1
|
AlHadidi A, Lam PPY, Hassona Y. Developmental and Acquired Abnormalities of the Teeth. Dent Clin North Am 2024; 68:227-245. [PMID: 38417988 DOI: 10.1016/j.cden.2023.09.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/01/2024]
Abstract
This review aims to present a detailed analysis of the most common developmental and acquired dental abnormalities, including caries, resorptive lesions, and congenital anomalies of teeth number, size, form, and structure. This review highlights how diagnostic imaging can aid in the accurate identification and management of these conditions.
Collapse
Affiliation(s)
- Abeer AlHadidi
- Oral and Maxillofacial Pathology, Radiology, and Medicine, NYU College of Dentistry, 345 East 24th Street, New York, NY 10010, USA; School of Dentistry, The University of Jordan, Queen Rania Street, Amman, Jordan 11942.
| | - Phoebe Pui Ying Lam
- The University of Hong Kong, Prince Philip Dental Hospital, 34 Hospital Road, Sai Ying Pun, Hong Kong
| | - Yazan Hassona
- School of Dentistry, The University of Jordan, Queen Rania Street, Amman, Jordan 11942; School of Dentistry, Al Ahliyya University
| |
Collapse
|
2
|
Hassona Y, Alqaisi D, Flaifl Y, Alkilani A. The oral phenotype and dental management in patients with maple syrup urine disease; case report and scoping review. BMC Oral Health 2024; 24:362. [PMID: 38515181 PMCID: PMC10956203 DOI: 10.1186/s12903-024-04135-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 03/12/2024] [Indexed: 03/23/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The literature about oral manifestations and dental management in maple syrup urine disease (MSUD) is sparse. The aim of this report is to present a new case of MSUD with special emphasis on oral findings and to review the relevant literature. METHOD A case report of a 4-year-old boy with MSUD was described according to the CARE guidelines for describing case reports. Scoping review of relevant literature was performed, according to the PRISMA-ScR guidelines, by searching PubMed, Medline, Embase, and the grey literature for articles describing dental management and/or oral manifestations in MSUD. RESULTS The initial search identified 219 articles, but only 4 met the inclusion criteria. Rampant caries and plaque induced gingivitis were the main oro-dental findings in MSUD. Other oral findings included enamel hypoplasia, skeletal abnormalities, and abnormal oral behaviors. Disease-related factors appeared to play a major role in the development of the observed oral phenotype. CONCLUSION Oral health in MSUD seems to be influenced by the reliance on semi-synthetic diet and associated neurocognitive complications. Tailored oral health promotional interventions should be included in the multidisciplinary management of patients with MSUD.
Collapse
Affiliation(s)
- Yazan Hassona
- Oral Medicine and Special Care Dentistry Faculty of Dentistry, Centre for Oral Diseases Studies (CODS), Al-Ahliyya Amman University, Amman, Jordan.
- School of Dentistry, The University of Jordan, Amman, Jordan.
| | - Dua'a Alqaisi
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Yara Flaifl
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Asma Alkilani
- School of Medicine, The University of Jordan, Amman, Jordan
| |
Collapse
|
3
|
Hassona Y. An interview with ChatGPT about special care dentistry. Spec Care Dentist 2024. [PMID: 38445799 DOI: 10.1111/scd.12987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2024] [Accepted: 02/21/2024] [Indexed: 03/07/2024]
Affiliation(s)
- Yazan Hassona
- Faculty of Dentistry, Center for Oral Diseases Studies (CODS), Al-Ahliyya Amman University, Amman, Jordan
- School of Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
4
|
Hassona Y, Alqaisi DA. "My kid has autism": An interesting conversation with ChatGPT. Spec Care Dentist 2024. [PMID: 38415857 DOI: 10.1111/scd.12983] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2024] [Revised: 02/11/2024] [Accepted: 02/16/2024] [Indexed: 02/29/2024]
Affiliation(s)
- Yazan Hassona
- Faculty of Dentistry, Centre for Oral Diseases Studies, Al-Ahliyya Amman University, Amman, Jordan
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Dua A Alqaisi
- School of Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
5
|
Hassona Y, Hassan S, Atef A, Flaifl Y, AlShammas F, Abdaljaleel M. Primary hyperoxaluria: Description of a new oral finding and review of literature. Spec Care Dentist 2024. [PMID: 38321570 DOI: 10.1111/scd.12968] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 01/04/2024] [Accepted: 01/20/2024] [Indexed: 02/08/2024]
Abstract
OBJECTIVES Oro-dental manifestations of hyperoxaluria and dental management of affected patients are rarely reported in the literature. We describe a new oral presentation of primary hyperoxaluria (PH) and review relevant literature about oro-dental manifestations and management of dental complications of hyperoxaluria. METHODS A case report of a 44-year-old female who presented with symptoms of temporomandibular joint dysfunction due to hyperoxaluria was described according to the CARE guidelines. In addition, an extensive search of biomedical databases (PubMed, Medline, Google Scholar, and Embase) for articles describing oro-dental manifestations and/or dental management in patients with hyperoxaluria was performed using the key words ("oral" and/or "hyperoxaluria" and/or "dental" and/or "oxalosis"). Included articles were reviewed and data about patient demographics, disease type and stage, oral and dental manifestations, and dental treatment outcome were retrieved and analyzed. RESULTS A total of 14 articles describing the oral and dental manifestations in 15 patients with hyperoxaluria were included. Tooth mobility, root resorption, and radiographic alterations were consistently described in all cases. Oral manifestations were described mainly in PH at late stages, and only after the onset of chronic renal disease. Dental management in all reported cases was palliative and aimed to relive pain and treat periodontal infection. Tooth loss due to extraction or uncontrolled mobility was the ultimate outcome in almost all reported cases. CONCLUSION Oral and dental manifestations in hyperoxaluria are rarely reported in the literature. Management of tooth mobility and root resorption in hyperoxaluria is challenging and clinical guidelines and evidence-based recommendations are lacking. Early diagnosis and treatment of hyperoxaluria might be the only effective approach to prevent dental and periodontal complications of the disease.
Collapse
Affiliation(s)
- Yazan Hassona
- Faculty of Dentistry, Centre for Oral Diseases Studies (CODS), Al-Ahliyya Amman University, Amman, Jordan
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Sora Hassan
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Alaa Atef
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Yara Flaifl
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Faris AlShammas
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Maram Abdaljaleel
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| |
Collapse
|
6
|
Al Karadsheh O, Atef A, Alqaisi D, Zabadi S, Hassona Y. Content analysis of oral (mouth) cancer-related posts on Instagram. Oral Dis 2024. [PMID: 38308094 DOI: 10.1111/odi.14886] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 12/15/2023] [Accepted: 01/21/2024] [Indexed: 02/04/2024]
Abstract
OBJECTIVE To examine the content of Instagram posts about oral cancer and assess its usefulness in promoting oral cancer awareness and early detection practices. METHODS A systematic search of Instagram for posts about oral (mouth) cancer was conducted using the hashtags #oral cancer and #mouth cancer. Posts usefulness in promoting awareness and early detection was assessed using the early detection usefulness score, and caption readability was assessed using the Flesch Kincaid readability score. RESULTS A total of 81,000 posts were identified, and 200 posts were thoroughly evaluated. Included posts gathered a total of 48,118 (mean = 420.59 likes) and 27,898 views. Most posts (81.5%) were educational to the lay person, and India and the UK were the major contributors. The most discussed topics were prevention and early detection (55%). Representative clinical images were present in 35.5% of posts. Only 9.5% of posts mentioned the source of information, and the mean usefulness score was only 2.1 out of 10. The mean reading ease score was 56.7 ± 43.8 (range from 1 to 98 out of 100). CONCLUSION Instagram shows potential for promoting oral cancer awareness, particularly in prevention and early detection. However, concerns regarding content quality, scientific validity, and clarity persist.
Collapse
Affiliation(s)
| | - Alaa Atef
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Dua'a Alqaisi
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Siraj Zabadi
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Yazan Hassona
- School of Dentistry, The University of Jordan, Amman, Jordan
- Faculty of Dentistry, Centre for Oral Diseases Studies (CODS), Al-Ahliyya Amman University, Amman, Jordan, Al-Ahliyya Amman University, Amman, Jordan
| |
Collapse
|
7
|
Alrashdan MS, Andreadis D, Zisis V, Hassona Y. Immune-mediated oral mucosal pathology: a comprehensive review and update for clinicians - part II. Ital J Dermatol Venerol 2024; 159:11-22. [PMID: 38345290 DOI: 10.23736/s2784-8671.23.07690-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/15/2024]
Abstract
The oral mucosa can be involved in a wide variety of mucocutaneous conditions that may present primarily in the mouth or affect other cutaneous or mucosal sites. Many of these conditions are immune mediated and typically present as inflammatory mucosal pathology. Patients experiencing such conditions usually seek medical evaluation and treatment due to the associated pain and discomfort, and occasionally taste disturbance or dysphagia and the overall deterioration in the oral health-related quality of life. These conditions share some common features and there could be some overlap in their clinical presentation, which can lead to delays in diagnosis and proper management of patients. Clinicians dealing with such disorders, including dermatologists, need to be aware of the oral manifestations of mucocutaneous conditions, their clinical features, underlying mechanisms, diagnostic approaches, and treatment options, as well as the recent advances in the research on these conditions. This review provides a comprehensive, evidence-based reference for clinicians, with updated insights into a group of immune mediated conditions known to cause oral mucosal pathology. Part one will cover oral lichen planus, erythema multiforme and systemic lupus erythematosus, while part two will cover recurrent aphthous stomatitis, pemphigus vulgaris and mucous membrane pemphigoid, in addition to the less common disorders linear IgA disease, dermatitis herpetiformis and epidermolysis bullosa.
Collapse
Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates -
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan -
| | - Dimitrios Andreadis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Zisis
- Department of Oral Medicine/Pathology, School of Dentistry, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Yazan Hassona
- Faculty of Dentistry, Al-Ahliyya Amman University, Amman, Jordan
| |
Collapse
|
8
|
Hassona Y, Altoum D, Alqaisi D, Taimeh D, Sawair F. Management of auto-immune blistering disease in an older patient with severe intellectual disability. Spec Care Dentist 2024; 44:117-123. [PMID: 37016562 DOI: 10.1111/scd.12854] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 03/19/2023] [Accepted: 03/20/2023] [Indexed: 04/06/2023]
Abstract
Management of chronic oral mucosal diseases might be challenging in older individuals with intellectual disability because of associated comorbidities, variable clinical presentations, and various barriers imposed by the intellectual disability. This report describes the presentation and management of pemphigus vulgaris in an older female with severe intellectual disability.
Collapse
Affiliation(s)
- Yazan Hassona
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Dana Altoum
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Dua'a Alqaisi
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Dina Taimeh
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Faleh Sawair
- School of Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
9
|
Hassona Y. Self-provoked oral illness: When the mouth mirrors the soul. Spec Care Dentist 2023. [PMID: 37803823 DOI: 10.1111/scd.12929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 07/07/2023] [Accepted: 09/27/2023] [Indexed: 10/08/2023]
Abstract
BACKGROUND Factitious disorder imposed on self (FDIS), also known as Munchausen's syndrome, is a psychological disorder characterized by falsification of physical or psychological symptoms without an obvious external incentive. Oral presentations of FDIS are infrequently reported, and diagnosis might be challenging because affected patients often have impressive skills in fabricating symptoms and deceiving healthcare professionals. AIM To describe the diagnostic dilemma and management challenges in a female patient who presented with tooth ache and oral ulcers. CASE DESCRIPTION A 53-year-old female presented with complex medical history, vague symptoms and confusing dental history regarding persistent toothache and generalized oral ulcers. She underwent extensive investigations and multiple dental and oral surgical procedures without reaching a confirmed diagnosis or achieving symptomatic improvement. Thorough review of her medical records revealed multiple admissions to various hospitals across the country and abroad for various reasons, and failed to find any laboratory, clinical, or radiographic evidence of her "claimed" symptoms. CONCLUSION Oral healthcare professionals should suspect FDIS in patients presenting with vague and complex history that is not explained by clinical or radiographic findings. Consultation with psychiatric department and hospital administration might be needed to confirm diagnosis and plan appropriate management of the case.
Collapse
Affiliation(s)
- Yazan Hassona
- Faculty of Dentistry, Amman Al Ahliyya University, Amman, Jordan
- Oral Medicine and Special Care Dentistry, School of Dentistry, The University of Jordan, Amman Queen Rania Street, Amman, Jordan
| |
Collapse
|
10
|
Alrashdan MS, Al-Rawi NH, Hassona Y, Al Kawas S, Cirillo N. Mechanisms underlying sex bias in oral immune-mediated conditions, an insight. J Oral Pathol Med 2023; 52:795-802. [PMID: 37452464 DOI: 10.1111/jop.13466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 07/03/2023] [Accepted: 07/05/2023] [Indexed: 07/18/2023]
Abstract
The predilection for women in systemic autoimmune diseases is well established. However, this sex bias in oral autoimmune diseases has been classically reported from an epidemiological perspective without any elaborate attempts to unveil the underlying mechanisms. The unique nature of the oral environment is likely to impose a combination of systemic and local factors that ultimately result in the sex bias in autoimmune diseases of the oral cavity. Variations of immune responses, target organ vulnerability, endocrine and genetic factors, sex chromosomes and modes of parental inheritance are potential systemic factors, while the oral microbiome, oral tolerance, saliva, and oral epithelial stem cells may account for local contributing factors. This review will discuss the preponderance of women in oral immune-mediated diseases, the potential systemic and local mechanisms underlying this predominance and highlight the crucial need for further research in this area.
Collapse
Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Natheer H Al-Rawi
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Sausan Al Kawas
- Department of Oral and Craniofacial Health Sciences, College of Dental Medicine, University of Sharjah, Sharjah, United Arab Emirates
| | - Nicola Cirillo
- Melbourne Dental School, Faculty of Medicine, Dentistry & Health Sciences, University of Melbourne, Carlton, Victoria, Australia
| |
Collapse
|
11
|
Salim NA, Sawair FA, Abusidu Z, Sharaireh AM, Satterthwaite JD, Hassona Y. Pattern, frequency and causes of tooth extraction among adult Syrian refugees. Spec Care Dentist 2023; 43:588-596. [PMID: 36414414 DOI: 10.1111/scd.12803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 10/06/2022] [Accepted: 11/02/2022] [Indexed: 11/24/2022]
Abstract
AIMS OR OBJECTIVES The Syrian crisis has resulted in a significant impact on refugee oral health status, but the scientific literature lacks information characterizing the pattern of tooth extraction in refugees. MATERIALS AND METHODS The current study analyzed the pattern of tooth extraction and the associated sociodemographic factors among 626 (53.4% females, 46.6% males) Syrian refugees who were treated in dental clinics in the Zaatari camp. All adult Syrian refugees attending the dental unit at Zaatari camp were eligible to participate. Clinical and sociodemographic data were collected from the study sample using a validated semi-structured survey over a period of 4 months. Descriptive statistics were generated and Chi-square test, independent sample t-test, ANOVA test and Bonferroni Post Hoc test were used to examine associations between the different variables. RESULTS More than one third of the attendees (33.9%) were young adults (18-29 years), and nearly two thirds (69.8%) had no or very basic education. The mean number of teeth that needed extraction was (1.46 ± 0.84) and was significantly higher in males, smokers, older patients, and those with no or basic education. The most common cause for tooth extraction was dental caries (54.8%), followed by tooth fracture/un-restorability (38.5%), and periodontitis (3.4%); while the least common reason was tooth extraction for orthodontic treatment (0.20%). CONCLUSIONS Dental caries and its sequelae were the leading cause of tooth extraction in this refugee population. Molar teeth were found to be the most frequently extracted and lower anteriors were the least. Older age, smoking, patients with lower educational level, poor oral hygiene and male gender all predispose to a higher incidence of tooth extractions.
Collapse
Affiliation(s)
- Nesreen A Salim
- Prosthodontic Department, School of Dentistry, The University of Jordan, Amman, Jordan
- Fixed and Removable Prosthodontics, The University of Jordan Hospital, Amman, Jordan
| | - Faleh A Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Jordan University Hospital, Amman, Jordan
| | - Ziad Abusidu
- Fixed and Removable Prosthodontics, University of Jordan, Amman, Jordan
| | - Aseel M Sharaireh
- Conservative Dpartment, School of Dentistry, The University Jordan, Amman, Jordan
| | - Julian D Satterthwaite
- Restorative Dentistry, Division of Dentistry, School of Medical Sciences, University of Manchester, Manchester, UK
| | - Yazan Hassona
- Oral Medicine and Special Care Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
12
|
Hassona Y. Applications of artificial intelligence in special care dentistry. Spec Care Dentist 2023. [PMID: 37532677 DOI: 10.1111/scd.12911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2023] [Revised: 07/19/2023] [Accepted: 07/23/2023] [Indexed: 08/04/2023]
Affiliation(s)
- Yazan Hassona
- School of Dentistry, The University of Jordan, Amman, Jordan
- School of Dentistry, Al Ahliyya Amman University, Amman, Jordan
| |
Collapse
|
13
|
Ababneh NA, Barham R, Al-Kurdi B, Ali D, Hadidi SA, Ismail M, Muamar AS, Abdulelah AA, Madadha A, Sallam M, Hassona Y, Masri A, Awidi A. Generation of a human induced pluripotent stem cell (iPSC) line (JUCTCi019-A) from a patient with Charcot-Marie-Tooth disease type 2A2 (CMT2A2) due to a heterozygous missense substitution c.2119C>T (p.Arg707Trp) in MNF2 gene. Stem Cell Res 2022; 62:102786. [DOI: 10.1016/j.scr.2022.102786] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 04/10/2022] [Indexed: 11/27/2022] Open
|
14
|
Hassona Y, Salim NA, Tarboush N, Sartawi S, Alrashdan M, Rajab L, Sawair F. Knowledge about oral manifestations of systemic diseases among medical and dental students from Jordan: An interdisciplinary educational gap. Spec Care Dentist 2022; 42:383-389. [PMID: 34984709 DOI: 10.1111/scd.12692] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 12/23/2021] [Accepted: 12/23/2021] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To assess the ability of medical students to recognize oral manifestation of selected systemic diseases and compare their performance with dental students. MATERIALS AND METHODS A total of 400 senior medical and dental students were approached to participate. The study protocol involved two parts; a self-administered survey and a direct interview involving clinical photographs for oral signs of systemic diseases. RESULTS A total of 283 (70.8%) agreed to participate and completed the two- part study. The study population was made of 110 (38.9%) [82 females and 28 males] dental students, and 173(61.1%) [98 females and 75 males] medical students. The knowledge score regarding questions about the normal mouth and oral structures was 15.7 ± 6 out of 22. Dental students had a significantly higher knowledge score about normal mouth and oral structures (20.9 ± 4; range from 17 to 22) compared to medical students (10.6 ± 7; range from 4 to 21) (p = .029). The knowledge score regarding questions about oral manifestations of systemic diseases was 26.8 ± 6 out of 40. Dental students had a significantly higher knowledge score about oral manifestations of systemic diseases (30.8 ± 7; range from 15 to 37) compared to medical students (22.9 ± 4; range from 10 to 36) (p = .031). Only 24.3% (n = 42) medical students reported having adequate training to be able to distinguish between normal mouth and diseases. Nearly all medical students (91.3%; n = 158) felt that it is important to have more formal training in oral examination and disease diagnosis. CONCLUSION Medical students lack adequate knowledge, diagnostic ability, and confidence with regard to diagnosis of oral signs of systemic diseases. To ensure that medical students have necessary skills in assessing oral diseases, curricula revisions and modifications are required, and specific oral health-related learning outcomes should be introduced and reinforced through clinical training.
Collapse
Affiliation(s)
- Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Nesreen A Salim
- Department of Prosthodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Nafez Tarboush
- Department of Biochemistry and Physiology, School of Medicine, The University of Jordan, Amman, Jordan
| | - Samiha Sartawi
- Department of Prosthodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Mohammad Alrashdan
- Department of Oral Surgery and Oral Medicine, School of Dentistry, Jordan University for Science and Technology, Amman, Jordan
| | - Lamis Rajab
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Faleh Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
15
|
Alqaisi D, Hassona Y. Oral findings and healthcare management in Shashi-Pena syndrome. Spec Care Dentist 2021; 42:432-436. [PMID: 34902171 DOI: 10.1111/scd.12689] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Revised: 11/22/2021] [Accepted: 11/23/2021] [Indexed: 11/30/2022]
Abstract
Shashi Pena syndrome (SHAPNS) is a newly recognized and rare neurodevelopmental disorder with unique phenotypic features. The syndrome is caused by truncating variants in ASXL2 gene. To date, there are only seven documented cases in scientific literature, but oral and dental findings are sparsely reported. Here, we present a new case of SHAPNS and describe the oro-dental findings and oral healthcare management of affected patients.
Collapse
Affiliation(s)
- Dua'a Alqaisi
- School of Dentistry, the University of Jordan, Amman, Jordan
| | - Yazan Hassona
- School of Dentistry, the University of Jordan, Amman, Jordan.,Oral Medicine and Special Care Dentistry, the University of Jordan, Amman, Jordan
| |
Collapse
|
16
|
Yaseen A, Mahafzah A, Dababseh D, Taim D, Hamdan AA, Al-Fraihat E, Hassona Y, Şahin GÖ, Santi-Rocca J, Sallam M. Oral Colonization by Entamoeba gingivalis and Trichomonas tenax: A PCR-Based Study in Health, Gingivitis, and Periodontitis. Front Cell Infect Microbiol 2021; 11:782805. [PMID: 34950608 PMCID: PMC8688919 DOI: 10.3389/fcimb.2021.782805] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 11/22/2021] [Indexed: 12/13/2022] Open
Abstract
Background The etiology of periodontitis remains unclear, as is the place of gingivitis in its pathophysiology. A few studies linked the colonization by oral parasites (Entamoeba gingivalis and Trichomonas tenax) to periodontal disease and its severity. The aim of the current study was to estimate the prevalence of these oral parasites among healthy individuals, and in patients with gingivitis and periodontitis in Jordan. Methods The study was conducted during July 2019–December 2019. Samples were composed of saliva and periodontal material including dental plaque sampled with probes. The detection of oral parasites was done using conventional polymerase chain reaction (PCR). Results The total number of study participants was 237: healthy (n=94), gingivitis (n=53) and periodontitis (n=90). The prevalence of E. gingivalis was 88.9% among the periodontitis patients, 84.9% among the gingivitis patients and 47.9% in the healthy group. For T. tenax, the prevalence was 25.6% among the periodontitis patients, 5.7% among the gingivitis patients and 3.2% in the heathy group. Positivity for E. gingivalis was significantly correlated with the presence of periodontal disease compared to the healthy group with odds ratio (OR) of 6.6. Periodontal disease was also correlated with lower monthly income (OR=8.2), lack of dental care (OR=4.8), and history of diabetes mellitus (OR=4.5). Colonization by E. gingivalis was correlated with gingivitis (OR=6.1) compared to the healthy group. Colonization by E. gingivalis and T. tenax were significantly correlated with periodontitis (OR=6.4 for E. gingivalis, and OR=4.7, for T. tenax) compared to the healthy group. T. tenax was only detected among individuals with generalized periodontal disease compared to its total absence among those with localized disease (19.6% vs. 0.0%; p=0.039). The co-infection rate by the two oral parasites was 11.0%. Conclusions The higher prevalence of human oral parasites in periodontal disease compared to healthy individuals appears to be more than a mere marker for the disease and might also be associated with disease severity and potential for progression. Thus, the dogmatic view of E. gingivalis and T. tenax as commensals needs to be re-evaluated and their contribution to pathophysiology of periodontal diseases cannot be neglected.
Collapse
Affiliation(s)
- Alaa Yaseen
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Azmi Mahafzah
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
| | - Deema Dababseh
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Duaa Taim
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Ahmad A. Hamdan
- School of Dentistry, The University of Jordan, Amman, Jordan
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, Jordan University Hospital, Amman, Jordan
| | - Esraa Al-Fraihat
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
| | - Yazan Hassona
- School of Dentistry, The University of Jordan, Amman, Jordan
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, Jordan University Hospital, Amman, Jordan
| | - Gülşen Özkaya Şahin
- Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
- Department of Clinical Microbiology, Laboratory Medicine, Skåne University Hospital, Lund, Sweden
| | | | - Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
- Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
- Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
- *Correspondence: Malik Sallam,
| |
Collapse
|
17
|
Hamdan AA, Bouchard P, Hamdan AI, Hassona Y. Chronic lymphocytic leukemia presenting as gingival swelling and tooth mobility. Spec Care Dentist 2021; 42:312-316. [PMID: 34766641 DOI: 10.1111/scd.12679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2021] [Revised: 10/26/2021] [Accepted: 10/29/2021] [Indexed: 10/19/2022]
Abstract
Chronic-lymphocytic-leukemia (CLL) is the most prevalent leukemia in developed countries, caused by monoclonal proliferation of CD5+ B-cells and accumulation of mature-appearing-neoplastic lymphocytes in blood, bone marrow, and secondary lymphoid organs. Oral manifestations of CLL are infrequent and rarely reported in literature. We report a new case of a 67-year old man who presented with the complaints of tooth mobility and gingival swelling. Extra-oral examination was remarkable for cutaneous pallor and bilateral cervical lymphadenopathy involving the submandibular, and deep cervical lymph nodes on both sides of the neck. Complete blood count revealed normal red blood cell count (4.25 × 106/μl), normal platelet count (136 × 103/μl) and increased white blood cell count (25.3 × 103/μl). Differential white blood cell count showed marked lymphocytosis (88%), and blood film revealed the presence of leukocytosis, with small mature-looking lymphocytes, and mild thrombocytopenia. A flow cytometry immune-phenotyping revealed that 55% of peripheral blood cells were monoclonal B-lymphocytes expressing CD19, CD20, CD23, CD200, CD22, CD5, CD38, CD11c, sIgD and Kappa light chain confirming the diagnosis of CLL. Oral healthcare professionals should consider systemic causes, such as CLL, in the differential diagnosis of generalized tooth mobility and gingival swelling, particularly in patients with associated symptoms such as lymphadenopathy, fever, weight loss, and general fatigue.
Collapse
Affiliation(s)
- Ahmad A Hamdan
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Philippe Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, Denis Diderot University, Paris, France
| | - Ahmad I Hamdan
- Department of Dentistry, The University of Jordan Hospital, Amman, Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
18
|
Sallam M, Dababseh D, Yaseen A, Al-Haidar A, Ettarras H, Jaafreh D, Hasan H, Al-Salahat K, Al-Fraihat E, Hassona Y, Şahin GÖ, Mahafzah A. Lack of knowledge regarding HPV and its relation to oropharyngeal cancer among medical students. Cancer Rep (Hoboken) 2021; 5:e1517. [PMID: 34291614 PMCID: PMC9327668 DOI: 10.1002/cnr2.1517] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/19/2022] Open
Abstract
Background Oropharyngeal cancer (OPC) is an important cause of cancer‐related mortality. Early detection of OPC results in a favorable prognosis and higher survival rates. Infection by high‐risk types of human papillomavirus (HPV) is a risk factor for OPC with an upward trend globally. Medical students' knowledge and awareness of HPV‐related OPC can be crucial in the preventive efforts. Aim To assess HPV knowledge among medical students at the University of Jordan, with particular focus on its relation to different cancers. Methods This paper‐based survey study was conducted in November 2019. The survey items were based on previously validated surveys used to evaluate HPV‐related OPC knowledge among dental students and professionals. To assess HPV knowledge and students' confidence in personal history taking and physical examination, we developed a knowledge and confidence scores that showed acceptable reliability. Results The total number of participants was 1198 students, with a median age of 21 and female predominance (n = 697, 58.2%). Among the participants, 93.3% heard of HPV prior to this survey (n = 1118). Higher levels of knowledge regarding cervical cancer, OPC and HPV vaccination was seen among clinical students compared to their preclinical counterparts, but their overall HPV knowledge was low. Only 18.4% and 21.0% of the clinical students correctly identified the association of HPV with penile and oropharyngeal cancers, respectively. Additionally, 34.5% of the clinical students were not aware of the availability of HPV vaccines. The majority of students (92.0%) reported that the university courses were their major source of knowledge about HPV. Conclusion A profound lack of knowledge regarding HPV role in OPC was found among medical students. This insufficiency included several aspects of the virus and its associated diseases. Such gaps in knowledge could have negative consequences in early detection and prevention of OPC and should be addressed by evaluation of the current curriculum.
Collapse
Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan.,Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan.,Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden
| | - Deema Dababseh
- School of Dentistry, the University of Jordan, Amman, Jordan
| | - Alaa Yaseen
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Ayat Al-Haidar
- School of Dentistry, the University of Jordan, Amman, Jordan
| | - Hajar Ettarras
- School of Dentistry, the University of Jordan, Amman, Jordan
| | - Dania Jaafreh
- School of Dentistry, the University of Jordan, Amman, Jordan
| | - Hanan Hasan
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Khaled Al-Salahat
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan
| | - Esraa Al-Fraihat
- Department of Basic Medical Sciences, Faculty of Medicine, Al-Balqa Applied University, Salt, Jordan
| | - Yazan Hassona
- School of Dentistry, the University of Jordan, Amman, Jordan.,Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, Jordan University Hospital, Amman, Jordan
| | - Gülşen Özkaya Şahin
- Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden.,Department of Clinical Microbiology, Laboratory Medicine, Skåne University Hospital, Lund, Sweden
| | - Azmi Mahafzah
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, The University of Jordan, Amman, Jordan.,Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Amman, Jordan
| |
Collapse
|
19
|
Abstract
OBJECTIVES To identify research articles related to cleft lip and/or cleft palate (CL/P) that generated the highest online attention. METHODS Altmetric Explorer was used to identify the 100 articles with the highest Altmetric Attention Score (AAS). Descriptive and correlation statistics were performed to study the characteristics of these articles in relation to their publication data, research type and domain, number of Mendeley readers, and dimensions citations. Citation counts were extracted from Scopus and Google Scholar. RESULTS The median AAS for the top 100 outputs was 22 (range from 12 to 458). The outputs were mostly discussed on Twitter (median = 8; range = 0-131). Topics discussing treatment and care for patients with CL/P accounted for 38% of the articles with the highest AAS followed by etiology and risk factors (32%). The majority of articles originated from the USA (46%) followed by Europe (16%) and the United Kingdom (15%). No significant differences were observed in AAS among different study designs, topic domains, journals' ranking and impact factor, and the number of citations in Scopus and Google Scholar. CONCLUSIONS Researchers should consider use of social platforms to disseminate their work among scholars and nonscholars. Altmetrics can be combined with traditional metrics for a more comprehensive assessment of research impact.
Collapse
Affiliation(s)
- Serene Badran
- Department of Orthodontics, Pediatric Dentistry and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
20
|
Jubair F, Al-Karadsheh O, Malamos D, Al Mahdi S, Saad Y, Hassona Y. A novel lightweight deep convolutional neural network for early detection of oral cancer. Oral Dis 2021; 28:1123-1130. [PMID: 33636041 DOI: 10.1111/odi.13825] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 01/30/2021] [Accepted: 02/06/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVES To develop a lightweight deep convolutional neural network (CNN) for binary classification of oral lesions into benign and malignant or potentially malignant using standard real-time clinical images. METHODS A small deep CNN, that uses a pretrained EfficientNet-B0 as a lightweight transfer learning model, was proposed. A data set of 716 clinical images was used to train and test the proposed model. Accuracy, specificity, sensitivity, receiver operating characteristics (ROC) and area under curve (AUC) were used to evaluate performance. Bootstrapping with 120 repetitions was used to calculate arithmetic means and 95% confidence intervals (CIs). RESULTS The proposed CNN model achieved an accuracy of 85.0% (95% CI: 81.0%-90.0%), a specificity of 84.5% (95% CI: 78.9%-91.5%), a sensitivity of 86.7% (95% CI: 80.4%-93.3%) and an AUC of 0.928 (95% CI: 0.88-0.96). CONCLUSIONS Deep CNNs can be an effective method to build low-budget embedded vision devices with limited computation power and memory capacity for diagnosis of oral cancer. Artificial intelligence (AI) can improve the quality and reach of oral cancer screening and early detection.
Collapse
Affiliation(s)
- Fahed Jubair
- Computer Engineering Department, School of Engineering, The University of Jordan, Amman, Jordan
| | - Omar Al-Karadsheh
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Dimitrios Malamos
- Oral Medicine Clinic, 1st Regional Health District of Attica, National Organization for the Provision of Health Services, Athens, Greece
| | - Samara Al Mahdi
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Yusser Saad
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
21
|
Salim NA, Maayta WA, Hassona Y, Hammad M. Oral health status and risk determinants in adult Syrian refugees in Jordan. Community Dent Health 2021; 38:53-58. [PMID: 33507649 DOI: 10.1922/cdh_00046salim06] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
OBJECTIVES Lack of data regarding the oral health of Syrian refugees represents a crucial gap in the literature. This study aimed to investigate the oral health status of Syrian refugees and related socio and behavioral factors. BASIC RESEARCH DESIGN Cross-sectional study from June to September 2019 at Zaatari refugee camp, Jordan. METHODS An experienced, calibrated field investigator performed an oral clinical examination of 505 Syrian refugees (18-60 years) using the WHO criteria. DMFT, SiC, oral health indices and socio-demographic variables were recorded. RESULTS A total of 264 males and 241 females were included. The prevalence of caries was 96.0%, of which 76.0% had 4-17 carious lesions. The mean number of decayed, missing and filled teeth was 5.76, 2.55 and 1.88 respectively. The mean DMFT score was 10.19 (100% had DMFT⟩0), SiC was 17.09, and the mean simplified Oral hygiene index score was 2.18. The most common chief complaint was pain (92.7%). Nearly half of the participants were smokers (45.7%). There was a negative association between level of education and oral health (P=0.011). Most participants did not brush their teeth regularly (87.5%). Females had better oral hygiene practices than males (P=0.015). CONCLUSIONS Syrian refugees had a high prevalence of caries, high unmet dental treatment needs and poor oral hygiene practices. Preventive programs and focused interventions may reduce the burden of disease in this underprivileged population, on funding agencies and host countries as well.
Collapse
Affiliation(s)
- N A Salim
- Prosthodontic Department, University of Jordan, School of Dentistry, Jordan University Hospital, Jordan
| | - W A Maayta
- Oral and Maxillofacial Surgery, Jordan University Hospital, Jordan
| | - Y Hassona
- Department of Oral and Maxillofacial Surgery, Oral medicine and Periodontics, University of Jordan, Jordan University Hospital, Jordan
| | - M Hammad
- Conservative Dentistry and Endodontics Department, the University of Jordan, School of Dentistry, Jordan University Hospital, Jordan
| |
Collapse
|
22
|
AL-Haddad A, Hassona Y, Silawi A, Al Kayed A. A narrative review of Diabetes mellitus: An update for dentists. Saudi J Oral Sci 2021. [DOI: 10.4103/sjos.sjoralsci_68_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
23
|
Hassona Y, Saleh MW, Alkhawaldeh H, Al Abweh R. Unusual cause of tooth mobility. BMJ Case Rep 2020; 13:13/12/e235086. [PMID: 33370928 DOI: 10.1136/bcr-2020-235086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We describe a case of a 71-year-old otherwise healthy man who presented to the dental clinic with the chief complaint of mobility involving his upper left molar teeth. The patient was a febrile, and clinical oral examination revealed localised grade II mobility and absence of gingival swelling, erythema or sinus tract. Orthopantogram revealed a poorly defined radiolucency involving the upper left second and third molar teeth. Surgical exploration of the involved area was performed and revealed the presence of a 'jelly like' brown tissue that fragments easily. Pathological examination confirmed the diagnosis of diffuse large B cell lymphoma.
Collapse
Affiliation(s)
- Yazan Hassona
- Faculty of Dentistry, University of Jorddan, Amman, Jordan
| | | | | | - Ruba Al Abweh
- Faculty of Dentistry, University of Jorddan, Amman, Jordan
| |
Collapse
|
24
|
Hassona Y, Aljafari A, Atef A, Abdalfattah L, Hosey MT. Failure on all fronts: Qualitative analysis of the oral health care experience in individuals with intellectual disability. Spec Care Dentist 2020; 41:235-243. [PMID: 33264435 DOI: 10.1111/scd.12550] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2020] [Revised: 11/15/2020] [Accepted: 11/18/2020] [Indexed: 11/28/2022]
Abstract
AIM To explore the oral health care experience of individuals with intellectual disability and their families. METHODS A qualitative approach utilising face-to-face semi-structured interviews with parents of individuals with intellectual disability. All interviews were audio recorded and transcribed verbatim, and Qualitative Framework Analysis was used to present the results. RESULTS Twenty-six parents of 26 individuals with intellectual disability were interviewed. The interviewees were 10 males and 16 females, and their average age was 46.4 ± 11.2 years (range 28-66). The average age of individuals with intellectual disability was 17.9 ± 9.2 years (range 6-48), and there were 11 (42.3%) males and 15 (57.7%) females. The interviewees reported that challenges to oral health care do occur on multiple levels: (a) home environment; (b) primary dental care; (c) secondary dental care facilities; (d) health and education policies and systems; and (e) societal views on individuals with intellectual disability. CONCLUSION Individuals with intellectual disability and their families are being failed at multiple levels of oral health care, leaving parents feeling frustrated, isolated, and sometimes helpless. Collaborative efforts are needed to train families to prevent oral health disease at home, establish better primary and secondary oral health care systems, and overcome wider cultural, social, and economic barriers.
Collapse
Affiliation(s)
- Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Ahmad Aljafari
- Department of Paediatric Dentistry, Orthodontics, and Preventive Dentistry, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Ala'a Atef
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Leen Abdalfattah
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Marie Therese Hosey
- Division of Population and Patient Health, King's College London Dental Institute, London, UK
| |
Collapse
|
25
|
Hassona Y, Al Haddad A, Atef A. Oral findings in Crigler‐Najjar syndrome type I. Spec Care Dentist 2020; 40:611-612. [DOI: 10.1111/scd.12518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2020] [Revised: 08/22/2020] [Accepted: 08/24/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Yazan Hassona
- Oral Medicine and Special Care Dentistry School of Dentistry The University of Jordan Amman Jordan
| | - Ala'a Al Haddad
- Oral Medicine and Special Care Dentistry School of Dentistry The University of Jordan Amman Jordan
| | - Ala'a Atef
- Oral Medicine and Special Care Dentistry School of Dentistry The University of Jordan Amman Jordan
| |
Collapse
|
26
|
El-Ma'aita A, Da'as N, Al-Hattab M, Hassona Y, Al-Rabab'ah M, Al-Kayed MA. Awareness of the risk of developing medication-related osteonecrosis of the jaw among bisphosphonate users. J Int Med Res 2020; 48:300060520955066. [PMID: 32924697 PMCID: PMC7493245 DOI: 10.1177/0300060520955066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Objective In this retrospective observational study, we evaluated awareness among patients using bisphosphonates (BPs) regarding the risk of developing medication-related osteonecrosis of the jaw (MRONJ) and whether they received appropriate dental screening and treatment prior to commencing medication. Methods Patients using BPs who attended the endodontics clinic at Jordan University Hospital in 2019 were interviewed using a pre-designed questionnaire. Data were analysed using descriptive statistics and chi-squared tests. Results In total, 110 patients were interviewed (84 women, 26 men; age 40–78 years). A total of 94 patients were using oral BP and 16 received intravenous (IV) BP. We found that only 12.4% of participants were aware about the risk of MRONJ following BP use, and only one third of them has received information from their prescribing physicians. In total, 5% of participants were referred to a dentist for screening prior to initiating BP treatment. Patients receiving IV BP and those with a university-level education had better awareness about the risk of MRONJ than oral BP users and those with a high school education level. Conclusion Patients’ awareness about MRONJ risk was low in our population. Better patient education and collaboration among physicians and dentists are needed prior to starting BP treatment.
Collapse
Affiliation(s)
| | - Noor Da'as
- Jordan University Hospital, Amman, Jordan
| | | | - Yazan Hassona
- School of Dentistry, University of Jordan, Amman, Jordan
| | | | | |
Collapse
|
27
|
Abstract
Introduction Diagnosis of underlying causes for desquamative gingivitis (DG) is often delayed in clinical settings, but little is known about factors influencing its delayed diagnosis. We investigated the diagnostic patterns and associated factors in a cohort of patients presenting primarily with DG.Materials and methods A total of 41 patients presenting primarily with DG were interviewed to evaluate professional and patient diagnostic delays. Severity of DG was evaluated using the desquamative gingivitis clinical score (DGCS) proposed by Arduino <i>et al.</i> (2017).Results The study sample was composed of 29 females and 12 males. On average, patients waited 10.8 ± 10 months (range 4-20 months) before seeking their first professional consultation (that is, patient delay). Less severe disease and female gender were significantly associated with longer patient delay. Patients consulted an average of 4.1 ± 2 healthcare professionals (range two to six) before a definitive diagnosis was reached, with an average professional delay of 7.3 ± 5 months (range 2-11 months). Professional delay was positively correlated with the number of professional consultations (r = 0.69) and absence of other oral mucosal lesions or extraoral involvement.Conclusions Considerable diagnostic delay is a feature of the natural history of DG. Increased patient knowledge and professional awareness regarding DG symptoms and diagnostic measures is needed to reduce diagnostic delay and improve patients' experience with this disease.
Collapse
Affiliation(s)
- Murad Shaqman
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan.
| | - Ahmad Hamdan
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
| | - Omar Karadsheh
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
| | - Faleh Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, 11942, Jordan
| |
Collapse
|
28
|
Hassona Y, Al Boosh D, Al Saed A, Al Mousa M, Barghout N, Al Kayed A, Sawair F. The range of pathological diagnoses of oral diseases in Jordan: An 11-year-retrospective study. Saudi J Oral Sci 2020. [DOI: 10.4103/sjos.sjoralsci_17_20] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
29
|
Abstract
Objectives: The objective of this study is to assess the knowledge and practice of dentists from Jordan, regarding prevention of infective endocarditis (IE) in dental practice. Materials and Methods: A sample of Jordanian dentists was interviewed regarding their IE knowledge and practice using a validated and pretested survey instrument. Results: Most of the dentists have encountered a patient with IE who needed prophylactic antibiotic (PA) and have prescribed antibiotics to prevent IE. Jordanian dentists’ approach to patients in need for PA varied between the National Institute for Health and Clinical Excellence recommendations and the American Heart Association to a lesser degree, but still a relatively high percent (39%) did not know any guidelines to follow although 74% have encountered patients who needed endocarditis prophylaxis. Patients with prosthetic heart valve were ranked on top of medical conditions that required PA (87.4%), and most dentists (94.5%) thought that dental extractions need PA followed by periodontal surgery (88.2%). Conclusion: There is a lack of consistency in the knowledge and practice of Jordanian dentists with regard to IE. There is a need to take actions to improve dentist's knowledge regarding this topic.
Collapse
Affiliation(s)
- Soukaina Ryalat
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, Faculty of Dentistry, The University of Jordan, Amman, Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, Faculty of Dentistry, The University of Jordan, Amman, Jordan
| | - Mohammad Al-Shayyab
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, Faculty of Dentistry, The University of Jordan, Amman, Jordan
| | - Mais Abo-Ghosh
- Internist at the Department of Oral and Maxillofascial Surgery, Faculty of Dentistry, The University of Jordan, Amman, Jordan
| | - Faleh Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, Faculty of Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
30
|
Abu-Awwad M, Al-Omoush S, Shqaidef A, Hilal N, Hassona Y. Oral health-related quality of life among Syrian refugees in Jordan: a cross-sectional study. Int Dent J 2019; 70:45-52. [PMID: 31489618 DOI: 10.1111/idj.12521] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION Reports examining the impact of oral health on the quality of life of refugees are lacking. The aim of this study was to examine factors influencing oral health-related quality of life (OHRQoL) among Syrian refugees in Jordan. METHODS A cross-sectional survey was conducted on a convenience sample of Syrian refugees, who attended dental clinics held at Azraq camp. The survey assessed the refugees' oral hygiene practices, and measured their OHRQoL using the Arabic version of the United-Kingdom Oral Health-Related Quality of life measure. RESULTS In total, 102 refugees [36 male and 66 female; mean age 34 (SD = 10) years] participated. Overall, 12.7% did not brush their teeth and 86.3% did not use adjunctive dental cleaning methods. OHRQoL mean score was 56.55 (range 32-80). Comparison of the physical, social and psychological domains identified a statistically significant difference between the physical and the psychological domain mean scores (ANOVA; P = 0.044, Tukey's test; P = 0.46). The factors which revealed association with OHRQoL scores in the univariable analyses, and remained significant in the multivariable linear regression analysis, were: age (P = 0.048), toothbrushing frequency (P = 0.001) and attending a dental clinic in the last year (P = 0.004). CONCLUSION The physical aspect of quality of life was more negatively impacted than the psychological aspect. Toothbrushing frequency and attending a dental clinic at least once in the last year were associated with more positive OHRQoL scores. Older refugees seemed to be more vulnerable to the impact of poor oral health on OHRQoL.
Collapse
Affiliation(s)
| | | | | | - Nour Hilal
- Royal Tropical Institute - Tropical Medicine, Amsterdam, The Netherlands
| | - Yazan Hassona
- School of Dentistry, University of Jordan, Amman, Jordan
| |
Collapse
|
31
|
Sallam M, Al-Fraihat E, Dababseh D, Yaseen A, Taim D, Zabadi S, Hamdan AA, Hassona Y, Mahafzah A, Şahin GÖ. Dental students' awareness and attitudes toward HPV-related oral cancer: a cross sectional study at the University of Jordan. BMC Oral Health 2019; 19:171. [PMID: 31370845 PMCID: PMC6670240 DOI: 10.1186/s12903-019-0864-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 07/24/2019] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND The incidence of human papilloma virus (HPV)-related oral cancer has recently increased worldwide. The role of dentists is of prime importance in the early detection of oral cancer which would result in a favourable outcome for the patients. The aim of the current study was to assess the knowledge, awareness and attitudes of dental students, interns and postgraduate maxillofacial residents at the University of Jordan (UJ) to different aspects of oral cancer, particularly those related to HPV. METHODS A paper-based survey was conducted at UJ among all pre-clinical dental students (pre-clinical group), clinical dental students, interns and postgraduate maxillofacial residents (clinical group). The survey included five sections comprising 29 items. The sections included questions investigating oral cancer knowledge, oral cancer screening, HPV knowledge and the ability to discuss personal topics with patients. RESULTS A total of 376 respondents out of 1052 potential participants completed at least one item of the survey (study coverage of 35.7%). Among the study participants, the pre-clinical group represented 41.2% (n = 155) and the clinical group represented 58.8% (n = 221). The majority of participants in the clinical group showed better knowledge on oral cancer potential anatomic sites, clinical presentation and possible risk factors compared to the pre-clinical group. Most participants in the clinical group (n = 195, 88.2%) correctly identified HPV as a risk factor for oral cancer development. The majority of participants in the clinical group displayed suitable attitude towards oral cancer screening despite their desire for a reliable screening device and additional training in oral cancer screening. A number of limitations in basic knowledge about HPV was noticed among participants in the clinical group particularly related to unawareness of the vaccine availability. The majority of participants in the clinical group displayed hesitancy in discussing personal topics with the patients, including the history of previous sexually transmitted infections and sexual abuse. CONCLUSIONS Gaps in knowledge regarding HPV-related oral cancer has been detected which necessitate intervention measures including curricular changes, training workshops and awareness campaigns.
Collapse
Affiliation(s)
- Malik Sallam
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman, Jordan. .,Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Queen Rania Al-Abdullah Street-Aljubeiha/P.O. Box: (13046), Amman, Jordan. .,Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden.
| | - Esraa Al-Fraihat
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman, Jordan.,Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Queen Rania Al-Abdullah Street-Aljubeiha/P.O. Box: (13046), Amman, Jordan
| | - Deema Dababseh
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Alaa' Yaseen
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman, Jordan
| | - Duaa Taim
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Seraj Zabadi
- School of Dentistry, The University of Jordan, Amman, Jordan
| | - Ahmad A Hamdan
- School of Dentistry, The University of Jordan, Amman, Jordan.,Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, Jordan University Hospital, Amman, Jordan
| | - Yazan Hassona
- School of Dentistry, The University of Jordan, Amman, Jordan.,Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, Jordan University Hospital, Amman, Jordan
| | - Azmi Mahafzah
- Department of Pathology, Microbiology and Forensic Medicine, School of Medicine, the University of Jordan, Amman, Jordan.,Department of Clinical Laboratories and Forensic Medicine, Jordan University Hospital, Queen Rania Al-Abdullah Street-Aljubeiha/P.O. Box: (13046), Amman, Jordan
| | - Gülşen Özkaya Şahin
- Department of Translational Medicine, Faculty of Medicine, Lund University, Malmö, Sweden.,Department of Clinical Microbiology, Laboratory Medicine, Skåne University Hospital, Lund, Sweden
| |
Collapse
|
32
|
Hassona Y, Qutachi T. A bibliometric analysis of the most cited articles about squamous cell carcinoma of the mouth, lips, and oropharynx. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 128:25-32.e6. [DOI: 10.1016/j.oooo.2019.01.076] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2017] [Revised: 12/15/2018] [Accepted: 01/26/2019] [Indexed: 12/18/2022]
|
33
|
Hassona Y, Qutachi T, Dardas L, Alrashdan MS, Sawair F. The online attention to oral cancer research: An Altmetric analysis. Oral Dis 2019; 25:1502-1510. [DOI: 10.1111/odi.13111] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2019] [Revised: 04/17/2019] [Accepted: 04/19/2019] [Indexed: 01/21/2023]
Affiliation(s)
- Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry The University of Jordan Amman Jordan
| | - Tala Qutachi
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry The University of Jordan Amman Jordan
| | - Latefa Dardas
- School of Nursing The University of Jordan Amman Jordan
| | - Mohammad S. Alrashdan
- Department of Oral Medicine and Oral Surgery, Faculty of Dentistry Jordan University of Science and Technology Irbid UK
| | - Faleh Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry The University of Jordan Amman Jordan
| |
Collapse
|
34
|
Hamdan AA, Shaqman M, Abu Karaky A, Hassona Y, Bouchard P. Medical reliability of a video-sharing website: The gingival recession model. Eur J Dent Educ 2019; 23:175-183. [PMID: 30633844 DOI: 10.1111/eje.12417] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/26/2018] [Accepted: 01/07/2019] [Indexed: 06/09/2023]
Abstract
OBJECTIVES To evaluate the quality of the scientific/clinical information in dentistry delivered by videos hosted by a popular video-sharing website. METHODS The gingival recession condition was used as a model and YouTube™ as the video hosting service. A systematic observation of videos containing information on gingival recession was conducted. Videos were analysed to evaluate (i) the scientific reliability and quality of the information using Global Quality Scale (GQS) and DISCREN criteria; and (ii) the understandability of this information using a tailor-made custom comprehensiveness index (CI). RESULTS One hundred and eighty videos were identified. Videos dealing with surgical procedures were not included in the present review. After selection, 41 videos were analysed. The mean GQS was 2.34 on a 0-5 scale, and 25 (61%) videos showed clear aims according to DISCREN criteria. Misleading content was observed in eight videos (19.5%). The scientific sources of information were unclear in 26 (63.4%) videos. All videos failed to give additional references for supplemental information. Only three videos (7%) provided basic information on aetiology, clinical presentations and management of gingival recession. Based on 0-2 CI scores, three, nine and 29 videos had a score of 2, 1 and 0, respectively. CONCLUSION The present model indicates that social media websites aiming to provide health information should be carefully accounted, especially when dealing with dentistry. It also suggests professional involvement to improve the quality of the delivered information.
Collapse
Affiliation(s)
- Ahmad A Hamdan
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Murad Shaqman
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Ashraf Abu Karaky
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Philippe Bouchard
- Department of Periodontology, Service of Odontology, Rothschild Hospital, Denis Diderot University, Paris, France
| |
Collapse
|
35
|
Makan R, Gara M, Awwad MA, Hassona Y. The oral health status of Syrian refugee children in Jordan: An exploratory study. Spec Care Dentist 2019; 39:306-309. [PMID: 30985010 DOI: 10.1111/scd.12377] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Revised: 02/24/2019] [Accepted: 03/22/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine the oral health status and dental treatment needs of children Syrian refugees in Jordan. METHODS A convenience sample of Syrian refugee children who aged between 6 and 12 years at al-Zaatari camp was used for the purpose of this study. Examination was performed according to the method proposed by WHO. DMFT and gingival indices were examined and reported by a trained dentist. RESULTS A total of 125 children were examined. The mean DMFT score was 3.64 ± 9.83, and the mean dmft score was 2.98 ± 4.7. More than half of children (50.4%) were found to have high caries risk according to CAMBRA scale. Most of the DMFT score was contributed by decayed and missing teeth. Nearly, half of children (44.8%) showed fluorosis and almost all children had chronic gingivitis. More than half of the participants (55.2%) reported that they needed dental treatment during their stay at the camp, but only half (52%) received treatment mainly tooth extraction and prescription of medication. Only 6.4% of children received conservative dental treatment. CONCLUSION Syrian refugee children in Jordan were found to have high levels of unmet dental needs. Accessibility of dental services was found to be a primary barrier to care.
Collapse
Affiliation(s)
- Rima Makan
- School of Dentistry, The University of Jordan, Amman
| | - Mohammad Gara
- School of Dentistry, The University of Jordan, Amman
| | - Motasum Abu Awwad
- Department of Prosthodontics, School of Dentistry, The University of Jordan, Amman
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, The University of Jordan, Amman
| |
Collapse
|
36
|
Hassona Y, El-Ma'aita A, Amarin J, Taee AA. Diagnostic delay and suboptimal management in persistent idiopathic facial pain and persistent dentoalveolar pain; a cross-sectional study. Oral Surg Oral Med Oral Pathol Oral Radiol 2019; 127:498-503. [PMID: 30956081 DOI: 10.1016/j.oooo.2019.02.013] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2018] [Revised: 01/06/2019] [Accepted: 02/11/2019] [Indexed: 01/03/2023]
Abstract
OBJECTIVES The aim of this study was to explore the diagnostic and therapeutic challenges encountered by patients with persistent idiopathic facial pain (PIFP) and to investigate factors influencing its delayed diagnosis. STUDY DESIGN In this cross-sectional study, 34 patients with newly diagnosed PIFP were interviewed. Data about diagnostic delay, number and nature of previous consultations, and previous medical and surgical interventions were recorded. Pearson's correlation and Student t test were used to examine the differences among the variables in relation to diagnostic delay. RESULTS The average time between the onset of symptoms to correct diagnosis was 19.3 ± 11.1 months. Diagnostic delay was significantly longer in patient with pain localized to intraoral sites (22.6 ± 7.4) compared with patients with extraoral pain (16.1 ± 9.3). The average number of health care professionals consulted before correct diagnosis was 3.7 ± 2.3. General dental practitioners were the most commonly consulted health care professionals (n = 27; 79.4%). On average, patients were given 2.3 ± 0.24 misdiagnoses before the correct diagnosis was determined and were prescribed 3.5 ± 2.4 classes of drugs. Twenty-five patients (73.5%) underwent unnecessary surgical/dental interventions. CONCLUSIONS Patients with PIFP are frequently misdiagnosed, leading to prescription of ineffective medications and unnecessary investigations and surgical interventions. Educational efforts should emphasize on improving knowledge and awareness of this condition.
Collapse
Affiliation(s)
- Yazan Hassona
- School of Dentistry, The University of Jordan, Amman, Jordan.
| | | | | | - Anas Al Taee
- School of Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
37
|
Alrashdan MS, Darwazeh AMG, Hassona Y, Bader DH, Khader YS. Awareness of oral medicine among medical practitioners, evidence of the unbridged interdisciplinary gap. J Eval Clin Pract 2019; 25:142-147. [PMID: 30280467 DOI: 10.1111/jep.13029] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Accepted: 08/20/2018] [Indexed: 01/26/2023]
Abstract
RATIONALE, AIMS, AND OBJECTIVES Inadequate awareness of oral health and related disciplines appears to be common among medical practitioners. This study was designed to evaluate the awareness of oral medicine (OM) specialty and its scope of practice among Jordanian medical practitioners and to outline potential strategies for improvement where appropriate. METHOD A specially designed questionnaire was electronically distributed to Jordanian medical practitioners and thereafter via personal interviews to improve the response rate. The questionnaire comprised nine questions and covered demographical details and characteristics of participants, in addition to their awareness of OM and agreement to refer a group of common oral and dental conditions to OM specialists. Pearson Chi-square tests were used to examine the significance of association between the variables of respondents and awareness of OM. Significance level was set at P values < 0.05. RESULTS A total of 1492 respondents completed the questionnaire, of which 779 (52.2%) were aware of OM as an independent specialty. Age group, higher degrees in medicine, country of graduation, and the specialty type were significant determinants of OM awareness level. Oral ulceration and other mucosal pathology, including fungal infections, were the most likely conditions to be referred to OM specialists while participants had apparent problems separating the scope of practice of OM from other dental disciplines. CONCLUSION This study provides evidence on the profound interdisciplinary gap between medicine and dentistry and highlights the importance of more focused education and training in oral health-related disciplines to be provided to clinicians and medical trainees as described.
Collapse
Affiliation(s)
- Mohammad S Alrashdan
- Department of Oral Medicine and Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Azmi M G Darwazeh
- Department of Oral Medicine and Surgery, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, University of Jordan, Amman, Jordan
| | - Dima H Bader
- Dental department, Al-Bashir Hospital, Ministry of Health, Amman, Jordan
| | - Yousef S Khader
- Department of Community Medicine, Public Health and Family Medicine, Faculty of Medicine, Jordan University of Science and Technology, Irbid, Jordan
| |
Collapse
|
38
|
Banna SA, Hassona Y. New oral findings in Hamamy syndrome. SPECIAL CARE IN DENTISTRY 2018; 38:445-446. [DOI: 10.1111/scd.12322] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 07/26/2018] [Accepted: 08/14/2018] [Indexed: 11/29/2022]
Affiliation(s)
| | - Yazan Hassona
- School of Dentistry; The University of Jordan & Hospital; Amman Jordan
| |
Collapse
|
39
|
Abu-Ghazaleh S, Hassona Y, Hattar S. Dental trauma in social media-Analysis of Facebook content and public engagement. Dent Traumatol 2018; 34:394-400. [DOI: 10.1111/edt.12429] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Revised: 07/21/2018] [Accepted: 07/23/2018] [Indexed: 11/29/2022]
Affiliation(s)
- Suha Abu-Ghazaleh
- Department of Pediatric Dentistry, Orthodontics and Preventive Dentistry; School of Dentistry; University of Jordan; Amman Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology; School of Dentistry; University of Jordan; Amman Jordan
| | - Susan Hattar
- Department of Conservative Dentistry; School of Dentistry; University of Jordan; Amman Jordan
| |
Collapse
|
40
|
Tarboush NA, Al Masoodi O, Al Bdour S, Sawair F, Hassona Y. Antioxidant capacity and biomarkers of oxidative stress in saliva of khat-chewing patients: a case-control study. Oral Surg Oral Med Oral Pathol Oral Radiol 2018; 127:49-54. [PMID: 30121165 DOI: 10.1016/j.oooo.2018.07.011] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2018] [Revised: 06/16/2018] [Accepted: 07/16/2018] [Indexed: 10/28/2022]
Abstract
OBJECTIVES The aim of this study was to investigate the antioxidant levels and biomarkers of oxidative stress in saliva from khat-chewing patients compared with controls. STUDY DESIGN Saliva samples were collected from 51 chronic khat chewers and 46 age- and sex-matched controls. Concentrations of oxidative stress biomarkers (malonyl-dialdehyde [MDA], protein carbonyl, and 8-hydroxy-2'-deoxyguanosine) and antioxidant defense (total antioxidant capacity [TAC], superoxide dismutase, glutathione peroxidase, and catalase [CAT) were analyzed. RESULTS Salivary MDA level in the khat users group (45 ± 9.2 nmol/mL) was significantly increased in comparison with controls (13 ± 2.1 nmol/mL; P < .001), but there were no significant differences between the 2 groups regarding the levels of salivary protein carbonyl and oxidized guanine species. Salivary TAC was significantly reduced in khat users (0.25 ± 0.028 mmol/L) in comparison with controls (0.34 ± 0.037 mmol/L). Salivary CAT level was significantly reduced in khat users (6.0 ± 0.47 U/mL) in comparison with controls (7.7 ± 0.43 units/mL; P <.05), but no significant differences were observed between the 2 groups with regard to salivary superoxide dismutase or glutathione peroxidase levels. CONCLUSIONS Chronic khat chewing is associated with increased levels of salivary MDA and reduced levels of TAC and CAT among a population of adult men in comparison with non-khat-chewing controls. These findings suggest that the pro-oxidative effect of khat chewing may be a contributing mechanism for various oral diseases associated with khat use, including cancer, periodontitis, and caries.
Collapse
Affiliation(s)
- Nafez Abu Tarboush
- Department of Physiology and Biochemistry, School of Medicine, University of Jordan, Amman, Jordan
| | - Osama Al Masoodi
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, the University of Jordan, Amman, Jordan
| | - Suzan Al Bdour
- Department of Physiology and Biochemistry, School of Medicine, University of Jordan, Amman, Jordan
| | - Faleh Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, the University of Jordan, Amman, Jordan
| | - Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics, School of Dentistry, the University of Jordan, Amman, Jordan.
| |
Collapse
|
41
|
Abstract
The purpose of the present study was to examine the educational needs of patients regarding early detection of oral cancer. A total of 790 patients without cancer were interviewed and shown a set of validated clinical images of various oral lesions including early oral cancer. Participants were asked about their perception of cancer and the action that they would take if they notice a similar lesion. Lower risk lesions (e.g., lumps) were more likely to be perceived as cancer (52.4%), while higher risk lesions (e.g., red patches) were least likely to be perceived as cancer (8.8%). The perceived appearance of the lesions was correlated with patients' perceived need for medical advice. Higher risk lesions were less likely to make patients feel the need to seek professional advice. High-risk patients were less aware about oral cancer appearance and were less likely to take action if they notice an oral lesion. Patients are not aware of the various presentations of early oral cancers, especially higher risk lesions. Patients need to know more about the clinical appearance of early oral cancer. The use of representative clinical images of early oral cancer and educational videos on self-inspection of oral mucosa is important.
Collapse
Affiliation(s)
- Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Po-Box: 11942, Amman, Jordan.
| | - F Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Po-Box: 11942, Amman, Jordan
| | - D Matarweh
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Po-Box: 11942, Amman, Jordan
| | - A Abdalhamid
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Po-Box: 11942, Amman, Jordan
| | - D Thweib
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Po-Box: 11942, Amman, Jordan
| | - C Scully
- University College London, London, UK
| |
Collapse
|
42
|
Abukaraky A, Hamdan AA, Ameera MN, Nasief M, Hassona Y. Quality of YouTube TM videos on dental implants. Med Oral Patol Oral Cir Bucal 2018; 23:e463-e468. [PMID: 29924766 PMCID: PMC6051691 DOI: 10.4317/medoral.22447] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2018] [Accepted: 05/03/2018] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Patients search YouTube for health-care information. PURPOSE To examine what YouTube offers patients seeking information on dental implants, and to evaluate the quality of provided information. MATERIAL AND METHODS A systematic search of YouTube for videos containing information on dental implants was performed using the key words Dental implant and Tooth replacement. Videos were examined by two senior Oral and Maxillofacial Surgery residents who were trained and calibrated to perform the search. Initial assessment was performed to exclude non- English language videos, duplicate videos, conference lectures, and irrelevant videos. Included videos were analyzed with regard to demographics and content's usefulness. Information for patients available from the American Academy of Implant Dentistry, European Association of Osseointegration, and British Society of Restorative Dentistry were used for benchmarking. RESULTS A total of 117 videos were analyzed. The most commonly discussed topics were related to procedures involved in dental implantology (76.1%, n=89), and to the indications for dental implants (58.1%, n=78). The mean usefulness score of videos was poor (6.02 ±4.7 [range 0-21]), and misleading content was common (30.1% of videos); mainly in topics related to prognosis and maintenance of dental implants. Most videos (83.1%, n=97) failed to mention the source of information presented in the video or where to find more about dental implants. CONCLUSIONS Information about dental implants on YouTube is limited in quality and quantity. YouTube videos can have a potentially important role in modulating patients attitude and treatment decision regarding dental implants.
Collapse
Affiliation(s)
- A Abukaraky
- Oral Medicine and Special Care Dentistry, Department of Oral and Maxillofacial Surgery Oral Medicine and Periodontology, School of Dentistry- The University of Jordan, Queen Rania Street, 11942,
| | | | | | | | | |
Collapse
|
43
|
Hassona Y, Cirillo N, Taimeh D, Al Khawaldeh H, Sawair F. Diagnostic patterns and delays in autoimmune blistering diseases of the mouth: A cross-sectional study. Oral Dis 2018; 24:802-808. [DOI: 10.1111/odi.12839] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 01/14/2018] [Accepted: 01/24/2018] [Indexed: 01/19/2023]
Affiliation(s)
- Y Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics; School of Dentistry; The University of Jordan; Amman Jordan
| | - N Cirillo
- Melbourne Dental School; The University of Melbourne; Melbourne Vic. Australia
| | - D Taimeh
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics; School of Dentistry; The University of Jordan; Amman Jordan
| | | | - F Sawair
- Department of Oral and Maxillofacial Surgery, Oral Medicine, and Periodontics; School of Dentistry; The University of Jordan; Amman Jordan
| |
Collapse
|
44
|
Ryalat S, AlRyalat SA, Kassob Z, Hassona Y, Al-Shayyab MH, Sawair F. Impaction of lower third molars and their association with age: radiological perspectives. BMC Oral Health 2018; 18:58. [PMID: 29618350 PMCID: PMC5885350 DOI: 10.1186/s12903-018-0519-1] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 03/20/2018] [Indexed: 11/20/2022] Open
Abstract
Background Third molars are the most commonly impacted teeth, and their extraction is the most commonly performed procedure in oral and maxillofacial surgery. The aim of the present study is to describe the pattern of mandibular third molar impaction and to define the most appropriate age for prophylactic extraction of mandibular third molar teeth. Methods A total of 1198 orthopantomographs (OPGs) with 1810 impacted lower third molars were reviewed by two authors. The pattern of eruption in relation to patient’s age was examined using standard radiographic points and angles. Statistical analysis was performed using SPSS for Windows release 16.0 (SPSS Inc., Chicago, IL, USA). Results In patients older than 20 years, vertical pattern of impaction was the most common (21.4%); while in young patients; horizontal impaction was more common (21.3%). Furthermore, there was a constant pattern of increase in Pell-Gregory ramus class 1 with increasing age, as the prevalence of class 1 was 0% at age 18 years compared to 54.9% at the age of 26 years. Conclusion Frequency of vertical impaction of lower third molars was seen more at an older age (> 20 years) in this study, with an increase in the retromolar space. Late extraction of mandibular third molar teeth (i.e. after the age of 20) is therefore recommended when prophylactic extraction is considered.
Collapse
Affiliation(s)
- Soukaina Ryalat
- Department of oral surgery, oral medicine, oral pathology, periodontics and oral radiology, faculty of dentistry, The University of Jordan, Amman, Jordan.
| | | | - Zaid Kassob
- Department of oral surgery, oral medicine, oral pathology, periodontics and oral radiology, faculty of dentistry, The University of Jordan, Amman, Jordan
| | - Yazan Hassona
- Department of oral surgery, oral medicine, oral pathology, periodontics and oral radiology, faculty of dentistry, The University of Jordan, Amman, Jordan
| | - Mohammad H Al-Shayyab
- Department of oral surgery, oral medicine, oral pathology, periodontics and oral radiology, faculty of dentistry, The University of Jordan, Amman, Jordan
| | - Faleh Sawair
- Department of oral surgery, oral medicine, oral pathology, periodontics and oral radiology, faculty of dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
45
|
Hassona Y, Malamos D, Shaqman M, Baqain Z, Scully C. Management of dental patients taking direct oral anticoagulants: Dabigatran. Oral Dis 2018; 24:228-232. [DOI: 10.1111/odi.12755] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2017] [Accepted: 08/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Y Hassona
- Department of Oral and Maxillofacial Surgery; Oral Medicine and Periodontics; School of Dentistry; The University of Jordan; Amman Jordan
- Department of Dentistry; The University of Jordan Hospital; Amman Jordan
| | - D Malamos
- Oral Medicine Clinic; 1 Regional Health District of Attica; National Organization for the Provision of Health Services; Athens Greece
| | - M Shaqman
- Department of Oral and Maxillofacial Surgery; Oral Medicine and Periodontics; School of Dentistry; The University of Jordan; Amman Jordan
- Department of Dentistry; The University of Jordan Hospital; Amman Jordan
| | - Z Baqain
- Department of Oral and Maxillofacial Surgery; Oral Medicine and Periodontics; School of Dentistry; The University of Jordan; Amman Jordan
- Department of Dentistry; The University of Jordan Hospital; Amman Jordan
| | - C Scully
- University College London; London UK
| |
Collapse
|
46
|
Abstract
OBJECTIVES The aim of this report is to describe the orofacial manifestations and dental management of a girl with Sanjad-Sakati syndrome. CLINICAL PRESENTATION AND INTERVENTION The facial features included microcephaly, thin lips, beaked nose, low set ears, and a retrognathic mandible. An oral examination revealed oligodontia/hypodontia, small dental arches, a high arched palate, and a deep overbite and increased overjet. Oral rehabilitation involved full coverage prosthetic crowns on the upper central incisors, stainless steel crowns on the lower molars, and removable partial prostheses to replace missing teeth. CONCLUSION Recognition of orofacial features might help in the diagnosis of Sanjad-Sakati syndrome. Dental management of affected patients might be complicated by intellectual, neurological, and endocrine abnormalities.
Collapse
Affiliation(s)
- Yazan Hassona
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
- Department of Dentistry, The University of Jordan Hospital, Amman, Jordan
- *Yazan Hassona, Oral Medicine and Special Needs Dentistry, School of Dentistry, The University of Jordan, Queen Rania Street, Amman (Jordan), E-Mail
| | - Lamis Rajab
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, The University of Jordan, Amman, Jordan
- Department of Dentistry, The University of Jordan Hospital, Amman, Jordan
| | - Dina Taimeh
- Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
- Department of Dentistry, The University of Jordan Hospital, Amman, Jordan
| | | |
Collapse
|
47
|
Abstract
The immune system is the body’s primary defence mechanism against infections, and disturbances in the system can cause disease if the system fails in defence functions (in immunocompromised people), or if the activity is detrimental to the host (as in auto-immune and auto-inflammatory states). A healthy immune system is also essential to normal health of dental and oral tissues. This series presents the basics for the understanding of the immune system, this article covering innate immunity. Clinical relevance: Modern dental clinicians need a basic understanding of the immune system as it underlies health and disease.
Collapse
|
48
|
Abstract
Aggressive periodontitis and premature tooth loss in leucocyte adhesion deficiency (LAD) have adverse functional and psychological consequences on affected individuals. Dental implant rehabilitation might become necessary to overcome the functional and psychological adverse effects of LAD periodontitis, especially in patients with milder forms who are expected to have a relatively normal life expectancy. Outcome of dental implants in patients with LAD has not been previously reported; we describe the dental rehabilitation of a 24-year-old man with clinical features of LAD using endosseous dental implants.
Collapse
Affiliation(s)
- Ashraf Abu Karaky
- Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Faleh Sawair
- Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Zaid Tamimi
- Oral Surgery and Oral Medicine, Faculty of Dentistry, Jordan University of Science and Technology, Irbid, Jordan
| | - Yazan Hassona
- Oral and Maxillofacial Surgery, Oral Medicine and Periodontics, School of Dentistry, The University of Jordan, Amman, Jordan
| |
Collapse
|
49
|
Affiliation(s)
- Y. Hassona
- Associate Professor/Consultant, Department of Oral and Maxillofacial Surgery; Oral Medicine and Periodontics-School of Dentistry; The University of Jordan; Amman Jordan
- Dentist, Department of Dentistry; The University of Jordan Hospital; Amman Jordan
| | - H. Kharoub
- Dentist, Department of Dentistry; The University of Jordan Hospital; Amman Jordan
| | - C. Scully
- Professor Emeritus; University College London; London UK
| |
Collapse
|
50
|
Abstract
BACKGROUND Patients can and do search the Internet for information on various health-related topics. YouTube™ is one popular website they may consult. AIM To examine the quality of information offered by YouTube™ for patients seeking information on early childhood caries (ECC). DESIGN YouTube™ was searched for videos on ECC. The usefulness of selected videos in providing adequate information about ECC was evaluated using a 13-point usefulness score. The guidelines of the American Academy of Pediatric Dentistry were used for benchmarking. RESULTS Most videos were uploaded by healthcare professionals (60%, n = 18). Videos had generally low usefulness scores (mean: 5.1 ± 2.9; range: 1-11). An average YouTube™ video on ECC was viewed two times/day (range: 0.07-34.4 views/day). Less useful videos ranked early on the viewing list, and viewer's interactions with videos were not affected significantly by their usefulness. CONCLUSION YouTube™ should not be used as a trusted site for educating patients on ECC.
Collapse
Affiliation(s)
- Rawan ElKarmi
- Department of Pediatric Dentistry and Orthodontics, School of Dentistry, The University of Jordan, Amman, Jordan.,Department of Dentistry, The University of Jordan Hospital, Amman, Jordan
| | - Yazan Hassona
- Department of Dentistry, The University of Jordan Hospital, Amman, Jordan.,Department of Oral and Maxillofacial Surgery, Oral Medicine and Periodontology, School of Dentistry, The University of Jordan, Amman, Jordan
| | - Dina Taimeh
- Department of Dentistry, The University of Jordan Hospital, Amman, Jordan
| | | |
Collapse
|