Nasal Morphology in a Young Adult Middle-Eastern Population: A Stereophotogrammetric Analysis.

AIM: This study aimed to describe gender-specific three-dimensional morphology of the soft-tissue nose in Lebanese young adults and to explore the associations between nasal morphology with age and body mass index (BMI). MATERIALS AND METHODS: Three-dimensional photographs were captured for 176 young healthy Lebanese adults (75 males and 101 females) aged 18.1-37.68 years. Linear and angular nasal measurements were computed and compared between genders, in addition to other established norms. Associations with age and BMI were also assessed. RESULTS: All linear measurements were greater in males than in females, and only the nasolabial angle was significantly larger in females by 2.97 degrees on average. Most of the measurements were found to be larger than the Caucasian norms. A few significant correlations were found between the measurements and age or BMI. CONCLUSION: This study is the first to present the sex-specific norms for nasal morphology in the Lebanese population and highlights the presence of gender dimorphism in the majority of measurements. Additional studies are needed to validate our data and expand the associations with age and BMI. CLINICAL SIGNIFICANCE: The data offered in this study could help enhance the accuracy of facial reconstructive surgery and aid in personalized treatment planning for both medical and cosmetic nasal interventions. How to cite this article: Saadeh M, Shamseddine L, Fayyad-Kazan H, et al. Nasal Morphology in a Young Adult Middle-Eastern Population: A Stereophotogrammetric Analysis. J Contemp Dent Pract 2024;25(3):199-206.

In vivo evaluation of the virucidal efficacy of chlorhexidine and povidone-iodine mouthwashes against salivary SARS-CoV-2. A randomized-controlled clinical trial.

OBJECTIVES: The oral cavity is potentially high-risk transmitter of COVID-19. Antimicrobial mouthrinses are used in many clinical preprocedural situations for decreasing the risk of cross-contamination in the dental setting. It is important to investigate the efficacy of mouthwash solutions against salivary SARS-CoV-2 in order to reduce the exposure of the dental team during dental procedures. AIMS: The aim of this in vivo study was to evaluate the efficacy of 2 preprocedural mouthrinses in the reduction of salivary SARS-CoV-2 viral load and to compare the results of the mouthwashes to a control group. MATERIALS AND METHODS: In this randomized-controlled clinical trial, studied group comprised laboratory-confirmed COVID-19 positive patients through nasopharyngeal swabs. Participants were divided into 3 groups. For 30 s, the control group mouthrinsed with distilled water, the Chlorhexidine group mouthrinsed with 0.2% Chlorhexidine and the Povidone-iodine group gargled with 1% Povidone-iodine. Saliva samples were collected before and 5 min after mouthwash. SARS-CoV-2 rRT-PCR was then performed for each sample. Evaluation of the efficacy was based on difference in cycle threshold (Ct) value. The analysis of data was carried out using GraphPad Prism version 5 for Windows. Kristal wullis and Paired t-test were used. A probability value of less than 0.05 was regarded as statistically significant. RESULTS: Sixty-one compliant participants (36 female and 25 male) with a mean age 45.3 ± 16.7 years-old were enrolled. A significant difference was noted between the delta Ct of distilled water wash and each of the 2 solutions Chlorhexidine 0.2% (P = .0024) and 1% Povidone-iodine (P = .012). No significant difference was found between the delta Ct of patients using Chlorhexidine 0.2% and 1% Povidone-iodine solutions (P = .24). A significant mean Ct value difference (P < .0001) between the paired samples in Chlorhexidine group (n = 27) and also in Povidone-iodine group (n = 25) (P < .0001) was found. In contrast, no significant difference (P = .566) existed before and after the experiment in the control group (n = 9). CONCLUSION: Chlorhexidine 0.2% and 1% Povidone-iodine oral solutions are effective preprocedural mouthwashes against salivary SARS-CoV-2 in dental treatments. Their use as a preventive strategy to reduce the spread of COVID-19 during dental practice should be considered.

Legal liability facing COVID-19 in dentistry: Between malpractice and preventive recommendations.

The dental profession is considered at high potential risk of exposure and transmission of SARS-Cov-2. Thus, dentists should implement special safety measures in order to prevent any possible contamination during dental sessions and should be aware of the legal implications of their act in order to avoid malpractice leading them to be a causative agent of transmission of this virus. This paper aimed to provide a global review on COVID-19 preventive recommendations at dental clinics and discussed the legal values of such procedures, the dentist criminal and civil liability arising from transmitting this virus to a patient, the obligation of care under COVID-19 and the possible solution to this dilemma. The review concluded that dentists should follow all modern scientific procedures which are in their interest and in the interest of patients to maintain their safety and advised dentists to document all steps taken during the period of COVID-19 outbreak, because any undocumented action is considered not to have taken place, and they shall be bound by the burden of proof.

Facial Flatness Indices: A Comparison of Two Methods of Assessment.

OBJECTIVES: The objective of the study was to evaluate and compare facial flatness indices calculated from the trigonometric formula as opposed to those generated from the direct measurements on three-dimensional radiographs. MATERIAL AND METHODS: A total of 322 cone-beam computed tomography radiographs were digitized and three facial indices (frontal, simotic, and zygomaxillary) were assessed in two different methods and compared between different groups. RESULTS: There was a discrepancy between facial flatness indices generated from the two different approaches. The highest difference was seen in the findings of the simotic index and the lowest for the zygomaxillary index. No statistically significant difference was displayed in the three formula-generated flatness indices between males and females and between growing and non-growing subjects (P > 0.05). The zygomaxillary index was the only measurement revealing no statistically significant difference in Class III sagittal malocclusions (t = -0.5 P = 0.621). The orthodontic application would yield to the same interpretations for both ways of indices calculation. CONCLUSION: The validity of the trigonometric formula used to appraise facial flatness indices might be questionable. The zygomaxillary index could be more clinically considered compared to the frontal and simotic indices.

Facial soft tissue thickness differences among different vertical facial patterns.

In forensic facial approximation, facial soft tissue thickness (FSTT) measurements play a major role. These values are affected by many factors such as ethnicity, age and sex, in addition to measurement errors. We hypothesize that an additional source of error is the lack of consideration of facial type in the assessment of FSTT norms. The purpose of this study was to: 1- evaluate the presence of significant effects of vertical facial type within the FSTT measurements in adults and 2- assess the correlations between FSTT and hard and soft tissue cephalometric measurements. The sample consisted of the lateral cephalometric radiographs of 222 adult individuals (87 males; 135 females, 23.49±6.24 years of age) with normal occlusion and balanced profiles. Hard and soft tissue cephalometric measurements were taken, in addition to FSST at 10 facial landmarks. The sample was categorized into 3 vertical pattern groups based on the MP/SN angle: hypodivergent, normodivergent and hyperdivergent. Statistical analyses included MANOVA test and Pearson moment product for associations among variables. Statistically significant effect of vertical divergence on FSTT values was limited to the levels of Stomion, Labiomentale and Pogonion and FSTT measurements were associated with measurements related to the lower face (Lm and Pog) Moderate to high correlations between mandibular length and ramus length and FSTT values related to the lower face (LL, Lm and Pog mainly) emphasize further the important role of the underlying skeleton.

Appropriateness of Therapeutic Antibiotic Prescriptions by Lebanese Dentists in the Management of Acute Endodontic Abscesses.

The misuse of antibiotics in dentistry is a serious concern especially in regards to the emergence of antibiotic resistance. The objective of the study was to evaluate the appropriateness of antibiotics prescriptions by Lebanese dentists to patients with endodontic abscesses and their compliance with the guidelines of the American Association of Endodontists (AAE) and the European Society of Endodontology (ESE). The treating dentists recorded clinical information from 127 patients diagnosed with acute or chronic endodontic abscess. The information also included the type of antibiotic prescribed, dosage, and duration of the prescription. Prescriptions were not given to 14/20 patients with an acute endodontic abscess despite the presence of an indication to prescribe. All the prescriptions given to patients with an acute endodontic abscess were inappropriate according to the ESE and AAE guidelines. Antibiotics were also prescribed unnecessarily to 17/42 patients with a chronic endodontic abscess. This study concluded that antibiotics prescriptions by Lebanese dentists for the management of endodontic abscesses were inappropriate. Penicillin V potassium (VK) was not available in Lebanon when the study was conducted. Only broad-spectrum antibiotics were prescribed. This finding raises concerns about the emergence of antibiotic resistance.

Facial flatness indices: application in orthodontics.

Facial flatness indices have been used in anthropology to discern differences among populations. They were evaluated on skulls from around the world. AIMS: (1) to evaluate the use of facial flatness indices in orthodontics and (2) to assess their variation among malocclusions, age and sex. MATERIALS AND METHODS: A total of 322 cone beam computed tomography radiographs were digitized and three facial indices (frontal, simotic and zygomaxillary) along with three transverse distances (fmo1-fmo2, zma1-zma2 and n1-n2) were assessed and compared between different groups. RESULTS: The zygomaxillary index was increased in Class II (32.6 ± 0.42; p < 0.001) and decreased in Class III malocclusions (29.4 ± 0.66; p < 0.001) compared to Class I (31.18 ± 0.3; p < 0.001). The frontal and nasal flatness are not characteristic features of any of the sagittal malocclusions. Facial flatness indices did not differ between males and females and between growing and non-growing patients. CONCLUSION: The position of subspinale point (A point) forward or backward relative to the zygomaxillary width is a factor of assessment of facial flatness. The zygomaxillary index could be helpful in weighting proportionally the width of the maxilla (expansion) relative to its sagittal position in Class II and Class III malocclusions.

Midsagittal facial soft tissue thickness norms in an adult Mediterranean population.

The use of facial soft tissue thickness (FSTT) values is essential in forensic facial approximation. Few studies have assessed the FSTT norms in Mediterranean populations and none in the Lebanese population. The purpose of this study was to (1) present midsagittal facial FSTT norms for Lebanese adults with well-balanced faces and normal occlusion; (2) evaluate the presence of sexual dimorphism within these measurements; (3) establish a potential correlation between these measurements and (4) build on the existing database of FSTT data from previously published studies. FSTT measurements at 10 midsagittal locations were obtained from the lateral cephalometric radiographs of 87 males and 135 females (mean age of 23.49±6.24years). In additional to means, Shorth and 75-Shormax values are presented. Differences between sexes were assessed using the MANOVA test and correlations between different measurements were computed. The thinnest (3.07±0.72mm) and thickest (15.61±2.38mm) craniofacial soft tissue measurements existed at Rhinion and Subnasale, respectively. There was a statistically significant and large effect of sex on the combined FSTT variables (p<0.001; eta-squared=0.393). Males displayed larger FSTT values at all landmarks except at Glabella (p=0.162). Significant correlations were observed between almost all measurements with the highest being between the upper and lower lips (r=0.763) and between Pogonion and Gnathion (r=0.784). The descriptive values of FSTT values reported in this study add to the body of research necessary for the enhancement of facial approximation methods The uniquely strong effects of sex on FSTT measurements combined and on selected single FSTT measurements are an area for further research.

Stereophotogrammetric analysis of labial morphology in a young adult Middle-Eastern population.

INTRODUCTION: The majority of previous research delineating the morphological characteristics of the orolabial region has been on Caucasian populations, with very minor research on Mediterranean populations, and none on the Lebanese population. AIM: The primary aim was to collect information on the gender-specific 3D morphology of the mouth and lips in young Middle Eastern adults. The secondary aim was to explore the presence of associations between orolabial morphology and age and body mass index (BMI), and to assess correlations between linear orolabial dimensions and area/volume measures. METHODS: The study used non-invasive stereophotogrammetry to collect information on gender-specific 3D labial morphology (linear distances, areas, and volumes) for 122 adult Lebanese subjects, aged 18-30 years (47 males, 75 females). Associations between labial morphology and age and body mass index were assessed, in addition to correlations between linear orolabial dimensions and area/volume measures. RESULTS: All linear, angular, area, and volume lip measurements displayed significant variability. Both lip area and volume were smaller in the upper than in the lower lip. Eighteen out of the 20 linear measurements were significantly larger in males. The ratio, area, and volume measurements mostly displayed no statistically significant gender dimorphism. CONCLUSIONS: Alongside presenting the first documented report on anthropometric labial measurements of a young Lebanese adult population, this research highlights the presence of gender dimorphism in linear and angular measurements, but not in area and volume measurements, and a strong association between certain linear labial measurements and lip area and volume. In addition, it presents pilot data on the association between labial anthropometry and body mass index.

Clinical and Radiographic Evaluations of Biodentine™ Pulpotomies in Mature Primary Molars (Stage 2).

INTRODUCTION: The preservation of the integrity and health of primary teeth and their supporting tissues is of great importance in maintaining arch length space, mastication, speech, and esthetics. A pulpotomy is a common therapy performed on a primary tooth presenting reversible pulpitis or a traumatic pulp exposure, allowing its conservation on the arch until its loss. AIM: The study aims to clinically and radiographically evaluate the rates of success and efficacy of Biodentine™ as pulpotomy medicament exclusively on deciduous molars with complete roots formation (stage 2). MATERIALS AND METHODS: A total number of 75 primary molars in stage 2 of formation were selected to undergo pulpotomy treatment. All teeth were restored with a stainless-steel crown.The clinical success was evaluated at 1, 3, 6 and 12-month intervals. The radiographic follow-up evaluations were at 6 and 12 months. The resulting data were tabulated and statistically analyzed. RESULTS: Among the 75 teeth treated with Biodentine™, one tooth revealed abnormal mobility and tenderness to percussion at the end of the 1st month. PLS widening and the bone lesion was not seen in any of the 74 remaining cases. Forty teeth (54.1%) showed pulp canal obliteration (PCO), and none of the cases developed a draining sinus or had increased mobility. At the end of the 1-year follow-up, the clinical and radiographic success rates were 98.7% and 100%, respectively. CONCLUSION: Pulpotomies performed with Biodentine™ on stage 2 primary molars were generally very satisfactory and fulfilled all requirements, covering all needs. This innovative bioactive medicament seems to be a "heroic" material. The excellent outcomes of the present study are indicative that Biodentine™ is a promising biomaterial to promote pulp repair after pulpotomy in clinical practice. HOW TO CITE THIS ARTICLE: Nasrallah H, El Noueiri B, Pilipili C, Ayoub F. Clinical and Radiographic Evaluations of Biodentine™ Pulpotomies in Mature Primary Molars (Stage 2). Int J Clin Pediatr Dent 2018;11(6):496-504.

Evaluation of Biodentine Pulpotomies in Deciduous Molars with Physiological Root Resorption (Stage 3).

INTRODUCTION: Conservation of primary dentition is essential for maintenance of arch length, esthetic, mastication, speech and prevention of abnormal habits. The commonly supported treatment for retaining carious primary molars with affected pulp is pulpotomy. AIM: The study aims to evaluate clinically and radiographically the rates of success and efficacy of Biodentine™ as pulpotomy medicament exclusively on primary molars with physiological root resorption. MATERIALS AND METHODS: A total number of 35 primary molars in stage three of formation were selected to undergo pulpotomy treatment. All teeth were restored with pediatric stainless-steel crowns.The clinical findings were evaluated at 1, 3, 6 and 12-month intervals and the radiographic follow-ups evaluations were done at 6 and 12 months. The resulting data were tabulated and statistically analyzed using IBM SPSS© for Windows version 20.0 (SPSS, Chicago, IL, USA). Mc Nemar test was conducted to evaluate the differences in results between months 6 and 12. RESULTS: Periodontal ligament space (PLS) widening and alveolar bone lesion were not seen in any of the 35 cases, 9 teeth (25.7%) manifested pulp canal obliteration (PCO), and none of the cases showed signs of pathologic root resorption. The clinical and radiographic success rates in pulpotomy using Biodentine™ at 6 and 12 months were 100%. CONCLUSION: Pulpotomies performed with Biodentine™ were entirely successful. This dressing material appears to be a serious pulpotomy agent in primary molars with root resorption.How to cite this article: Nasseh HN, Noueiri BE, Pilipili C, Ayoub F. Evaluation of Biodentine Pulpotomies in Deciduous Molars with Physiological Root Resorption (Stage 3). Int J Clin Pediatr Dent., 2018;11(5):393-398.

Choice of Endodontic Fiber Posts and its Influence on Dental Malpractice: An in vitro Evaluation.

AIMS AND OBJECTIVES: The fiber post type used in restoring endodontically treated teeth may affect the dental expert decision in the case of dental malpractice. The aim of this study was to evaluate the low-cost commercial fiber post in comparison with a higher cost or well-known documented fiber post system. MATERIALS AND METHODS: A total of 20 premolars were selected for the study; following endodontic treatment, specimens were randomly divided into two groups of 10 specimens each according to the type of fiber post used: (1) Low-cost commercial fiber post (OYAPost, Taper Lucent, OYARICOM) and (2) higher cost well-known fiber post (Rely X Fiber post, 3M ESPE). Both fiber posts were cemented using self-adhesive cement (Rely X Unicem). Samples were subjected to push-out bond strength and to failure analysis. One-way analysis of variance was used (p < 0.005). RESULTS: There was no significant difference between the bond strength of the two tested groups (p > 0.05), while statistically significant difference (p < 0.05) was noted between the different post space regions (cervical, middle, and apical). CONCLUSION: Based on the evidence from the study, it can be concluded that the type of fiber post should not affect the dental expert decision in the case of dental malpractice/lawsuit. CLINICAL SIGNIFICANCE: All types of low-cost fiber posts may behave similarly to other higher cost or well-documented fiber posts.

Evaluation of Periodontal Status and Treatment Needs of Institutionalized Intellectually Disabled Individuals in Lebanon.

AIMS AND OBJECTIVES: No reported data is available on the periodontal health and treatment needs of the intellectually disabled in Lebanon. To evaluate the periodontal condition and treatment needs of institutionalized intellectually disabled individuals in Lebanon. MATERIALS AND METHODS: A total of 272 individuals (141 males and 131 females) aged 15 years and 35-44 years were examined. Periodontal health was recorded following the community periodontal index of treatment needs (CPITN), and treatment need was assigned accordingly. The IBM® SPSS® statistics 20.0 and Stata/SE 11.1 statistical packages were used to carry out all statistical analyses. Statistical analysis was performed using linear regression (P ≤ 0.05). RESULTS: Healthy periodontium was recorded in 26.1%, bleeding on probing in 27.9%, supra-/sub-gingival calculus in 31.3%, pockets of 4-5 mm in 11% and ≥6 mm in 3.7%. The largest proportion of the sample was in need for oral hygiene instruction and calculus removal (42.3%). Age, geographical location, consumption of carbohydrate-rich meals and sweets between meals were significantly associated with CPITN score severity in multivariate analysis (P < 0.05). Gender, severity of disability, frequency of tooth brushing, and caretaker characteristics were not significant predictors of CPITN (P > 0.05). CONCLUSION: The predominantly poor periodontal health and social inequalities warrant nationwide preventive oral health programs in addition to planning the provision of treatment services to meet existing treatment needs.

Oral Health Status of Institutionalized Individuals with Intellectual Disabilities in Lebanon.

OBJECTIVES: To assess the dental status of institutionalized intellectually disabled individuals in Lebanon and the role of background and behavioural determinants. MATERIAL AND METHODS: Oral health was recorded for 652 individuals (6, 12, 15 and 35 - 44 years old) using the decayed, missing and filled teeth/decayed and filled teeth (DMFT/dft) index. Data collected was statistically analysed with statistical significance set at P = 0.05. RESULTS: Overall, mean DMFT index score was 5.86 (SD 6); composed of 3.64 (SD 4.05) decayed (D) teeth; 1.71 (SD 4.38) missing (M) teeth; 0.87 (SD 2.51) filled (F) teeth. DMFT was highest in adults (12.71 [SD 7.43]) and had a large component of missing (6.24 [SD 7.02]) and filled (3.31 [SD 4.56]) teeth. DMFT scores ranged between 3.5 (SD 4.44) at 6 years and 4.8 (SD 4.52) at 15 years and the decayed component was the main contributor. In multivariate analyses, governorate of residence was statistically significantly (P ≤ 0.040 and P ≤ 0.044) associated with D and DMFT, the degree of disability and caretaker educational level were statistically significantly (P = 0.009 and P = 0.008) associated with D, oral hygiene practices were statistically significantly (P ≤ 0.017; P < 0.001; P ≤ 0.017; P < 0.001) associated with D, M, F and DMFT and sugar consumption was statistically significantly (P ≤ 0.03 and P ≤ 0.019) associated with D and DMFT. CONCLUSIONS: In Lebanon, preventive and treatment programs to improve the oral health status of institutionalized intellectually disabled subjects are needed.

A survey of Oral Health in Institutionalized Population with Intellectual Disabilities: Comparison with a National Oral Health Survey of the Normal Population.

INTRODUCTION: Compared to the general population, the intellectually-disabled (ID) experience poor health and inferior access to high quality health services. AIM: To compare the oral health of institutionalized ID Lebanese individuals to that of the normal Lebanese population (NLP). MATERIALS AND METHODS: Caries and periodontal indices were recorded in 652 ID individuals (aged 6, 12, 15, and 35-44 years) residing in the 5 major Lebanese governorates. The comparison population was derived from the National Oral Health Survey conducted in 1994. RESULTS: Six-year-old ID children had an average of 3.28 decayed primary teeth, 0.22 filled primary teeth, and an overall dft score of 3.50, whereas in the general population decayed, filled, and overall dft scores were 4.90, 0.10, and 5.4, respectively. The lowest number of permanent decayed teeth in the ID was recorded in the 35-44-year-old group (3.17) and the highest in 15-year-old group (4.01). In the NLP, the number of decayed permanent teeth gradually increased from age 12 (5.14) to age 35-44 years (7.20). Caries indices were generally better in the ID than that in the NLP, except for more missing teeth in ID adults (6.24 compared to 4.98). The ID population presented with more severe periodontal disease (pocketing) whereas the NLP presented with a greater proportion with calculus. CONCLUSION: This study highlighted important differences in oral health and treatment needs in the ID compared than that of the NLP. Policy changes are required if adequate services are to be provided for this group of the population.

The Psychological Attitude of Patients toward Health Practitioners in Lebanon.

BACKGROUND: Patients often complain about their doctor's attitude toward them. They describe the interaction that they have with some doctors as quick, cold, discourteous, or hardhearted. Although this does not apply to all Lebanese doctors, it does apply to some. AIMS: The purpose of this study was to (1) examine the general perception of satisfaction, trust, and openness that Lebanese patients hold toward the work, office, personal, and social characteristics of their doctors - physician or dentist; and (2) identify the aspects on which a Lebanese health practitioner should focus to improve his/her practice. MATERIALS AND METHODS: A convenient sample of 450 individuals from an area housing nine hospitals and hundreds of private clinics in Greater Beirut were surveyed regarding the qualities of their health practitioners. They were asked to complete a nine-page, 85-item, anonymous, and voluntary questionnaire that dealt with the medical and dental practice in Lebanon. Participants were older than 18 years and mentally competent. None was physicians, dentists, or nurses. The questionnaire was open-ended and initially pretested and piloted among a random sample. RESULTS: Four hundred-fifteen (92%) individuals responded. Participants were from different ages, genders, geographical areas, educational backgrounds, and professions. The doctor traits most preferred by the Lebanese public were found to be: Empathy (90%), professionalism (87%), miscellaneous traits (86%), and academics (81%). CONCLUSION: The results support the conventional wisdom that the idealized perception of a doctor as a care-giving, compassionate, knowledgeable, well-appearing, and healthy role model still holds true within the Lebanese community.

A Novel Approach for the Reimbursement of Permanent Partial Dental Disability Following Dental Injury.

Reimbursement of long-term permanent disability following a dental injury can lead to claims and legal involvement by the injured person. This will delay the treatment the patient's quality of life and the court system. A new formula has been hypothesized to address the problem. This might help the stakeholders including patients, insurance companies. The details of calculating the index and its significance are discussed. Implication studies are mandatory to refine the proposed hypothesis.

Oral and craniofacial clinical signs associated to genetic conditions in human identification part I: a review.

BACKGROUND: Forensic dentistry is one of the most reliable methods used in human identification when other technique as fingerprint, DNA, visual identification cannot be used. Genetic disorders have several manifestations that can target the intra-oral cavity, the cranio-facial area or any location in the human body. MATERIALS AND METHODS: A literature search of the scientific database (Medline and Science Direct) for the years 1990 to 2014 was carried out to find out all the available papers that indicate oral, cranio-facial signs, genetic and human identification. RESULTS: A table with 10 genetic conditions was described with oral and cranio-facial signs that can help forensic specialist in human identification. CONCLUSION: This review showed a correlation between genetics, facial and intra-oral signs that would help forensic ondontologist in the identification procedures.

Mandibular canine dimorphism in establishing sex identity in the lebanese population.

Background and Objective. In forensic investigations, mandibular canines provide excellent materials to identify gender since they are more likely to survive disasters. The objective of this study was to investigate gender dimorphism by comparing the mesiodistal width of mandibular permanent canines and intercanine distance in a group of Lebanese population. Methods. Participants consisted of undergraduate students from the School of Dentistry, Lebanese University, for two academic years who fulfilled the inclusion criteria. Canine widths and intercanine distance were measured by one operator directly on dental casts using a digital caliper. Results. One hundred thirty-three Lebanese dental students (54 males and 69 females) aged 18-25 were included in the study. The intercanine distance was significantly greater in males (P value < 0.0001). The right and the left canine widths were significantly greater in males than in females (P value < 0.0001). However, no significant difference was found between left and right canines for males (P value > 0.05) and females (P value > 0.05). The mean width of canine was greater than 7.188 mm for males. Conclusion. The parameters measured in the present study are of great help in sex identification in forensic investigations in the Lebanese adult population.

Pain and neurological sequelae of cluster munitions on children and adolescents in South Lebanon.

This paper aims at evaluating the neurological repercussions arising from injuries sustained due to cluster munitions in children up to 18 years in South Lebanon following the 2006 conflict. Data on neurological and pain symptoms suffered during and after treatment because of sub-munitions in South Lebanon from August 2006 till late 2011 were prospectively recorded. Patients were divided into subcategories; children aged 12 and under and adolescents aged between 13 and 18. During the study period, there were 407 casualties, 122 (30%) of which were aged 18 years or younger. There were 116 (95%) males and six (5%) females. Average age was 14 years. 10 (8.2%), all males, died as a result of their injuries. 42 (34.4%) were children and 80 (65.6%) were adolescents. 112 had surgical treatments for their injuries. 83 out of 112 patients (74%) with non-lethal injuries had amputations, 67% children and 78% adolescents. Among those who had amputations, 31 (37.4%) suffered from phantom limb pain and 71% suffered from stump/residual limb pain. 88% of patients were diagnosed with post-traumatic stress disorder (44% children and 77% adolescents) and 41% were diagnosed with post-concussion syndrome. Four patients (3.6%) suffered from traumatic brain injuries, both penetrating and closed. Pain syndromes were found in all patients who had amputation. The injury related comorbidities together with many post-concussion syndrome cases, and fewer traumatic brain injuries lead into a high level of physical, psychosocial and economic burdens on the community.