Impact of Protracted War Crisis on Dental Students: A Comparative Multicountry Cross-sectional Study.

BACKGROUND: The impact of conflict and war crisis on dental students is poorly understood. Given the prolonged conflicts and political instability in the Arabic-speaking countries, it is crucial to investigate the effect of these conditions on dental students. This study aimed to assess the impact of protracted war on dental students by comparing the personal, university, and wider context challenges they face across war-affected and unaffected countries. METHODS: A cross-sectional study was conducted including a convenience sample of dental students from 13 universities in 12 Arabic-speaking countries. Respondents were those at entry and exit points of their undergraduate dental training. A self-administered paper questionnaire collected anonymized data on sociodemographics, and personal, university, and wider context challenges that students were facing. Multivariable Poisson regression analyses were carried out. RESULTS: The overall response rate was 64.8%. The mean age was 21.2 (standard deviation = 2.1) years, with 68% of participants being female. After adjusting for age and sex, dental students in Arabic-speaking countries affected by protracted war crisis were significantly more likely to report wider context challenges compared to their counterparts in unaffected countries (n = 2448; beta = 1.12; 95% confidence interval: 1.10-1.13; P < 0.001). DISCUSSION: Dental students in Arabic-speaking countries affected by protracted war crisis were more likely to suffer from wider context challenges such as difficulties in attendance due to the deterioration of security and lack of flexibility of teaching time to accommodate the different circumstances induced by the war crisis. Supporting dental students in areas affected by protracted war crises is needed and may include developing online dental education programs.

Cross-Cultural Adaptation and Validation of "Malocclusion Impact Questionnaire" into Moroccan Arabic.

INTRODUCTION: The malocclusion index questionnaire (MIQ) is widely used in research and clinical practice. To our knowledge, there are no studies of its use in Moroccan patients. AIM: The objective of this study was to translate and culturally adapt the malocclusion impact questionnaire (MIQ) into Moroccan Arabic and to assess its reliability and validity among a sample of young Moroccan teenagers. The PIDAQ was cross-culturally adapted into Malay version by forward- and backward-translation processes, followed by psychometric validation. MATERIALS AND METHODS: The MIQ was cross-culturally adapted into Moroccan Arabic by forward- and backward-translation processes, followed by psychometric validations. The MIQ was completed by a representative sample of 94 Moroccan adolescents aged 12-17 years selected randomly from five public schools of Casablanca. Internal consistency reliability was determined from Cronbach's alpha, and the intraclass coefficient of the item scores was obtained in 1 month in a subset of 30 subjects. Data were analyzed using the Statistical SPSS software, version 16.0, SPSS Inc, Chicago, IL, USA. RESULTS: The MIQ was completed twice by each participant at one-month interval to assess test reliability; the intraclass coefficient was r = 0.958, showing an excellent reproducibility. The internal consistency demonstrated the reliability of the questionnaire with Cronbach's alpha coefficient of 0.917. The validity of the questionnaire was assessed by evaluation of the relationship between the total scores of the MIQ and normative need for orthodontic treatment according to ICON. The questionnaire showed an insignificant correlation (0.129, p < 0.05). CONCLUSION: The Moroccan Arabic version of the MIQ was found to be reliable, whereas it has unacceptable validity according to ICON, and hence, it is unlikely to be a useful measure in orthodontic clinical trials for Moroccan adolescents.

A new methodology for automatic detection of reference points in 3D cephalometry: A pilot study.

OBJECTIVE: The aim of this study was to develop a new method for an automatic detection of reference points in 3D cephalometry to overcome the limits of 2D cephalometric analyses. MATERIALS AND METHODS: A specific application was designed using the C++ language for automatic and manual identification of 21 (reference) points on the craniofacial structures. Our algorithm is based on the implementation of an anatomical and geometrical network adapted to the craniofacial structure. This network was constructed based on the anatomical knowledge of the 3D cephalometric (reference) points. RESULTS: The proposed algorithm was tested on five CBCT images. The proposed approach for the automatic 3D cephalometric identification was able to detect 21 points with a mean error of 2.32mm. DISCUSSION: In this pilot study, we propose an automated methodology for the identification of the 3D cephalometric (reference) points. A larger sample will be implemented in the future to assess the method validity and reliability.

Evaluation of arch forms depending on the angle classification.

It is generally accepted that each individual has his or her own dental arch form. However, during orthodontic treatment, industrially preshaped archwires are widely used. The resulting use of the same arch form for all malocclusions may compromise occlusal stability after orthodontic treatment. AIM: To determine the average dental arch form of a non-consulting Moroccan population depending on the Angle classification, after digitization of plaster models of the dental arches. MATERIAL AND METHODS: A sample of 50 dental students aged between 21 and 27 was selected. After digitization of the plaster models to produce a cloud of points, the barycentric method was applied to this representation, enabling all the arch shapes of each series to be superimposed with Photoshop CS 5 software (layer mode) and the average curves for each Angle class to be thereby determined. RESULTS: The average maxillary and mandibular arch forms were defined for each class: Class I: a normal maxillary form and an ovoid mandibular form; Class II: a tapered maxillary form and a narrow tapered mandibular form; Class III: narrow tapered forms for both upper and lower arches. Globally speaking, in this sample an ovoid mandibular arch form and a normal maxillary arch form are the dominant shapes. DISCUSSION AND CONCLUSION: The studied population exhibited specific arch form features. This study could serve as the basis for the choice and use of preformed archwires better-adapted to the needs of our patients.

Motivational factors influencing career choices of Moroccan dental students.

This study aims to investigate the factors that motivate dental students to choose dentistry as a career. A questionnaire-based survey involving 752 dental students from the only two Moroccan dental schools was conducted between April and May 2011. The questionnaire was designed in terms of financial factors, human factors and working conditions factors. The students were asked to rank the career choices' set of questions on a five point Likert scale from 1 (strongly disagree) to 5 (strongly agree). The internal reliability of the scale was investigated using Cronbach's alpha coefficient and validity was investigated by a confirmatory principal component analysis. Results indicate that dentistry has a noble function; the "desire to help people" and "job opportunities" determines career choice among Moroccan dental students. Another result that emerged from the study is that men were motivated by working conditions factors (p=0.025) while women were motivated by human factors (p=0.001). In brief, the results of the present study can be used by health policy makers to persuade students to pursue dentistry as a career.

Craniomandibular disorders and mandibular reference position in orthodontic treatment.

The aim of this paper is to bring into focus the literature on the choice of the mandibular reference position in orthodontic treatment; of a particular reference to this paper is intercuspal position, centric relation position, or therapeutic position. To give a comprehensive account of the literature review on craniomandibular disorders (CMD), we have relied on books and articles using both Google Scholar and PubMed. Selection criteria included a combination of Mesh and type of article. Article classification was made by two authors, using the following structure outline: prevalence of craniomandibular disorders, its etiology and pathophysiology, occlusion and craniomandibular disorders, orthodontic treatment and CMD, and the mandibular reference position in orthodontics. An important conclusion that emerged from the present literature review is that CMD do not seem to be directly related to orthodontic treatment, and their appearance cannot be predicted or prevented by any means. Therefore, orthodontists must adopt a mandibular reference suitable to their patients and which best respects the balance existing in the stomatognathic system.

Effect of orthodontic treatment on lip position.

UNLABELLED: Does an advanced or retracted position of the upper and lower incisors lead to modifications in lip position? The aim of our study was to evaluate modifications in lip position following orthodontic treatments. MATERIAL AND METHODS: This study concerned 100 patients who underwent treatment in the dento-facial orthopedic unit in Casablanca. Profile headfilms at the start and at the end of orthodontic treatment were compared using Frapier's analysis. The Student test was applied to evaluate the variations in the cephalometric measurements. RESULTS: We noted a non-significant increase in the nasolabial angle (P = 0.274), a significant decrease in the sagittal position of the lower vermillion border (PsVei) (P < 0.001) and the sagittal position of the soft-tissue supramentale (PsSmc) (P < 0.001), and a significant increase in the vertical position of the soft-tissue menton (PvMec) (P = 0.035). CONCLUSION: The results of this study demonstrate marked improvements in the situation of soft tissues. We suggest further investigation to throw light on the relationship between tooth movement and soft tissue, increasing the size of the sample and taking growth into account.

Anchorage miniscrews: a histologic study of peri-implant soft tissue.

INTRODUCTION: The aim of our study was to investigate the different histologic reactions of peri-implant soft tissue to miniscrews used in various orthodontic indications in patients during the course of treatment. MATERIAL AND METHODS: Our study focuses on patients receiving orthodontic treatment and in whom we placed anchorage miniscrews for various orthodontic indications. Twenty-eight miniscrews from the same manufacturer (Dual Top Anchor system(®), Korea) were studied. The soft tissue surrounding each miniscrew was sampled for histologic analysis. RESULTS: All the peri-implant soft tissue samples displayed signs of inflammation. Each tissue sample exhibited either a moderately or highly inflamed surface epithelium and underlying connective tissue. DISCUSSION AND CONCLUSION: The variations in tissue response shown by the different human biopsies could be greater than those observed in standardized conditions in animal experiments. Interpretations regarding tissue response on a small number of human biopsies should be made cautiously. Nevertheless, this histological information is invaluable in order to validate and confirm the animal model.

Prevalence of malocclusions and orthodontic treatment need in 8- to 12-year-old schoolchildren in Casablanca, Morocco.

OBJECTIVES: The purpose of this work was to evaluate the prevalence of malocclusions and orthodontic treatment need among schoolchildren in Casablanca, Morocco. MATERIALS AND METHODS: A sample of 1000 children aged between 8 and 12 years, with no history of orthodontic treatment, was chosen at random in state schools in different administrative areas of the city of Casablanca. Data was registered using the method of Bjork et al. (1964). Orthodontic treatment need was assessed with the index used by the Swedish National Board of Health (SweNBH). RESULTS: We found Angle Class I malocclusions in 61.4%, Class II in 24%, Class III in 10% and an indeterminate molar class with one or more missing molars in 4.6% of the children. Overjet was 1-4mm in 63.8%, 4-6 mm in 17.2% and >6 mm in 10%. Bite was normal in 65.4%, 23.6% presented an overbite greater than 4 mm, 1.7% an anterior open bite ≤3 mm, 1.2% an anterior open bite >3 mm and 0.2% a bilateral open bite. Half of the sample presented anterior crowding, while only 2.5% presented posterior crowding. In all, 84.2% of the subjects needed some orthodontic treatment, and 15.8% needed no treatment. No statistically significant difference was found between sex or age and orthodontic treatment need (P>0.05). CONCLUSIONS: This study found a strong need for orthodontic treatment, confirming the utility of implementing a programme of bucco-dental prevention and screening for malocclusion.

Tooth transposition: a descriptive study in a 547-patient sample.

INTRODUCTION: The aim of this investigation was to study the prevalence of tooth transposition in a population of orthodontic patients. MATERIALS AND METHODS: A total of 547 patient records from our dentofacial orthopedics department were consulted. Each file included clinical observations, panoramic radiography, lateral cephalograms and dental casts. Patients with incomplete or poorly kept orthodontic records were excluded from the sample, as were those with unreadable panoramic radiographs. The classification of tooth transpositions used in the study was that first proposed by S. Peck and L. Peck in 1995. Computerized statistical analysis was performed using Epi-Info 6.0. RESULTS: The prevalence of tooth transposition was 2%, with the female population more heavily affected (64%). Tooth transposition occurred only in the maxillary arch. Of all the teeth, the canines were the most involved in this anomaly (100%). Transposition was associated with tooth agenesis in 18% of cases, peg lateral incisors in 27%, and persistent deciduous teeth in 18%. CONCLUSION: The prevalence of tooth transposition in this study population remained low, but was nonetheless higher than that found in most published investigations.

Anchorage miniscrews: a surface characterization study using optical microscopy.

INTRODUCTION: The aim of this study was to assess the surface changes in orthodontic miniscrew implants retrieved after usage and compare them with brand-new, as-received control miniscrews. MATERIAL AND METHODS: The study sample consisted of 28 miniscrews from the same manufacturer: Dual Top Anchor system® (Korea) of different diameters and lengths. One brand-new miniscrew served as a control. Surface characterization was carried out using optical microscopy (Leica DM2500M®) and image magnification (×5, ×10 and ×20). RESULTS: Observations under optical microscopy showed signs of pitting and crevice corrosion mainly at manufacturing defects. Retrieved miniscrew implants displayed larger surface cracks from corrosive attacks (pitting and crevice). Qualitative sample analysis suggested a loss of gloss and texture, giving the surface a dull appearance. Localized pitting was the most frequent form of corrosion observed in our sample. DISCUSSION AND CONCLUSION: Despite a smooth appearance to the naked eye, the miniscrews all had crack-like surface manufacturing defects. Examination of the surface of these miniscrews, after usage, evidenced pitting or crevice corrosion principally in the area of enhance corrosion resistance.

Prevalence of temporomandibular dysfunction in orthodontic treatment.

UNLABELLED: The aim of our study was to investigate the prevalence of temporomandibular dysfunction (TMD) during orthodontic treatment. MATERIAL AND METHOD: the study investigated all the patients receiving orthodontic treatment in the dentofacial orthopedic department in Casablanca in the course of the different stages of treatment over a 4-month period. We looked for a possible association between the presence of at least one sign of TMD, the Helkimo anamnesis index, the clinical Helkimo index and the following factors: age, gender, extractions, or not, of premolars, duration, type and stage of orthodontic treatment, molar and canine class, crowding, overjet, overbite and unilateral crossbite. Data were analysed using Epi-info 6.0.fr software. The analysis of the results was done using the Chi(2) test (P<0.05). RESULTS AND CONCLUSION: no statistically significant association could be established between TMD and the various factors under investigation with the exception of the association between gender and the Helkimo anamnesis index, stage of treatment and the Helkimo anamnesis index and the Angle molar class and the Helkimo clinical index.

[Craniomandibular dysfunction and malocclusions]. / Dysfonctionnement cranio-mandibulaire et malocclusions.

INTRODUCTION: For many years, the literature reported the key role of occlusal factors in the development of craniomandibular dysfunctions (CMD). In our study, we investigated the connections between the functional and morphological features of dental occlusion and CMDs in a population of students at the Casablanca Faculty of Dental Medicine, Morocco. MATERIAL AND METHOD: Our study comprised a sample of 142 students from the Casablanca Faculty of Dental Medicine aged between 18 and 30 years. An information card was filled in providing general details, medical history, the clinical examination and an assessment of the orofacial functions. We looked for possible links between CMDs and the various malocclusions. The statistical test used was the Khi2 test under Epi-info 6.0 under MS Dos. RESULTS AND CONCLUSION: There is no connection between craniomandibular dysfunctions and certain malocclusions in the student population at the Casablanca Faculty of Dental Medicine.

Surgical-orthodontic management of dental impaction.

UNLABELLED: The aim of this study was to assess the management of impacted teeth using surgical-orthodontic techniques at a dental treatment centre in Casablanca and to suggest strategies designed to enhance treatment of dental impaction. MATERIALS AND METHODS: The sample comprised 30 patients represented by their clinical files (mean age: 17 years; standard deviation: 8.141). RESULTS: Impaction most often involved a single tooth (56.7%), generally the upper canine (66%). The location was buccal in 43.3% of cases and generally high (63.3%). Presurgical orthodontic treatment was required in 80 of these cases. A closed eruption technique is reported in 93.1% of cases. Mean treatment duration was 11.4 months. The success rate of the surgical technical technique was 70%. DISCUSSION: A similarity exists between most of the variables studied and findings of other studies published on the same topic.