Enamel matrix derivative for alveolar ridge preservation: A randomized controlled trial.

OBJECTIVE: The aims of this clinical trial were to evaluate the radiographic dimensional changes in alveolar ridge and patient-reported outcomes following tooth extraction and alveolar ridge preservation (ARP) using either deproteinized bovine bone mineral (DBBM) with EMD or DBBM alone. METHODS: Participants requiring at least one posterior tooth extraction and ARP were randomly allocated into two treatment groups: ARP using either DBBM with EMD or DBBM alone. Cone-beam computed tomography (CBCT) images were recorded immediately prior to extraction and at 6 months. Changes in alveolar ridge height (ARH) and alveolar ridge width (ARW) at 1, 3, and 5 mm were recorded. RESULTS: A total of 18 participants with 25 preserved sites were evaluated. ARH and ARW changed significantly from baseline to 6 months for both treatment groups but the difference between the groups was not statistically significant over the 6-month follow-up period (ARH: DBBM/EMD 1.26 ± 1.53 mm vs. DBBM 2.26 ± 1.60 mm; ARW-1 DBBM/EMD 1.98 ± 1.80 mm vs. DBBM 2.34 ± 1.89 mm). A significant difference, favoring DBBM with EMD group, was observed in percentage of sites that had less than 1 mm loss in ARH (54.5% sites in DBBM/EMD group vs. 14.3% sites in DBBM alone group). The participants' perception of bruising, bleeding, and pain in the first two postoperative days was significantly in favor of DBBM alone group. CONCLUSIONS: There were no significant differences in radiographic mean measurements of ARH and ARW following ARB with DBBM and EMD or DBBM alone.

Does the Use of Cone-Beam Computed Tomography Before Mandibular Third Molar Surgery Impact Treatment Planning?

PURPOSE: We aimed to investigate whether cone-beam computed tomography (CBCT) alters the treatment decision for impacted mandibular third molar (M3M) surgery when the third molars show proximity to the inferior alveolar canal (IAC) on panoramic radiography (OPG) and to examine surgeons' confidence in the various treatment options. METHODS: We performed a retrospective study evaluating a series of randomized OPG and CBCT images and answering a set of questions regarding impacted M3Ms. The anatomic risk factors studied included the proximity of M3M roots to the IAC, vertical relationship between the M3M and the IAC, and interruption of the IAC cortex by M3M roots. The primary outcome variable was the treatment decision of whether to observe, extract under local anesthesia, extract under general anesthesia, or perform coronectomy. The secondary outcome variable was confidence in the proposed treatment plan. The χ2 test was used to compare proportions and to test the differences in the treatment plan according to the studied independent variables. Binary logistic regression was used to determine the effect of anatomic factors. P < .05 was considered statistically significant. RESULTS: The study sample consisted of 132 impacted M3Ms in 71 patients. No significant differences in the proposed treatment plan were found when the imaging modalities (OPG and CBCT) were compared (P > .05). Examination of CBCT enabled detection of anatomic risk factors (P < .001). Binary logistic regression showed the absence of IAC cortex interruption to be the most significant determinant toward planning for extraction on OPG (odds ratio, 3.1; P < .005) and on CBCT (odds ratio, 5.0; P < .001). Surgeons were more confident when planning for extraction (P < .001). CONCLUSIONS: The use of CBCT provides a better understanding of the anatomic relationship between M3M roots and the IAC. However, experienced surgeons dealing with impacted M3Ms with evidence of proximity to the IAC on OPG can decide on the treatment modality without CBCT.

Factors predictive of the onset and duration of action of local anesthesia in mandibular third-molar surgery: a prospective study.

The aim of this study was to assess the influence of patients' and surgical variables on the onset and duration of action of local anesthesia (LA) in mandibular third-molar (M3) surgery. Patients scheduled for mandibular M3 surgery were considered for inclusion in this prospective cohort study. Patients' and surgical variables were recorded. Two per cent (2%) lidocaine with 1:100,000 epinephrine was used to block the nerves for extraction of mandibular M3. Then, the onset of action and duration of LA were monitored. Univariate analysis and multivariate regression analysis were used to analyze the data. The final cohort included 88 subjects (32 men and 56 women; mean age ± SD = 29.3 ± 12.3 yr). With univariate analysis, age, gender, body mass index (BMI), smoking quantity and duration, operation time, and 'volume of local anesthetic needed' significantly influenced the onset of action and duration of LA. Multivariate regression revealed that age and smoking quantity were the only statistically significant predictors of the onset of action of LA, whereas age, smoking quantity, and 'volume of local anesthetic needed' were the only statistically significant predictors of duration of LA. Further studies are recommended to uncover other predictors of the onset of action and duration of LA.

FAM20A mutations can cause enamel-renal syndrome (ERS).

Enamel-renal syndrome (ERS) is an autosomal recessive disorder characterized by severe enamel hypoplasia, failed tooth eruption, intrapulpal calcifications, enlarged gingiva, and nephrocalcinosis. Recently, mutations in FAM20A were reported to cause amelogenesis imperfecta and gingival fibromatosis syndrome (AIGFS), which closely resembles ERS except for the renal calcifications. We characterized three families with AIGFS and identified, in each case, recessive FAM20A mutations: family 1 (c.992G>A; g.63853G>A; p.Gly331Asp), family 2 (c.720-2A>G; g.62232A>G; p.Gln241_Arg271del), and family 3 (c.406C>T; g.50213C>T; p.Arg136* and c.1432C>T; g.68284C>T; p.Arg478*). Significantly, a kidney ultrasound of the family 2 proband revealed nephrocalcinosis, revising the diagnosis from AIGFS to ERS. By characterizing teeth extracted from the family 3 proband, we demonstrated that FAM20A(-/-) molars lacked true enamel, showed extensive crown and root resorption, hypercementosis, and partial replacement of resorbed mineral with bone or coalesced mineral spheres. Supported by the observation of severe ectopic calcifications in the kidneys of Fam20a null mice, we conclude that FAM20A, which has a kinase homology domain and localizes to the Golgi, is a putative Golgi kinase that plays a significant role in the regulation of biomineralization processes, and that mutations in FAM20A cause both AIGFS and ERS.

Monolithic Zirconia Single Crowns Supported by Narrow or Standard Diameter Titanium-zirconium Implants in Posterior Sites: One-year Results of a Randomized Controlled Trial.

The replacement of missing teeth with implant-supported prostheses has become a standard treatment option with reliable long-term outcomes in various clinical indications.1-6 The implant-supported single crowns, in particular, presented the most favorable outcome with a survival rate of 89.5% to 96% over a 10-year period.5,6 A notable prosthetic maintenance requirement, however, was reported irrespective of the prosthetic material used for the crown construction.1,7 Metal-ceramic restorations have been considered the gold standard when replacing single or multiple missing teeth with implant-supported fixed dental prostheses.8 A systematic review of 4363 metal-ceramic implant-supported single crowns in the anterior and posterior region reported an impressive survival rate of 98.3% over five years.9 Yet, the biologic and prosthetic complications associated with these restorations were substantial with a rate of 13.5%. In the posterior region, a recent systematic review of short-term randomized controlled trials10 reported a survival rate of 99.1% for metal-ceramic implant-supported single crowns. The reported prosthetic complications, mainly ceramic chipping, were also notable with an incidence rate of 7.6%.mIn recent years, the introduction of high-strength all-ceramic materials as well as digitaldesign and manufacturing processes, has allowed faster fabrication of more esthetic and cost effective restorations.11 Zirconia-based fixed dental prostheses on teeth and implants are now increasingly used and show 5-year cumulative survival rates of 89.4 to 100%.12 These restorations are typically made up of a zirconia framework that is veneered with a layer of glass ceramic to impart translucency for enhanced esthetics.13 However, chipping of the ceramic layer has been a lingering issue, shifting the attention toward the use of full anatomic monolithic zirconia restorations.14,15 Replacement of missing teeth with dental implants in posterior ridges with limited bone width can be surgically challenging and the notion of narrow diameter implants has been suggested.16,17 These implants were thought to offer potential advantages in terms of costeffectiveness and surgical morbidity.18,19 The literature, however, remains controversial on treatment outcomes with narrow diameter implants, particularly in posterior sites.19-21 When single tooth replacement with monolithic zirconia implant-supported single crowns in posterior sites are considered, only short to medium-term outcomes are available.22-26 The survival rates and clinical performances reported in these studies were variable. Crown survival rates between 84% and 100% were demonstrated over an observation time of one to three years, while the prosthetic complications were between 0% to 14%. In three studies,22,23,25 standard diameter titanium implants were used in premolar and molar sites to support the single crowns. The remaining two studies by Mühlemann et al. (2020) and Zumstein et al. (2023) reported the one-year and three-year outcomes, respectively, of the same cohort. In these studies, narrow titanium-zirconium (TiZr) implants of 3.3 mm diameter were exclusively utilized in molar sites. The implant and crown survival rates reported at one and three years were 97.4% and 84%, respectively. The lower survival rate observed in the report of Zumstein et al. (2023) resulted from fracture of five implants and the subsequent loss of their respective crowns. Aside from these two reports, no other information on the outcomes of monolithic zirconia single crowns supported by narrow diameter TiZr implants in posterior sites are available. The validity of this treatment, therefore, needs further investigation with well-designed clinical trials. Hence, a randomized controlled trial was undertaken to assess various implant, prosthetic, and patient-reported outcomes of monolithic zirconia single crowns supported by either narrow or standard diameter titanium-zirconium (TiZr) implants in posterior sites. The present report focuses on the one-year prosthetic results.

Traumatic dental injuries among 12-year-old schoolchildren in Jordan: prevalence, risk factors and treatment need.

PURPOSE: To assess the prevalence and related factors of traumatic dental injuries (TDI) among 12-year-old Jordanian schoolchildren. MATERIALS AND METHODS: For this cross-sectional study among schoolchildren, a sample of 2560 schoolchildren (1209 boys, 1351 girls) aged 12 years were randomly selected. The epidemiological classification adopted by the World Health Organization (WHO) and modified by Andreasen et al was used to record TDI on incisors. RESULTS: Of the children examined, 5.5% showed TDI. The difference in prevalence between boys and girls was statistically significant (P < 0.01). Maxillary central incisors were the most affected and the most common type of crown injury was enamel/dentin fracture. The relationship between dental injuries and geographic location, area, and socioeconomic indicators was not statistically significant. Most of the TDI occurred at home, followed by school; the most frequent cause was falls. No statistically significant association was found between TDI and dental caries experience (P > 0.05). There was a tendency for boys (P < 0.01), children with an incisal overjet > 3 mm (P < 0.01) and incompetent lip closure (P < 0.001) to have experienced dental injuries. Treatment need due to dental injuries was very high. CONCLUSION: The prevalence of traumatic injuries to permanent incisors in 12-year-old Jordanian schoolchildren was relatively low. TDI was associated with gender, overjet and lip competence, but was not influenced by dental caries experience. There was a great unmet treatment need.

The influence of insertion torque values on the failure and complication rates of dental implants: A systematic review and meta-analysis.

BACKGROUND: The influence of using different insertion torque values on clinical and radiographic outcomes of implant therapy is unclear in the current literature. The aim of this systematic review and meta-analysis was to evaluate the implant outcomes and complications rates using high insertion torque values compared with those using regular insertion torque value levels. METHODS: Randomized controlled trials (RCTs), nonrandomized controlled clinical trials (NRCCTs), prospective and retrospective cohorts were searched for in electronic databases and complemented by hand searching relevant dental journals. The risk of bias was assessed using the Cochrane Collaboration's Risk of Bias tool for randomized and nonrandomized studies. Data were analyzed using a statistical software. RESULTS: A total of 718 studies were identified, of which, nine studies were included with 1229 dental implants in 684 participants. The meta-analysis of RCTs showed that the overall implant failure rate was not notably in favor of any insertion torque value and the difference between the two groups was not statistically significant (risk ratio 0.85; 95% confidence interval 0.07-10.52; P = 0.90). None of the RCTs was registered. The secondary analyses of non-RCTs did not either show any statistically significant difference. Overall meta-analysis did not show any significant differences in peri-implant marginal bone loss or biological/technical complications between high (≥50 Ncm) and regular insertion torque (<50 Ncm). CONCLUSIONS: There is insufficient evidence to support the use of high or regular insertion torque even with immediate implant restoration/loading. The short-term implant failure rates, changes in marginal bone level and complication rates were comparable when high or regular insertion torques were used for implant placement. The wide confidence interval indicated that results cannot be interpreted with clinically meaningful benefit for using either high or regular insertion torque.

Dentists' knowledge, attitudes, and professional behavior toward the COVID-19 pandemic: A multisite survey of dentists' perspectives.

BACKGROUND: COVID-19 continues to affect the dental community worldwide. The authors conducted a cross-sectional electronic study using a multisite survey to examine dentists' knowledge, attitudes, and professional behavior toward COVID-19 and the affect on their livelihood. METHODS: A questionnaire was circulated via e-mail and social media platforms to dentists in North America, Europe, Eastern Mediterranean, and Western Pacific regions. It covered demographic characteristics and questions about the COVID-19 outbreak related to dentists' levels of comfort for preventive and safety measures, provision of treatment, affect on work, and financial implications. Responses were tabulated and analyzed by means of χ2 or Fisher exact test. Mann-Whitney and Kruskal-Wallis tests were used to compare means. P < .05 was considered significant. RESULTS: A total of 1,251 dentists responded. General dentists represented 63.9% of the respondents and 62.5% worked in private practice. The global score for level of comfort with the preventive measures and provisions of treatment during the COVID-19 pandemic was low (14 of 30), and differences between regions were significant (P < .01); dentists working in private practice and general dental practitioners were less comfortable (P < .01). CONCLUSIONS AND PRACTICAL IMPLICATIONS: The respondents reported a lack of preparedness to confront a highly infectious respiratory disease. A new level of protective armamentarium in the dental operatory and updated operational guidance and policies are required, necessitating educators and regulators to ensure the delivery of knowledge and skills to oral health care providers. Dentists need to address the sustainability of their practices and have a robust business plan.

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.

Morbidity from anterior iliac crest bone harvesting for secondary alveolar bone grafting: an outcome assessment study.

PURPOSE: To determine the postoperative morbidity of harvesting cancellous bone from the anterior iliac crest for treating secondary cleft alveolus patients. PATIENTS AND METHODS: Twenty-four patients treated for alveolar clefts in the Oral and Maxillofacial Surgery unit at the Jordan University Hospital were included. Medical notes were reviewed for intraoperative and postoperative complications; patients were interviewed to fill a questionnaire on postoperative recovery. The donor site was evaluated for the following factors: chronic pain, neurapraxia of the lateral femoral cutaneous nerve, abnormal gait, altered sensation over the scar, skin tenderness, bone tenderness, deformity of the bony contour, and scar length and width were measured. RESULTS: Age at the time of surgery was 14.0+/-4.1 years (mean +/- SD), and follow-up was 23.2+/-19.3 months. Patients spent a median of 3 days in hospital (range=2-4 days), patients walked normally after 10.4+/-13.2 days and resumed normal activities, including sports, after a mean of 16.0+/-19.6 days. Two patients had neurapraxia of the lateral femoral cutaneous nerve (8%), 2 reported mild residual scar tenderness (8%) and 1 of the latter complained of tenderness on palpating the iliac crest (4%). CONCLUSIONS: Harvesting cancellous bone from the anterior iliac crest in young patients is well-tolerated, allows early resumption of normal activities, has no effect on growth, has minimal morbidity, and a reasonable esthetic outcome.

Assessment of self-medication of antibiotics in a Jordanian population.

OBJECTIVE: 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. RESULTS: 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. CONCLUSION: 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.

Multicenter retrospective study of cement-retained implant-supported anterior partial prostheses: success and restoration evaluation.

PURPOSE: The aim of this multicenter study was to evaluate implant success and restorative complications of cement-retained implant-supported anterior partial prostheses in Jordan. MATERIALS AND METHODS: A retrospective study of all implants with a minimum of 1-year follow-up were used to support fixed, cement-retained restorations from April 2000 until March 2007. The cement-retained implants were loaded with either single- or multiple-tooth replacements. The Fisher exact test was performed to test the presence of any statistically significant difference in success concerning gender or arch of placement. RESULTS: Eighty-seven implants were placed in the anterior region of the mandible or maxilla in 49 patients at multiple clinical practices in Jordan. The age of the patients ranged from 17 to 85 years. Eighteen implants were placed in the mandible and 69 in the maxilla. Three maxillary implants in 2 male patients had 3-mm horizontal bone loss. Those 3 implants are still functioning and were considered surviving implants but not successful implants. Therefore, the implant cumulative survival rate for both arches and genders was 100%. The implant cumulative success rate was 95.78%. Three crowns (maxillary) were dislodged. No significant differences were revealed regarding gender or arch of placement (P > .05). CONCLUSIONS: Cement-retained implants exhibited high survival and success rates among a Jordanian population.

Subtarsal approach for orbital floor repair: a long-term follow-up of 12 cases in a Jordanian teaching hospital.

PURPOSE: To evaluate the long-term functional and esthetic outcomes of using the subtarsal approach for orbital trauma patients in a group of Jordonian patients. PATIENTS AND METHODS: Twelve patients treated using the subtarsal approach for orbital floor fractures in the Oral and Maxillofacial Surgery unit at the Jordan University Hospital were involved. Aspects evaluated included: the distance between scar and lower lid lash margin, scar length, esthetic appearances of the scar, lid edema, scleral show, ectropion, lagophthalmous, epiphora, subconjunctival injections, and keratoconjunctivitis. RESULTS: Half the cases were the result of road traffic accidents. Follow-up time ranged from 10 to 73 months (mean +/- SD, 37.25 +/- 23.7 months). The postoperative outcome was favorable; 1 scar was noticeable, but was not hypertrophic. One patient suffered from scleral show that was associated with subconjunctival injections. One patient suffered from mild lid edema and 1 had keratoconjunctivitis. No other complications were recorded and patients were satisfied with the outcome. CONCLUSIONS: The subtarsal approach is a safe and simple to perform procedure for treating orbital floor fractures. It results in a good surgical outcome functionally and esthetically.

Frequency estimates and risk factors for postoperative morbidity after third molar removal: a prospective cohort study.

PURPOSE: The aim of this study was to estimate the frequency of postoperative complications after mandibular third molar (M3) surgery and identify the risk indicators. PATIENTS AND METHODS: This was a prospective cohort study of a sample of subjects having at least 1 mandibular M3 surgically extracted at a teaching hospital in Jordan. The predictor variables were categorized as patient, anatomic, and operative specific. The outcome variables were postoperative complications recorded as present or absent. Bivariate analyses were computed, then a multivariate logistic regression model was used to identify independent predictors for the common postoperative complications. RESULTS: The study sample was comprised of 149 patients who had 245 extractions. The mean age was 21.6 +/- 3.32 years; 64.9% were females. In the multivariate logistic regression model, age (P = .033, odds ratio [OR] = 1.178), M3 side in relation to the handedness of the operator (P = .048, OR = 4.078), and lingual retraction (P = .001, OR = 11.293) were the variables found as independent predictors for alveolar osteitis. The level of impaction had a significant association with trismus, and operation time acted as an independent predictor for pain (P < .001, OR = 1.085). CONCLUSION: Postoperative morbidity increases with older age, deeper impaction, M3 side differing from the handedness of the operator, and longer procedures.

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

OBJECTIVE: To determine the most effective intervention program for prevention of early childhood caries. MATERIALS AND METHODS: 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. RESULTS: 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. CONCLUSION: Conclusive evidence regarding the best intervention to prevent early childhood caries could not be drawn due to the flawed design of somepapers. However, fluoride-based interventions appear to be effective in young children. More studies are required to determine the best method of delivery.

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.

Abutment rotational displacement of external hexagon implant system under lateral cyclic loading.

PURPOSE: This in vitro study investigated the effect of lateral cyclic loading with different load positions and periods on abutment rotational displacement (RD) of external hexagon implant system. MATERIALS AND METHODS: Four groups of five implant assemblies each were used. Each assembly consisted of Brånemark System Mk IV implant (Nobel Biocare AB, Göteborg, Sweden), CeraOne abutment (Nobel Biocare AB), and a cement-retained casting. A cyclic load of 50 N was applied centrally and perpendicular to the long axis of the implant for groups A and B for 0.25 and 0.50 x 10(6) cycles, respectively, while for groups C and D, the same load was applied at 4-mm distance eccentrically for 0.25 and 0.50 x 10(6) cycles, respectively. The displacement was evaluated by hand drawing a longitudinal line across the implant-abutment interface. Before and after loading, the lateral distance between two reference points on the abutment and implant was measured under high resolution (x200) and the difference formed the RD value. The data were analyzed with one-way analysis of variance and compared with Tukey test (alpha=0.05). RESULTS: Group D had the highest mean of RD value (55.00 +/- 1.871 microm), while group A had the lowest (2.800 +/- 0.837 microm). Groups A and B had a high statistically significant difference in RD values, as compared to groups C or D (p < .001). Moreover, group C had statistically significant difference from group D (p=.011). Conversely, no statistical significance was obtained when group A was compared with group B. CONCLUSION: Within the limits of this in vitro study, the RD of the external hexagon joint components occurred significantly under eccentric lateral loading when compared to centric loading. The displacement increased significantly with longer period of eccentric lateral loading.

Recurrence of a solitary bone cyst of the mandible: case report.

We report a case of a solitary bone cyst in the mandible of an elderly woman who presented with a bilateral radiolucent lesion that caused bony expansion, and which recurred 30 months after enucleation and bone grafting of the cavity.

Use of information and communication technology among dental students at the University of Jordan.

The aim of this study was to investigate the current knowledge, skills, and opinions of undergraduate dental students at the University of Jordan with respect to information communication technology (ICT). Dental students from the second, third, fourth, and fifth years were asked to complete a questionnaire presented in a lecture at the end of the second semester in the 2002-03 academic year. The response rate was 81 percent. Besides free and unlimited access to computers at the school of dentistry, 74 percent of the students had access to computers at home. However, 44 percent did not use a computer regularly. Male students were more regular and longer users of computers than females (p<0.001). A significant number of students (70 percent) judged themselves competent in information technology (IT) skills. More males felt competent in basic IT skills than did females (p<0.05). More than two-thirds acquired their computer skills through sources other than at the university. The main educational use of computers was accessing the Internet, word processing, multimedia, presentations, Medline search, and data management. More clinical students felt competent in word-processing skills (p<0.05) and many more used word processing for their studies (p<0.001) than did preclinical students. More males used word processing for their studies than females (p<0.001). Students used computers for personal activities more frequently than for academic reasons. More males used computers for both academic (p<0.01) and personal activities (p<0.001) than did females. All students had access to the Internet at the university, and 54 percent had access at home. A high percentage of students (94 percent) indicated they were comfortable using the Internet, 75 percent said they were confident in the accuracy, and 80 percent said they were confident in the relevance of information obtained from the Internet. Most students (90 percent) used email. Most students (83 percent) supported the idea of placing lectures on the web, and 61.2 percent indicated that this would not influence lecture attendance. Students used the Internet more for personal reasons than for the study of dentistry. More clinical students used the Internet for dentistry than preclinical students (p<0.001). More males than females used the Internet for dentistry (p<0.01) as well as for pleasure (p<0.01). Time and availability were the main obstacles to Internet use. Dental students at the University of Jordan have access to substantial IT resources and demonstrated attitudes toward the computer and Internet technology and use that were similar to other students in other nations. However, the educational use of ICT among Jordanian students remains low.

Sublingual varices in relation to smoking, cardiovascular diseases, denture wearing, and consuming vitamin rich foods.

OBJECTIVES: To identify potential risk factors such as smoking, cardiovascular diseases (CVD), denture wearing, and consuming vitamin rich foods, and its relation to the development of sublingual varices (SLV). METHODS: This cross-sectional observational study was conducted on patients who attended the Department of Dentistry at The University of Jordan Hospital, Amman, Jordan between February and May 2013. Clinical examinations and inspections of 391 patients (203 males and 188 females), 13-74 years of age were conducted to determine the presence of SLV. Sublingual varices were classified into 2 categories: grade 0 (few or none visible), and grade one (moderate or severe). Frequency distributions of both SLV and risk factors were obtained. Multiple logistic regression analysis and Chi-square test were used to analyze the influence of individual risk factors on the incidence of SLV. RESULTS: There were 88 subjects (22.5%) who had SLV. In the multivariate logistic regression model, SLV were significantly associated with age (odds ratio [OR]: 2.27, p=0.008) with highest occurrences in the eighth decade of life, gender (OR: 2.74, p=0.001), smoking (OR: 2.93, p=0.002), denture wearing (OR: 2.03, p=0.044), and CVD (OR: 4.01, p=0.00). CONCLUSION: The presence of SLV could be indicative of some potential risk factors including old age, female gender, and denture wearing, and may alert the dental clinician to recognize underlying systemic conditions, particularly CVD.