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Nowadays, dental implants have become more common treatment for replacing missing teeth and aim to improve chewing efficiency, physical health, and esthetics. The favorable clinical performance of dental implants has been attributed to their firm osseointegration, as introduced by Brånemark in 1965. Although the survival rate of dental implants over a 10-year observation has been reported to be higher than 90% in totally edentulous jaws, the clinical outcome of implant treatment is challenged in compromised (bone) conditions, as are frequently present in elderly people. The biomechanical characteristics of bone in aged patients do not offer proper stability to implants, being similar to type-IV bone (Lekholm & Zarb classification), in which a decreased clinical fixation of implants has been clearly demonstrated. However, the search for improved osseointegration has continued forward for the new evolution of modern dental implants. This represents a continuum of developments spanning more than 20 years of research on implant related-factors including surgical techniques, implant design, and surface properties. The methods to enhance osseointegration of dental implants in low quality (type-IV) bone are described in a general manner in this review.

Ongoing global crises, including climate change and the COVID-19 pandemic, have made Saudi Arabia recognise the importance of moving away from its oil-dependent economy. This inaugural, exploratory study focused on female postgraduate students who, in addition to striving for intellectual growth and development, are shouldering a social obligation to strengthen their country's economy per Saudi's most recent national development plan, Vision 2030. Qualitative data were collected in Spring 2020 at an Eastern Province university by engaging 20 Saudi female students (convenience sampling) in debates and extracting relevant, structured reflections from their journals. A content analysis revealed they enjoyed and learned from the debate experience with comments revolving around what constitutes the essence of a debate, special skill sets required, learner benefits, learner challenges, and lessons learned as novice debaters. Findings add to the nascent body of knowledge about utilising debate as a constructive learning experience for female students in a Middle Eastern university. Saudi university curriculum planners and instructors are invited to design learning interventions that teach women critical thinking, sound reasoning, and argumentation with the debate strategy a positive first step.

The increasing resistance of pathogenic bacteria to antibiotics is a challenging worldwide health problem that has led to the search for new and more efficient antibacterial agents. Nanotechnology has proven to be an effective tool for the fight against bacteria. In this paper, we present the synthesis and traits of trimetal (CuZnFe) oxide nanoparticles (NPs) using X-ray diffraction, high-resolution transmission electron microscopy, and energy dispersive x-ray spectroscopy. We evaluated the antibacterial activity of these NPs against gram-negative and gram-positive and then compared it to that of their pure single-metal oxide components CuO and ZnO. Our study showed that the antibacterial activity of the trimetal oxide NPs was greater against . than against . . Overall, the antimicrobial effect of trimetal NPs is between those of pure ZnO and CuO nanoparticles, which may mean that their cytotoxicity is also between that of pure ZnO and CuO NPs, making them potential antibiotics. However, the cytotoxicity of trimetal NPs to mammalian cells needs to be verified. The combination of three metal oxide NPs (ZnO, CuO, and Fe O ) in one multimetal (CuZnFe) oxide NPs will enhance the therapeutic strategy against a wide range of microbial infections. Bacteria are unlikely to develop resistance against this new NP because bacteria must go through a series of mutations to become resistant to the trimetal oxide NP. Therefore, this NP can combat existing and emerging bacterial infections.

Peri-implant diseases including peri-implant mucositis and peri-implantitis are among the major causes of failure of implant-supported dental restorations. They are characterized by progressive inflammation of the peri-implant mucosa, extending to the surrounding connective tissues and leading to bone loss and implant failure. Although strict oral hygiene practices help in preventing peri-implant diseases, plaque buildup around the implant restoration leads to chronic inflammation, due to the adherent bacterial biofilm. While mechanical debridement and non-surgical therapy to remove inflamed connective tissue (ICT) form the mainstay of treatment, additional local adjunctive therapies enhance clinical outcomes. Topical oxygen therapy is known to reduce inflammation, increase vascularity, and act as a bacteriostatic measure. The use of oxygen-based therapy (blue®m) products as a local adjunctive therapy for peri-implant mucositis and peri-implantitis can result in clinical outcomes similar to that of conventional local adjuncts such as chlorhexidine, antibiotics, and antibacterial agents. This report aims to present the clinical findings of patients with peri-implant mucositis and peri-implantitis, who were managed using local oxygen-based therapy as an adjunct to non-surgical therapy. In addition, a review of the literature about commonly used local adjuncts for peri-implant diseases has been included in the report to provide a means of comparison between conventional local adjunct therapy and topical oxygen-based therapy. Based on the reported findings and reviewed literature, local oxygen-based adjunct therapy was equally effective as conventionally used local adjuncts such as antibiotics, antibacterials, and probiotics, in treating patients with peri-implant diseases.

English is now widely considered the most powerful and influential language in the world. Saudi Arabia believes that its transition from oil to a knowledge-based economy is dependent on its citizenry learning English as a foreign language (EFL). To play their role, Saudi women need access to EFL, access that is affected by their agency and responses to challenging gendered norms. This exploratory qualitative study sheds light on two discourses associated with Saudi women investing in learning EFL: guilt and defiance. Data were collected (2018-2019) via semi-structured interviews with nine Saudi women of various ages, social, educational, employment, and sectarian backgrounds. A thematic analysis revealed how Saudi women exhibited the discourses of guilt and defiance throughout their EFL learning journey. The major guilt subthemes were child rearing guilt, L1 (loss of first language) guilt, and regret for not starting to learn EFL sooner. Defiance subthemes included gendered identity, professional hegemony, and Eurocentrism defiance. Despite personal and other-attributed guilt and shame, study participants defied societal and cultural norms and chose to invest in learning EFL. This study demonstrated the benefit of hearing Saudi women's voices to address the paucity of research targeting their investment in learning EFL.

Purpose>This classroom-based qualitative study explored the effectiveness of the debate learning strategy in female postgraduate education in Saudi Arabia, which is implementing its recent national development plan, Vision 2030. Educational reform is key to its transition to a modernized, knowledge-based economy. The debate format was used to elicit views on educational reforms and necessitated forming and articulating well-reasoned arguments and logic.Design/methodology/approach>At a Saudi Eastern Province university, 13 female postgraduate students (preservice teachers) participated in a student-centered learning environment conducive to debates. Documents prepared for the debate underwent a qualitative content analysis.Findings>Data were readily classified into five categories: educational reforms should meet 21st century skills, achieve educational outcomes, ensure Saudi Arabia’s knowledge-based economy, prioritize the role of the university and recognize the impact of both teachers and curricula. As key players in the nation’s future, participants affirmed the ongoing need for educational innovation and modernization.Originality/value>While debates are an authentic part of Arabian heritage, they are less utilized in Saudi higher education settings. Findings affirm that debates are a beneficial learning strategy for bolstering future educators’ participation in Saudi Arabia’s educational reform.

Gingivitis and periodontitis are common oral pathological conditions. Several optional adjunctive local therapies are used clinically. While antibiotics and chlorhexidine are the most common agents of choice, their long-term use is associated with several adverse effects. Some of these include staining of teeth and restorations, cellular cytotoxicity and hypersensitivity. Topical oxygen therapy has been recently introduced and could be clinically capable of inhibiting plaque bacterial biofilm growth. Available as a mouthwash, toothpaste and oral gel, this formulation comprises cellulose, glycerol and sodium peroxoborate, and releases topical oxygen in a controlled manner. Moreover, it releases topical oxygen, in a controlled manner, and lactoferrin, which are capable of antibacterial action and stimulation of bone cells, respectively. The aim of this paper is to report a case of gingivitis and another case of periodontitis, both of which were successfully treated clinically with adjunctive local oxygen therapy (blue®m). Additionally, this paper aims to review the relevant literature in terms of adjunct topical or local therapies used in the treatment of gingivitis and periodontitis, in order to understand how local therapies are helpful and to know if local oxygen therapy is a suitable clinical alternative.

Background: In chronic hepatitis B virus (HBV) patients, fluctuations in HBV DNA serve as a \"gray area\" and impede the accurate identification of inactive carriers. We aimed to assess if such fluctuations impact the presence of significant hepatic fibrosis (Metavir F2-4) in chronic HBV patients. Methods: Consecutive, untreated HBeAg-negative carriers (n = 234) with fluctuating HBV DNA (n = 73) above or below a level of 2000 IU/mL were included and compared to those without fluctuations (n = 161). Patients without fluctuating HBV DNA were further analyzed based on those with persistently low (<2,000 IU/mL, n = 137) and higher HBV DNA (2,000-20,000 IU/mL, n = 24). Hepatic fibrosis (assessed by transient elastography) was correlated with virologic and biochemical profiles. Results: The mean age of the overall cohort was 47.8 ± 11.1 years, of whom 107 (45.7%) were male. During a median of 60 months (interquartile range [IQR] 34-82) of follow-up, 73 (31.2%) patients had a mean of 1.6 ± 0.9 fluctuations in HBV DNA. The median time to the first fluctuation was at 14.5 (IQR 5.0-33.7) months. Patients with fluctuating viremia had higher log10 qHBsAg (3.1 ± 0.8 vs. 2.7 ± 1.0, P = 0.022) and HBV DNA (3.4 ± 0.5 vs. 2.7 ± 0.8, P < 0.001) compared to those without fluctuations. Patients with fluctuant viremia were less likely to have F2-4 fibrosis (8.2%) compared to those without fluctuant viremia (18.2%, odds ratio [OR]: 0.407, 95% confidence interval [CI]: 0.161-1.030; P = 0.052). Males tended to have less fluctuation constituting 37.0% of patients with fluctuating HBV DNA (P = 0.071). Fluctuations occurred more frequently in those with predominantly higher HBV DNA levels (26.0%) compared to those without fluctuations (14.9%; P = 0.030). Conclusions: Fluctuating HBV DNA levels occur frequently but are not associated with significant fibrosis. Minor fluctuations in HBV DNA levels are unlikely to be of clinical relevance.

Abstract Hepatitis C virus (HCV) infection has been a major global health concern, with a significant impact on public health. In recent years, there have been remarkable advancements in our understanding of HCV and the development of novel therapeutic agents. The Saudi Society for the Study of Liver Disease and Transplantation formed a working group to develop HCV practice guidelines in Saudi Arabia. The methodology used to create these guidelines involved a comprehensive review of available evidence, local data, and major international practice guidelines regarding HCV management. This updated guideline encompasses critical aspects of HCV care, including screening and diagnosis, assessing the severity of liver disease, and treatment strategies. The aim of this updated guideline is to assist healthcare providers in the management of HCV in Saudi Arabia. It summarizes the latest local studies on HCV epidemiology, significant changes in virus prevalence, and the importance of universal screening, particularly among high-risk populations. Moreover, it discusses the promising potential for HCV elimination as a public health threat by 2030, driven by effective treatment and comprehensive prevention strategies. This guideline also highlights evolving recommendations for advancing disease management, including the treatment of HCV patients with decompensated cirrhosis, treatment of those who have previously failed treatment with the newer medications, management in the context of liver transplantation and hepatocellular carcinoma, and treatment for special populations.

Education for sustainable development (ESD) flourishes with student-centered learning methods, including project-based learning (PBL). These methods are still new to Saudi Arabian university students who tend to experience teacher-centered approaches. Saudi Arabia’s recent policy decision to shift to a knowledge-based economy that respects sustainability will benefit from PBL-enhanced learning. This small-scale qualitative study investigated faculty and students’ feedback on their experience with PBL. Four faculty members (three female, one male in accounting, sports management, and information management) and six female students (financial sciences or accounting) from an Eastern Province university college were interviewed (45 minutes) in 2020–2021 using Zoom. Without exception, the instructors were in favor of PBL as a teaching strategy, and students’ overall experience could be described as positive. A thematic analysis (89 % inter-rater reliability coefficient) generated three themes: (a) beneficial learning strategy, (b) beneficial but challenging learning strategy with room for improvement, and (c) sustained student support over the semester with exceptions. Saudi universities are encouraged to employ PBL in all courses and use assessment methods conducive to student-centered learning. Universities are encouraged to streamline the project approval process, which was quite involved herein. Communications with community partnerships are important, and faculty and students should be thoroughly in-serviced and oriented to PBL.