The study sought to assess whether the soft tissue facial profile measurements of direct Cone Beam Computed Tomography (CBCT) and wrapped CBCT images of non-standardized facial photographs are accurate compared to the standardized digital photographs. In this cross-sectional study, 60 patients with an age range of 18–30 years, who were indicated for CBCT, were enrolled. Two facial photographs were taken per patient: standardized and random (non-standardized). The non-standardized ones were wrapped with the CBCT images. The most used soft tissue facial profile landmarks/parameters (linear and angular) were measured on direct soft tissue three-dimensional (3D) images and on the photographs wrapped over the 3D-CBCT images, and then compared to the standardized photographs. The reliability analysis was performed using concordance correlation coefficients (CCC) and depicted graphically using Bland–Altman plots. Most of the linear and angular measurements showed high reliability (0.91 to 0.998). Nevertheless, four soft tissue measurements were unreliable; namely, posterior gonial angle (0.085 and 0.11 for wrapped and direct CBCT soft tissue, respectively), mandibular plane angle (0.006 and 0.0016 for wrapped and direct CBCT soft tissue, respectively), posterior facial height (0.63 and 0.62 for wrapped and direct CBCT soft tissue, respectively) and total soft tissue facial convexity (0.52 for both wrapped and direct CBCT soft tissue, respectively). The soft tissue facial profile measurements from either the direct 3D-CBCT images or the wrapped CBCT images of non-standardized frontal photographs were accurate, and can be used to analyze most of the soft tissue facial profile measurements.

Aim: To investigate and compare the levels of dental anxiety (DA) in relation to khat and non-khat chewer subjects of both genders from Jazan subpopulation, Kingdom of Saudi Arabia (KSA). Materials and methods: A cross-sectional study was conducted to assess DA using the modified dental anxiety scale (MDAS). A total of 352 subjects from the city of Jazan who attended dental clinics for regular treatment were recruited for this study. A questionnaire was used to collect the required information, which consisted of three parts. Descriptive statistics including means, standard deviations, and percentages were calculated. Multiple group comparisons were analyzed using Chi-square tests using the Statistical Package for Social Science (SPSS) program. p < 0.05 was considered as the significance level. Results: Among the participants, 75.6% was male, while 71.3% khat chewers, and most of them were male (91.2%). The percentage of the overall mean of MDAS was low; 40% to moderate; 38%, while sever anxiety were present in 4% only. Anxiety related to endodontic treatments represents 33.8% in both genders and 34.3% among the khat chewers, while fear was 42.1% among males and 45.4% among khat chewers. The local anesthesia injection in the gum and tooth drilling items of MDAS were represented by 36.6% for both khat and gender groups and resulted in a fairly and extremely anxious situation during dental treatments. All variables were significantly different. Conclusion:The overall DA level was low to moderate among the majority of the assessed subjects. Endodontic treatments were the first type of dental treatments for the subjects, while fear of pain was the most common cause of irregular dental visits. Significant differences were detected between khat and non-khat chewers and between genders in relation to anesthesia injection, and drilling of teeth in the MDAS items. Clinical significance: Community programs focusing on the high DA levels caused by khat chewing might be important in order to minimize the fear of dental treatments and improve and regularize the overall dental treatments.