Browsing by Author "Shah, Maanas"

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Awareness of Periodontal Health among Pregnant Females in Government Setting in United Arab Emirates
(2023) Khamis, Amar Hassan; Tawfik, Abdel Rahman; Bain, Crawford; Jamal, Mohamed; Atieh, Momen; Shah, Maanas
Objective: Periodontal disease is one of the most common infectious diseases. Several factors are associated with increased susceptibility of periodontal disease such as hormonal changes during pregnancy. Although pregnancy does not directly cause gingivitis, it can aggravate preexisting periodontal disease. This study aimed to evaluate knowledge of the association between periodontal disease and pregnancy in pregnant females. Materials and Methods: A convenience sample of pregnant females attending two United Arab Emirates government hospitals was recruited for this study. A 23-item questionnaire was developed with four sections, covering sociodemographic details, oral hygiene, oral symptoms during pregnancy, and knowledge of periodontal health during pregnancy. The study was conducted between April and October 2017. All participants consented to the survey. Results: A total of 100 participants with a mean age of 31 years (± 5.9) completed the survey. Most respondents brushed their teeth 2 to 3 times a day (65%), used a manual toothbrush (93%) but only visited the dentist when in pain (62%). Few respondents self-reported any gingival signs and symptoms during pregnancy; 38% had bleeding gums, 27% had no gum swelling, and 34% had bad odor/taste/smell. Only 21% of pregnant females lost a tooth/teeth during pregnancy, 15% believed that pregnancy increased the likelihood of gum disease, and 66% of gynecologists did not advise a visit to the dentist. Housewives were significantly less knowledgeable about periodontal health than students/employed respondents (p = 0.01). Quality of knowledge was not associated with educational attainment (< 0.06). Respondents > 30 years of age were more likely to believe in “a tooth for a baby” than younger participants aged < 30 years (p < 0.05). A logistic regression model showed that educational attainment was not a predictor for the belief in “a tooth for a baby” but age was a significant predictor (odds ratio = 2.0).
Changes in oral home care and smoking habits during COVID‐19 pandemic: A cross‐sectional study
(2024) Atieh, Momen A.; Aldhanhani, Afrah; Shah, Maanas
Objectives: The coronavirus disease‐19 (COVID‐19) pandemic has caused disruption in the health behavior in many aspects of life. While hand hygiene was promoted as one of the precautionary measures to mitigate and contain COVID‐19, oral health and smoking might have received less attention in the media campaigns. The aim of this study was to examine health behavioral changes in terms of oral home care habits, smoking, and perception of dental care during the COVID‐19 pandemic. Material and Methods: An online survey was designed to assess oral home care, smoking habits, and attitude toward dental services of participants aged 18 years and older. The data were collected between September and November 2021. The strength of association between changes in oral home care habits, smoking, and attitude toward invasive/long dental procedures and each variable was measured by χ 2 analysis. Estimates of relative risk were also calculated for all variables. Predictors of avoiding dental procedures were estimated by a binary logistic regression. Results: A total of 532 participants, based in the United Arab Emirates, took part in this online survey with a response rate of 88.7%. The age of the participants ranged between 18 and 67 with mean age of 34.9 ± 9.0 years. The majority of the participants have adopted changes in their routine oral home care habits, with 82.1% of them changing the toothbrush more frequently. Participants who changed their oral home care habits were more likely to have received sufficient information on the importance of maintaining oral health. Likewise, the changes in smoking habits were significantly associated with receiving information on the relationship between smoking and the severity of the COVID‐19 (p < 0.001). Conclusions: The findings showed that positive behavior toward oral home care and smoking was noticed during the pandemic particularly when public receives sufficient and up‐to‐date information.
Diode Laser as an Adjunctive Treatment for Peri-implant Mucositis: A Systematic Review and Meta-analysis
(2022-08) Atieh, Momen; Shah, Maanas; Hannawi, Haifa; Fadhul, Israa
Abstract: The early detection and management of peri-implant mucositis may help in reducing inflammatory parameters and arrest disease progression to peri-implantitis. The potential therapeutic benefits of different adjunctive therapies, such as the diode laser, are still not completely understood. The objective of this systematic review and meta-analyses was to assess the outcomes of using diode laser on the management of peri-implant mucositis in terms of changes in periodontal parameters. Electronic databases were searched to identify randomised controlled trials (RCTs) that compared the combined use of mechanical debridement and diode laser with mechanical debridement alone. A specific risk-of-bias tool was used to assess the risk of bias. Data were analysed using a statistical software programme. In total, 149 studies were found. A meta-analysis of 3 RCTs showed no statistically significant differences in probing pocket depths (mean difference [MD], 0.36; 95% confidence interval [CI], 0.88 to 0.16; P = .18) or bleeding on probing (MD, 0.71; 95% CI, 1.58−0.16; P = .11) between the 2 groups at 3 months. In the management of peri-implant mucositis, the combined use of diode laser and mechanical debridement did not provide any additional clinical advantage over mechanical debridement alone. Long-term, well designed RCTs are still needed.
Enamel matrix derivative for alveolar ridge preservation: A randomized controlled trial
(2023) Atieh, Momen A.; Al-Ali, Bashayer; Shah, Maanas; Amir-Rad, Fatemeh; Baqain, Zaid H.; Al-Suwaidi, Salem
Objective: The aims of this clinical trial were to evaluate the radiographic dimensional changes in alveolar ridge and patient-reported outcomes following tooth extraction and alveolar ridge preservation (ARP) using either deproteinized bovine bone mineral (DBBM) with EMD or DBBM alone. Methods: Participants requiring at least one posterior tooth extraction and ARP were randomly allocated into two treatment groups: ARP using either DBBM with EMD or DBBM alone. Cone-beam computed tomography (CBCT) images were recorded immediately prior to extraction and at 6 months. Changes in alveolar ridge height (ARH) and alveolar ridge width (ARW) at 1, 3, and 5 mm were recorded. Results: A total of 18 participants with 25 preserved sites were evaluated. ARH and ARW changed significantly from baseline to 6 months for both treatment groups but the difference between the groups was not statistically significant over the 6-month follow-up period (ARH: DBBM/EMD 1.26 ± 1.53 mm vs. DBBM 2.26 ± 1.60 mm; ARW-1 DBBM/EMD 1.98 ± 1.80 mm vs. DBBM 2.34 ± 1.89 mm). A significant difference, favoring DBBM with EMD group, was observed in percentage of sites that had less than 1 mm loss in ARH (54.5% sites in DBBM/EMD group vs. 14.3% sites in DBBM alone group). The participants' perception of bruising, bleeding, and pain in the first two postoperative days was significantly in favor of DBBM alone group. Conclusions: There were no significant differences in radiographic mean measurements of ARH and ARW following ARB with DBBM and EMD or DBBM alone.
Etiology of Peri-Implantitis
(2020) Atieh, Momen; Shah, Maanas
Purpose of Review: Peri-implant diseases represent the biological complications associated with implant therapy. They are defined as inflammatory responses of the peri-implant soft tissues with or without progressive loss of marginal bone. The term peri-implantitis is used when the bone loss extends beyond initial bone remodeling after loading. Knowledge of the etiology and case definitions of peri-implant diseases are used to evaluate the impact of peri-implant diseases on the long-term survival and maintenance of dental implants. The present review summarizes the current knowledge about case definitions and contemporary understanding of the etiopathogenesis of peri-implant diseases. Recent Findings: Recent studies have evaluated the instigation of peri-implant mucositis and its natural deterioration to periimplantitis. Animal models, similar to the ones used for showcasing biofilm-induced periodontal disease, have been utilized to understand the inflammatory response of supporting soft and hard tissue around dental implants. In addition, similarities have been drawn regarding the microbial composition around diseased natural teeth and implants. Summary: A better insight of the pattern of disease progression and understanding of the host response to the increased inflammatory overload provides a foundation on which future research studies can focus on host-microbial interactions and therapies that could lead to more favorable outcomes in prevention and treatment of peri-implant diseases.
Influence of implant restorative emergence angle and contour on peri-implant marginal bone loss: A systematic review and meta-analysis
(2023) Atieh, Momen; Shah, Maanas; Ameen, Mohammed
Background: Implant restorative emergence angle and profile may have a negative impact on peri-implant marginal bone level and may increase the risk of developing peri-implantitis. However, the role of these prosthetic features on peri-implant health is still unclear. The aim of this systematic review and meta-analyses was to evaluate the long-term outcomes of implant restorations with an emergence angle of >30º in comparison to those with ≤30º in terms of changes in peri-implant marginal bone level, periodontal parameters, and prevalence rate of peri-implantitis. Methods: Electronic databases were searched to identify observational studies that compared implant restorations with an emergence angle of >30º to those with ≤30º. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool. Results: Four studies with 912 dental implants in 397 participants were included in the present review. Of these, 455 implants had restorations with an emergence angle of >30º, while the remaining implants had restorative emergence angle of ≤30º. The follow-up time varied between 3.8 and 10.9 years. Implant restorations with an emergence angle of ≤30º were associated with less changes in peri-implant marginal bone level compared to those with emergence angle of >30º. The difference, however, was not statistically significant (mean difference 0.80; 95% confidence interval (CI) 0.13 to 1.72; p = 0.09). In platform-matched implants, the difference between the two groups was statistically significant in favor of implant restorations with emergence angle of ≤30º. In terms of emergence profile, implant restorations with convex profile had significantly higher rate of peri-implantitis (57.8%) compared to implant restorations with concave or straight profile (21.3%) (risk ratio 2.32; 95% CI 1.12– 4.82; p = 0.02). Conclusions: Within the limitation of this review, implant restorations with an emergence angles of >30º or ≤30º seem to have no significant influence on peri-implant marginal bone level. Platform-matched implants with an emergence angle of ≤30º may have positive effects on the peri-implant marginal bone level changes, but the evidence support is of low to moderate certainty.
Knowledge of Physicians about the Interrelationship between Diabetes Mellitus and Periodontitis in the United Arab Emirates
(2022-07) Tawfik, Abdel R; Hassan Khamis, Amar; Bain, Crawford; Atieh, Momen; Shah, Maanas
Objective: Diabetes mellitus is a major cause of morbidity in the United Arab Emirates (UAE), highlighting a significant social and economic burden impacting the development of the country. Studies have shown a bidirectional relationship between diabetes and periodontal disease. The awareness of this relationship is imperative not only for dentists but also for the physicians who contribute toward enhancing a diabetic patient’s health and lifestyle. There is a general need to highlight the importance of maintaining periodontal health and its positive effect on controlling diabetic health status. The purpose of this study is to investigate the knowledge of the physicians regarding diabetes and periodontal health. Materials and Methods: A cross-sectional study involving a questionnaire was distributed to the physicians who were attending the Arab Health Conference in Dubai in 2019. Statistical Analyses: A cross-tabulation analysis compared attitude, knowledge, and awareness across sector, gender, and country of graduation. A logistic regression model was used to explain the “knowledge” regarding possible confounding factors. Results: A total of 344 physicians with an average age of 38.11 (9.31) years, comprising of 186 (53.8%) males, participated in the survey. Of those participants, 285 (82.8%) were working in the government sector health care centers versus the private health care organizations. Also, 108 (31.4%) of the participants graduated within the universities based in the UAE, while the remaining 263 (68.6%) participants graduated from medical schools from other countries. At least 265 (77%) of the participants had positive outlook toward referring patients with diabetes to their dental colleagues, while 283 (82.3%) of the physicians acknowledge that diabetes affects periodontal health. While a majority of participants 261 (76%) treat diabetic patients in their clinical practice, only 50 (19%) of the participants admit to referring these patients for a dental consultation. In addition, the survey also revealed that 225 (65.5%) physicians comprehend the bidirectional relationship of periodontal disease and diabetes. Conclusion: An appropriate dental referral protocol is recommended for all diabetic patients who visit physicians. This survey demonstrated that although the physicians present with good knowledge, they rarely refer diabetic patients to receive proper periodontal care.
Overview of transnational recommendations for COVID-19 transmission control in dental care settings
(2020) Jamal, Mohamed; Shah, Maanas; Khawaja, Summayah; El Abed, Rashid
Abstract: On 11 March 2020, the World Health Organization (WHO) declared the coronavirus disease (COVID-19) caused by severe acute respiratory syndrome coronavirus (SARS-CoV-2) as a pandemic. Until an effective treatment or a vaccine is developed, the current recommendations are to contain the disease, and control its transmission. It is now clear that the primary mode of SARS-CoV-2 transmission is aerosol/droplet spread, and by contacting virus-contaminated surfaces acting as fomites (inanimate vectors). Furthermore, recent data indicate that the live virus particles are present in saliva, and, more alarmingly, asymptomatic individuals may transmit the infection. By virtue of the nature of the practice of dentistry where intrinsically, a high volume of aerosols is produced, as well as the close proximity of dentists and patients during treatment, dentists and allied health staff are considered the highest risk health professional group for acquiring SARS-CoV-2 during patient management. Therefore, several organizations and specialty associations have proposed guidelines and recommendations for limiting the transmission of SARS-COV-2 from carriers to dentists and vice versa. This paper aims to provide a review of these guidelines, and concludes with a brief look at how the practice of dentistry may be impacted by COVID-19, in the post-pandemic era.
Systemic azithromycin versus amoxicillin/metronidazole as an adjunct in the treatment of periodontitis: a systematic review and meta-analysis
(2024) Atieh, Momen; Shah, Maanas; Hakam, Abeer; Alghafri, Meera
Background: The use of systemic azithromycin (AZT) and amoxicillin/metronidazole (AMX/MTZ) as adjuncts provided additional clinical and microbiological benefits over subgingival instrumentation alone. However, the superiority of one antibiotic regimen over another has not been proven. Therefore, the aim of this systematic review and meta-analyses was to evaluate the clinical efficacy and safety of subgingival instrumentation (SI) in conjunction with the systemic use ofAZT or AMX/MTZ for the treatment of periodontitis from current published literature. Methods: Electronic databases were searched to identify randomized controlled trials (RCTs), controlled clinical trials, prospective and retrospective human studies that compared the adjunctive use of systemic AZT to AMX/MTZ with SI in the treatment of periodontitis. The eligibility criteria were defined based on the participant (who had periodontitis), intervention (SI with adjunctive use of systemic AZT), comparison (SI with adjunctive use of systemic AMX/MTZ), out-comes (primary outcome: changes in probing pocket). The risk of bias was assessed using the Cochrane Collaboration’s Risk of Bias tool. Data were analyzed using a statistical software program. Results: Five studies with 151 participants with periodontitis were included in the present review. Of these, 74 participants received adjunctive AZT, while the remaining participants received AMX/MTZ as an adjunct to SI. The adjunctive use of AZT and AMX/MTZ had comparable changes in probing pocket depths at 1–3 months with no statistically significant difference (mean difference (MD) 0.01; 95% CI–0.20 to 0.22;P=0.94). The adjunctive use of AZT had significantly fewer number of residual sites with probing pocket depths of≥5mmat1–3 months compared to the adjunctive use of AMX/MTZ (MD–3.41; 95% CI–4.73 to–2.10;P<0.0001). The prevalence rates of adverse events among participants who received AZT and AMX/MTZ were 9.80% and 14.8%, respectively. The meta-analysis showed that the difference between the two groups was not statistically significant (risk ratio 0.69; 95% CI 0.28 to 1.72;P=0.43). Conclusions: Within the limitation of this review, there was no superiority between AZT and AMX/MTZ in terms of mean changes in probing pocket depths, clinical attachment level, bleeding on probing at 1–3 months. AZT seem to be associated with less sites with residual probing pocket depths of≥5mmat1–3 months and fewer adverse events com-pared with AMX/MTZ.©2023 Australian Dental Association.
Systemic azithromycin vs. amoxicillin/metronidazole as an adjunct in the treatment of periodontitis: a systematic review and meta-analysis
(2024) Atieh, Momen A.; Shah, Maanas; Hakam, Abeer; Alghafri, Meera
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