Fouad Ayoub

Sexual dimorphism of mandibular angle in a Lebanese sample

Sexual dimorphism represents a group of morphologic characteristics that differentiate males from females. Craniofacial morphology and more specifically the mandibular angle have been evaluated for their interest in orthodontic, anthropologic and forensic applications. Currently, limited data are available relative to the significance of the mandibular angle in sex determination in various populations. The objective of this preliminary study is to evaluate the significance of the mandibular angle in sex determination in a sample of Lebanese young individuals. Lateral cephalometric radiographs were obtained from 83 young individuals (40 males and 43 females) aged between 17 and 26 years. No statistically significant differences were detected between both genders relative to the mean values of A1, A2 and A3 measured for each individual using the ramus plane intersected with the mandibular planes of Downs, Sassouni and Steiner, respectively. This study demonstrated no significant difference of the mandibular angle in sex determination in the young Lebanese population. Further investigations with a larger sample size and a strongly established Lebanese background should be conducted to test the applicability of the mandibular angle sexual dimorphism.

Mandibular Canine Dimorphism in Establishing Sex Identity in the Lebanese Population

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

The Psychological Attitude of Patients toward Health Practitioners in Lebanon

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

Oral Health Status of Institutionalized Individuals with Intellectual Disabilities in Lebanon

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

A survey of oral health in institutionalized population with intellectual disabilities: Comparison with a national oral health survey of the normal population

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

Evaluation of periodontal status and treatment needs of institutionalized intellectually disabled individuals in Lebanon

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