Saudi Cultural Missions Theses & Dissertations
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Item Restricted The Association Between Metabolic Syndrome and Oral Diseases Among US Adults(Harvard University School of Dental Medicine, 2025) Alhassan, Hameedaldeen; Natto, ZuhairThe objective was to assess the association between oral diseases and metabolic syndrome (MetS), examining both the individual and combined effects of MetS five components. Also, to validate the NHANES diagnostic criteria and Overjet artificial intelligent (AI) platform with the gold standard for periodontal disease diagnosis. First, a systematic review and meta-analysis were conducted by searching PubMed, Embase, and Web of Science for studies published between 1990 and 2023 that examined the association between Dental caries and MetS in adults. Two independent authors selected and analyzed articles, assessed risk of bias, and evaluated the overall evidence certainty. Meta-analyses were performed to estimate pooled odds ratios (ORs), or mean differences (MDs), and corresponding 95% confidence intervals (CIs) for decayed teeth (DT) and DMFT (Decayed, Missing, and Filled Teeth). Second, data from NHANES 2011-2018 were used to assess the association between MetS and oral diseases (dental caries and periodontal disease). The sample included adults over 29 years who completed laboratory and clinical assessments for MetS and oral diseases. Logistic regression models (OR and 95% CI) were used to assess associations between MetS and both untreated caries and periodontal disease. Negative binomial regression (mean ratio [MR] and 95% CI) was conducted to examine the association between MetS and DMFT score. Third, clinical and radiographic records of patients aged over 29 years were utilized to validate the NHANES diagnostic criteria (based on clinical measures alone) and the Overjet AI software (using full-mouth radiographs) for detecting periodontal disease. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated to assess the accuracy of both clinical measures and the Overjet AI software, using a gold standard defined as a combination of clinical and radiographic analysis conducted by a periodontist. The meta-analysis (nine studies with 59,075 participants) revealed that there was a positive statistically insignificant association between DT and MetS (OR: 1.17, 95% CI: 0.87–1.58; MD: 0.22, 95% CI: -0.08–0.52). However, a significant positive association was found between MetS and DMFT (OR: 1.28, 95% CI: 1.08–1.51). Results from NHANES showed that participants with MetS were more likely to have untreated caries and high DMFT mean score by 34% and 10%, respectively. While there was no association between MetS and periodontal disease. Low HDL was the most significant MetS component associated with dental caries, while insulin resistance was the strongest component linked to periodontal disease. Having all five MetS components was associated with a 17% higher likelihood of a high DMFT score. Results from the validity study showed that detecting periodontal disease using clinical measures achieved 96% sensitivity and 99% specificity. While Overjet AI software achieved 100% sensitivity and 89% specificity. In conclusion, the study revealed a positive association between MetS and dental caries, while there was no association between MetS and periodontal disease. Future prospective cohort studies could provide a better understanding of these associations. The validity study demonstrated that both clinical measures and Overjet AI software achieved high accuracy in detecting periodontal disease.6 0Item Restricted Association Between Diet Quality, Tooth Loss, and Dental Caries: Data from NHANES 2015-2018(Saudi Digital Library, 2023-04) Alghamdi, Sondos; AlDosari, Muath; Hayes, Catherine; Chamut, Steffany; Leung, CindyBackground: Optimum oral health and nutrition are essential to achieve and maintain overall and systemic health. The relationship between nutritional status and oral health has been examined in several studies. Cariogenic dietary patterns have been associated with tooth loss and dental caries. Dietary factors affect a variety of health factors, such as oral health, aside from social and psychological areas essential to maintaining the quality of life (QoL). This study aims to investigate the association between AHEI-2010, tooth loss and dental caries. Methods: Using the data from NHANES 2015-2018, we included adults 18 years and older. We measured the status of tooth loss, dental caries, and the diet quality of the individuals using AHEI-2010 and investigated the association between them while adjusting for covariates using Poisson and Logistic regression. Results: The mean AHEI-2010 score was 38.7±10.8 (out of 100). Our results showed an inverse association between the diet quality index (AHEI-2010) score and the presence of untreated coronal and root carious lesions and the loss of functional dentition. The mean ratio of teeth with untreated caries among the third quartile was 0.61 times the average number of teeth (95% CI=0.47, 0.78) and 0.49 times among individuals in the fourth quartile (95% CI=0.36, 0.66) compared to the lowest quartile group. Conclusion: This study indicates that lower diet quality measured using the AHEI- 2010 is associated with coronal and root dental caries and loss of functional dentition. Establishing a strong evidence-based foundation of the association between diet patterns and oral-systemic health can facilitate the development and promotion of sustainable, effective policies, strategies, and cost-effective interventions with the end goal of improving diet intake, oral-overall health, and food security while reducing the risk of developing malnutrition, diet-related NCDs, disability, and premature deaths.26 0Item Restricted Prevalence and Distribution of Dental Caries on Occlusal Surfaces of Primary Molars among Children 3-5 Years of age in Newark, New Jersey(2023) Alagl, Hanan; Caceda, JorgeBackground: Dental caries is considered one of the most prevalent chronic diseases affecting children globally, and it is an international public health issue that affects 60-90% of schoolchildren. Early detection of dental caries is of extreme importance to allow for implementation of appropriate prevention protocols and the avoidance of early treatment in the pediatric population. Aims of the study: The purpose of the present study was: (1) to describe and determine if the distribution of caries is associated with the type of primary molars and gender, and (2) to compare the prevalence and mean number of caries on in five zones of the occlusal surfaces of primary first and second molars of children 3-5 years old. Materials and methods: One-hundred and forty-three dental records of pre-school children ages 3-5 years old from the head-start program and pre-school in Newark’s School System who had dental screenings performed at Rutgers School of Dental Medicine were included in the study. The occlusal surfaces of all examined primary molars were divided into five zones: (1) mesial, (2) distal, (3) buccal, (4) lingual, and (5) central. Caries detection was performed using the International Caries Detection System (ICDAS II). From the 143 children examined, a total of 5,720 occlusal zones were analyzed. Results: The overall prevalence of dental caries in the preschool children aged 3-5 years old was 80.4 %. The Occlusal Distal Zone (ODZ) showed the highest prevalence of dental caries. It was found that although the mean number of occlusal zones affected by caries for total caries (TC) and caries in enamel only (CE) in primary second molars were higher than the mean caries of primary first molars. Only the Occlusal Distal Zone (ODZ) and the Occlusal Lingual Zone (OLZ) showed statistical differences (P=0.029). For TC, the ODZ and Occlusal Mesial Zone (OMZ) appeared to be the least affected by dental caries in the primary mandibular left first molar, with values of 8% and 3% respectively. Prevalence of EC for the primary first molars was statistically significant only in Occlusal Central Zone (OCZ), where the primary mandibular right first molar exhibited the highest prevalence (8%). For TC, the primary maxillary right second molar demonstrated the lowest prevalence of TC in OMZ, Occlusal Buccal Zone (OBZ), and OLZ, with values of 8%, 4%, and 8% respectively, when compared to other primary second molars. This difference was statistically significant. On the other hand, and for CE, the primary mandibular right second molar displayed the highest prevalence of caries in OMZ, OBZ, and OLZ with values of 16%,16%, and 18% respectively. It was found that males have more caries than females in all three categories, and all showed statistically significant differences. Conclusions: The dental caries is still affecting a high percentage of 3-5 years old children, with a higher prevalence in males when compared to females. According to the results obtained, the occlusal surfaces of primary molars showed that the distal occlusal zone has the highest prevalence of dental caries when compared with other zones of the occlusal surface. Not all primary molars present the same prevalence and distribution of occlusal caries according to the occlusal zones analyzed in this study. In general, the study was unique and gathered important information that should be further analyzed.21 0