Nevin Manimala

Saudi Dent J. 2025 Oct 15;37(7-9):50. doi: 10.1007/s44445-025-00070-7.

ABSTRACT

PURPOSE: This study aimed to provide a comprehensive national overview of the prosthodontic workforce in Saudi Arabia, focusing on its demographic composition, educational background, geographic distribution, and workforce trends. The findings are intended to support policymakers in postgraduate education planning, and equitable access strategies to prosthodontics care.

MATERIALS AND METHODS: A retrospective cross-sectional analysis was conducted using official data obtained from the Saudi Commission for Health Specialties (SCFHS) as of May 2025. The dataset included all registered practicing prosthodontists across Saudi Arabia. Key variables included gender, nationality, professional classification, practice region, and postgraduate training background. The prosthodontist-to-population ratio was calculated based on the 2024 national census data. Descriptive statistics were used to analyze the characteristics of the prosthodontic workforce.

RESULTS: A total of 1,542 prosthodontists were identified across Saudi Arabia, resulting in a national ratio of 4.37 prosthodontists per 100,000 population. The workforce was predominantly male (65.8%), with females representing 34.2%. Non-Saudis accounted for 56.5% of the workforce, while Saudis made up 43.5%. Most prosthodontists were located in major metropolitan areas, with 34.1% practicing in Riyadh, 24.6% in Makkah, and 11.8% in the Eastern Region. The most common countries of postgraduate education were Egypt (29.3%), Saudi Arabia (27.3%), India (9.0%), and the United States (7.2%). The workforce was almost evenly divided between the public sector (48.3%) and the private sector (47.8%).

CONCLUSION: Saudi Arabia has witnessed steady growth in its prosthodontics workforce, marked by increased training capacity, diverse educational backgrounds, and encouraging participation of female practitioners. Despite this progress, challenges remain in achieving balanced gender representation, equitable regional distribution, and consistency in training standards. These findings highlight the importance of thoughtful workforce planning and the need to reassess classification systems and align training pathways with internationally recognized benchmarks. Such efforts will be essential to ensure high-quality, inclusive, and sustainable prosthodontics care across all regions.

PMID:41091410 | DOI:10.1007/s44445-025-00070-7

Saudi Dent J. 2025 Oct 15;37(7-9):51. doi: 10.1007/s44445-025-00063-6.

ABSTRACT

Considering the significant impact of the nasal form on the appearance of an individual, this study aimed to investigate the relationship between nasal morphology and skeletal malocclusion in a sample of Iranian population. In this descriptive cross-sectional study, 141 lateral cephalograms of individuals of both genders, aged 18 to 30 years were selected. The participants were classified into Class I, II, and III malocclusions. Then, naso-facial landmarks related to the form and shape of the nose and facial skeleton were manually traced on each lateral cephalogram and 13 angular and linear parameters were measured. These parameters were compared among the three types of malocclusions. Statistical analysis of the data was performed using ANOVA, Kruskal-Wallis, and Chi-square tests. P < 0.05 was considered significant. Most of the measurements such as nasal morphology as well as nasal height, nasal bone length, nasal bone angle, nasofrontal angle, dorsum length, total nasal length, nasal depth, columellar convexity, and nasal hump did not show significant differences among different malocclusions (p > 0.05). However, lower dorsum convexity, soft tissue convexity, naso-facial angle, and naso-mental angle were reported to have significant differences among different malocclusions (p < 0.05). According to the results of the present study, the overall shape of the nose is not affected by the type of underlying skeleton in the sample studied. However, future studies with larger sample sizes are recommended to further confirm the results of the present study.

PMID:41091395 | DOI:10.1007/s44445-025-00063-6

Lifetime Data Anal. 2025 Oct 15. doi: 10.1007/s10985-025-09672-z. Online ahead of print.

ABSTRACT

In many clinical trials, one is interested in evaluating the treatment effect based on different types of outcomes, including recurrent and terminal events. The most popular approach is the time-to-first-event analysis (TTFE), based on the composite outcome of the time to the first event among all events of interest. The motivation for the composite outcome approach is to increase the number of events and potentially increase power. Other composite outcome or composite analysis methods are also studied in the literature, but are less adopted in practice. In this article, we first review the mainstream composite analysis methods and classify them into three categories: (A) Composite-outcome Methods, which combine multiple events into a composite outcome before analysis, e.g., combining events into a time-to-event outcome in TTFE and into a single recurrent event process in the combined-recurrent-event analysis (CRE); (B) Joint-analysis Methods, which test for the recurrent event process and the terminal event jointly, e.g., Joint Frailty Model (JFM), Ghosh-Lin Method (GL), and Nelsen-Aalen Method (NA); (C) Win-ratio type Methods that account for the ordering of two types of events, e.g., Win-fraction Regression (WR). We conduct comprehensive simulation studies to evaluate the performance of various types of methods in terms of type I error control and power under a wide range of scenarios. We found that the non-parametric joint testing approach (GL/NA) and CRE have overall the best performance. However, TTFE and WR exhibit relatively low power. Also, adding events that have no or weak association with treatment usually decreases power.

PMID:41091394 | DOI:10.1007/s10985-025-09672-z

Saudi Dent J. 2025 Oct 15;37(7-9):57. doi: 10.1007/s44445-025-00064-5.

ABSTRACT

To assess and compare the post-fatigue fracture resistance of two types of ceramic crowns, zirconia and lithium-disilicate, when used with two margin designs (vertical and horizontal). Forty sound human premolar teeth collected from the orthodontic department were divided randomly into two main groups according to the type of ceramic material (n = 20): Group A: Lithium-disilicate and Group B: Monolithic zirconia. Each group was further subdivided according to the margin design into two subgroups (n = 10): feather-edge (1) and shoulder (2) preparation designs. After digital scanning and designing, the crowns were bonded with self-adhesive resin cement. Each assembly underwent cyclic loading (1,000,000 cycles; 100 N; 1 Hz) in water and was then subjected to axial compressive loading till fracture. Failure modes were analyzed through fractographic analysis under SEM. The highest mean of fracture resistance was recorded for subgroup B1 (Zirconia with vertical preparation: 3129 N), followed by subgroup B2 (Zirconia with horizontal preparation: 2616 N). while lithium-disilicate crowns showed lower fracture values (Group A1: 1880 N, Group A2: 1512 N). One-way ANOVA test revealed statistically significant differences in fracture resistance between the two crown materials (p < 0.05). However, there was no statistically significant difference between the vertical and horizontal preparation designs within the same material group (p > 0.05). Both zirconia and lithium-disilicate crowns demonstrated fracture strengths exceeding the level of biting forces in the premolar area, supporting the use of conservative feather-edge preparation for lithium-disilicate and zirconia crowns in posterior regions.

PMID:41091390 | DOI:10.1007/s44445-025-00064-5

Saudi Dent J. 2025 Oct 15;37(7-9):65. doi: 10.1007/s44445-025-00069-0.

ABSTRACT

Periodontal disease is an inflammatory disease that affects periodontal tissue, such as the gingiva, periodontal ligament and alveolar bone. Recently, a link between periodontal disease, oral cancer and inflammation has been suggested. In this study, the concentration of the inflammatory cytokine salivary IL-6 was measured to determine its role in the inflammatory process of periodontitis and oral squamous cell carcinoma. An analytical cross-sectional study was conducted at the Khartoum Dental Teaching Hospital, Sudan. Three study groups were enrolled with their consent: patients diagnosed with chronic periodontitis with at least two interproximal sites showing clinical attachment loss > 4 mm and pocket depth > 5 mm. (n = 32); patients with chronic periodontitis and oral squamous cell carcinoma (OSCC) pathology reports of OSCC at the time of saliva collection (n = 22); and matched healthy controls (n = 30). Patients were excluded if they had any chronic inflammatory condition or disease; had a history of recent trauma, acute infection, burns, laceration, previous surgery, chemotherapy, or radiotherapy; had used antibiotics within the previous three months; had a history of periodontal treatment within the previous three months; were pregnant or lactating; were taking drugs that induce hyposalivation; or had a history of previous radiation therapy to the head and neck area. A trained dentist clinically examined the participants. Periodontal parameters (plaque index, bleeding on probing, probable pocket depth and clinical attachment level) were measured, and the IL-6 concentration in the saliva samples was measured via enzyme-linked immunosorbent assay. A statistically significant difference in periodontal parameters was observed between the OSCC patient group and the other groups. OSCC patients had significantly greater IL-6 concentrations in their saliva (log 2.40 ± 0.37) pg/ml) than did chronic periodontitis patients (CP) (log 1.42 ± 0.418 pg/ml) and healthy controls (log 1.25 ± 0.13 pg/ml) (P < 0.001). High salivary IL-6 levels suggest potential utility as a biomarker for OSCC unconfounded by chronic periodontitis.

PMID:41091387 | DOI:10.1007/s44445-025-00069-0

Saudi Dent J. 2025 Oct 15;37(7-9):64. doi: 10.1007/s44445-025-00073-4.

ABSTRACT

This in vitro study aimed to evaluate the antibacterial activity of various restorative dental materials against Streptococcus mutans, a major cariogenic pathogen. The materials tested included a resin composite (Estelite Sigma Quick), conventional glass ionomer cement (Fuji IX), resin-modified glass ionomer cement (Fuji II LC), a bioactive resin-based material (Activa BioACTIVE Restorative), and a calcium silicate-based material (Biodentine). Antibacterial activity was assessed using the direct contact test (DCT). Each material was tested against S. mutans at 3, 6, 16, and 24-h intervals. Colony-forming units (CFU) were quantified following serial dilution and culture on BHI agar. Statistical comparisons were conducted using the Kruskal-Wallis test. All materials except Estelite demonstrated significant antibacterial effects. Biodentine exhibited the greatest inhibition (P ≤ 0.001), followed by Fuji IX (P ≤ 0.001), and Fuji II LC (P ≤ 0.01). Activa BioACTIVE showed significant bacterial reduction at 16 and 24 h (P ≤ 0.05). Estelite showed no significant antibacterial effect (P > 0.05). Biodentine displayed sustained and pronounced antibacterial effects, suggesting its suitability for patients at high risk of caries. Fuji IX and Fuji II LC also exhibited antibacterial properties, though to a lesser extent. The findings support the use of bioactive restorative materials in managing bacterial presence and enhancing restoration longevity. The superior antibacterial performance of Biodentine highlights its potential role in preventing secondary caries, particularly in high-risk populations. Clinicians are encouraged to consider bioactive materials as part of comprehensive caries management strategies.

PMID:41091362 | DOI:10.1007/s44445-025-00073-4

J Autism Dev Disord. 2025 Oct 15. doi: 10.1007/s10803-025-07085-3. Online ahead of print.

ABSTRACT

PURPOSE: Unmet social determinants of health (SDOH) play a significant role in the reported barriers to healthcare access and support experienced by children with autism spectrum disorder (ASD). Limited studies have explored how unmet SDOH needs impact children with ASD during early childhood. This study examined SDOH needs in children with a positive Modified Checklist for Autism in Toddlers (MCHAT) or ASD diagnosis and whether specific needs are more strongly associated with these outcomes.

METHODS: Using cross-sectional data from pediatric patients’ electronic health records, descriptive statistics were used to examine the prevalence of SDOH needs and associations were examined using multinomial logistic regression among children (< 5 years of age) with developmental delays. Patients were stratified into 3 groups: (1) no positive MCHAT screen or no ASD diagnosis, (2) positive MCHAT screen and no diagnosis, and (3) ASD diagnosis (ICD-10 code: F84.0). Patients and/or their caregivers were screened for five SDOH factors: food insecurity, housing stability, financial strain, health literacy, and transportation issues.

RESULTS: Children diagnosed with ASD had 49% higher odds of reporting at least one SDOH (AOR:1.49, p = 0.045), compared to those with no positive MCHAT screen or diagnosis. Although not significant, a positive MCHAT screen and/or ASD diagnosis trended toward higher odds of financial strain, housing instability, and low health literacy.

CONCLUSIONS: The findings emphasize the need to screen and address SDOH, particularly financial risk and health literacy, during early childhood among autistic children. Pediatric primary care SDOH programs should be tailored to better support families’ unique needs.

PMID:41091358 | DOI:10.1007/s10803-025-07085-3

Saudi Dent J. 2025 Oct 15;37(7-9):53. doi: 10.1007/s44445-025-00061-8.

ABSTRACT

This study comprehensively assessed the factors affecting the complexity of wisdom tooth surgery, the prevalence of each factor class, and the relationships between them. This retrospective cross-sectional study analyzed 526 Cone Beam Computed Tomography (CBCT) scans of wisdom teeth. Variables examined included impaction positions using Winter’s and Pell and Gregory’s classifications, root counts, and frequency of contact with the inferior alveolar canal. The statistical analysis was performed using Pearson’s chi-square test. The vertical type was the most prevalent impaction position (n = 189, 35.9%), followed by the mesioangular type. According to Pell and Gregory’s classification, the most frequent impactions were in positions A and 1. Of the cases studied, 234 involved mesial root contact, 239 had distal root contact, and 158 showed contact with both roots. In total, 345 cases (65.6%) exhibited contact between the third molar and the inferior alveolar nerve, most frequently in the apical third of the root (62.7%). The canal was most often positioned apical to the third molar (n = 415, 78.9%), and the highest ridge position was lingual (N = 234, 44.5%). These findings underscore the high prevalence of contact between impacted mandibular third molars and the inferior alveolar nerve, emphasizing the importance of meticulous preoperative planning to minimize the risk of nerve injury.

PMID:41091355 | DOI:10.1007/s44445-025-00061-8

Environ Sci Pollut Res Int. 2025 Oct 15. doi: 10.1007/s11356-025-37035-6. Online ahead of print.

ABSTRACT

This study provides a comprehensive assessment of polycyclic aromatic hydrocarbons (PAHs) and heavy metal concentrations in the surface sediments of the Pars Special Economic Energy Zone (PSEEZ), aiming to identify potential contamination sources and evaluate their ecological impacts. Sediment samples were collected from 14 stations during winter 2023 and analyzed for 16 priority PAHs and a suite of heavy metals. PAH concentrations ranged from below detection limits to 25.21 ng/g, with localized hotspots near industrial discharge zones. Heavy metals, including cadmium (Cd), lead (Pb), and arsenic (As), were detected at varying levels, with some exceeding sediment quality thresholds such as the Effects Range Low (ERL). Statistical source identification revealed petrogenic inputs from oil spills. The predominance of coarse-grained sediments in the PSEEZ, with minimal fine silt and clay content, suggests a lower overall retention capacity for PAHs and heavy metals. While fine particles were present only in limited areas, their potential for adsorbing contaminants remains a concern. Although most PAH and heavy metal concentration indicate below harmful thresholds, the detection of carcinogenic PAHs and elevated metal levels at specific stations indicates localized ecological risks, particularly for benthic organisms and potential trophic transfer within the marine food web.

PMID:41091349 | DOI:10.1007/s11356-025-37035-6

Nano Lett. 2025 Oct 14. doi: 10.1021/acs.nanolett.5c04034. Online ahead of print.

ABSTRACT

Small extracellular vesicles (sEVs) are nanoscale vesicles carrying biomolecules reflective of their cellular origin, making them attractive biomarkers for cancer diagnosis. In this study, we present a high-throughput strategy integrating amphiphile-dendrimer supramolecular probe (ADSP)-based sEV capture with surface-enhanced Raman scattering (SERS) for sensitive, multiplexed detection of breast cancer (BC)-related surface proteins. Plasma-derived sEVs from BC patients at different clinical stages were analyzed, focusing on CD9, EpCAM, and HER2 as key proteins linked to vesicle identity and tumor progression. Gold nanoparticle-based SERS nanotags conjugated with specific antibodies enabled precise detection. Statistical and machine learning analyses of protein profiles allowed accurate discrimination among healthy donors, ductal carcinoma in situ (Stage 0), early stage BC (Stage I-II), and metastatic-stage BC (Stage IV). This integrated platform provides a powerful tool for BC diagnosis and highlights the potential of sEV-based liquid biopsy strategies for clinical application.

PMID:41084822 | DOI:10.1021/acs.nanolett.5c04034