Mandibular brown tumor as the first manifestation of primary hyperparathyroidism: a case report

Patients with primary hyperparathyroidism [brown tumor] are usually asymptomatic and clinical presentation of the tumor in the jaws is rarely the first sign of the disease. We report a 45-year-old female patient who presented with a mandibular swelling as the first sign of the disease

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

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. 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. 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. Operative variables were the main predictors of temporary LN damage

Maximum mouth opening associated factors and dental significance

To estimate active maximum mouth opening [AMMO] in a Jordanian subpopulation and to study associated factors and relationship to patient's dental conditions. This cross-sectional study was conducted on 496 patients aged 15-80 years at the University of Jordan Hospital, Amman, Jordan between October 2008 and March 2009. The AMMO was measured as maximum distance between incisal edges of upper and lower central incisors. Descriptive statistics and uni- and multivariate analyses were used to determine factors affecting AMMO. Mean AMMO +/- standard deviation was 42.9 +/- 5.7 mm. The AMMO varied significantly between men [45.3 +/- 5.7mm] and women [41.5+-5.3 mm], decreased with age, and correlated positively with body height and weight, but no relation was found with body mass index and temporomandibular joint complaints. The relationship of AMMO to patient's dental conditions revealed a negative correlation with number of missing teeth, but not with number of decayed or restored teeth. Subjects who had present third molars had wider AMMO compared to subjects with extracted, impacted, or congenitally missing third molars. Multivariate regression analysis revealed gender, age, and weight to be the only independent predictors of AMMO. In this population, AMMO is influenced by gender, age, and weight of patients and was generally narrower than that reported in European populations. Wide AMMO was associated with less risk of tooth loss and preservation of third molars

Assessment of self-medication of antibiotics in a Jordanian population

To assess the extent of self-medication with antibiotics [SMA] in a Jordanian population, and to evaluate the sociodemographic factors affecting this behaviour. Subjects and Methods: Face-to-face interviews were conducted with 477 patients aged 16-65 years attending the Department of Dentistry, University of Jordan Hospital. Socio-demographic data were collected and interviewees were asked about their SMA behaviour during the last 6 months, the reasons and motives for this behaviour, and the source and dose of the antibiotics were noted. The prevalence rate of SMA in the sample during the 6 months preceding the interview was 40.7% [194/477]. Patients aged 36-55 years and those in the middle-class income group were most likely to perform SMA. SMA was mainly for sore throats, common colds and dental infections, and community pharmacies were the major source [104, 53.6% cases]. Amoxicillin was the most commonly used antibiotic, and only 73 [37.6%] patients followed the correct dosage guidelines. Previous experience with similar illness and saving time were the most common reasons for SMA. Ninety-four [19.7%] patients admitted that they consulted another physician to obtain antibiotics when their first physician did not prescribe any. The findings showed that SMA was a frequent practice among Jordanians, signifying the need for an educational campaign on the proper use of antibiotics in this population

Perception of outcome after orthognathic surgery at Jordan university hospital

To study the motives for seeking orthognathic surgery at the Jordan University Hospital and evaluate patients' satisfaction with the treatment. 54 patients underwent orthognathic surgery between October 2002 and October 2007. Data were collected through a questionnaire consisting of 30 questions. Questions were divided into sections; motivation for seeking orthognathic treatment, pre-operative counseling, treatment outcome, satisfaction with outcome and quality of life. The sample included 43 females [79.6%] and 11 males [21.4%], with a mean age at the time of study of 25.4 years. The most common reason for this type of treatment was to improve facial appearance [55.6%], function and appearance combined [11.1%], pain [11.1%] and function alone was responsible for 7.4% of the cases. Females and younger patients were more likely to seek treatment for esthetic reasons and the difference was statistically significant [P = 0.04 and 0.005, respectively]. The most unpleasant component of treatment was intermaxillary fixation, followed by the pre-operative fear and anxiety and postoperative recovery. Almost all patients complained of a postoperative sequel: sensory deficit, pain, depression and facial swelling were the most common. However, 94.4% were satisfied with the overall results, with 87% reporting better facial appearance and 53.7% reported improved chewing. Esthetic improvement is the major cause for patients seeking surgery, pre-operative counseling has an important role in patients satisfaction. Orthognathic surgery has a positive impact on patients'quality of life

Effects of programs for prevention of early childhood caries. A systematic review

To determine the most effective intervention program for prevention of early childhood caries. All studies published after 1966 were identified by searching electronic databases [Medline, The Cochrane Library, Embase, Dissertation and Serfile databases] and manual searching. Studies were included if they analyzed the effect of an intervention to prevent caries in 0- to 5-year-old children, recorded caries as dmfs, dmft, dfs or dft, and utilized a randomized controlled study design. The initial search produced 916 citations, 19 of which met the inclusion criteria. The quality of the articles was assessed independently by the reviewers based on randomized selection and double blinding. The 7 articles included in the actual review evaluated the effects of dental health education, prenatal fluoride administration, topical fluoride application, preventive dental programs, and use of fluoridated toothpaste. Meta-analysis was not possible because of differences in the types of intervention among the studies. Conclusive evidence regarding the best intervention to prevent early childhood caries could not be drawn due to the flawed design of some papers. However, fluoride-based interventions appear to be effective in young children. More studies are required to determine the best method of delivery

Management of mandibular condyle fractures in Jordan

The aim of this study was to assess the attitudes of Jordanian oral and maxillofacial surgeons [OMFS] with regard to the management of mandibular condyle head and neck fractures in adults and to compare results with those found in the international literature. A questionnaire comprising five clinical scenarios, on the management of condylar head and neck fractures in isolation and in combination with other mandibular fractures, and questions on fixation method and surgical approach was used. The questionnaire was sent to 54 registered OMFS practicing in Jordan. Thirty-three completed questionnaires were returned [61%]. A consensus was found among the respondents on the use of closed treatment for slightly displaced [P<0.001] and intra-capsular and /or comminuted fractures [P<0.001], and the majority preferred open treatment for displaced [P<0.05] and dislocated [P<0.001] condylar fractures with abnormal occlusion. In bilateral fractures, the respondents were more likely to openly treat at least one condyle if either was displaced or dislocated. Almost all surgeons were familiar with the use of osteosynthesis mini-plates and the preauricular approach was the most favoured. Oral and maxillofacial surgeons in this survey were more likely to use open reduction for displaced and dislocated fractures associated with malocclusion in adults, and this is in accordance with the current trend in the literature