Exam evaluation in prosthodontics across preclinical and clinical years from students' perspective: A cross-sectional study

INTRODUCTION

The purpose of this study was to explore the students' perceptions and performance in prosthodontics theory exam.

METHODS

A cross-sectional descriptive study was conducted on 560 (80.82%) students of different levels (third, fourth and fifth years) to explore their opinions and performance with regard to a number of issues on a prosthodontics theory exam (exam evaluation, exam preparation, exam material, exam timing). Demographic data were also collected. Descriptive statistics were generated and Chi-square test, independent sample t-test, ANOVA test and Pearson's correlation coefficient were used to examine the associations between different variables. The significance level was set at p < .05.

RESULTS

Students' responses regarding exam evaluation was influenced by their gender, study level, high-school Grade Point Average (GPA) and undergraduate cumulative GPA. Perceived exam difficulty was significantly affected by gender (p = .03) and study level (p < .001), and negatively correlated to both high-school GPA (p < .001) and university GPA (p = .03). The vast majority (88.2%) depended on lecture hand-outs and lecture notes for study. Exam material and preparation were not significantly affected by any of the demographic variables with most respondents (76.8%) thinking that the lectures blended with prosthodontics laboratories/clinics would improve their understanding of the exam material. The suggested best time to conduct the exam was early afternoon (31.6%). Student performance was significantly affected by the study level (p < .001) and cumulative GPA (p < .001) with significant positive correlation between the high-school GPA and the mark in the exam (r = .29, p < .001) and by the amount of time students spent for exam preparation (p < .001). Those students who reported using textbooks to prepare for the exam got significantly higher marks (66.1 ± 8.7) compared to the students who did not (62.8 ± 9.7) (p = .03).

CONCLUSIONS

Course level, GPA and gender were identified as the most influential factors in different aspects of exam evaluation and students' performance. Regular study and use of textbooks were demonstrated to improve academic performance. Additional orientation and guidance relating to the exam (especially for third year students) would be welcomed, as would alternate teaching methods such as small group discussions or study groups.

How good is ChatGPT at answering patients' questions related to early detection of oral (mouth) cancer?

OBJECTIVES

To examine the quality, reliability, readability, and usefulness of ChatGPT in promoting oral cancer early detection.

STUDY DESIGN

About 108 patient-oriented questions about oral cancer early detection were compiled from expert panels, professional societies, and web-based tools. Questions were categorized into 4 topic domains and ChatGPT 3.5 was asked each question independently. ChatGPT answers were evaluated regarding quality, readability, actionability, and usefulness using. Two experienced reviewers independently assessed each response.

RESULTS

Questions related to clinical appearance constituted 36.1% (n = 39) of the total questions. ChatGPT provided "very useful" responses to the majority of questions (75%; n = 81). The mean Global Quality Score was 4.24 ± 1.3 of 5. The mean reliability score was 23.17 ± 9.87 of 25. The mean understandability score was 76.6% ± 25.9% of 100, while the mean actionability score was 47.3% ± 18.9% of 100. The mean FKS reading ease score was 38.4% ± 29.9%, while the mean SMOG index readability score was 11.65 ± 8.4. No misleading information was identified among ChatGPT responses.

CONCLUSION

ChatGPT is an attractive and potentially useful resource for informing patients about early detection of oral cancer. Nevertheless, concerns do exist about readability and actionability of the offered information.

Management of auto-immune blistering disease in an older patient with severe intellectual disability

Management of chronic oral mucosal diseases might be challenging in older individuals with intellectual disability because of associated comorbidities, variable clinical presentations, and various barriers imposed by the intellectual disability. This report describes the presentation and management of pemphigus vulgaris in an older female with severe intellectual disability.

Knowledge about oral manifestations of systemic diseases among medical and dental students from Jordan: An interdisciplinary educational gap

OBJECTIVE

To assess the ability of medical students to recognize oral manifestation of selected systemic diseases and compare their performance with dental students.

MATERIALS AND METHODS

A total of 400 senior medical and dental students were approached to participate. The study protocol involved two parts; a self-administered survey and a direct interview involving clinical photographs for oral signs of systemic diseases.

RESULTS

A total of 283 (70.8%) agreed to participate and completed the two- part study. The study population was made of 110 (38.9%) [82 females and 28 males] dental students, and 173(61.1%) [98 females and 75 males] medical students. The knowledge score regarding questions about the normal mouth and oral structures was 15.7 ± 6 out of 22. Dental students had a significantly higher knowledge score about normal mouth and oral structures (20.9 ± 4; range from 17 to 22) compared to medical students (10.6 ± 7; range from 4 to 21) (p = .029). The knowledge score regarding questions about oral manifestations of systemic diseases was 26.8 ± 6 out of 40. Dental students had a significantly higher knowledge score about oral manifestations of systemic diseases (30.8 ± 7; range from 15 to 37) compared to medical students (22.9 ± 4; range from 10 to 36) (p = .031). Only 24.3% (n = 42) medical students reported having adequate training to be able to distinguish between normal mouth and diseases. Nearly all medical students (91.3%; n = 158) felt that it is important to have more formal training in oral examination and disease diagnosis.

CONCLUSION

Medical students lack adequate knowledge, diagnostic ability, and confidence with regard to diagnosis of oral signs of systemic diseases. To ensure that medical students have necessary skills in assessing oral diseases, curricula revisions and modifications are required, and specific oral health-related learning outcomes should be introduced and reinforced through clinical training.

Desquamative gingivitis: a challenging diagnosis for clinicians

Introduction Diagnosis of underlying causes for desquamative gingivitis (DG) is often delayed in clinical settings, but little is known about factors influencing its delayed diagnosis. We investigated the diagnostic patterns and associated factors in a cohort of patients presenting primarily with DG.Materials and methods A total of 41 patients presenting primarily with DG were interviewed to evaluate professional and patient diagnostic delays. Severity of DG was evaluated using the desquamative gingivitis clinical score (DGCS) proposed by Arduino <i>et al.</i> (2017).Results The study sample was composed of 29 females and 12 males. On average, patients waited 10.8 ± 10 months (range 4-20 months) before seeking their first professional consultation (that is, patient delay). Less severe disease and female gender were significantly associated with longer patient delay. Patients consulted an average of 4.1 ± 2 healthcare professionals (range two to six) before a definitive diagnosis was reached, with an average professional delay of 7.3 ± 5 months (range 2-11 months). Professional delay was positively correlated with the number of professional consultations (r = 0.69) and absence of other oral mucosal lesions or extraoral involvement.Conclusions Considerable diagnostic delay is a feature of the natural history of DG. Increased patient knowledge and professional awareness regarding DG symptoms and diagnostic measures is needed to reduce diagnostic delay and improve patients' experience with this disease.

Dentists' knowledge and practice regarding prevention of infective endocarditis

Objectives:

The objective of this study is to assess the knowledge and practice of dentists from Jordan, regarding prevention of infective endocarditis (IE) in dental practice.

Materials and Methods:

A sample of Jordanian dentists was interviewed regarding their IE knowledge and practice using a validated and pretested survey instrument.

Results:

Most of the dentists have encountered a patient with IE who needed prophylactic antibiotic (PA) and have prescribed antibiotics to prevent IE. Jordanian dentists’ approach to patients in need for PA varied between the National Institute for Health and Clinical Excellence recommendations and the American Heart Association to a lesser degree, but still a relatively high percent (39%) did not know any guidelines to follow although 74% have encountered patients who needed endocarditis prophylaxis. Patients with prosthetic heart valve were ranked on top of medical conditions that required PA (87.4%), and most dentists (94.5%) thought that dental extractions need PA followed by periodontal surgery (88.2%).

Conclusion:

There is a lack of consistency in the knowledge and practice of Jordanian dentists with regard to IE. There is a need to take actions to improve dentist's knowledge regarding this topic.

Efficacy of intraligamentary anesthesia in maxillary first molar extraction

INTRODUCTION

Infiltration anesthesia (IA) is the method to anaesthetize maxillary teeth successfully. In contrast, intraligamentary anesthesia (ILA) has been used as supplementary anesthesia during tooth extraction, particularly when regional block anesthesia has failed. In this study, we compare the efficacy of and patient satisfaction with ILA vs IA when extracting maxillary first molar teeth.

METHODS

Forty patients were enrolled in this study and 80 maxillary first molars extracted. All patients served as their own control, with ILA as the experimental side and IA as the control side. The two techniques were compared for efficacy using a visual analog scale (VAS) and patient satisfaction compared using a verbal rating scale (VRS).

RESULTS

The mean VAS pain score for extraction using ILA was lower than that for IA (20.30±3.18 and 13.93±1.95 mm, respectively; P<0.001). For injection pain, the mean VAS pain score in the ILA side was higher than the IA side (42.28±4.51 and 31.73±3.1 mm, respectively; P<0.001). VRS results showed a higher number of patients who felt that pain during ILA was greater than expected compared with IA.

CONCLUSION

IA appears less painful during injection compared with ILA, and provides sufficient pain relief during extraction. However, ILA can be used when IA fails to achieve the desired pain suppression, as it provides higher extraction-pain relief.

Antioxidant capacity and biomarkers of oxidative stress in saliva of khat-chewing patients: a case-control study

OBJECTIVES

The aim of this study was to investigate the antioxidant levels and biomarkers of oxidative stress in saliva from khat-chewing patients compared with controls.

STUDY DESIGN

Saliva samples were collected from 51 chronic khat chewers and 46 age- and sex-matched controls. Concentrations of oxidative stress biomarkers (malonyl-dialdehyde [MDA], protein carbonyl, and 8-hydroxy-2'-deoxyguanosine) and antioxidant defense (total antioxidant capacity [TAC], superoxide dismutase, glutathione peroxidase, and catalase [CAT) were analyzed.

RESULTS

Salivary MDA level in the khat users group (45 ± 9.2 nmol/mL) was significantly increased in comparison with controls (13 ± 2.1 nmol/mL; P < .001), but there were no significant differences between the 2 groups regarding the levels of salivary protein carbonyl and oxidized guanine species. Salivary TAC was significantly reduced in khat users (0.25 ± 0.028 mmol/L) in comparison with controls (0.34 ± 0.037 mmol/L). Salivary CAT level was significantly reduced in khat users (6.0 ± 0.47 U/mL) in comparison with controls (7.7 ± 0.43 units/mL; P <.05), but no significant differences were observed between the 2 groups with regard to salivary superoxide dismutase or glutathione peroxidase levels.

CONCLUSIONS

Chronic khat chewing is associated with increased levels of salivary MDA and reduced levels of TAC and CAT among a population of adult men in comparison with non-khat-chewing controls. These findings suggest that the pro-oxidative effect of khat chewing may be a contributing mechanism for various oral diseases associated with khat use, including cancer, periodontitis, and caries.

Oral Cancer Early Detection: What Do Patients Need To Know?

The purpose of the present study was to examine the educational needs of patients regarding early detection of oral cancer. A total of 790 patients without cancer were interviewed and shown a set of validated clinical images of various oral lesions including early oral cancer. Participants were asked about their perception of cancer and the action that they would take if they notice a similar lesion. Lower risk lesions (e.g., lumps) were more likely to be perceived as cancer (52.4%), while higher risk lesions (e.g., red patches) were least likely to be perceived as cancer (8.8%). The perceived appearance of the lesions was correlated with patients' perceived need for medical advice. Higher risk lesions were less likely to make patients feel the need to seek professional advice. High-risk patients were less aware about oral cancer appearance and were less likely to take action if they notice an oral lesion. Patients are not aware of the various presentations of early oral cancers, especially higher risk lesions. Patients need to know more about the clinical appearance of early oral cancer. The use of representative clinical images of early oral cancer and educational videos on self-inspection of oral mucosa is important.

Impaction of lower third molars and their association with age: radiological perspectives

Background

Third molars are the most commonly impacted teeth, and their extraction is the most commonly performed procedure in oral and maxillofacial surgery. The aim of the present study is to describe the pattern of mandibular third molar impaction and to define the most appropriate age for prophylactic extraction of mandibular third molar teeth.

Methods

A total of 1198 orthopantomographs (OPGs) with 1810 impacted lower third molars were reviewed by two authors. The pattern of eruption in relation to patient’s age was examined using standard radiographic points and angles. Statistical analysis was performed using SPSS for Windows release 16.0 (SPSS Inc., Chicago, IL, USA).

Results

In patients older than 20 years, vertical pattern of impaction was the most common (21.4%); while in young patients; horizontal impaction was more common (21.3%). Furthermore, there was a constant pattern of increase in Pell-Gregory ramus class 1 with increasing age, as the prevalence of class 1 was 0% at age 18 years compared to 54.9% at the age of 26 years.

Conclusion

Frequency of vertical impaction of lower third molars was seen more at an older age (> 20 years) in this study, with an increase in the retromolar space. Late extraction of mandibular third molar teeth (i.e. after the age of 20) is therefore recommended when prophylactic extraction is considered.

Dental implants in a patient with suspected leucocyte adhesion deficiency

Aggressive periodontitis and premature tooth loss in leucocyte adhesion deficiency (LAD) have adverse functional and psychological consequences on affected individuals. Dental implant rehabilitation might become necessary to overcome the functional and psychological adverse effects of LAD periodontitis, especially in patients with milder forms who are expected to have a relatively normal life expectancy. Outcome of dental implants in patients with LAD has not been previously reported; we describe the dental rehabilitation of a 24-year-old man with clinical features of LAD using endosseous dental implants.

Oral Cancer Knowledge and Diagnostic Ability Among Dental Students

The purpose of this study is to examine factors that influence the diagnostic ability of dental students with regards to oral cancer and oral potentially malignant disorders. Dental students at different levels of study were directly interviewed to examine their oral cancer knowledge and diagnostic ability using a validated and pre-tested survey instrument containing validated clinical images of oral cancer and oral potentially malignant disorders. An oral cancer knowledge scale (0 to 31) was generated from correct responses on oral cancer general knowledge, and a diagnostic ability scale (0 to 100) was generated from correct selections of suspicious oral lesions. Knowledge scores ranged from 0 to 27 (mean 10.1 ± 6.0); mean knowledge scores increased with year of study; 5th year students had the highest mean knowledge score (19.1 ± 4.0), while 1st year students had the lowest (5.6 ± 3.5). Diagnostic ability scores increased with year of study and ranged from 0 to 88.5 % (mean 41.8 % ± 15.6). The ability to recognize suspicious oral lesions was significantly correlated with knowledge about oral cancer and oral potentially malignant disorders (r = 0.28; P < 0.001). There is a need to improve oral cancer education curricula; increasing students' contact with patients who have oral lesions including oral cancer will help to improve their future diagnostic ability and early detection practices.

Angioleiomyoma of the upper lip

This report describes a case of labial angioleiomyoma in a 52-year-old woman. The patient had noticed a slow-growing painless isolated mass in her upper lip for 6 months. The mass was surgically excised, and pathological examination was consistent with angioleiomyoma. Surgical excision was curative, and there was no recurrence at 12-month follow-up.

p53, Cyclin D1, p21 (WAF1) and Ki-67 (MIB1) Expression at Invasive Tumour Fronts of Oral Squamous Cell Carcinomas and Development of Local Recurrence

BACKGROUND

Expression of p53, cyclin D1, p21 (WAF1) and Ki-67 (MIB1) was evaluated in oral squamous cell carcinoma (OSCC) to test whether levels of these markers at invasive tumour fronts (ITFs) could predict the development of local recurrence.

MATERIALS AND METHODS

Archived paraffin-embedded specimens from 51 patients with T1/T2 tumours were stained immunohistochemically and analysed quantitatively. Local recurrence-free survival was tested with Kaplan-Meier survival plots (log-rank test) using median values to define low and high expression groups and with a Cox's proportional hazards model in which the expression scores were entered as continuous variables.

RESULTS

The assessment of expression of all markers was highly reliable, univariate analysis showing that patients with clear surgical margins, with low cyclin D1 and high p21 expression at the ITF had the best local recurrence-free survival. Multivariate analysis showed that these three parameters were independent prognostic factors but that neither p53 nor MIB1 expression were of prognostic value.

CONCLUSIONS

Assessment of p53, cyclin D1, p21 (WAF1), and Ki-67 (MIB1) at the ITF could help to predict local recurrence in early stage oral squamous cell carcinoma cases.

Oral Cancer Early Detection--a Pressing Need for Continuing Education in Jordan

AIMS

To identify deficiencies in the knowledge of general medical (GMPs) and dental practitioners (GDPs) regarding early detection of oral cancer, to compare differences between subgroups, and to identify educational needs for continuing education courses on this subject.

MATERIALS AND METHODS

165 GDPs and 165 GMPs were directly interviewed to assess their knowledge about oral cancer using a pre-tested survey. Knowledge scores were generated from correct responses of participants to factual questions about oral cancer.

RESULTS

Few participants (15.2% of GDPs and 12.8% of GMPs) reported that they attended any continuing education courses on oral cancer during their professional career. Most participants (81.6% of GDPs and 86.3% of GMPs) admitted that their knowledge about oral cancer was not up to date and that they would need to attend continuing education courses on oral cancer if available. A few significant differences were identified between groups regarding knowledge about risk factors, clinical presentations and diagnostic techniques but the overall knowledge scores showed no significant difference between GMPs and GDPs.

CONCLUSIONS

The present study identified several deficiencies in the knowledge of GMPs and GDPs regarding risk factors, clinical presentations, and diagnostic techniques of oral cancer. Interventions to correct these defects through properly designed continuing education courses are required.

Factors Influencing Early Detection of Oral Cancer by Primary Health-Care Professionals

The purposes of this study are to determine early detection practices performed by primary healthcare professionals, to compare medical and dental sub-groups, and to identify factors that influence the ability of medical and dental practitioners to recognize precancerous changes and clinical signs of oral cancer. A 28-item survey instrument was used to interview a total of 330 Jordanian primary health-care professionals (165 dental and 165 medical). An oral cancer knowledge scale (0 to 31) was generated from correct responses on oral cancer general knowledge. An early detection practice scale (0 to 24) was generated from the reported usage and frequency of procedures in oral cancer examination. Also, a diagnostic ability scale (0 to 100) was generated from correct selections of suspicious oral lesions. Only 17.8 % of the participants reported that they routinely performed oral cancer screening in practices. Their oral cancer knowledge scores ranged from 3 to 31 with a mean of 15.6. The early detection practice scores ranged from 2 to 21 with a mean of 11.6. A significant positive correlation was found between knowledge scores and early detection practice scores (r = 0.22; p < 0.001). The diagnostic ability scores ranged from 11.5 to 96 with a mean of 43.6. The diagnostic ability score was significantly correlated with knowledge scores (r = 0.39; p < 0.001), but not with early detection practice scores (r = 0.01; p = 0.92). Few significant differences were found between medical and dental primary care professionals. Continuous education courses on early diagnosis of oral cancer and oral mucosal lesions are needed for primary health-care professionals.

Lack of Utility of Cytokeratins in Differentiating Pseudocarcinomatous Hyperplasia of Granular Cell Tumors from Oral Squamous Cell Carcinoma

Granular cell tumor (GCT) of the oral cavity is a benign lesion. Half of oral GCTs demonstrate pseudocarcinomatous hyperplasia (PCH) of the mucosa which can mimic invasive islands of oral squamous cell carcinoma (SCC). Such similarity can be confusing when diagnosing or evaluating the two conditions, potentially leading to misdiagnosis or misclassification. Indeed, several misdiagnosed cases of oral GCT have been reported in the literature as OSCC or malignant oral GCT that resulted in unnecessary aggressive treatment for the affected patients. The aim of this study was to investigate if the cytokeratin pattern of the PCH can help in differentiating GCT from oral SCC. To distinguish between these two entities, we examined 12 patient specimens of oral GCT-PCH and oral SCC histologically and via immunohistochemistry (IHC) for CK13, CK17 and P75. The results suggest that the cytokeratin profile of PCH is similar to that of oral SCC. Therefore, consideration of IHC findings for epithelial markers alone may lead to erroneous diagnosis; thus, the presence of the granular tumor underneath the PCH and its immunopositivity for P75 or other neural definition markers can be essential to identify the underlying tumor and exclude oral SCC. Finally we recommend more studies on the molecular biology of PCH to understand how it can mimic oral SCC histologically without harboring its malignant phenotype clinically, which could have significant translational potential for understanding invasive oral SCC.

Oral potentially malignant disorders among dental patients: a pilot study in Jordan

BACKGROUND

To determine the prevalence, types, and risk factors of oral potentially malignant disorders (OPMDs) among a group of Arab Jordanian dental patients, and to evaluate their awareness and attitudes toward early diagnosis and treatment.

MATERIALS AND METHODS

A total of 1,041 patients attending a University Hospital for dental care were examined for the presence of OPMDs. Histopathological examination was performed on all cases clinically diagnosed and patients were directly interviewed to evaluate their knowledge and attitudes toward early detection and treatment of oral cancer.

RESULTS

The prevalence of OPMDs overall was 2.8%. Lichen planus/lichenoid lesions were the most common lesions (1.8%) followed by leukoplakias (0.48%), chronic hyperplastic candidiosis (0.38%), and erythroplakia (0.096%). Smoking, alcohol, and age (>40 years) were the main identifiable risk factors. Patients with OPMDs displayed a general lack of awareness and negative attitudes towards early diagnosis and treatment.

CONCLUSIONS

OPMDs among Arab dental patients are relatively uncommon and awareness about oral cancer among Jordanian dental patients is low. Interventions to improve public knowledge about oral cancer and attitudes toward early diagnosis and treatment are urgently indicated.

Bond strength of self-adhesive resin cements to tooth structure

OBJECTIVES

The aim of this study was to evaluate the strength of the bond between newly introduced self-adhesive resin cements and tooth structures (i.e., enamel and dentin).

METHODS

Three self-adhesive cements (SmartCem2, RelyX Unicem, seT SDI) were tested. Cylindrical-shaped cement specimens (diameter, 3 mm; height, 3 mm) were bonded to enamel and dentin. Test specimens were incubated at 37 °C for 24 h. The shear bond strength (SBS) was tested in a Zwick Roll testing machine. Results were analyzed by one-way ANOVA and t-test. Statistically significant differences were defined at the α = 0.05 level. Bond failures were categorized as adhesive, cohesive, or mixed.

RESULTS

The SBS values ranged from 3.76 to 6.81 MPa for cements bonded to enamel and from 4.48 to 5.94 MPa for cements bonded to dentin (p > 0.05 between surfaces). There were no statistically significant differences between the SBS values to enamel versus dentin for any given cement type. All cements exhibited adhesive failure at the resin/tooth interface.

CONCLUSIONS

Regardless of their clinical simplicity, the self-adhesive resin cements examined in this study exhibit limited bond performance to tooth structures; therefore, these cements must be used with caution.

Mouth cancer awareness and beliefs among dental patients

OBJECTIVES

The aim of the present study was to assess the levels of awareness, knowledge about signs and risk factors of mouth (oral) cancer, and attitudes towards early diagnosis and treatment among dental outpatients.

MATERIAL AND METHODS

A total of 1,200 adult outpatients attending dental clinics at the University of Jordan Hospital for dental examination and treatment were randomly selected to participate in the study. An 18-item pretested close-ended questionnaire was used for the study. Descriptive statistics were generated and chi-square tests, t-tests, one-way analysis of variance (ANOVA), and Spearman's rho test were used to examine differences between groups.

RESULTS

Only 45.6% of the subjects had heard about oral cancer. Some 66.9% and 33.8%, respectively, were able to correctly identify tobacco and alcohol as risk factors. Some 24.1% had no knowledge about any signs of oral cancer. Male subjects, smokers, alcohol drinkers, older participants (>40 years), and participants with less than a university education were significantly less aware, and had much less knowledge, of the signs and risk factors of oral cancer (P<0.05).

CONCLUSION

Awareness about oral cancer among Jordanian dental outpatients is low. These dental patients, especially those in high-risk groups for mouth cancer and those of lower socio-economic status (SES), are less well informed about the signs and risk factors of oral cancer. Interventions to improve public knowledge about oral cancer and attitudes towards early diagnosis and treatment are urgently indicated.

Age and the architecture of oral mucosa

Age changes affect the oral mucosa (the protective lining of the oral cavity), but few of these have been studied objectively. The aim of this study was to quantitatively analyse a number of morphometric parameters of the ageing oral mucosa. The fractal dimension of the epithelial connective tissue interface (ECTI) was estimated in 42 samples of normal buccal mucosa to correlate any changes in their irregularity to the age of the individuals. Morphometric parameters extracted from theoretical cell areas computed programatically were also analysed. Results showed no significant change in ECTI complexity associated with age; however, there was indication that epithelial cells tended to become larger and flatter with age. Interestingly, while some parameters did not show significant differences case wise, cluster analysis showed that the data clustered the cases into three main age groups: one representing the first two decades of life, another group represents adult life (21-50 years) and the last group representing the ageing population (50-90 years).

Effect of oral diseases on mothers giving birth to preterm infants

OBJECTIVES

To determine the association between preterm birth (PTB) and maternal oral diseases during pregnancy.

SUBJECTS AND METHODS

This prospective study was performed by the neonatal and dental departments at Jordan University Hospital. The study included 100 women who gave birth to preterm singleton infants (born less than 37 complete weeks from last menstrual period) between January and July 2009. The control group included an equal number of women who delivered singleton, full-term infants on the same day or the day after the women in the study. The mothers' demographic data were collected using a questionnaire, and an oral examination was conducted for each participant. Statistical analysis was performed using SPSS for Windows release 16.0 (SPSS Inc., Chicago, Ill., USA). Factors related to PTB were studied in univariate and multivariate logistic regression analyses.

RESULTS

Significantly higher DMFT (decayed, missing, filled teeth) index scores, Silness and Loe plaque index scores and Mühlemann tooth mobility index scores were associated with PTB. Mothers who did not have prepregnancy dental checkups had a significantly higher incidence of PTB. Fewer mothers in the PTB group visited dentists during their last pregnancy compared with controls.

CONCLUSIONS

Oral health, especially healthy periodontium, is one reliable indicator for predicting a safe pregnancy outcome.

Lingual nerve morbidity and mandibular third molar surgery: a prospective study

OBJECTIVE

The objective of this study was to estimate the frequency of postoperative lingual nerve (LN) impairment after the surgical removal of mandibular third molars (M3) and to identify potential risk indicators.

SUBJECTS AND METHODS

A prospective cohort study involving 321 subjects who had 443 mandibular M3 surgically extracted at the University Hospital, Amman, Jordan. Predictor variables were categorized as patient-, anatomy- and operation-specific. The outcome variable was the presence or absence of LN impairment. Bivariate and multivariate analyses were performed to identify independent predictors.

RESULTS

The prevalence of temporary LN hypoesthesia was 2.5% and all 11 cases resolved within 6 months. Factors that predicted LN injury by univariate analysis were horizontal and mesioangular tooth angulation, bone removal, tooth sectioning, longer operations, lingual flap retraction and bleeding into the socket. In the multivariate logistic regression model, lingual flap retraction (p = 0.002, OR = 26.790) and bleeding into the socket (p = 0.044, OR = 4.918) were the independent predictors.

CONCLUSION

Operative variables were the main predictors of temporary LN damage.

Prevalence of temporomandibular joint disorders among students of the university of jordan

Background

This study aimed to investigate the prevalence of temporomandibular disorder (TMD) among students of the University of Jordan.

Methods

Information about the symptoms of TMD and the possible risk factors were collected using specifically designed questionnaires. The collected data sets were treated statistically using the SPSS release 14 package.

Results

The results of the present investigation showed that pain in or about the ears or cheeks was the most prevalent symptom whereas locking of the temporomandibular joint (TMJ) was the least prevalent. Nearly one-third of the investigated sample (31.4%, 346/1103) had no symptoms of TMD whereas 68.6% (757/1103) had at least one symptom. Students of health science studies had significantly the highest risk in developing TMJ clicking compared to students studying pure science or humanitarian studies.

Conclusions

TMD is of a high prevalence among students of the University of Jordan, particularly among students of health and science studies, which signify the role of stress in the development and/or progression of TMD. The findings of this study are alarming and entailing further investigations to identify risk factors associated with TMD in order to establish measures for prevention and treatment.

Keywords

TMD; Clicking; Health sciences; Humanitarian studies

Dental extraction for patients presenting at oral surgery student clinic

The aim of this study was to examine the reasons for dental extraction and to determine the pattern of tooth loss in patients seeking care at the oral surgery teaching clinics in the Faculty of Dentistry of the University of Jordan, Amman, Jordan, over a 3-year period. Data pertaining to the dental extractions of 2435 patients were analyzed. The results showed that 63.8% of the teeth included in this study were extracted because of dental caries, 22.9% because of periodontal disease, and 11.0% for prosthetic reasons. Pericoronitis, orthodontic treatment, trauma, and eruption problems accounted for 2.4% of the reported extractions. The upper premolars were the teeth most commonly extracted, and the lower first and second molars were the teeth most commonly extracted because of dental caries. The logistic regression test revealed that extraction because of dental caries occurred mostly in the group aged 21 to 30 years (P < .001). Periodontal disease was not likely the cause of extraction in patients younger than 40 years. Mandibular incisors were the teeth least likely extracted because of dental caries (P < .001), but they were the teeth most commonly extracted because of periodontal disease (P < .001). Extraction for orthodontic reasons mostly involved the premolars (P < .05) and occurred in patients 20 years of age or younger (P < .001). Men were less likely to lose teeth because of caries and periodontal disease (P < .05 and P < .001, respectively) and were more likely to lose teeth for prosthetic reasons and trauma. The information gained from this study is useful to shift oral health planning toward emphasizing the importance of maintaining natural dentition and preventing dental disease.