The impact of surgical guide design and bone quality on heat generation during pilot implant site preparation: an in vitro study.

BACKGROUND: Surgical guides restrict the flow of cooling agent to osteotomy site, which will lead to a temperature rise that provokes tissue injury. Few studies compared differences in the temperature changes between non-limiting 'conventional' and limiting 'guided' surgical guides during implant site preparation. The objective of this study was to investigate the difference in temperature changes during bone drilling for implant placement using non-limiting and limiting surgical guides at cortical and cancellous bone levels. METHODS: Forty-four bovine rib samples were used for implant bed preparation in this study with a minimum thickness of 11 mm was chosen for the ribs. The bone was stored in a freezer at 10 °C until it was used. On the day of the study, the bone was defrosted and soaked in water at 21 °C for three hours before embarking on drilling to make sure each sample was at the same temperature when tested. Forty-four bone specimens were prepared and randomly allocated to receive either a limiting or a non-limiting surgical guides (22 for each group). The osteotomy site was prepared by one operator following the manufacturer's instructions, using limiting and non-limiting surgical guides. Temperature changes were recorded during implant bed preparation using thermocouples that fit into 7 mm-horizontal channels at two different depths (Coronally) and (Apically) at 1 mm distance from the osteotomy site. The data were tested for homogeneity of variances using Levene's test, then data were analyzed using an Independent sample t-test and the significance level was set at P ≤ 0.05. RESULTS: The mean temperature rise for all samples was 0.55 °C. The mean temperature rises for the limiting and non-limiting surgical guides were 0.80 °C and 0.33 °C respectively. There was a statistically significant difference in temperature rise between the limiting and non-limiting surgical guides (P = 0.008). In relation to position of temperature recording (coronal vs. apical), there was no significant difference (P > 0.05). No significant difference was noted between the two groups at cancellous bone level (P = 0.68), but the difference was significant at cortical bone level (P = 0.036). CONCLUSION: Limiting surgical guides showed higher readings than non-limiting. However, for both techniques, temperature rise was not significant clinically and within a safe range.

Pattern of Facial Fractures and Its Association with a Cervical Spine Injury in a Tertiary Hospital in Jordan.

Background: Facial fractures can be accompanied by serious and life-threatening injuries such as cervical spine injury (CSI), which can lead to serious consequences if misdiagnosed. Objective: To assess the patterns of maxillofacial fractures and to explore the association between these fractures and cervical spine injuries (CSIs) in patients with a traumatic facial injury. Methods: A retrospective analysis was conducted on the data of the subjects who were admitted to the King Abdullah University Hospital (KAUH) and had a maxillofacial fracture in the period from January 2017 through December 2020. Stepwise binary logistic regression analysis was conducted to find the variables which are significantly and independently associated with CSIs. Results: A total of 394 maxillofacial fractures were reported for a total of 221 subjects. The mandible was the most common site of the reported fractures (41.88%). The majority of the subjects had associated injuries (70.6%), of which 82.7% were CSIs. The most common type of the CSIs was the vertebral fracture (52%). Increased age (OR = 1.543, P < 0.05), having a mandibular fracture (OR = 4.382, P < 0.01), and having a maxillary fracture (OR = 3.269, P < 0.05) were significantly associated with the presence of CSI. Conclusion: The current study revealed that the most common type of facial fracture occurred in the mandible area, and CSI was the most common fracture-associated injury (82.7%). Increased age and having mandibular or maxillary fracture were associated with an increased risk of developing CSI. Therefore, it is necessary to rule out the presence of concomitant CSI during the emergency management of maxillofacial fractures, particularly for elderly patients and those with mandibular or maxillary fractures.

Oral Cancer Awareness, Attitudes, and Barriers among Jordanian Adults: A Cross-sectional Study.

PURPOSE: To identify the gaps in the Jordanian population's knowledge about oral cancer, screening and attitudes toward screening, in addition to determining the barriers to oral cancer screening. MATERIALS AND METHODS: A cross-sectional web-based study was conducted. The first section of the questionnaire employed collected the participants' sociodemographic data. A question about whether patients had heard about oral cancer was then included, and those who answered 'no' were instructed to submit the questionnaire. The subsequent parts evaluated the participants' knowledge of oral cancer and screening, attitudes toward screening, and barriers against screening. ANOVA and chi-squared tests were conducted to investigate the sample characteristics associated with the participants' unfamiliarity with oral cancer. Binary regression was conducted to predict the variables associated with the participants' knowledge and attitudes. RESULTS: The questionnaire was filled by 1307 participants (1011 females). Most of the participants (70.01%) stated that they had heard of oral cancer, and the variables associated with awareness of oral were sex, monthly income, health insurance coverage, working status, and educational level. Sources of information and age were significantly associated with knowledge and attitude levels. The most 'agree/strongly agree' responses about barriers were lack of knowledge and lack of awareness. CONCLUSION: The study participants had moderate knowledge about oral cancer and satisfactory attitudes toward screening. Nearly all barriers to screening can be overcome by the joint efforts of healthcare providers and health authorities.

Antibiotic dosing adjustments in patients with declined kidney function at a tertiary hospital in Jordan.

BACKGROUND: Estimating kidney function is essential to consider in drug dosing for renally eliminated drugs. It has been estimated that more than half of medications' adverse effects are caused by the inappropriate dosing. Limited data are available on drug dosing adjustment, particularly the antibiotics, among Jordanian patients with declined kidney function. AIM: The aim of this study was to evaluate the extent of antibiotics' dose adjustment according to the recent guidelines of drugs' renal dose adjustment. METHOD: The present study utilised data from a previous retrospective study, which recruited inpatients who were clinically stable and received IV antibiotics for more than 24 hours at King Abdullah University Hospital. Sociodemographic and clinical data were collected by referring to information technology departments at KAUH. The percentage of antibiotics which were inappropriately adjusted based on creatinine clearance was evaluated using Lexicomp-Clinical Drug information website. RESULTS: A total of 110 antibiotics were dispensed for 80 patients. Results showed that (36.25%) of patients were given antibiotics without renal dose adjustments based on their creatinine clearance. Urinary tract infections followed by respiratory tract infections were the most common among the study participants. The most commonly prescribed antibiotic was Imipenem/cilastatin (41.25%). Among antibiotics prescribed without renal dose adjustment, Imipenem/cilastatin was the most common and represented 62% of the cases while vancomycin was the least and represented only 3.45% of the non-renally adjusted doses. CONCLUSIONS: The current study clearly demonstrates the lack of adherence to recent guidelines of renal dose adjustment for renally excreted antibiotics. Such findings shed the light on the necessity of considering antibiotics dose adjustment in patients with declined kidney function with the aim of ensuring medication safety and improve health outcomes.

Erratum to: Duration of Hospital Stay Following Orthognathic Surgery at the Jordan University Hospital.

[This corrects the article DOI: 10.1007/s12663-011-0327-5.].

Assessment of knowledge of dental staff at a saudi arabian university regarding the prophylaxis for infective endocarditis.

UNLABELLED: The use of prophylactic antibiotics for the prevention of infective endocarditis following dental procedures has long been debated and there is still confusion regarding its efficacy. As a result, the prophylactic treatment varies considerably amongst different countries across the world and amongst different dental practitioners. AIM: To evaluate the knowledge of dental staff regarding the guidelines for the prevention of infective endocarditis. METHODS: This was a cross sectional analytical study which included all staff members. A self administered questionnaire was used and responses were "graded" according to the American Heart Association (AHA) guidelines. RESULTS: The response rate was 87% (N=39) and 97% reported to use the AHA guidelines; 66% reported their knowledge was based on previous training and scientific journals. Of those cardiac conditions and dental procedures which required prophylaxis; 47% and 65% chose the correct option, respectively. Penicillin was prescribed as the drug of choice by the majority of respondents. CONCLUSIONS: Although almost all staff reported the use of the AHA guidelines, many were not following them. The study emphasizes the need for continuous education and evaluation of this critical aspect of dentistry.

Duration of hospital stay following orthognathic surgery at the jordan university hospital.

BACKGROUND: Major oral and maxillofacial surgery procedures have been routinely performed on an inpatient basis in order to manage both, the recovery from anesthesia and any unpredictable morbidity that may be associated with the surgery. The use of inpatient beds is extremely expensive and if the surgical procedures could be done on an outpatient setting, it would reduce the costs and the need for inpatient care. The aim was to determine the length of hospital stay (LHS) and the factors which influence the LHS following orthognathic surgery at the Jordan University Hospital over 5 years (2005-2009). METHODS: This was a retrospective record review of patients who underwent orthognathic surgery at Jordan University Hospital between 2005 and 2009. The variables were recorded on a data capture form which was adapted and developed from previous studies. Descriptive and analytical statistical methods were used to correlate these variables to the LHS. RESULTS: Ninety two patients were included in the study and 74% of them were females. The mean age was 23.7 years and the mean LHS was 4 days. The complexity of the procedure, length of operation time, intensive care unit (ICU) stay and year of operation were significantly correlated with a positive LHS (P < 0.05). CONCLUSION: Patients' hospital stay was directly related to the complexity of the orthognathic procedure, the operation time, time spent in ICU and the year in which the operation was done. There was a significant reduction in the LHS over the progressing years and this could be due to an increase in experience and knowledge of the operators and an improvement in the hospital facilities.

A randomized controlled trail comparing the efficacy of 0.5% centbucridine to 2% lignocaine as local anesthetics in dental extractions.

The development of local anesthesia in dentistry has marked the beginning of a new era in terms of pain control. Lignocaine is the most commonly used local anesthetic (LA) agent even though it has a vasodilative effect and needs to be combined with adrenaline. Centbucridine is a non-ester, non amide group LA and has not been comprehensively studied in the dental setting and the objective was to compare it to Lignocaine. This was a randomized study comparing the onset time, duration, depth and cardiovascular parameters between Centbucridine (0.5%) and Lignocaine (2%). The study was conducted in the dental outpatient department at the Government Dental College in India on patients attending for the extraction of lower molars. A total of 198 patients were included and there were no significant differences between the LAs except those who received Centbucridine reported a significantly longer duration of anesthesia compared to those who received Lignocaine. None of the patients reported any side effects. Centbucridine was well tolerated and its substantial duration of anesthesia could be attributed to its chemical compound. Centbucridine can be used for dental procedures and can confidently be used in patients who cannot tolerate Lignocaine or where adrenaline is contraindicated.