Faculty Publications (HBMCDM)

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Complications Due to Medicaments
(Springer Nature Switzerland, 2025) Alkhatib, Zuhair; El Abed, Rashid
Medicaments used in the root canal system are of numerous varieties and have effects on both pulpal tissues and microbial flora, not just inside the root canal system, but also on the periodontium. That is why, when choosing any medicament, the clinician must make the right choice. Choose a medicament that has an effect on the microorganisms, as this is the most important factor in root canal failures, and it should have the least effect on the tissues surrounding the root. The medicament should be confined in the root canal system during its use, and care should be taken not to expel it beyond the root apex into the periapical tissues. In case this happens, damage to the periapical tissues ensues, leading to inflammation, swelling and probably tooth loss. In this chapter, we will discuss the most common intracanal irrigation solutions and interim medicament used by endodontist, referring to literature and case reports that provide scientifically based evidence.
Large language models in periodontology: Assessing their performance in clinically relevant questions.
(2024-11-18) Kaklamanos, Eleftherios G
Statement of problem: Although the use of artificial intelligence (AI) seems promising and may assist dentists in clinical practice, the consequences of inaccurate or even harmful responses are paramount. Research is required to examine whether large language models (LLMs) can be used in accessing periodontal content reliably.
Understanding Residents' and Supervisors' Views on Developing Support-Autonomy Balance Through Supervision Methods in Postgraduate Dental Training: A Qualitative Study.
(2024-11) Amir-Rad, Fatemeh
Background: Supervisors continuously need to decide when to provide clinical opportunities for unsupervised patient care to facilitate residents' development in the complex clinical learning context. The aim of this study is to explore residents' and supervisors' views and understanding of the influence of clinical supervision on affording a balanced support-autonomy from the cognitive apprenticeship (CA) theoretical lens.
Comparative Assessment of Pharyngeal Airway Dimensions in Skeletal Class I, II, and III Emirati Subjects: A Cone Beam Computed Tomography Study.
(2024-09-25) AlAskar, Sara; Jamal, Mohamed; Khamis, Amar Hassan; Ghoneima, Ahmed
The aim of the current study was to evaluate the pharyngeal airway dimensions of individuals with different skeletal patterns in a cohort of the Emirati population. The specific aim was to assess the relationship between pharyngeal airway dimensions and anterior facial height in relation to different skeletal patterns. This retrospective study was conducted on a sample of 103 CBCT scans of adult Emirati subjects categorized into three groups according to their skeletal classification as indicated by the ANB angle: Class I (n = 35), Class II (n = 46), and Class III (n = 22). All CBCT scans were taken using an i-CAT CBCT imaging machine (Imaging Sciences, Hatfield, PA, USA). The age range of the patients was 19 to 68 years (62 women and 41 men). ANOVA, -tests, Kruskal-Wallis, and Mann-Whitney tests were employed for comparing means among groups. The correlation coefficient was used to evaluate the association between variables. A -value of less than 0.05 was considered statistically significant. This study revealed significant associations between various airway parameters and cephalometric measurements. Positive correlations were observed between nasal cavity volume and nasopharynx volume, as well as anterior facial height. Oropharynx volume exhibited positive correlations with hypopharynx volume and total airway volume, and negative correlations with overjet, ANB angle, and patient age. Hypopharynx volume correlated positively with total airway volume and the most constricted area of the airway (MCA). Total airway volume showed positive correlations with MCA and anterior facial height. MCA had negative correlations with ANB angle and patient age. Nasopharynx volume was significantly larger in the skeletal Class I group than in the Class II or Class III groups, while the other airway parameters showed no significant differences among the groups ( > 0.05). Several airway parameters showed a correlation with anterior facial height among the different skeletal patterns. Nasopharyngeal airway volume was significantly larger in the skeletal Class I group than in Class II and III groups in the studied sample.
Barriers and Facilitators to Dental Care Services Utilization Among Children With Disabilities: A Systematic Review and Thematic Synthesis.
(2024-10) Alsalami, Anas; Al Mashhadani, Shiamaa
Background: This systematic review investigates barriers and enablers to dental care utilization by disabled children. Given the high global prevalence of disabilities in children, coupled with poor oral hygiene and a 45% rate of dental caries in this group, developing inclusive oral health strategies is critical. The review aims to synthesize literature on factors affecting oral healthcare improvement for disabled children, identifying barriers, facilitators and knowledge gaps.
Comparative evaluation of commercially available AI-based cephalometric tracing programs.
(2024-10-18) Baig, Nida; Gyasudeen, Kabir Syed; Chaudhry, Jahanzeb; Prasad, Sabarinath
Objectives: Compare the accuracy and diagnostic concordance of three commercially available AI-based lateral cephalometric tracing software.
Monolithic Zirconia Single Crowns Supported by Narrow or Standard Diameter Titanium Zirconia Implants in Posterior Sites: 1-Year Results of a Randomized Controlled Trial.
(2025-02-07) Amir-Rad, Fatemeh; Shah, Maanas; Baqain, Zaid H; Atieh, Momen A
Purpose: To compare the prosthetic outcomes of screw-retained monolithic zirconia (Zr) single crowns supported by either narrow-diameter (3.3 mm) or standard-diameter (4.1 mm) tissue-level titanium-zirconia (TiZr) implants in posterior sites.
The Effect of Implantoplasty on Fracture Resistance and Implant Surface Changes: An In Vitro and Finite Element Analysis Study.
(2023-11) Atieh, Momen A
Introduction: Implantoplasty can be performed on implants diagnosed with peri-implantitis to facilitate implant decontamination and improve access for oral home care. However, its effect on the mechanical strength of the implant is still uncertain. This study aimed to evaluate the effect of implantoplasty on the fracture resistance of dental implants with various degrees of bone loss, as well as its surface changes.
Influence of Implant Surfaces on Peri-Implant Diseases - A Systematic Review and Meta-Analysis.
(2024-11-11) Hussein, Ahmad; Shah, Maanas; Atieh, Momen A; Alhimairi, Sara; Amir-Rad, Fatemeh; Elbishari, Haitham
Objectives: The aim of this systematic review and meta-analysis was to evaluate the current literature on the effect of implant surface characteristics on peri-implant marginal bone levels (MBL), soft tissue periodontal parameters, peri-implantitis, and implant failure rates.
The Effects of Electronic Cigarettes on Oral Microbiome and Metabolome in 3D Tissue-Engineered Models.
(2024) Maan, Meenu; Mohamed, Dalia Alsadig; Jalaleddine, Nour; Abuzayeda, Moosa; Khamis, Amar Hassan; Moharamzadeh, Keyvan
Background and aim: Recent studies have shown that electronic cigarettes (ECs) use disrupts the oral microbiome composition and diversity, impairing the metabolic pathways of the mucosal cells. However, to date, no reports have evaluated the role of EC exposure in the context of oral metabolome. Hence, the aim of this study was to investigate the role of EC aerosol exposure in the dysregulation of the oral microbiome and metabolome profile using in vitro 3D organotypic models of human oral mucosa.
The Anthropological Process of Identifying Missing Persons as a Teaching Method for Increasing Awareness in Legal and Forensic Dentistry in the Republic of Cyprus
(2024) Kaklamanos, Eleftherios G.
Forensic Odontology is a critical field within forensic science, with significant importance in legal contexts and the identification of victims in mass disasters or cases of abuse. This article focuses on the efforts made by the European University Cyprus (EUC) School of Dentistry to raise awareness amongdental students regarding legal and forensic dentistry practices. Through voluntary visits to the Anthropological Laboratory of the Committee on Missing Persons (CMP) in Cyprus, students gain firsthand experience and insights into anthropological analysis for identifying missing individuals. These visits provide students with practical application opportunities, emphasizing record-keeping practices, oral tissue morphology analysis, and unique aspects of restorative work during identification processes. Feedback from participating students highlights the value of exCitation: Giannakopoulos, K.; Lambrou, P.; Kaklamanos, E.G.; Aristotelous, A. The Anthropological Process of Identifying Missing Persons as a Teaching Method for Increasing Awareness in Legal and Forensic Dentistry in the Republic of Cyprus. Forensic Sci. 2024, 4, 598–603. https://doi.org/10.3390/ forensicsci4040041 Academic Editors: Hiroshi Ikegaya and HugoCardoso Received: 30 August 2024 Revised: 31 October 2024 Accepted: 5 November 2024 Published: 8 November 2024 Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). periential learning in increasing awareness about forensic odontology’s importance and relevance in real-world scenarios. The initiatives undertaken by the EUC School of Dentistry contribute to enhancing legal and forensic dentistry awareness among future dental professionals in Cyprus.
Palatal rugae change shape following orthodontic treatment: a comparison between extraction and non-extraction borderline cases using fractal analysis and 3D superimposition.
(2024-12-04) Athanasiou, Athanasios E
Introduction: Palatal rugae are used as anatomical landmarks on the hard palate, in various clinical applications; in forensics, for insertion of mini-screws, and for superimposition. There is ambiguous evidence on whether they change during orthodontic treatment and to what extent. Therefore, we investigated changes in the shape, complexity, and area occupied by palatal rugae following orthodontic treatment with and without extractions.
Characterizing Circulating microRNA Signatures of Type 2 Diabetes Subtypes.
(2025-01-14) Sulaiman, Fatima; Khyriem, Costerwell; Dsouza, Stafny; Abdul, Fatima; Alkhnbashi, Omer; Faraji, Hanan; Tawfik, Abdel Rahman; Khamis, Amar Hassan; Bayoumi, Riad
Type 2 diabetes (T2D) is a heterogeneous disease influenced by both genetic and environmental factors. Recent studies suggest that T2D subtypes may exhibit distinct gene expression profiles. In this study, we aimed to identify T2D cluster-specific miRNA expression signatures for the previously reported five clinical subtypes that characterize the underlying pathophysiology of long-standing T2D: severe insulin-resistant diabetes (SIRD), severe insulin-deficient diabetes (SIDD), mild age-related diabetes (MARD), mild obesity-related diabetes (MOD), and mild early-onset diabetes (MEOD). We analyzed the circulating microRNAs (miRNAs) in 45 subjects representing the five T2D clusters and 7 non-T2D healthy controls by single-end small RNA sequencing. Bioinformatic analyses identified a total of 430 known circulating miRNAs and 13 previously unreported novel miRNAs. Of these, 71 were upregulated and 37 were downregulated in either controls or individual clusters. Each T2D subtype was associated with a specific dysregulated miRNA profile, distinct from that of healthy controls. Specifically, 3 upregulated miRNAs were unique to SIRD, 1 to MARD, 9 to MOD, and 18 to MEOD. Among the downregulated miRNAs, 11 were specific to SIRD, 9 to SIDD, 2 to MARD, and 1 to MEOD. Our study confirms the heterogeneity of T2D, represented by distinguishable subtypes both clinically and epigenetically and highlights the potential of miRNAs as markers for distinguishing the pathophysiology of T2D subtypes.
Narrow Versus Standard Diameter Implants for Supporting Single Crown Restorations in the Posterior Jaw: A Randomised Controlled Trial.
(2025-01-25) Atieh, Momen A; Amir Rad, Fatemeh; Shah, Maanas; Baqain, Zaid H
Objectives: The aim of this randomised controlled trial was to assess clinical, radiographic and patient reported outcomes of narrow versus standard diameter titanium zirconium (TiZr) implants supporting single crown restorations in posterior sites with limited bone width.
Airflowing as an adjunctive treatment for periodontitis: A randomized controlled trial
(2024) Alsuwaidi, Salem; Shah, Maanas; Hakam, Abeer; Atieh, Momen A
Abstract Background: The aim of this randomized controlled trial was to assess clinical and patient-reported outcomes of subgingival instrumentation (SI) with adjunctive use of erythritol airflowing (EAF) compared to SI alone in the treatment of periodontitis. Methods: Twenty-six participants with Stage III/IV periodontitis requiring non surgical periodontal treatment were randomly allocated into two treatment groups: SI with EAF or SI alone. Clinical parameters of percentage of probing pocket depths (PPDs) of ≥5 mm, full mouth bleeding and plaque scores (FMBS and FMPS), and PPD values were recorded at baseline, and at 3- and 6-months posttreatment. A visual analogue scale was used to evaluate postoperative participants’ perception of pain, swelling, bleeding, bruising, and root sensitivity. The impact of periodontal treatment on quality of life was assessed using the General Oral Health Assessment Index (GOHAI) at six months. Results: A total of 26 participants with Stage III/IV periodontitis completed the 6-month follow-up. SI with or without EAF resulted in a statistically significant reductions in the FMBS, FMPS, PPDs, and percentage of PPDs of ≥5mmatthe 3- and 6-month follow-up visits. There was no statistically significant difference between the two treatment groups for any time interval. Participants receiving SI/EAF exhibited a higher reduction in FMBS compared to those in SI alone group at 3 (SI/EAF: 19.4 ± 11.9, SI alone: 30.1 ± 20.5; P = 0.12) and 6 months (SI/EAF: 14.3 ± 9.6, SI alone: 24.5 ± 18.2; P = 0.09). A lower percentage of sites with deep PPDs (≥5 mm) was also noted amongst participants in the SI/EAF group compared to SI alone at 3 months (SI/EAF:14.3±14.1, SI alone: 19.2 ±20.3; P = 0.48) and 6 months (SI/EAF: 8.3 ± 10.0, SI alone: 15.4 ± 17.4; P = 0.22). Patient-reported outcomes showed no significant differences between the two treatment groups, except in the psychosocial domain of the GOHAI at 6 months favoring the SI/EAF group (P = 0.03). Conclusions: Within the limitations of the study, the adjunctive use of EAF in addition to SI in the treatment of Stage III/IV periodontitis did not result in a significant improvement in clinical parameters. Limited improvement in the QoL with EAF could be achieved.
Reliability of sealer penetration measurement methods and assessment of dentine penetrability after endodonticre treatment: A correlation in vitro study
(2024) Amre R., Atmeh
Abstract: This study evaluated the reliability of sealer penetration measurement methods used with confocal laser scanning microscopy in correlation with the percentage of residual root filling and examined the effect of residual root-filling material on dentine penetrability after retreatment. Extracted teeth were randomly divided into different groups according to the obturation sealer used (n = 6); Bio Root RCS; MTA Fillapex; Bio-C and AH Plus. Root-filling material was removed before the secondary chemo-mechanical preparation and obturation using fluorescein labelled AH Plus. Multiplemicro-computed tomography scans were obtained followed by confocal laser scanning microscopy to measure the penetration of the labelled sealer into the dentinal tubules using four different methods. Measuring sealer penetration into radicular dentine using the penetration percentage method was found to be the most reliable. Dentine penetrability during retreatment did not seem to be affected by the type of residual root-filling material.
Xenogeneic Collagen Matrix Versus Free Gingival Graft for Augmenting Peri‐Implant Keratinized Mucosa Around Dental Implants: A Systematic Review and Meta‐Analysis
(2024) Momen A., Atieh; Maanas, Shah; Abeer, Hakam; Suhailah, Alshaali; Reem, Kasouha
Abstract Objectives: There is a growing evidence to suggest augmenting peri‐implant keratinized mucosa in the presence of ≤ 2 mm of keratinized mucosa. However, the most appropriate surgical technique and augmentation materials have yet to be defined. The aim of this systematic review and meta‐analyses was to evaluate the clinical and patient‐reported outcomes of augmenting keratinized mucosa around implants using free gingival graft (FGG) versus xenogeneic collagen matrix (XCM) before commencing prosthetic implant treatment. Material and Methods: Electronic databases were searched to identify observational studies comparing implant sites augmented with FGG to those augmented with XCM. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Results: Six studies with 174 participants were included in the present review. Of these, 87 participants had FGG, whereas the remaining participants had XCM. At 6 months, sites augmented with FGG were associated with less changes in the gained width of peri‐implant keratinized mucosa compared to those augmented with XCM (mean difference 1.06; 95% confidence interval −0.01 to 2.13; p = 0.05). The difference, however, was marginally significant. The difference between the two groups in changes in thickness of peri‐implant keratinized mucosa at 6 months was statistically significantly in favor of FGG. On the other hand, XCM had significantly shorter surgical time, lower postoperative pain score, and higher color match compared to FGG. Conclusions: Within the limitation of this review, the augmentation of keratinized mucosa using FGG before the placement of the final prosthesis may have short‐term positive effects on soft tissue thickness. XCM might be considered in aesthetically demanding implant sites and where patient comfort or shorter surgical time is a priority. The evidence support, however, is of low to moderate certainty; therefore, further studies are needed to support the findings of the present review.
Tip, torque and rotation of maxillary molars during distalization using Invisalign: a CBCT study
(2024) Ahmed, Ghoneima
Abstract Background: Desirable molar distalization by bodily movement is challenging and can be difcult to achieve. This study investigated changes in molar angulation (mesiodistal tipping), molar inclination (buccolingual torque) and rotation during distalization using clear aligner therapy (CAT). Materials and methods: This retrospective study included 38 cone beam computed tomographic images (CBCTs) taken for patients treated with molar distalization using CAT. The study evaluated pre- (T0) and post-treatment (T1) CBCTs of 19 adult patients (36.68±13.50 years) who underwent maxillary molar distalization using Invisalign® align ers (Align Technology, Inc., San José, CA, USA) with a minimum of 2 mm distalization. Changes in maxillary molar tip, torque and rotation were measured for 61 molars (183 roots). Paired t-test was used to evaluate the diferences between pre- and post-treatment readings. The level of signifcance was set at p≤0.05. The reproducibility of meas urements was assessed by the intraclass correlation coefcient (ICC). Results: Molar angulation did not show signifcant change after distalization (p=0.158) however, there was signifcant increase in buccal molar inclination (p=0.034) and mesiobuccal molar rotation (p<0.001). Conclusion: Molar distalization of 2 mm did not cause signifcant molar tipping. Maxillary molars showed signifcant buccal inclination (increased torque) and mesiobuccal rotation after distalization.
The effect of irrigation solution temperature and novel heat-treated rotary files on apical debris extrusion and canal preparation time
(2024) Amre R., Atmeh
Abstract: This study aimed to compare apical debris extrusion and canal preparation time with ProTaper Gold (PTG) and ProTaper Ultimate (PTU) files at different temperatures. Mesio-buccal roots of 60 mandibular first molars were distributed into six groups depending on the file type (PTG, PTU) and irrigation solution temperature (20, 37, 45°C). During instrumentation, extruded debris were collected and weighed to measure the mass in milligrams. The canal preparation time was recorded in seconds. ANOVA followed by Bonferroni post-hoc tests were used for analysis. The amount of debris extrusion was significantly higher in PTU, which was affected by the irrigation solution temperature (p <0.05). The difference in canal preparation time was not significant between the two file systems, however, it was significant between the different temperatures (p=0.001). Both file systems had shorter canal preparation times at 20°C. The irrigation solution temperature could influence the debris extrusion and time of canal preparation.
Open access databases of craniofacial cone beam computed tomography scans are vital for advancements in artificial intelligence
(2024) Sabarinath, Prasad; Jahanzeb, Chaudhry
Letter to the Editor Dear Editor-in-Chief, Dear Professor Lakshman P. Samaranayake, We recently read your editorial in the International Dental Journal, and concur with the views expressed. The call for action to wholeheartedly embrace artificial intelligence (AI) has been particularly loud in the speciality of dentomaxillofacial radiology. Residents at MBRU have ongoing research projects using AI and machine learning (ML) for understanding impacted maxillary canines in cone beam computed tomography (CBCT) images and panoramic radiographs. Although the university is relatively young, a large database of panoramic radiographs is available. Additionally, public databases of panoramic radiographs are also accessible. However, similar open-access CBCT databases are currently unavailable. The purpose of our correspondence is to emphasize the critical need to establish open-access repositories for CBCT scans. In the context of the growing importance of AI and ML, the creation of such databases will be instrumental in developing AI and ML methodologies that require large-scale datasets for optimal functionality. The robustness and generalizability of AI and ML algorithms are directly proportional to the size and diversity of the training datasets. Large datasets are indispensable for training models to recognize patterns, anomalies, and variations, ultimately leading to improved clinical decision-making. Open-access CBCT databases will provide the necessary breadth of diagnostic images to enhance the development and performance of these cutting-edge technologies. Since the lack of such a repository hinders the development and advancement of AI and ML in dentistry, we urge all stakeholders to work towards the creation of such databases. Establishing open-access, cloud-based CBCT databases can facilitate collaboration and innovation within the dental research community. The databases will permit large-scale, multicentre studies and also expedite research initiatives. In anticipation of the positive impact that the International Dental Journal will have in shaping the future of dentistry, thank you for your thoughtful consideration.

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