Patients satisfaction with the dental treatment provided at the University of Jordan's student clinics.

INTRODUCTION: To assess patients' satisfaction with the dental care provided to them by the undergraduate students at Jordan University Hospital. In addition, to investigate whether the age or gender of patients had any correlation with the level of satisfaction. MATERIALS AND METHODS: The Dental Satisfaction Questionnaire (DSQ) developed by the RAND Corporation was used to measure patient satisfaction. The questionnaire was translated to Arabic the native language of the country and it consisted of 14 questions, which measure the overall satisfaction and the subscales of access, convenience and availability, continuity of treatment and quality of dental care provided. RESULTS: A total of 94 patients (58.5% female, 41.5% male) answered the DSQ, the Overall Dental Satisfaction Index (DSI) was found to be 86.2%, and there was no correlation between gender or age groups and the DSI (p < .05). All 14 questions scored above 4/5 except the question about whether the schools' building and dental units being modern and well equipped (3.7/5), and the general satisfaction question (3.2/5). CONCLUSIONS: Patients who were treated at the student clinics at the University of Jordan, School of Dentistry were found to be satisfied about both the quality of treatment and the dental environment, while reporting some negative aspects related mainly to the clinics building which they found to be very old and crowded. This study found no correlation between patients' satisfaction and the age or gender of the participants.

Blended Learning with Video Demonstrations Enhances Dental Students' Achievements in Tooth Carving.

Background: Learning fine motor skill is central to preclinical dental education. Dental students are introduced to anatomical tooth carving to facilitate the development of their fine motor skill and manual dexterity. Various carving technique exists, such as wax build-up, and geometric (block carving technique). Since substantial laboratory Time and instructors' effort are required to teach students the desired techniques, blended learning approach via pre-recorded demonstration may improve the teaching and learning efficiency of anatomical tooth carving. For years, we used the Geometric method to teach preclinical dental students to carve down tooth sculptures after performing live demonstrations for them. Multiple practical laboratory demonstrations are necessary to deepen the student's comprehensive understanding of dental anatomical features and teach them correct instrumentation; this is time-consuming and challenging due to limited laboratory hours and limited view field. Accordingly, in 2016 the teaching staff created videos for tooth drawing, carving, and identification, and uploaded them to the students' university platform. Years later, we decided to perform this retrospective study. Objective: To assess the enhancement in students' tooth carving skills after implementing blended learning with video demonstrations. Methods: The student's total grades were used for comparative purposes. The students' total grades between 2010 and 2019 were collected and categorized into two groups: Group 1 (n=858), which learned tooth carving by the Geometric method after live demonstrations, and Group 2 (972), which benefited from blended learning with video demonstrations in learning. The two groups' mean, median, mode, Percentile 75, and Percentile 90 were compared. Results: Group 2 showed higher grades than group 1, and the differences between the two groups' mean and median were statistically significant p<0.001. Moreover, the mode, P75 and P90 favored group 2. Conclusion: Results show that blended learning with video demonstrations enhanced the achievements of dental students in tooth carving.

Dental Students' Perception and Self-Perceived Confidence Level in Key Dental Procedures for General Practice and the Impact of Competency Implementation on Their Confidence Level, Part I (Prosthodontics and Conservative Dentistry).

Background: Evaluating the level of dental students' competence is crucial for validating their preparedness for graduation. Confidence has a significant role in achieving competence. There are limited studies that assess the level of self-perceived confidence among final-year dental students regarding their ability to conduct key dental procedures. This study aims to assess the self-perceived confidence level of final-year dental students in performing essential dental procedures across various dental disciplines and to assess the effect of implementing competencies in the curriculum on the self-perceived confidence level of students by comparing two cohorts of final-year students in two different years 2016 (Traditional Cohort) and 2019 (Competencies Cohort). Materials and Methods: An questionnaire was answered by two cohorts of final-year dental students: one group in 2016 before the implementation of the competency-based assessment system (group 1, n = 153), and the other in 2019 after the implementation of this system (group 2, n = 199), the same questionnaire was used for both cohorts. The results from the two groups were compared regarding the degree of self-perceived confidence in conducting key dental procedures. The data were analysed using SPSS statistics and Levene's Test for Equality of Variances and t-test for Equality of Means calculated. Results: Group 1 showed a significantly higher means of self-perceived confidence levels than group 2 in the ability to conduct seven out of the 20 prosthodontics procedures studied: providing patients with Cobalt-Chromium (Co-Cr) removable partial dentures (RPD) (3.77 vs. 3.56), providing the patient with Acrylic RPD (3.70 vs. 3.23), treatment planning for partially edentulous patients (3.83 vs. 3.34), giving OHIs for denture patients (4.17 vs. 3.95), dealing with CD postinsertion complaints (3.97 vs. 3.76), giving postinsertion instructions for removable prostheses cases (4.12 vs. 3.82), and providing patients with immediate dentures (2.67 vs. 2.32). The same applies to 6 out of 16 conservative dentistry procedures: placing anterior composite (4.41 vs. 4.12), placing posterior composite (4.43 vs. 3.88), placing posterior amalgam (4.29 vs. 4.02), placing matrix band for Class II restorations (4.24 vs. 3.71), placing a prefabricated post (3.34 vs. 2.88), and placing fiber post (3.45 vs. 3.34). On the other hand, group 2 shows higher means of self-perceived confidence than group 1 in only two conservative dentistry procedures: onlay restorations (2.18 vs. 2.76) and inlay restorations (2.22 vs. 2.75). No significant differences in means of self-perceived confidence were found between the two groups in the remaining 21 procedures studied. Conclusions: This study has shown that final-year dental students have high self-perceived confidence levels in doing simple dental procedures yet less confidence in more complex ones. Although, students' self-perceived confidence decreases after the introduction of a competency-based assessment system. Competency implementation and execution criteria may differ between schools which may have an impact on final outcomes. Hence, there is a need for regular evaluation of competencies being assessed to maintain a curriculum that is up to date.

Age of the donor affects the nature of in vitro cultured human dental pulp stem cells.

OBJECTIVES: The dental pulp stem cells (DPSCs) of six donors (three young donors aged < 19 years and three adult donors aged > 25 and < 30 years) were characterized for their stem cell marker expression and differentiation potential to study the effect of donor age on DPSCs in vitro. METHODS: DPSCs were cultured in αMEM supplemented with 20% fetal calf serum (conventional conditions) or on fibronectin-coated flasks with neurobasal medium supplemented with B27, bFGF and EGF (alternative conditions). DPSCs were characterized by immunofluorescence staining to detect the neural crest/mesenchymal stem cells markers P75 and CD146, respectively. The differentiation potential was tested by the induction of DPSCs into osteogenic, adipogenic and glial lineages and then by detecting the corresponding markers osteocalcin, lipidtox and S100ß, respectively. RESULTS: The DPSCs of the young donors expressed CD146 only under the conventional conditions and expressed P75 regardless of the culture conditions. However, the DPSCs of adult donors expressed CD146 only under the alternative conditions and expressed P75 only under conventional conditions. Only the DPSCs of the young donors differentiated into the glial linage. The DPSCs of the adult donors differentiated more efficiently into the adipogenic linage. Osteogenic differentiation was comparable. CONCLUSION: Donor age affects the expression of stem cell markers and differentiation potential of DPSCs. Moreover, the effect of culture conditions on DPSCs is age dependent.

Do upper third molars provide more accurate age estimation in the adult based on the pulp-to-tooth ratio than lower third molars? A cone-beam CT study.

INTRODUCTION: Age-at-death estimation is an essential part of the identification process of individuals in many forensic dentistry cases where identity of the individual cannot be resolved by visual recognition or other means. Dental age estimation in adults is more of a challenge as most teeth complete their development by the age of 18 years. AIM: This study aims at using the mesio-distal (MD) pulp-to-tooth ratio taken at the cervix of upper third molars (UM3) to estimate age at the time of radiographic imaging. MATERIALS AND METHODS: A set of 135 Cone-beam computed tomography (CBCT) radiographs of UM3s for a random sample of 135 Jordanian adults (65 females, 70 males; age range = 18-63 years, mean age = 34.4 years, SD = 11.2 years) were used. Both pulp and tooth MD diameters were measured at the cervix. MD pulp-to-tooth ratios for UM3s were correlated with age. RESULTS: Statistically significant negative moderate correlation was found between the age of the individual and the cervix MD pulp/tooth ratio (r = -0.516). This indicates that only 26.6% of the variation in age can be explained by the cervix MD pulp-to-tooth ratio. CONCLUSIONS: This study concludes that cervix MD pulp-to-tooth ratio of UM3s, although apparently stronger than that of lower M3s (r = -0.361), is not a sufficiently reliable estimator of age in adults, and this is perhaps attributed to the greater variability in the time line of third molars development.

Comparison of oral health indicators between two places of endemic dental fluorosis in Jordan.

INTRODUCTION: Excessive fluoride intake during tooth development causes dental fluorosis. AIM: This study aimed to (1) determine the prevalence of dental fluorosis in association with fluoride concentrations in drinking water, (2) explore the effects of altitude on the severity of fluorosis in two towns with high fluoride levels in the drinking water, and (3) assess decayed, missing, and filled teeth (DMFT) and oral hygiene practices among participants. MATERIAL AND METHODS: The sample consisted of 100 and 141 schoolchildren, aged 15.3 ± 1.4 and 16.1 ± 1.3 years, living in Ruwaished and Kuraymah, respectively. Oral examinations were carried out, and dental fluorosis was assessed using the Dean's index. The DMFT index was also used for assessment. Samples of drinking water were analyzed using a fluoride-ion selective electrode. SPSS was used to analyze the data. RESULTS: Two-thirds (68.8%) of adults from Kuraymah had moderate to severe fluorosis, with only 7% being unaffected. In Ruwaished, 50% of the sample had severe fluorosis, 22% showed moderate fluorosis, and none were unaffected. The average DMFT scores were 3.18 ± 1.81 and 3.81 ± 1.41 for Kuraymah and Ruwaished, respectively. In both towns, males had significantly higher caries scores than females. Oral hygiene was poor, as 64% and 57% of the participants from Kuraymah and Ruwaished, respectively, did not brush their teeth. A significant correlation was found between poor oral hygiene and increased DMFT scores. CONCLUSIONS: This study concluded that higher fluorosis incidence and severity were present in the higher-altitude location (Ruwaished). Moreover, this study also indicated that fluorosed teeth are not immune to caries, and the preventive management of dental fluorosis should be directed to de-fluoridation of drinking water in endemic areas.

The discoloration effect of diluted minocycline containing triple antibiotic gel used in revascularization.

BACKGROUND/PURPOSE: Triple antibiotic paste (TAP) has been successfully used in revascularization procedure. However, one of the problems associated with TAP use is teeth discoloration, which is attributed to the presence of minocycline constituent. The aim of this study is to investigate the discoloration effect of different concentrations of triple (TAP) and double (DAP) antibiotics pastes on root dentine. MATERIALS AND METHODS: Sterilized dentine specimens (4 × 4 × 1) were prepared, and randomly assigned to 5 groups; 1000 mg/mL of Triple antibiotic paste (TAP), 1000 mg/mL of Double antibiotic paste (DAP), 1 mg/mL of TAP in Methylcellulose gel (MTAP), 1 mg/mL of DAP in Methylcellulose gel (MDAP), and distilled water control groups (n = 12). The assigned treatment was applied for 14 days. The CIE L*a*b calorimetric parameters were measured for all dentine specimens using a Chroma meter. One-way ANOVA and multiple comparisons were used for statistical analyses (p < 0.05). ΔE for the different treatments as compared to distilled water group was calculated. RESULTS: TAP and MTAP groups significantly affects the L* values of the root dentine (p < 0.05). ΔE change was noticeable between TAP and MTAP compared to the distilled water group. CONCLUSION: The incorporation of minocycline in TAP medicaments, even in low concentrations, can still provoke a noticeable tooth discoloration.

Assessment of the dental morphological pattern of living Jordanian Arabs suggesting a genetic drift from the Western-Eurasia pattern: A cone beam computed tomography study.

The objectives were to determine the expression frequency and sexual dimorphism of 15 dental morphological traits on the permanent dentitions of living Jordanians, and to compare the dental morphological pattern of this sample with those of 22 groups representing the various geographic regions of the world, for the purpose of assessing the population structure and genetic history of this group. Cone beam computed tomography images for the dentitions of 150 adult Jordanians (67 males, 83 females; age range = 18-58, mean ages 28.2, sd = 10.0 years) were studied in 2017. The traits were classified using the Arizona State University dental anthropology system, counted with the individual count method, and dichotomized according to the criteria of Scott & Turner for the purpose of group comparisons. Fisher's exact test for dichotomized scores was used to assess sexual dimorphism in these traits. Smith's Mean Measure of Divergence was used to measure all pairwise distance values among the groups. Statistically significant sexual dimorphism was found in two traits (i.e., UI1 shoveling and 4-cusped LM1), and apparent but statistically insignificant difference was found in three traits (i.e., UC canine mesial ridge, 3-rooted LM1, and 1-rooted LM2), all in favour of females. This study revealed that the dental pattern of Jordanians is distinct from the other reported Western Eurasian patterns and all other known dental patterns. This differentiated dental pattern suggests a genetic drift for this population from the Western Eurasian Ancestry.

Assessment of occupational noise-related hearing impairment among dental health personnel.

OBJECTIVES: The purpose of the study was to examine hearing thresholds among dental personnel. The secondary aim was to evaluate sound levels among dental equipment that dental personnel are exposed to. METHODS: Two hundred forty-four dentists, dental technicians, dental assistants, and dental students participated. Sixty-two participated as a control group. Audiological thresholds for the test groups were compared to the control group. All participants were from Jordan University Hospital. Participants completed a questionnaire in addition to their audiometric testing. Otoscopy, tympanometry, and pure tone audiometry were included in their assessment. Three-factor ANOVA and t tests were utilized to assess the statistical differences of hearing thresholds among the groups and between the two ears. Pearson correlation test was used to assess the effect of age, experience, and duration of exposure on the degree of hearing loss in the test groups for both ears. RESULTS: The authors reported statistically significant differences among hearing thresholds between the control group and others. Left hearing thresholds were noted to be significantly poorer in the left versus right ear at 1000, 2000, 4000, and 8000 Hz in dental assistants. The authors also reported a significant relationship between the degree of hearing impairment among dental assistants and the daily duration of exposure to dental occupational noise, followed by age. CONCLUSION: Hearing impairment was higher among dental professionals than the control group and especially among dental assistants and technicians. The authors recommended screening guidelines and adapting hearing protection methods for dental professionals and particularly for dental assistants and technicians.

Unexpectedly low levels of dental morphological asymmetry suggesting developmental resilience amongst living Jordanians: A cone beam computed tomography study.

The objective was to determine the degree of fluctuating asymmetry in the expression of 13 dental morphological traits among adult Jordanians. Cone beam computed tomography images for the dentitions of 150 adult Jordanians (67 males, 83 females; age range = 18-58, mean ages 28.2, SD = 10.0 years) were studied in 2017. The traits were classified using the Arizona State University dental anthropology system, and dichotomized according to the most widely accepted criteria to define trait presence. Asymmetry was assessed using three different methods: percentage of discordance including bilateral absence cases (PDIBAC), percentage of discordance excluding bilateral absence cases (PDEBAC), and inter-side correlation (ISC) using Kendall's tau coefficient. Fisher's exact test was used to assess sexual dimorphism in the degree of asymmetry. The mean PDIBAC and the mean ISC for all the traits considered are 4.1% and 0.837, respectively. For traits observed on key teeth (mesial members of teeth districts) the mean PDIBAC and the mean ISC are 3.0% and 0.860, respectively; and for those observed on variable teeth (distal members of teeth districts) the mean PDIBAC and the mean ISC are 6.5% and 0.783, respectively. No statistically significant difference was found in the degree of asymmetry between sexes. The overall low degree of asymmetry found in the present sample (4.1%) compared to the world range of 5-15% may indicate great ability of its individuals to buffer the adverse effects of environmental stresses affecting the living Jordanians during early tooth development.

Morphometric predictors of lingual undercut depth in the posterior mandible and their relevance to immediate dental implant insertion: recommendations for CBCT / Predictores morfométricos de la profundidad de la «undecurt¼ lingual en la parte posterior de la mandíbula y su relevancia para la inserción inmediata de implantes dentales: recomendaciones para la CBCT

Deep lingual undercut (LU) is commonly encountered in the posterior mandible, and is considered a risk factor in dental implants. In this study we investigated the value of data extracted from OPGs in predicting LU depth. Such predictors might be valuable in reducing the chance of lingual plate perforation (LPP) by recommending CBCTs prior to dental implant insertion when deep LU is anticipated We aimed at assessing the following variables as potential predictors of LU depth: 1) alveolar process height (measured on OPGs), 2) alveolar process width (measured on CBCTs), and 3) the distance from apical region of dental alveoli to superior margin of IAN canal (measured on OPGs). 128 CBCTs and corresponding OPGs of posterior mandibles of 128 patients (70 females, 58 males; age range=18-87 years, mean age=45.8 years, SD=17.0 years) were used. Only dentate sites of lower first (LM1) and second molars (LM2) were considered. Four predictors of LU depth were found, the strongest was the ratio between alveolar process width (which could be assessed clinically) and alveolar process height as measured on OPGs (r=.454 at LM1 site, r=.592 at LM2 site). Predictors derived from OPG measurements might be valuable in anticipating LU depth and might be more valuable when combined with alveolar process width (which might be assessed clinically). We recommend considering the suggested predictors in assessing the need of CBCT prior to immediate dental implant insertion in posterior mandible.

El socavado lingual profundo (SLU) se encuentra comúnmente en la porción posterior de la mandíbula y es considerado un factor de riesgo en los implantes dentales. En este estudio, investigamos el valor de los datos extraídos de los OPG para predecir la profundidad del SLU. Dichos predictores podrían ser valiosos para reducir la posibilidad de perforación de la placa lingual (PPL) recomendando CBCT antes de la inserción del implante dental cuando se anticipa un SLU. El objetivo consistió en evaluar las siguientes variables como posibles predictores de profundidad de SLU: 1) altura del proceso alveolar (medida en OPG), 2) ancho del proceso alveolar (medido en CBCT) y 3) la distancia desde la región apical de los alvéolos dentales al margen superior del canal IAN (medido en OPG). Se utilizaron 128 CBCT y las OPG correspondientes de mandíbulas de 128 pacientes (70 mujeres, 58 hombres; rango de edad = 18-87 años, edad media = 45,8 años, SD = 17,0 años). Sólo se consideraron los sitios dentados de los primeros molares inferiores (LM1) y los segundos molares inferiores (LM2). Se encontraron cuatro predictores de profundidad de SLU, el más fuerte fue la relación entre el ancho del proceso alveolar (que podría evaluarse clínicamente) y la altura del proceso alveolar medida en OPG (r = 0,454 en el sitio LM1, r = 0,592 en el sitio LM2). Los predictores derivados de las mediciones de OPG podrían ser valiosos para anticipar la profundidad de SLU y podrían ser más valiosos cuando se combinan con el ancho del proceso alveolar (que podría evaluarse clínicamente). Recomendamos considerar los factores predictivos sugeridos para evaluar la necesidad de CBCT antes de la inserción inmediata del implante dental en la porción posterior de la mandíbula.

Age and gender variations in the cone-beam computed tomographic location of mandibular canal: Implications for mandibular sagittal split osteotomy

Background: Mandibular sagittal split osteotomy (MSSO) may incur unfavorable split and sensorineural injuries. Knowledge of the anatomic location of the mandibular canal (MC) and bone thickness in the region of interest for MSSO, and the possible variations by age and gender can assist in avoiding such complications. Purpose: To study the location of the MC and bone thickness in the region of MSSO by cone-beam computed tomography (CBCT) radiographs and to evaluate the possible variations by age and gender in a Jordanian population. Material and Methods: This retrospective radio-anatomical study examined all CBCT radiographs for patients treated over three years at the University of Jordan Hospital, Amman, Jordan. Distances from the MC to the cortical external surfaces and MC diameter (MCD) were measured by a reliable observer at three predetermined regions for MSSO: region (A) [mandibular foramen area], region (B) [mandibular angle area] and region (C) [directly mesial to the second molar]. Gender and age differences in all measurements were then compared using non-parametric Mann-Whitney U test. Results: The final study radiographs comprised a total of 202 CBCT belonged to a cohort of 202 subjects; 91 males (45.1%) and 111 (54.9%) females, with mean age (± SD) of 42.94 ± 18.54 years (range 18-90 years). Whereas only the bone thickness superior, buccal and inferior to MC in regions (B) and (C), and MCD in the three regions exhibited significant (p < 0.05) gender differences, all measured distances exhibited statistically significant (p < 0.05) differences between young and adult patients. Conclusion: The location of MC and bone thickness in the region of MSSO were significantly variable according to age, but exhibited sexual diamorphism only in regions (B) and (C). This fundamental knowledge should be considered during MSSO planning

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Is there a correlation between students' performance in dental anatomy and performance in operative dentistry? / ¿Existe una correlación entre el rendimiento de los estudiante de anatomía dental y el rendimiento en odontología operativa?

SUMMARY: Manual skills form only a part of the capabilities required for a future dentist. Nevertheless, they are very important components that should be tested. The aim of this study is to investigate if a correlation exists between dental students' grades in the preclinical courses and their clinical performance. Preclinical/clinical grades were collected for first, fourth, and fifth year students who graduated from the Faculty of Dentistry at the University of Jordan, Amman, Jordan, in 2016, and 2017. Two courses (Dental Anatomy and Operative Dentistry) were selected. Corre-lations comparing the practical grades of Dental Anatomy course for first year students, and the practical grades of Operative Dentistry course for the same students in fourth and fifth years. Statistically significant positive correlation was found between the soap carving grades of first-year dental students and their practical grades in Operative Dentistry course during fourth and fifth years. Also, statistically significant strong positive correlation was found between the grades of fourth-year practical Operative Dentistry and the grades of fifth-year practical Operative Dentistry. The clinical performance of dental students in their practical courses in fourth and fifth years can be predicted from their soap carving grades at their first year in Dental School.

RESUMEN: Las habilidades manuales forman solo una parte de las capacidades requeridas para un futuro dentista. Sin embargo, son componentes muy importantes que deben ser probados. El objetivo de este estudio fue investigar si existe una correlación entre las calificaciones de los estudiantes de odontología en los cursos preclínicos y su desempeño clínico. Los grados preclínicos / clínicos se obtuvieron para los estudiantes de primero, cuarto y quinto año, graduados de la Facultad de Odontología, de la Universidad de Jordania, Amman, Jordania, en 2016 y 2017. Se seleccionaron dos cursos (Anatomía Dental y Odontología Operativa). Correlaciones que comparan los grados prácticos del curso de Anatomía Dental para estudiantes de primer año y las notas de calificación prácticas del curso de Odontología Operativa para los mismos estudiantes en cuarto y quinto año. Se encontró una correlación positiva estadísticamente significativa, entre las notas de tallado de jabón de los estudiantes de primer año de odontología y sus notas de calificación prácticas en el curso de Odontología Operativa durante el cuarto y quinto años. Además, se encontró una fuerte correlación positiva estadísticamente significativa entre las notas de calificación en Odontología Operativa práctica de cuarto año y los grados de Odontología Operativa práctica de quinto año. El rendimiento clínico de los estudiantes de odontología en sus cursos prácticos en cuarto y quinto año se puede predecir a partir de las calificaciones en tallado de jabón durante su primer año en la Escuela de Odontología.

The mental foramen: A cone beam CT study of the horizontal location, size and sexual dimorphism amongst living Jordanians.

Accurate information regarding the horizontal location and size of mental foramen (MF) has a well-known clinical importance. In addition, these variables have been reported to exhibit inter-population variation. The aims of the present study were to study the horizontal position and size of MF, as seen on cone beam CT (CBCT) images, and to assess sexual dimorphism in these variables. Total of 139 CBCT images of a random Jordanian sample (50 males, 89 females, average age = 43.5, SD = 13.0, range = 23-69 years) were included. The most frequent horizontal locations of MF were found to be: between the two lower premolars (50%), and in line with lower second premolar (40%). The average long diameter of MF was 3.08 mm, SD = 0.65 mm in males (n = 50, range = 1.5-4.8 mm) and 2.46 mm, SD = 0.58 mm in females (n = 89, range = 1.2-4.0 mm), and the difference was statistically significant. Very weak positive correlation was found between age and MF diameter in females (r = 0.161) and the correlation was approaching statistical significance (p-value = 0.066), while a weak negative correlation was found between these two variables in males (r = -0.276) and the correlation was statistically significant (p-value = 0.038). It could be inferred from the results of the present study that about 95% success rate for mental nerve block anesthesia is expected when the anesthetic solution is administered between the two premolars; however this needs to be tested experimentally. It appears that there is a tendency for an increase in MF size with age in females as opposed to a tendency for size reduction with age in males; this might suggest a role for sexual hormones in influencing MF size.

The influence of leadership behavior, organizational commitment, organizational support, subjective career success on organizational readiness for change in healthcare organizations.

Purpose The purpose of this study is to investigate the influence of leadership behavior, organizational commitment, organizational support and subjective career success on organizational readiness for change in the healthcare organizations. The authors want to determine if nurses who had higher levels of organizational commitment, organizational support and subjective career success relationships were more open and prepared for change. Design/methodology/approach Cross-sectional, descriptive-correlational survey design was conducted using self-reported questionnaires to collect data from registered nurses. Findings The subjective career success was the strongest predictors ( ß = 0.36, p < 0.001) followed by leadership behavior ( ß = -0.19, p = 0.03) and participants' age ( ß = -0.13, p = 0.049). Research limitations/implications This study highlights the influence of leadership behavior, organizational commitment, organizational support and subjective career success on the organizational readiness for change in healthcare organizations. Therefore, this study forms baseline data for future local and national studies. Moreover, it will strengthen the research findings if future research includes a qualitative approach that explores other healthcare professionals regarding readiness for organizational change. Practical implications This study provides information to policymakers and healthcare leaders who seek to improve management and leadership skills and respond to organizational change efforts. Social implications It is important to know the extent to which healthcare professionals, especially nurses, understand how the influence of organizational support and organizational commitment on organizational readiness for change, as well as why specific leadership behavior and subjective career success, is important in implementing the change. Originality/value This study examined the nurses' readiness for change in hospitals. Organizational readiness for change could occur in situations where nurses can exert extra efforts at work because of leaders' behaviors and the relationship between nurses and the institution.

Age prediction in the adult based on the pulp-to-tooth ratio in lower third molars: a cone-beam CT study / Predicción de edad en el adulto basada en la proporción pulpa-a-diente en terceros molares inferiores: un estudio por TC de haz de cono

Estimation of age-at-death is an integral part of the identification process of individuals in many forensic odontology cases where their identity cannot be determined by visualization or other ways. Dental age estimation in the adult is more challenging as most of the dentition is completely developed by 18 years of age. This study employs a mesio-distal (MD) pulp-to-tooth ratio taken at the neck of lower third molars (LM3) to provide an estimation of age at the time of radiographic imaging based on the well-known fact that pulp volume tends to decrease with advancing age due to continued apposition of secondary dentine throughout adulthood. A total of 155 Cone-beam computed tomography (CBCT) radiographs of LM3s for a random sample of 155 Jordanian Arabs (80 females, 75 males; age range= 18-58 years, mean age= 28.2 years, SD =10.0 years) were used. Both pulp and tooth MD diameters were measured at the neck. MD pulp-to-tooth ratios for LM3s were linearly regressed against age. Statistically significant negative association was found between an individual's age at the time of imaging and the MD pulp-to-tooth ratio taken at the neck. Specifically, the strength of the association is r= -0.361, which means only 13.0 % of the variation in age can be explained by the MD pulp-to-tooth ratio taken at the neck. Therefore, it was concluded that MD pulp-to-tooth ratio taken at the neck of LM3s is not a reliable predictor of chronological age in adults, possibly due to the large variation in the timing of LM3 development.

La estimación de la edad es una parte integral del proceso de identificación de los individuos, en muchos casos en odontología forense donde la identidad no puede ser determinada por visualización u otras formas. La estimación de la edad dental en el adulto es aún más difícil ya que la mayor parte de la dentición se desarrolla completamente a los 18 años de edad. Este estudio emplea una relación mesio-distal (MD) de pulpa a diente tomada a nivel del cuello de los terceros molares inferiores (LM3) para proporcionar una estimación de la edad en el momento de la imagen radiográfica basada en que el volumen de pulpa tiende a disminuir con el avance de la edad debido a la continua posición de la dentina secundaria a lo largo de la edad adulta. Se examinaron un total de 155 radiografías de LM3 en una muestra aleatoria de 155 árabes jordanos (80 mujeres, 75 varones), rango de edad = 18-58 años, edad media = 28,2 años, DE = 10,0 años. Específicamente, la fuerza de la asociación es r=0,361, lo que significa que sólo el 13,0 % de la variación en la edad puede explicarse por la proporción pulpa-a-diente.

The mental foramen II: radiographic study of the superior-inferior position, appearance and accessory foramina in Iraqi population / El foramen mental II: estudio radiográfico de la posición superior-inferior, aspecto y forámenes accesorios de una población Iraquí

Accurate information regarding the vertical location and appearance of the mental foramen, and the presence of accessory foramina, can have clinical significance, such as reducing complications that may occur during many oral surgical procedures involving the mental area. Geographic variations were reported in these variables. The aim was to evaluate the above-mentioned variables in an Iraqi sample. Five hundred eighteen panoramic radiographs of a random Iraqi sample (257 males, 261 females, average age= 46.5 years) were evaluated with regard to the above-mentioned variables, as well as the symmetry of the foramen regarding these variables. The area below the apices of mandibular premolars, and the continuous type were the most frequent vertical location and appearance of the mental foramen, respectively. Age advancement was found to be associated with an increase in the frequency of more inferior positioning and continuous appearance. The vertical position and appearance were asymmetrical in 16.2 % and 20.1 % of cases, respectively. Symmetry in the vertical location was statistically significant between sexes (P= 0.035), and young and old ages (P= 0.000). Symmetry in the appearance was found statistically significant (P= 0.025) only between the two age groups. Accessory foramina were recorded in 7.3 % of cases. The most common vertical location and appearance of the mental foramen on panoramic radiographs in this group are below the apices of mandibular premolars, and continuous type, respectively. This is in consistence with the findings of previous studies on other populations. The mental foramen usually has symmetrical vertical location and appearance. Accessory foramina are recorded in a percentage lower than that recently reported in some regional countries.

La información precisa acerca de la localización vertical, apariencia del foramen mental y la presencia de forámenes accesorios, puede tener importancia clínica, como la reducción de las complicaciones que pueden ocurrir durante muchos procedimientos quirúrgicos orales relacionados con el mentón. Las variaciones geográficas fueron reportadas en estas variables. El objetivo fue evaluar las variables anteriormente mencionadas en una muestra iraquí. Fueron evaluadas 518 radiografías panorámicas de una muestra aleatoria de Irak (257 varones, 261 mujeres, edad media = 46,5 años) con respecto a las variables antes mencionadas, así como la simetría del foramen con respecto a estas variables. El área por debajo de los ápices de los premolares mandibulares y el tipo continuo, fueron la localización vertical y apariencia del foramen mental más frecuentes, respectivamente. La edad avanzada se asoció con un aumento en la frecuencia de posicionamiento más inferior y de apariencia continua. La localización vertical y la apariencia fueron asimétricas en 16,2 % y 20,1 % de los casos, respectivamente. La simetría en la localización vertical fue estadísticamente significativa entre sexos (p= 0,035), y entre jóvenes y viejos (P= 0,000). La simetría en apariencia sólo fue estadísticamente significativa (p= 0,025) entre los dos grupos de edad. Se registró presencia de forámenes accesorios en un 7,3 % de los casos. La localización vertical del foramen mental más común en las radiografías panorámicas de este grupo están por debajo de los ápices de los premolares mandibulares, y respecto a la apariencia, el tipo continuo fue el más común. Esto está en coherencia con los resultados de estudios anteriores en otras poblaciones. Los forámenes mentales tienen una localización vertical y apariencia que suelen ser simétricas. Los forámenes accesorios se registran en un porcentaje inferior al informado recientemente en algunos países de la región.

The mental foramen I: radiographic study of the anterior-posterior position and shape in Iraqi population / Foramen mental I: estudio radiográfico de su posición antero-posterior y forma en población iraquí

Accurate information regarding the horizontal location and shape of the mental foramen can have clinical significance, such as reducing complications that may occur during maxillofacial surgical procedures involving the mental area. Geographic variations were reported in these variables. The aim was to study the horizontal position and shape of the mental foramen, as seen on panoramic radiographs of an Iraqi sample, to assess difference in these variables between sexes and age groups, and to assess symmetry of the mental foramen. 518 panoramic radiographs of a random Iraqi sample (257 males, 261 females, average age=46.5 years) were evaluated with regard to the horizontal location, shape and symmetry of the mental foramina. The area between the long axes of the two mandibular premolars, and the round type were the most frequent horizontal location and shape of mental foramen, respectively. Age advancement was found to be associated with an increase in the frequency of more posterior positioning and irregular shape. The horizontal position and shape were asymmetrical in 21.6% and 31.6% of cases, respectively. The Symmetry in horizontal location and shape of mental foramina were found statistically significant between sexes (P=0.041), and between young and old age groups (P=0.001), respectively. The most common horizontal location and shape of the mental foramen on panoramic radiographs in this group are between the two premolars, and the round type, respectively. This is in consistence with the findings of previous studies on other populations. The mental foramina have usually symmetrical horizontal locations and shapes.

Información precisa sobre la ubicación horizontal y forma del foramen mental puede tener importancia clínica en la reducción de complicaciones durante procedimientos quirúrgicos maxilofaciales que involucran el área mental. Fueron reportadas variaciones geográficas en relación a estas variables. El objetivo fue estudiar la posición horizontal y forma del foramen mental, a partir de 518 radiografías panorámicas de una muestra aleatoria en sujetos de Irak (257 varones, 261 mujeres; edad media= 46,5 años), quienes fueron evaluados con respecto a la posición horizontal, forma y la simetría de los forámenes mentales. En individuos de edad avanzada se encontró una asociación con un aumento en la frecuencia de un posicionamiento posterior y con forma irregular. La posición horizontal y forma del foramen fueron asimétricos en 21,6% y 31,6% de los casos, respectivamente. La diferencia hallada en relación a la simetría en posición horizontal y forma de los forámenes mentales fue estadísticamente significativa entre sexos (p=0,041), y entre los grupos de edad jóvenes y mayores (P=0,001), respectivamente. Se encontró con mayor frecuencia la posición horizontal entre los ejes longitudinales de los dos premolares mandibulares, y la forma circular, en relación a la posición antero-posterior y forma del foramen, respectivamente. Estos fueron resultados similares a estudios anteriores sobre otras poblaciones. Los forámenes mentales son simétricos, respecto a su ubicación horizontal y su forma.

Hypodontia: prevalence and pattern amongst the living Druze population - a Near Eastern genetic isolate.

The Druze population is a small-sized Near Eastern genetic isolate with high rates of consanguineous marriages. The present study aimed at investigating prevalence, pattern and distribution of hypodontia in the permanent dentition, excluding wisdom teeth, amongst this population. Panoramic radiographs, dental casts, and anamnestic records of 85 un-admixed Druze schoolchildren (45 males, 40 females; age range=14-18 years, mean age=16 years, SD=0.5 years) were examined for evidence of hypodontia. Those with any type of facial clefts or craniofacial syndromes were excluded. Hypodontia prevalence was 11.8% (11.1% for males, 12.5% for females) with no statistically significant difference between sexes. The average number of missing teeth per child was 1.4 (1.2 for males, 1.6 for females). The majority (90%) of affected individuals exhibited minor hypodontia (one or two teeth missing). The most commonly missing teeth were upper lateral incisors and canines, followed by lower and upper second premolars. Asymmetrical hypodontia was more prevalent. Maxillary, left side, and anterior segment predominance were observed. The distinct features of hypodontia among the Druze population are the relatively high prevalence of minor hypodontia, and the upper lateral incisors and canines being the most commonly missing teeth.

Multiple lingual cusps trait on mandibular premolars and hypoconulid reduction trait on mandibular first molar in living Jordanian population. Intra- and inter-trait interactions.

The objective was to determine the expression and fluctuating asymmetry of two dental morphological traits in the living Jordanians: The lingual cusp number on the lower premolars (LP1 and LP2) and the hypoconulid (distal cusp) reduction on the lower first molar (LM1). In addition, both intra- trait and inter- trait interactions were analyzed. Three hundred school children (15.5 +/- 0.4 years) were involved. Impressions for the mandibular dental arches were taken, and dental casts were reproduced. The above-mentioned traits were observed. Paired sample t test and nonparametric correlation analysis were used for data analysis. Three-cusped LP1 was found in 11.40 % of the examined students, while the two-cusped LP1 was found in 88.60%. In comparison, the Three-cusped LP2 was found in 61.40% while the two-cusped LP2 was found in 38.60% of the observed subjects. The frequencies of the 4-cusped and 5-cusped LM1 were found to be 8.65% and 91.35%, respectively. Nonparametric correlation analysis revealed positive and statistically significant association between the expression of two lingual cusps on LP1 and on LP2 in both genders (p < 0.01), while there was no significant correlation between expression of two lingual cusps on either LP1 or LP2 and the hypoconulid loss on LM1 in both genders (p > 0.05). Bilateralism was highly significant in the tested traits in both genders (p < 0.001). This finding might be a sign of relatively low environmental stresses experienced by the living Jordanians and/or great ability of its individuals to buffer the adverse effects of such stresses on dental development. This study is a useful addition to the existing literature in that it examines a previously poorly characterized population and assists in placing the contemporary Jordanian population within the current framework of human population groups globally.