Intraoral versus extraoral measurement of the height of the interproximal contact area in maxillary anterior teeth

This study aimed to clinically quantify the apicoincisal height of the upper interproximal areas directly in patients' mouths compared to measurements on stone models. Subjects and One hundred and fifty participants [75 females and 75 males, age range 20-45 years] were recruited for this study. A digital caliper was used to measure the anterior maxillary interproximal contact areas directly in patients' mouths and on stone models. The digital caliper accuracy was up to 0.01. The Statistical Package for Social Sciences software [SPSS, version 19.0, Chicago, III., USA] was used for statistical analysis. Statistical significance was based on probability values <0.05. The intraoral measurement of proximal contacts as well as the measurement on stone models showed that the dimensions of interproximal contacts on both sides of each tooth were significantly different [p < 0.001] and that the dimension of the mesial contact point was larger than that of the distal contact point of each tooth. The largest contact point was the one between the central incisors [direct intraoral measurement = 2.9-6.49 mm; model measurement = 3.31-6.91 mm]. On the other hand, the contact point between the canine and first premolar was the smallest on both sides of the arch [0.63-2.52 mm intraorally, 0.98-2.88 mm on models]. The intraoral measurement of contact points was more accurate than model measurements, and the differences were statistically significant [p < 0.001]. The clinical evaluation of contact point dimensions using a digital caliper was more precise than measuring contact points on stone models; hence, it is a viable, quick and adequate method to be used routinely

new design for mandibular occlusal splint

The aim of this report is to describe the design and steps for construction of a new design of mandibular occlusal splint, which was designed in a manner that facilitated the engagement of the bilateral undercuts usually located on the lingual aspects of the lower posterior teeth and alveolar processes. This occlusal splint was composed of two parts. The split design provided the flexibility needed to engage the deep bilateral undercuts located lingual to the mandibular posterior teeth and alveolar processes. The parts of the two splint segments were connected with flexible connectors made from cast Ti-6Al-7Nb, an alloy characterized by its high flexibility [for the first part], and wrought Cobalt-Chromium wire [for the second part of the splint]. These flexible connectors were expected to flex repeatedly each time the appliance was inserted or removed from its position without undergoing permanent deformation. The described occlusal appliance had the following merits. Since it had the ability to engage the bilateral undercuts usually located lingual to the posterior segments of the mandibular arch, this could abolish the need for any necessary block out and eliminate the spaces between the appliance and the oral tissues. Such spaces can be annoying for some patients because of the noticeable borders or trapped food when the appliance is used for eating. An undercut engagement also added to the stability and retention of the appliance

Relationship between route of antibiotic administration and post-surgical complications following removal of lower third molars

This prospective clinical trial aims at evaluating the effects of antibiotic therapy following different administration routes on the postoperative complications of surgical removal of lower impacted third molars. Two hundred and fourty eight consecutive patients [100 males and 148 females] aged 18 to 38 years old [mean=24 +/- 5 years] were recruited into this study. The lower third molars of all recruited patients were surgically extracted. Participants received preoperative antibiotic cover either as intravenous Cephradine injection [1 gram] or oral dose of 500 mg Cephalexin. Immediate and late complications following the surgery; including pain, swelling, trismus, paraesthesia, bleeding, dry socket, infection and fracture of mandible; were assessed 3 days and 7-14 days following the surgery. The most frequent complications were slight pain, swelling, and trismus. Oral route of antibiotic administration was associated with more immediate and late complications [p<0.001]. Oral route of antibiotic administration was associated with more pain, swelling, trismus, and dry socket [p<0.05]. Following surgical extraction of third molars, intravenous antibiotic administration was more effective in reducing the post surgical complications than oral antibiotic administration

Risk indicators of postoperative complications following surgical extraction of lower third molars

The aim of this prospective clinical trial was to evaluate the incidence of postoperative complications following surgical extraction of lower third molars [l8] and the risk factors and clinical variables associated with these complications. Three-hundred and twenty-seven consecutive patients [128 men and 199 women, mean age = 23.1 +/- 3.9 years, range 18-40] were recruited to this study. The L8 of all the patients were surgically extracted. Immediate and late complications like pain, welling, trismus, paresthesia, bleeding, dry socket, infection and fracture were assessed 3 and 7-18 days, respectively, following the surgery. The most frequent immediate and late complications were slight pain, swelling, and trismus. Thirty-nine [11.9%] patients reported dry socket and 10 [0.3%] reversible sensory nerve complications. More immediate and late complications were experienced by females [p=0.000 and 0.016, respectively]. Older subjects reported more late complications. Frequent immediate and late complications were associated with preexisting pericoronitis, longer duration of operation, extraction of two molars, flaps with vertical incision, extractions with bone removal, extractions without tooth sectioning and distoangular impactions [p

Relationship between timing of antibiotic administration and complications following surgical extraction of lower third molars

The aim of this prospective clinical trial was to evaluate the effects of antibiotic therapy following different administration times on the postoperative complications of surgical removal of lower impacted third molars. Three hundred and twenty seven consecutive patients [128 males and 199 females] aged 18 to 40 years old [mean=23.1 +/- 3.9 years] were recruited into this study. The lower third molars of all recruited patients were surgically extracted. Participants received either intravenous Velocef 1 gram or intra-oral 500 mg Cephalexin pre- [Group A, n=122], pre- [Group B, n=70] or post-operatively [Group C, n=135]. Immediate and late complications following the surgery; including pain, swelling, trismum, paraesthesia, bleeding, dry socket, infection and fracture of mandible; were assessed 3 days and 7-14 days following the surgery. The most frequent complications were slight pain, swelling, and trismus. The most frequent complications were associated with post-operative antibiotics administration and least complications were associated with pre-operative antibiotic administration [p=0.000]. post-operative administration of antibiotic was associated with more pain [r=0.186, p=0.001], swelling [r=0.181, p=0.001], trismus [r=0.277, p=0.000], and dry socket [r=0.335, p=0.000]. Following surgical extraction of third molars, preoperative antibiotic administration is more effective in reducing the post-surgical complications than pre-operative antibiotic administration which in turn is more effective than post-operative antibiotic administration

Reasons for removal of bone plates after orthognathic surgery

The aim of this prospective clinical trial was to evaluate the reasons for removal of miniplates from patients who had orthognathic surgery over a 7-year period. Fifty consecutive patients with fixed miniplates following orthognathic surgery [11 males and 39 females] aged 20 to 43 years [mean=28 +/- 6 years] were recruited into this study. Personal information, dental and medical history, type of orthognathic operation, indications for plate removal, placement site of plates and time between insertion and removal were recorded. The site of plate insertion was classified into right, left and anterior maxilla; right, left and anterior mandible; and chin. All plates were inserted and removed intra-orally under local or general anesthesia. The association between the variables was analyzed using the Pearson correlation and Chi-Square test. For all statistical analysis, the significance level was set at P<0.05. 312 titanium miniplates were inserted in 50 patients. A total of 108 plates [34.6%] were removed. The retention period for the removed plates ranged from 4 months to 4.5 years. The most common sites for plate removal were maxilla [22 patients, 44%] followed by mandible [19 patients, 38%]. The most common cause for plate removal was palpable plates [27 patients] followed by infection [13 patients], patient discomfort and preference [7 patients] and plate exposure and wound dehiscence [3 patients]. No significant relationships were found between plate removal [including number and location of removed plates and reason for plate removal] and age and gender [p<0.05]. Reason of plate removal was significantly related to the number of plates [p=0.001, r=0.441] and the location of removed plate [p<0.001, r= 0.62]. Type of removed plate had no significant relation with reason for plate removal [p=0.576, r=-0.081] number of plates [p= 0.62, r= 0.072] and location of removed plates [p= 0.467, r= -0.105]. Reason for performing the orthognathic surgery and type of the orthognathic surgery had no significant relations with the number and location of removed plates and reason for plate removal [p<0.05]. Plate removal was attributed to palpable plates, infection, subjective discomfort and patient preference, and plate exposure and wound dehiscence. Plate-related complications caused plate removal which was more likely to occur within the first year of insertion. This should be accounted for during the process of obtaining informed consent

Risk factors and prevalence of musculoskeletal disorders among Jordanian dentists

To investigate the prevalence of Musculoskeletal Disorders [MSDs] symptoms [hand/wrist, neck, shoulder and back pain] among dentists and to identify the risk factors associated with these symptoms. A random sample of 200 dentists [114 males [mean age 40.6 years] and 86 females [mean age 40.1 years] were personally interviewed using a structured questionnaire. The questionnaire assessed age, gender, presence of MSDs, daily working hours, years of experience, working position, participants' knowledge of correct working posture and employment of dental surgeon assistant. Data were processed and analyzed by Chi-square test. P value was set at < 0.05. The majority of participants were general practitioners [87.5%]. 86% of the study sample suffered one or more of the MSDs [back pain [56%], neck pain [47%], shoulder pain [39%] and hand/wrist pain [26%]]. Females reported more shoulder pain and less back pain than males [P=0.001]. Neck, shoulder and back pain were significantly increased among older dentists and dentists with more years of professional experience [P<0.0001]. More than half of the participants were not aware of the correct working postures [62.5%], the more the awareness of healthy postures the less the hand/wrist, neck and back pain [P < 0.05]. Hand/wrist pain was most prevalent among dentists who only worked while standing while least prevalent among dentists mixing between sitting and standing postures [P<0.0001]. MSDs are common among Jordanian dentists. There seems to be a substantial need for further training and continuing education on occupational health among Jordanian dentists

Variation in time of emergence of permanent teeth among urban and rural Jordanian school children

To investigate the variation in time of permanent tooth emergence between urban and rural Jordanian school children. In this observational cross-sectional study, 1900 pupils at urban schools, and 772 at rural schools aged 5-16 years in both genders were examined for emergence of permanent teeth at different urban and rural primary schools and kindergartens in Jordan between March and June 2010. Probit analysis was used to estimate the median age of emergence per permanent tooth. The emergence ages for most of the permanent teeth were generally advanced in urban schoolboys in contrast to their fellows at rural schools. However, the differences were only statistically significant for the maxillary canine and maxillary premolars. Compared with boys, schoolgirls had smaller variation in permanent tooth emergence across school region, and none of the differences were statistically significant. Urban schoolboys have accelerated emergence of the maxillary canine and maxillary premolars compared to rural boys. The potential etiology behind this finding needs to be investigated further in the future