatosis from other pathology of palmoplantar keratoderma (PPK). The etiopathogenesis of this syndrome is somewhat obscure; however, immunologic, genetic, and possible bacterial etiologies have been proposed. The dental practitioner is often the first to diagnose the disease, as there is a significant degree of periodontal breakdown that is involved at an early age. This report presents a clinical presentation of two brothers detected with Papillon-Lefèvre syndrome (PLS). Fageeh HN. Papillon-Lefèvre Syndrome: A Rare Case Report of Two Brothers and Review of the Literature. Int J Clin Pediatr Dent 2018;11(4):352-355.
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http://dx.doi.org/10.5005/jp-journals-10005-1538DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6212664PMC
August 2018
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