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Hematopoietic stem cell transplantation is the only curative intervention for myelodysplastic syndrome, with graft-versus-host disease (GVHD) being a frequently encountered consequence. GVHD is classified as acute (aGVHD) or chronic (cGVHD). The oral cavity is the most impacted by chronic. Oral manifestations of cGVHD are variable and include plaque, Wickham striae, and lichenoid patches. In order to prevent malignant misdiagnosis, the 2014 NIH consensus report decided to exclude white plaque as a diagnostic indicator for oral cGVHD. Nevertheless, it is still possible to classify a white plaque lesion as cGVHD through histological confirmation. The performance of a biopsy should be undertaken following meticulous consideration and a thorough evaluation of the associated risks and benefits. The in-depth review of oral cancer risk assessment is crucial, necessitating a careful review of multiple factors to accurately estimate the likelihood of malignant transformation in individuals with oral cGVHD. This report describes a case of oral cGVHD manifesting as hyperkeratotic plaque lesions confirmed by histopathology in a 62-year-old man who received an allogeneic hematopoietic stem cell transplant over a decade ago.

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OBJECTIVE: To compare the clinical and radiographic parameters around short (6 to 8 mm in length) and long (11 mm in length) dental implants placed in patients with and without type 2 diabetes mellitus (T2DM). MATERIAL AND METHODS: Forty-five male patients with T2DM (Group-1) and 42 male non-diabetic controls (Group-2) who had undergone implant therapy in the posterior mandible were included. Depending upon the length of the implant, patients were divided into two subgroups: (a) patients with short implants (6-8 mm long) and (b) patients with long implants (11 mm long). Peri-implant plaque index (PI), bleeding on probing (BOP), probing depth (PD) and crestal bone loss (CBL) were measured at 18 and 36 months of follow-up in both groups. Hemoglobin A1c (HbA1c) levels were measured at baseline and after 18 and 36 months of follow-up in both groups. P-values less than 0.05 were considered statistically significant. RESULTS: The mean age of patients in groups 1 and 2 was 42.5 and 40.6 years, respectively. The mean HbA1c levels at baseline among patients in groups 1 and 2 were 7.7% and 4.5%, respectively. At 18 and 36 months of follow-up, the mean HbA1c levels among patients in groups 1 and 2 were 6.6% and 4.5% and 6.5% and 4.4%, respectively. The mean duration of T2DM among patients that received short and long implants was 4.3 years and 4.1 years, respectively. There was no significant difference in PI, BOP, PD and CBL around implants placed in both groups at 18 and 36 months of follow-up. Success rate of short and long dental implants was 100% in both groups. CONCLUSION: Short implants can demonstrate clinical and radiographic stability in a manner similar to conventional long implants in patients with and without T2DM. The role of oral hygiene and glycemic maintenance in this scenario cannot be disregarded.

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PURPOSE: To evaluate the accuracy of impressions on changing the implant component (coping and abutment replica) between Brånemark and BIOMET 3i and between Straumann and Allfit. MATERIALS AND METHODS: Two master casts were constructed, one containing pair of Brånemark self-tap Mk II fixtures (Nobel Biocare) labeled Master cast I and the other containing pair of Straumann Standard plus implant, SLA fixtures (Straumann) labeled Master cast II. Ten impressions of each master cast were made by open tray technique using polyether impression material. Five out of 10 impressions made from master cast I contained Brånemark pair of coping and replica and the other 5 contained 3i (Implant Innovations). Five out of 10 impressions made from master cast II contained Straumann pair of copings and replica and the remaining 5 contained Allfit implants (Ihde Dental). Duplicated casts were prepared, and distances between copings were measured using traveling microscope and compared the distance in master casts. RESULT: No significant difference was observed in mean value between 2 master casts and their duplicates. CONCLUSION: The interchangeability of coping and abutment replica between Brånemark and BIOMET 3i and between Straumann and Allfit was found to be possible without compromising the quality of impressions.

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OBJECTIVES: a) To correlate fluoride levels in drinking water sources with caries experience and dental fluorosis in Saudi Arabia, and suggest appropriate fluoride concentration for drinking water in the country. METHODS: Fluoride levels were determined from 3,629 samples obtained from drinking water sources in 11 regions of Saudi Arabia. Based on the fluoride concentrations, a stratified sample of subjects aged 6-7, 12-13, and 15-18 years was obtained from the regions. A total of 12,200 selected subjects were examined for dental caries according to the World Health Organization criteria, and dental fluorosis, using Thylstrup and Fejerskov classification. RESULTS: There was an inverse relationship between fluoride exposure and caries experience, but the prevalence of dental fluorosis increased with increase in fluoride concentration. There was no significant difference in caries experience or in the prevalence of dental fluorosis when fluoride levels increased from 0.3 ppm to 0.6 ppm. In contrast, caries experience was lower, while severity of fluorosis was significantly higher at fluoride levels above 0.6 ppm. CONCLUSIONS: a) Fluoride levels in drinking water sources in Saudi Arabia correlate significantly with caries experience and prevalence of dental fluorosis. b) Appropriate fluoride concentration for drinking water in Saudi Arabia may be about 0.6 ppm.

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BACKGROUND AND OBJECTIVES: Few studies have been conducted in the Saudi population on oral mucosal lesions. The purpose of this study was to evaluate the type and extent of oral lesions in a study among dental patients at a college of dentistry in Saudi Arabia. PATIENTS AND METHODS: Over a 3-year period, 2552 dental outpatients were interviewed and investigated clinically for the presence of oral mucosal conditions. A thorough oral clinical examination was performed, including a radiographic examination. The diagnosis was confirmed histopathologically when necessary. RESULTS: Of 383 (15.0%) patients found to have oral mucosal lesions, females constituted 57.7% (n=221) and males 42.3% (n=162). The age range of the patients was between 15 to 73 years with a mean age of 38.2 years. The most commonly affected age group was 31 to 40 years, which comprised 21.4% (n=82) of all affected individuals. The least affected age group were individuals older than 61 years. The most common lesion was Fordyce granules (3.8%; n=98), followed by leukoedema (3.4%; n=86) and traumatic lesions (ulcer, erosion) in 1.9% (n=48). Tongue abnormalities were present in 4.0% (n=101) of all oral conditions observed, ranging from 1.4% (n=36) for fissured tongue to 0.1% (n=2) for bifid tongue. Other findings detected were torous platinus (1.3%; n=34), mandibular tori (0.1%; n=2) aphthous ulcer (0.4%; n=10), herpes simplex (0.3%; n=7), frictional hyperkeratosis (0.9%; n=23), melanosis (0.6%; n=14), lichen planus (0.3%; n=9) and nicotinic stomatitis (0.5%; n=13). CONCLUSION: The findings of this study provide information on the types and prevalence of oral lesions among Saudi dental patients. This provides baseline data for future studies about the prevalence of oral lesions in the general population.

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BACKGROUND: This study was designed to assess the fluoride levels in drinking water in the Central Province of Saudi Arabia. MATERIALS AND METHODS: A total of 817 water samples were collected from 260 locations in Central Saudi Arabia. An atomic absorption spectrophotometer [HACH instrument, model DR 3000] was used in the analyses of water samples for fluoride levels. RESULTS: The results showed that fluoride levels vary between 0.00 and 6.20 ppm. About 75% and 6% of the population in Riyadh and Qassim regions, respectively, were exposed to very low fluoride levels (0.00-0.03 ppm), while less than 3% of the population in both regions were exposed to fluoride levels ranging from 0.61 to 0.80 ppm. A higher percentage of the population in Qassim than Riyadh region were exposed to high fluoride levels (>0.81 ppm); 28.63% than in Riyadh with 9.24%. CONCLUSION: The findings of this study can serve as a baseline data for water fluoridation and other dental preventive programs in the area.