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Abdalwhab Zwiri

Research

​​​A Randomized Controlled Trial Evaluating the Levels of the Biomarkers hs-CRP, IL-6, and IL-8 in Patients with Temporomandibular Disorder Treated with LLLT, Traditional Conservative Treatment, and a Combination of Both.

Authors : Zwiri, A.M.; Ahmad, W.M.A.W.; Asif, J.A.; Phaik, K.S.; Husein, A.; Kassim, N.K.; Ab-Ghani, Z​

Abstract :Temporomandibular disorders (TMDs) are a type of idiopathic orofacial pain. Inflammation, particularly elevated circulating levels of high-sensitivity C-reactive protein (hs-CRP), interleukin-6 (IL-6), and interleukin-8 (IL-8), has been linked to pain symptoms. The purpose of this study was to compare hs-CRP, IL-6, and IL-8 biomarkers and pain intensity with different treatment strategies (LLLT, standard conservative treatment, and combination) for TMD patients. Methods: A total of 32 participants were randomly included in the study and divided into three groups (Group I, Group II, and Group III) referred from the Dental Clinic, School of Dental Science, HUSM. Patients received LLLT (Groups II and III) in five sessions for the duration of 10 days. Patients in Groups I and III received standard conservative TMD treatment (diet and stress counseling, jaw exercises, physical therapy, which was a hot towel application) by the principal investigator. All blood samples for biomarkers were performed before starting treatments and directly after finishing the treatment protocols, where all results were recorded. Results: The result showed a significant difference in the mean IL-8 (p = 0.001) between the three intervention groups (LLLT, standard treatment, and combined treatment). IL-6 showed an increase in the mean of IL-6 levels from baseline to post-treatment with a better mean in the LLLT treatment group without any significant differences. Additionally, there were no significant mean differences found between the groups and in the group for the hs-CRP biomarker. Conclusions: A statistically non-significant difference was found in hs-CRP and IL-6 before and after LLLT, conservative, and combined treatment strategies of TMD. A statistically significant difference was observed in the mean levels of IL-8 between the LLLT intervention group and the combined treatment group. Although there was no statistically significant correlation between pain intensity and biomarkers, a statistically significant difference was found in pain intensity before and after LLLT, conservative, and combined treatment strategies. TMJ degeneration could be exacerbated by elevated IL-8 levels. Thus, this can be an important biomarker to mark or identify the painful condition of TMJ.

Keywords : IL-6; IL-8; LLLT; TMD biomarkers; TMD treatment; hs-CRP.

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​​​​​ IoT Adoption and Application for Smart Healthcare: A Systematic Review.

Authors : Al-rawashdeh, M.; Keikhosrokiani, P.; Belaton, B.; Alawida, M.; Zwiri, A. ​

Abstract :In general, the adoption of IoT applications among end users in healthcare is very low. Healthcare professionals present major challenges to the successful implementation of IoT for providing healthcare services. Many studies have offered important insights into IoT adoption in healthcare. Nevertheless, there is still a need to thoroughly review the effective factors of IoT adoption in a systematic manner. The purpose of this study is to accumulate existing knowledge about the factors that influence medical professionals to adopt IoT applications in the healthcare sector. This study reviews, compiles, analyzes, and systematically synthesizes the relevant data. This review employs both automatic and manual search methods to collect relevant studies from 2015 to 2021. A systematic search of the articles was carried out on nine major scientific databases: Google Scholar, Science Direct, Emerald, Wiley, PubMed, Springer, MDPI, IEEE, and Scopus. A total of 22 articles were selected as per the inclusion criteria. The findings show that TAM, TPB, TRA, and UTAUT theories are the most widely used adoption theories in these studies. Furthermore, the main perceived adoption factors of IoT applications in healthcare at the individual level are: social influence, attitude, and personal inattentiveness. The IoT adoption factors at the technology level are perceived usefulness, perceived ease of use, performance expectancy, and effort expectations. In addition, the main factor at the security level is perceived privacy risk. Furthermore, at the health level, the main factors are perceived severity and perceived health risk, respectively. Moreover, financial cost, and facilitating conditions are considered as the main factors at the environmental level. Physicians, patients, and health workers were among the participants who were involved in the included publications. Various types of IoT applications in existing studies are as follows: a wearable device, monitoring devices, rehabilitation devices, telehealth, behavior modification, smart city, and smart home. Most of the studies about IoT adoption were conducted in France and Pakistan in the year 2020. This systematic review identifies the essential factors that enable an understanding of the barriers and possibilities for healthcare providers to implement IoT applications. Finally, the expected influence of COVID-19 on IoT adoption in healthcare was evaluated in this study.

Keywords : IoT; IoMT; IoT adoption; systematic review; adoption theories; adoption factors; Internet of Things in healthcare; machine learning (ML); deep learning (DL)

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Effectiveness of the Laser Application in Temporomandibular Joint Disorder: A Systematic Review of 1172 Patients.

Authors : Zwiri, A., Alrawashdeh, M. A., Khan, M., Ahmad, W. M. A. W., Kassim, N. K., Ahmed Asif, J., Suan Phaik, K., Husein, A. & Ab-Ghani, Z ​

Abstract :Objective. The aim of this systematic review was to evaluate the effectiveness of laser application in temporomandibular joint disorder. Methods. PubMed, SCOPUS, Science Direct, Web of Science, and Google Scholar electronic databases were searched systematically with restricting the languages to only English and year (January 2001 to March 2020), and studies were selected based on the inclusion criteria. Study quality and publication bias were assessed by using the Robvis, a software package of R statistical software. Results. This systematic review included 32 studies (1172 patients) based on the inclusion and exclusion criteria. Most of the studies reported significant reduction of pain by the use of the laser during TMD treatment. Two-thirds of the study (78.13%) found a better outcome comparing with conventional one. According to Robvis, 84.4% of the studies were high methodological studies with low risk of bias. Conclusion. TMD patients suffer with continuous pain for long time even after conventional treatment. Laser therapy shows a promising outcome of pain reduction for TMD patients. Therefore, laser therapy can be recommended for the TMD patients’ better outcome. This trial is registered with PROSPERO (CRD42020177562).

Keywords :TMD, orofacial pain, laser therapy

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​​​​​Biomarkers for Temporomandibular Disorders: Current Status and Future Directions

Authors : Abdalwhab Zwiri , Mohammad Al-Hatamleh ,Wan Muhamad Amir W.Ahmad , Jawaad AhmedAsif ,SuanPhaikKhoo4, Adam Husein , Zuryati Ab-Ghani, and Nur Karyatee Kassim ​

Abstract :Numerous studies have been conducted in the previous years with an objective to determine the ideal biomarker or set of biomarkers in temporomandibular disorders (TMDs). It was recorded that tumour necrosis factor (TNF), interleukin 8 (IL-8), IL-6, and IL-1 were the most common biomarkers of TMDs. As of recently, although the research on TMDs biomarkers still aims to find more diagnostic agents, no recent study employs the biomarker as a targeting point of pharmacotherapy to suppress the inflammatory responses. This article represents an explicit review on the biomarkers of TMDs that have been discovered so far and provides possible future directions towards further research on these biomarkers. The potential implementation of the interactions of TNF with its receptor 2 (TNFR2) in the inflammatory process has been interpreted, and thus, this review presents a new hypothesis towards suppression of the inflammatory response using TNFR2-agonist. Subsequently, this hypothesis could be explored as a potential pain elimination approach in patients with TMDs

Keywords : TMJ, maxillofacial, cytokines, inflammation, pain

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​​​​​ Accuracy of cone beam computed tomography in the assessment of mandibular molar furcation defects

Authors :Alzwiri A, Ismail HS, Patil SR. ​

Abstract :Objective: To evaluate the accuracy of cone-beam computed tomography (CBCT) in the assessment of mandibular molar furcation defects. Material and Methods: Thirty patients with furcation defects were selected, oral hygiene instructions, scaling, and root planing with ultrasonic devices and hand instruments and occlusal adjustments were performed. Pre-surgical clinical measurements were carried out at the buccal aspect of the selected mandibular molars. The horizontal furcation measurements were measured with a Nabers Probe starting at the furcation entrance to the greatest horizontal depth. The degree of furcation involvement was graded from 0 to III. Bone loss in the horizontal and vertical direction and the width of the furcation entrance were measured on CBCT and after reflecting the full-thickness flap and debridement of the defects. The data were analyzed using t-test and Pearson’s correlation coefficient. Results: The width of furcation entrance in clinical method was 3.27 ± 0.77, while in CBCT method was 3.35 ± 0.71, clinically the vertical bone loss was 3.61±1.09, while in CBCT was 3.57 ± 1.15, horizontal bone loss in clinical method was 5.08 ± 2.21, while in CBCT was 5.11 ± 2.23. No significant difference between the two methods was noted, and a high correlation between the two methods was observed. With regards to the agreement between the two methods of assessment, the width of furcation entrance revealed a difference between the two methods by 0.08 ± 0.21, while vertical bone loss showed difference between the two methods by -0.04 ± 0.19, the horizontal bone loss showed a mean difference between the two methods by 0.03 ± 0.21. Conclusion: CBCT provided high accuracy for the furcation involvement detection and anatomy of surrounding periodontal tissues.

Keywords :Cone-Beam Computed Tomography, Furcation Defects, Molar

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​​​​​Obstructive sleep apnea and its relation with temporomandibular disorders: A narrative review.

Authors : Zwiri AM, Ab Ghani Z, Husein A, Suan Phaik K, Kassim NK, Zainal SA, et al​

Abstract :Sleep-disordered breathing (SDB) is a broad terminology that denotes a group of disorders. Conditions associated with SDB include obstructive sleep apnea (OSA), central sleep apnea, and upper airway resistance syndrome. Although OSA is most common in the general population, the reported prevalence shows a wide range of differences due to inconsistent study methodology. The pathophysiology of OSA has been described by active and passive theories. Polysomnography is considered as the gold standard and the most accurate tool for the diagnosis of OSA. Definitive diagnosis and determination of the severity of the OSA are instrumental before the commencement of the treatment. Patients with OSA are at increased risk of various endocrinal and metabolic disorders. OSA and temporomandibular disorders (TMD) have shown a clear relationship due to the highly prevalent rate of OSA in individuals with TMD. It may be concluded that concomitant TMD and sleep bruxism may be present in patients with OSA. Furthermore, the use of oral appliances in the treatment of OSA in mandibular advancement may cause TMD. The aim of this article was to review current knowledge on OSA and the association between TMD and OSA. This review also emphasizes that concomitant TMD in OSA is an object worthy of future study. Keywords: Bruxism, Obstructive Sleep Apnea, Temporomandibular Disorders

Keywords :Bruxism, Obstructive Sleep Apnea, Temporomandibular Disorders

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Hormonal fingerprints: A potential screening tool

Authors : Issrani R, Alzwiri A, Prabhu N, Hashem AS​

Abstract :The ratio between second and fourth digit lengths (2D:4D ratio) is termed as hormonal fingerprint. This ratio is sexually dimorphic and can be measured by various methods using digital vernier calipers, radiographs, photographs, photocopies, and scanners. In the medical scenario, 2D:4D ratio is used as a biological marker for predicting and diagnosis of many metabolic disorders mainly coronary heart disease and autism, whereas, in dentistry, this method is still in blooming stage. This article highlights the role of hormonal fingerprints as potential biomarkers in early diagnosis, prognosis, and early lifestyle interventions for many dental diseases

Keywords : Biomarker, caries risk, hormonal fingerprints, malocclusion, second‑to‑fourth digit ratio

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Upregulation of hsp90 in the tongue tissue of rats exposed to methyl methacylate.

Authors :Abdalwhab M. A. Zwiri. ​

Abstract :Exposure to Methyl Methacrylate (MMA) has been associated with several adverse effects including sensitivity reactions and inflammations. The objective of the present study was to explore the impacts of exposure to MMA on the tongue tissue of rat. The methodology involved the design of an experimental model of two groups control group (N = 10) and experimental group (N = 10). Experimental group rats received MMA 0.3 mgkg-1 body weight every day for 30 days. After the end of experiment, indirect immunoproxidase staining was carried out to study the expression of HSP90 in the tongue tissue of all rats. Study findings showed that the exposure of MMA increased significantly (p = 0.001) the expression of HSP90 in the tongue tissue of exposed rats. Taken together, the results of the present study demonstrated molecular impacts due to the exposure of MMA through the upregulation of HSP90 in the tongue tissue of exposed rats

Keywords :Methyl Methacrylate, HSP90 ,upregulation, rat, tongue

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Naidu when to use a particular statistical test in biomedical research?: a brief review

Authors :Abdalwahab MA Zwiri, Muhammad Nadeem Baig, Sudhakar Vundavalli, Radhika Doppalapudi, Guntipalli M. Naidu ​

Abstract :Statistics helps in interpreting results of study correctly and critically evaluating literature. As a researcher, knowing which test of significance is indicated in comparing different variables is sufficient and rest can be done by software. Test of significance is one of the common basic functions in statistics;this review presents various tests of significance in a simple form which should help researchers for quick reference in selecting an appropriate test for their research work.

Keywords : statistics, test of significance, post hoc analysis.

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​​​​​Influence of time on masticatory efficiency and muscular activity in bilateral free end saddle with different tooth width.

Authors :Mohammed Assayed Mousa, Edward Lynch, Mohd G. Sghaireen, Abdalwhab M.A. Zwiri, Osama A. Baraka. ​

Abstract :Purpose: To evaluate the influence of time on masticatory efficiency and muscular activity during mastication of different types of test foods in participants fitted with a lower bilateral free-end saddle removable partial denture (RPD) with wide or narrow teeth. Methods: Thirty-six participants consented to undergo evaluation of their masticatory efficiency and recording of their muscular activity, while they wore an RPD with a unified bilateral design, during mastication of different types of test foods. The width of the artificial teeth was changed as follows. Initially (A), the length was adjusted so that the distal end of the mandibular second molars occluded with the distal end of the maxillary second molar (buccolingual width of 7-8 mm). Next (B), the width was decreased to half the maxillary second molars (buccolingual width of only 5 mm). A statistical analysis was performed using SAS software. One-way analysis of variance (ANOVA) was performed followed by Duncan's multiple range tests. Results: At the 2-month follow-up visit, wider teeth demonstrated greater masticatory efficiency than narrower teeth. However, after 4 months, no significant differences were observed between the two tooth widths. No significant differences in muscular activity were observed. Conclusion: A reduction of the occlusal table width in free-end saddle RPDs resulted in decreased masticatory efficiency 2 months after denture fabrication, but there was no significant difference in muscular activity between narrow and wide teeth. However, after 4 months, the masticatory efficiency of the participants with narrower teeth improved without any changes in muscular activity

Keywords : ennedy class I; Masseter; electromyographic; masticatory efficiency; muscle activity; narrow teeth; temporalis.

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Prevalence of developmental oral mucosal lesions among a sample of denture wearing patients attending college of dentistry clinics in aljouf university

Authors : Abdalwhab M.A .Zwiri, santosh patil, Fadi AL- Omair, Mohammed Assayed Mousa, Ibrahim Ali Ahmad. ​

Abstract :Introduction: developmental oral lesions represent a group of normal lesions that can be found at birth or evident in later life. These lesions include fissured and geographic tongue, Fordyce’s granules and leukoedema. Study aims: to investigate the prevalence of some developmental oral mucosal lesions among dental patients wearing dentures who were attending college of dentistry clinics in Aljouf University, and specialized dental center of ministry of health. Methods and subjects: a retrospective design was conducted to collect data from 344 wearing denture dental patients who were attending college of dentistry clinics in Aljouf University, and specialized dental center of ministry of health. A working excel sheet was created for patients and included data related to personal information such as age and gender; and oral developmental lesions. The software SPSS version 20 was used to analyze data. Statistical tests including frequency, percentages, and One way Anova were used to describe data. Significance was considered at alpha level <0.05. Study findings: the majority of participants were males (86%), the mean age was 51.60+ 3.51years. The prevalence of fissured tongue was 10.2%, geographic tongue 11.3%, Fordyce’s granules 7%, and leukoedema 7.3%. Age was significantly associated with fissured tongue (p=0.04), and Fordyce’s granules (p=0.003). Gender was not associated significantly with any of the studied lesions. Conclusion: developmental oral lesions among dental patients wearing dentures exist with varying rates of prevalence as well as it provides valuable basic data about the prevalence of oral mucosal lesions among patients seeking dental care in Aljouf area.

Keywords : Oral lesions, fissured tongue, geographic tongue, leukoedema, Fordyce’s granules

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Root and Root canal Morphology of permanent third molar in a Jordanian subpopulation

Authors : Ibrahim Ali Ahmad, Manal Mahmoud Azzeh, Abdalwahab M. A. Zwiri,“Mohd Ashraf” Shakib Abu Haija, Maha Methqal Diab.​

Abstract :Introduction: The aims of this study were to (1) investigate the root and root canal morphology of human third molars in a Jordanian subpopulation and (2) determine the effect of age, gender, and tooth location on the morphology of these teeth. Materials and Methods: A total of 159 maxillary and mandibular third molars were used in this study. After canal staining and tooth clearing, the specimens were examined, and the following morphological features were recorded: Number of roots and presence of roots fusion, number of canals and their configurations in each root, total number of canals per tooth, and incidence of lateral canals and intercanal communications. Results: The majority (74.2%) of maxillary molars had 3 roots and 3 (55.1%) or 4 (27%) canals while the majority (74.3%) of mandibular molars had 2 roots and 2 (38.6%) or 3 (45.7%) canals. Roots fusion was found in 70.1% of maxillary molars and 40.7% of mandibular molars. Type I canal configuration was the predominant type in distal roots of mandibular molars and distobuccal and palatal roots of maxillary molars. Multiple canals were evident in 36% of the maxillary mesiobuccal roots and 56% of mandibular mesial roots. Single/fused roots showed a wide range of canals number and configurations. The number of roots and canals in both molars did not differ with gender, age, and tooth location. Females had a higher incidence of roots fusion than males and this difference was significant in mandibular molars (P = 0.034). Conclusions: Third molars showed a range of root and canal morphologies. Careful preoperative assessment is essential before commencing root canal treatment on these teeth.

Keywords :Clearing technique; Jordanian population; root canal system; third molars

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Prevalence of temporomandibular joint disorder among North Saudi University students

Authors : Abdalwhab M. A. Zwiri, Mahmoud K. Al-Omiri​

Abstract :Objective: The aim of the current investigation was to study the prevalence of temporomandibular disorder (TMD) among university students of North Saudi Arabia. Methods: A specifically constructed questionnaire was distributed to 489 university students to investigate the prevalence of temporomandibular joint (TMJ) findings among them. The study sample consisted of 346 males and 143 females (age range was 18-25 years). The data were analyzed, and probability values were set at p ≤ 0.05. Results: A total of 49.7% of participants had at least one sign or symptom of TMD. Clicking was the most reported finding. Pain in or about the ears/cheeks was the second most common finding. In all, 24.3% of the participants reported one TMJ finding; meanwhile, 0.4% reported the presence of five concurrent TMJ signs and symptoms. Females reported more TMJ signs and symptoms than males (p < 0.05). Science and health students reported more TMD findings than humanitarian college students (p < 0.05). Discussion: University students in north Saudi Arabia reported high prevalence of TMD. Also, students from science and health colleges reported higher prevalence of TMD findings than humanitarian college students. Clicking and pain are the most prevalent findings of TMD among university students. The results of this investigation highlight the need for additional research to shed more light on the risk factors and findings related to TMD. This will facilitate drawing adequate guidelines for prevention and management of TMD.

Keywords : Prevalence; Saudi; TMD; Temporomandibular dysfunction; Temporomandibular joint; University students.

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​​​​​The Prevalence And Associated Factors Of Denture Wearing Associated Oral Lesions Among Dental Patients Attending College Of Dentistry Clinics In Aljouf University

Authors : ​Abdalwhab M. A. Zwiri

Abstract :Background: oral lesions can be induced by wearing dentures and have been associated with impacting the quality of life of dental patients. Study objectives: to determine the prevalence of denture associated oral lesions and their associated possible factors in college of dentistry clinics, Aljouf University. Methods and subjects: this was a retrospective study to collect data from files of patients who wear dentures. The study included 344 patients. All files were reviewed and the extracted data were further analyzed using SPSS version 20. The relationships between variables were tested using One Way Anova and Pearson correlation. Data were presented as frequencies, percentages, means, and standard deviation. Significance was examined at alpha < 0.05. Results: a total of 344 files were reviewed. The following oral lesions were found: denture stomatitis (48.8%), papillary hyperplasia (39.8%), traumatic keratosis (22.1%), angular cheilitis (16.9%), and erythematous candidiasis (10.2%). No significant relationships were found between oral lesions and both age and gender bases on One Way Anova test. Pearson correlation showed a significant positive correlation between traumatic keratosis and age (r=0.110, p=0.042), and a negative correlation between traumatic keratosis and erythematous candidiasis (r=-0.110, p=0.039). Conclusions: The present studies showed that oral lesions associated with wearing denture are prevalent and create health problems that impact the quality of life of dental patients

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Aggressive adenoid cystic carcinoma involving palate extending to maxillary sinus in a young female

Authors : Santosh R. Patil, Abdalwahab M. Alzwiri Zwiri, Krishna A. Rao1, Ravi Kumar Gudipaneni2, Kuraym Khalid Alenaz​

Abstract :Adenoid cystic carcinoma (ACC) is a rare malignant tumor that affects the head and neck region. It is a malignant tumor arising from minor salivary glands, palate being the most common intraoral location, usually affecting individuals of the fifth decade. This tumor generally has a slow growth rate, and it is often present for several years before the patient seeks treatment. We report a case of extensive ACC involving palate, extending to a maxillary sinus in a young lady.

Keywords : Adenoid cystic carcinoma, cylindroma, minor salivary glands, prognosis

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​​​​​Recurrent aphthous stomatitis (RAS): a preliminary within-subject study of quality of life, oral health impacts and personality profiles

Authors : Mahmoud K Al-Omiri 1, Jumana Karasneh, Mohannad M Alhijawi, Abdalwhab M A Zwiri, Crispian Scully, Edward Lynch​

Abstract :Background: RAS may affect quality of life and impacts oral health and daily activities; consequently, psychological factors, dental needs and patients' perceptions. Professionals should understand this relation to adequately manage oral ulcers. This study aimed at investigating the relationship between oral health impacts, oral health-related quality of life and psychological profiles in patients with recurrent aphthous stomatitis (RAS). Methods: Fifty-three patients (30 men and 23 women, mean age: 31.1 ± 10.1 years) with RAS participated in this study. During ulcer episodes, participants completed Hospital Anxiety and Depression Scale (HAD), Neuroticism-Extraversion-Openness Five Factor Inventory (NEO-FFI), Oral Health Impact Profile (OHIP-14) and United Kingdom Oral Health-Related Quality of Life measure (OHQoL-UK) proformas. Patients completed OHIP-14 and OHQoL-UK again when they were ulcer-free. The statistically significance levels were set at P ≤ 0.05. Results: During ulcer episodes, patients reported worse oral health impacts and an inferior quality of life in comparison with ulcer-free times (P < 0.0001). Higher OHIP scores were significantly associated with higher HAD depression (P = 0.036) and anxiety (P = 0.012) scores. NEO-FFI scores had no significant relations with OHIP and OHQoL-UK scores (P > 0.05). During ulcer-free periods, no relationships were detected between OHIP, OHQoL-UK, HAD and NEO-FFI scores (P > 0.05), except between OHQoL-UK and conscientiousness scores (P = 0.05). Conclusions: RAS increased the negative oral health impacts on patients and consequently lowered their quality of life. Stressful situations and conditions (including anxiety and depression), rather than inherent personality profiles and stable psychological traits, were related to oral health impacts and quality of life in patients with RAS.

Keywords :HAD scale; NEO-FFI; OHIP-14; OHQoL-UK; recurrent aphthous stomatitis.

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​​​​​Role of female reproductive hormones estrogen and progesterone in temporomandibular disorder in female patients

Authors : Santosh R Patil, Nidhi Yadav, Mohammed Assayed Mousa, Abdalwhab M.A. Zwiri, Mohamed Kassab, Rohit Sahu, Satish Chuggani.​

Abstract :Aim: The aim of the present study is to investigate the role of female reproductive hormones estrogen and progesterone in temporomandibular disorder (TMD) in female patients.Materials and Methods: Serum estrogen and progesterone levels of 200 female participants who had varying grades of TMD were measured by enzyme immunoassay competition method in the luteal phase of menstrual cycle.Results: Mean serum concentration of estrogen was 302.1 ± 3.16 pg/mL, and the mean serum concentration of progesterone was 1.68 ± 38.3 ng/mL. Mean serum levels of estrogen and progesterone increased with increasing severity of TMD.Conclusion: Increased serum levels of estrogen and progesterone with increased grade of severity of TMD suggest role of these hormones as etiological factors for TMD.

Keywords : Estrogen, menstrual cycle, progesterone, temporomandibular disorders

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​​​​​Prevalence of Recurrent Aphthosis and the Possible Pathogenetic Role of Oral Hygiene Practices among Aljouf University Students Attending the College of Dentistry's Clinics , Sakaka , Saudi Arabia

Authors :Abdalwhab Zwiri ​

Abstract :

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​​​​​Anxiety, Depression and Quality of Life among Patients with Recurrent Aphthous Ulcers

Authors : ​Abdalwahab M A Zwiri

Abstract :Background: Recurrent aphtous ulcers (RAUs) are of the most painful and common oral mucosal diseases with uncertain etiology including trauma, genetics, stress, immune dysfunction, and vitamin deficiencies. The aim of this study was to investigate the relationship between oral health impacts, patients' oral health-related quality of life and anxiety and depression in patients with recurrent aphtous ulcers. Subjects and methods: Sixty patients were diagnosed RAU (30 men and 30 women, mean age: 29.5 ± 9.6 years) and sixty controls, who matched the patients with age and gender, participated in this study. Participants completed hospital anxiety and depression (HAD) scale, oral health impact profile (OHIP-14), and United Kingdom oral health related quality of life measure (OHQoL-UK). The statistically significance le Results: Both patients and controls reported comparable depression and anxiety scores (p > 0.05). Ulcer patients reported worse oral health impacts and inferior quality of life in comparison to controls (p < 0.001). Among both groups, no relationships were detected between HAD scores on one hand and OHIP and/or OHQoL-UK on the other hand (p > 0.05).vels were set at p ≤ 0.05. Conclusions: Recurrent aphthous ulcers increase the negative oral health impacts on patients and consequently cause inferior quality of life. Stressful situations and conditions (including anxiety and depression) were not related to oral health impacts and quality of life in patients with RAUs

Keywords :HAD scale; OHIP-14; OHQoL-UK; Recurrent aphthous ulcers.

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​​​​​Knowledge, Attitudes, Practices and Effectiveness of an Oral Hygiene Program among Saudi Male Children in Aljouf.

Authors : Abdalwhab MA Zwiri​

Abstract :Objective: The study was aimed to assess the knowledge, attitude and practices among male children living in Aljouf in KSA. This study also targeted to know the effectiveness of a preventive oral hygiene program. Material and methods: The study participants were male children (n = 324) between the age group of 5 and 10. The participants filled a questionnaire that aimed to evaluate their knowledge and attitude and oral hygiene practices. The preventive program was based on professional cleaning, dental health information and oral hygiene instruction over a period of 6 months. Results: One hundred thirty two (40.74%) children were aware about caries as one of the common problem associated with mouth and teeth. Though 44.13% children were aware that sweets and chocolates were the causative factors for dental caries, they were not aware of the other major factors that cause dental problems and how it can be prevented. The participants’ oral hygiene habits were found to be irregular, and children consulted the dentist only when there was pain (35.80 %). Teachers and care takers (58.64%) played an important role as a source of information to these children, than other sources. At the final examination of the preventive program the mean percentage of surfaces without visible plaque was 33.4 ± 26.8 in the experimental group and 16.5 ± 21.7 in the control group. Similar findings were reported in the gingival health status (p<0.05). Conclusion: The findings of this study showed that children’s teachers and care takers attitudes toward oral health and dental care need to be improved. Oral health educational packages and implementation of preventive programs for children and teachers of Aljouf are recommended.

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​​​​​COMPARATIVE EVALUATION OF NEWER DRUGS PENTOXIFYLLINE AND SPIRULINA IN THE MANAGEMENT OF OSMF

Authors :AMA Zwiri, S Patil, N Yadav ​

Abstract :Oral submucous fibrosis (OSMF) is a high risk premalignant condition predominantly seen in the Indian subcontinent. The aim of the present study was to compare the efficacy of newer drugs pentoxifylline and spirulina in the management of OSMF.112 subjects with clinic-pathologically diagnosed OSMF were included in the study and divided equally in 2 groups, Group A (pentoxifylline group) and Group B (spirulina group). Group A was administered 400 mg pentoxifylline twice daily and Group B was given 500 mg spirulina in 2 divided doses for 3 months. Evaluation for different clinical parameters was done at regular intervals and data was analyzed using the Student’s paired t test and Chi-square test. Pvalue <0.001 was considered to be statistically significant. The patients in both the groups showed improvement in all the parameters measured.Clinical improvements in mouth opening was significant in Group A (p<0.001) whereas, ulcers/erosions/vesicles showed significant (p<0.001) improvement in Group B. Subjective symptoms of pain associated with the lesion (p=0.0003) and burning sensation (p=0.0005) was statistically significant in Group A. However, few patients from Group A complained of bloating, nausea, anxiety and dyspepsia.Both the newer drugs showed improvements in the signs and symptoms in OSMF patients.Pentoxifylline can bring about significant clinical improvements in the symptoms like mouth opening and ulcers/erosions/vesicles, thereby improving the quality of life of the affected individuals.

Keywords :Oral submucous fibrosis ,Pentoxifylline ,Spirulina ,Treatment ,

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Anxiety due to Dental Treatment and Procedures among University Students and Its Correlation with Their Gender and Field of Study

Authors :Mohd G Sghaireen 1, Abdalwhab M A Zwiri, Ibrahim A Alzoubi, Sadeq M Qodceih, Mahmoud K Al-Omiri ​

Abstract :Aim of Study. To investigate dental anxiety levels among university students and its relation with their specialty and gender. Materials and Methods. 850 undergraduate university students were recruited into the study. The Modified Corah Dental Anxiety Scale (MDAS) was used to measure the levels of their dental anxiety. 700 questionnaires were returned, 390 females and 310 males (response rate of 0.92% among females, 0.73% among males). The MDAS score ranged from 5 to 25. Patients were considered to suffer from high dental anxiety if they scored 13 to 20 points. Statistical analysis significance was set at P ≤ 0.05. Results. Seven hundred students participated in this study including 13% of medical students, 10% of dental students, 58% of arts students, and 18% of computer science students. Medical and dental students were less anxious than arts and computer science students (P < 0.05). Local anesthesia injection was the most fearful dental procedure (P < 0.05). Females were more anxious than males (P < 0.05). Conclusion. Male students were less anxious than female students. Students from medical background faculties were less anxious than students from nonmedical faculties. Lack of adequate dental health education may result in a higher level of dental anxiety among nonmedical students in Saudi Arabia.

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The relationship between tobacco smoking and oral colonization with Candida species

Authors : Azmi Mohammad-Ghaleb Darwazeh 1, Ziad Nawaf Al-Dwairi, Abd Al-Wahab Al-Zwairi​

Abstract :Aim: The aim of this study was to assess and compare the quantitative and qualitative oral colonization of Candida species between a group of healthy tobacco smokers and a comparable group of nonsmokers, and to investigate a possible correlation between oral candidal colonization and the quantity or duration of the smoking habit. Methods and materials: Fifty smokers and 50 nonsmokers were included in the study. Candida species were isolated using the concentrated oral rinse (COR) technique and identified using the germ tube test and API 20 C AUX yeast identification system. Results: Overall candidal transmission was 84 percent. Candida species were isolated from 42 (84 percent) of the smokers and 37 (74 percent) of the nonsmokers (p>0.05). The mean CFU/ml were 333 (SD=358) and 268 (SD=332), respectively (p>0.05). Conclusion: Tobacco smoking did not appear to increase oral colonization with Candida species in healthy subjects. Clinical significance: The effects of smoking on oral tissues and the mechanisms by which Candida proliferate intra-orally as a result of cigarette smoking warrant additional study.

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