Taiseer Hussain Al-Khateeb

Oral pyogenic granuloma in jordanians: a retrospective analysis of 108 cases

Abstract Purpose: The purpose of the present study was to retrospectively analyze the clinicopathologic features and treatment of oral pyogenic granuloma in Jordanian patients. Patients and methods: Information regarding 108 cases of pyogenic granuloma of the oral cavity that underwent biopsy were retrieved from the records of patients seen at the maxillofacial and periodontology units of the Faculty of Dentistry, Jordan University of Science and Technology, during an 11-year period from 1991 to 2001. Data were reviewed and analyzed for age, gender, site, treatment, and clinical and histopathologic features. Results: Patient ages ranged from 3 to 85 years (mean, 30 years), with the greatest degree of occurrence (26.8%) in the second decade. The male-to-female ratio was 1:1.7. The mean age for females age was higher than that for males. The most frequently involved site was the gingiva (44.4%); other sites were the lips, tongue, buccal mucosa, and palate. Gingival pyogenic granulomas were more prevalent in the maxilla than in the mandible, with the anterior region of both jaws being more commonly affected. The labiobuccal gingiva of both jaws was more commonly affected. The main complaint was bleeding (59.3%), and almost half of the lesions had a pedunculated base, with surface ulceration in 9.2% of cases. The mean greatest granuloma diameter was 10 mm. All lesions were surgically excised, with 5.8% of cases known to have recurred. Conclusions: The clinicopathologic features of oral pyogenic granuloma in Jordanians are similar to those of other whites. In this series, we found that with surgical excision of pyogenic granuloma, there was a low recurrence rate.

A Comparison of the Ability of Intra-oral and Extra-oral Fibroblasts to Stimulate Extracellular Matrix Reorganization in a Model of Wound Contraction

Intra-oral wounds, like wounds in children, demonstrate privileged healing when compared with adult wounds at extra-oral sites. This study investigated whether this preferential healing is related to an increased ability of oral mucosal fibroblasts to reorganize extracellular matrix (ECM) when compared with their dermal counterparts. ECM reorganization was investigated by means of a fibroblast-populated collagen lattice (FPCL) system. The effect of donor age was also investigated in this system. Differences in ECM reorganization and FPCL contraction were evident: FPCL contraction was more rapid by oral mucosal fibroblasts than dermal fibroblasts (p < 0.01). FPCL contraction was also greater in child (donor < 10 years) than adult (donor > 18 years) oral mucosal fibroblasts (p < 0.01). These differences were not related to phenotypic differences in cell viability (p > 0.5), DNA synthesis (p > 0.05), and cell number (p > 0.5) within the FPCLs, or cellular attachment to collagen (p > 0.07). FPCL contraction was not stimulated by the addition of conditioned medium from oral mucosal or dermal fibroblasts (p > 0.05). These data show that the significantly increased ability of oral mucosal fibroblasts to reorganize ECM in vitro, when compared with dermal fibroblasts, represents a distinct phenotypic contractile difference, rather than differences in their production of soluble mediators or cell attachment to ECM.

Position of the mental foramen in a northern regional Jordanian population

BackgroundThe mental foramen is frequently encountered in a number of maxillofacial surgical procedures. Its position has been shown to vary according to race. The aim was to study the position, shape, and appearance of the mental foramen, as seen on panoramic radiographs of Jordanians, and to compare our findings with international values.Patients and methodsPanoramic radiographs were randomly selected from the records of dental patients attending three dental services, and were analyzed according to patients’ age and gender, and the mental foramina’s anterior–posterior and superior–inferior positions, shape, appearance, and symmetry.ResultsThere were 860 cases (1,720 sides) with a female-to-male ratio of 1:1.4, and mean age of 24. The most frequent anterior–posterior position was in the area between the long axes of first and second mandibular premolar teeth. With advancing age, there was an increase in the frequency of more posterior positioning. The anterior–posterior position was asymmetrical in 33% of cases. The most frequent superior–inferior position was below the level of apices of mandibular premolar teeth roots. With advancing age there was an increase in the frequency of more inferior positioning. The superior–inferior position was asymmetrical in 14% of cases. The majority of foramina were round in shape, and the most frequent appearance was the continuous type. Accessory mental foramina were seen in 10% of the cases.ConclusionThe position of the mental foramen on panoramic radiographs in this selected group of Jordanians is most commonly below and between the mandibular premolar teeth, and the most frequent appearance was the continuous type. These results are similar to previous findings in Caucasian populations.

Effect of the proteolytic enzyme serrapeptase on swelling, pain and trismus after surgical extraction of mandibular third molars

The aim of this study was to investigate the ability of serrapeptase to reduce postoperative swelling, pain and trismus after third molar surgery. Twenty-four healthy individuals with symmetrically impacted mandibular third molars underwent surgical removal in a prospective, intra-individual, randomized, double-blind, cross-over study. Teeth were removed in 2 sessions by the same surgeon. At each session, one third molar was removed under local anaesthesia via a buccal osteotomy. All patients received a combination of either serrapeptase 5mg or placebo tablets and 1000 mg paracetamol tablets at either the 1st or 2nd operation in accordance with the randomization plan. Cheek thickness, pain and interincisal distance were measured preoperatively, and on the 1st, 2nd, 3rd and 7th postoperative days. Cheek thickness and maximum interincisal distance were measured using calipers. Pain intensity was assessed clinically using a numeric scale. There was a significant reduction in the extent of cheek swelling and pain intensity in the serrapeptase group at the 2nd, 3rd and 7th postoperative days (P<0.05), but no significant difference in mean maximal interincisal distance was found between the 2 groups (P>0.05).

Cutaneous Cysts of the Head and Neck

PURPOSE A retrospective study on the features of cutaneous cysts of the head and neck as seen in a North Jordanian population. PATIENTS AND METHODS The records of the Department of Pathology at Jordan University of Science and Technology were reviewed for patients with cutaneous cysts of the head and neck during the 12-year period extending between 1991 and 2002. Applicable records were retrieved, reviewed, and analyzed. Primary analysis outcome measures included patient age, gender, location of the cyst, type, clinical presentation, and treatment. The records of 488 patients were available for analysis. RESULTS Epidermoid cyst was the most frequent lesion (49%) followed by pilar cysts (27%), and dermoid cysts (22%). The site affected most frequently was the scalp (34%), predominantly with pilar cysts (96%). Epidermoid cyst was the most frequent lesion in the neck (68%), cheeks (77%), periauricular area (70%), and the nasal area (55%). Dermoid cyst was the most frequent lesion in the periorbital area (52%). Females represented 51% of the patients and males accounted for 49%. The peak of age distribution for patients with dermoid cysts was at the first decade, and both of epidermoid and pilar cysts peaked at the third decade. Infection presented in 2.5% of cases. All cysts were enucleated surgically. CONCLUSION Maxillofacial surgeons often encounter cutaneous cysts of the head and neck, and they must be familiar with the clinicopathologic characteristics of these lesions.

Benign Oral Masses in a Northern Jordanian Population-a Retrospective Study

The aim of this study was to evaluate the relative frequencies, types and distribution of benign oral masses in North Jordanians. The records of the Department of Pathology at Jordan University of Science & Technology were reviewed and analyzed for patients with benign oral soft tissue masses, received during an 11-year period (1991-2001). The main outcome measures were patients’ age and sex, and the mass type and location. A sum of 818 benign oral soft tissue masses (4% neoplastic and 96% non-neoplastic) was analyzed. Common benign neoplasms were salivary pleomorphic adenoma and lipoma. Non-neoplastic lesions consisted of traumatic (43%) inflammatory/ infective (33%), cystic (14%) and developmental (9%) lesions. Common non-neoplastic lesions were fibroepithelial polyp, pyogenic granuloma, mucoceles, hemangioma and squamous papilloma, in a descending order. There were 330 (40%) males and 488 (60%) females with a male to female ratio of 1: 1.5. The mean age was 33 years, with the majority in the 2nd, 3rd and 4th decades. The sites commonly affected by benign neoplasms were the palate, tongue, upper lip and buccal mucosa, in a descending order and the sites commonly affected by non-neoplastic lesions were the gingiva, buccal mucosa, lower lip and tongue in a descending order. It is concluded that some of the features of benign oral masses in north Jordanians published in this paper are similar to those from other countries, and some are different. Further nationwide population-based surveys are needed to further define the epidemiology of benign oral masses among Jordanians.

Pain Experience After Simple Tooth Extraction

PURPOSE To assess pain experience after simple uncomplicated tooth extraction and to see if there is a need to prescribe analgesic drugs after such a procedure. PATIENTS AND METHODS A random sample of patients presenting for tooth extraction at the Maxillofacial Unit, Jordan University of Science and Technology was included. A baseline assessment of previously experienced general and dental pains using numeric scales was done. Subsequently, tooth extractions were done and telephone interviews were made during evenings for a week. Pain intensity was assessed on a numeric scale, and use of analgesic drugs and pain quality were recorded. RESULTS At the evening of extraction 81.8% of patients had pain. Female gender predominance in pain reporting was statistically significant on postextraction days 3 and 5. Chronically inflamed teeth caused the highest mean pain intensity scores and nonsmokers showed significantly higher mean pain intensity scores compared with smokers. Mild pain was experienced by most patients (38.6%) on the evening of extraction. It was found that 55.3% of participants (largely females) used analgesic drugs on the evening of extraction, and 6.8% of participants still used analgesic drugs on day 7 postextraction. There was a significant correlation between mean pain intensity score and previous dental injection pain. CONCLUSION Patients, notably females, experienced pain of varying intensity after simple uncomplicated tooth extraction maximally at the evening of extraction; and greater than 50% of the patients used analgesic drugs. We recommend offering regular analgesic drugs during the first week after tooth extraction.

An investigation of the interaction between alcohol and fibroblasts in wound healing

This study investigated the effect of clinical concentrations of alcohol on fibroblast function (proliferation and ECM synthesis) in vitro. Basal and TGF-beta-induced collagen synthesis was assayed in confluent cultures in serum-free medium at 48 h with a commercial collagen assay system. At concentrations of alcohol > 5%, fibroblast proliferation was significantly inhibited. Although noninhibitory, subclinical concentrations of alcohol failed to inhibit basal collagen synthesis (P > 0.1), they significantly decreased TGF-beta-induced collagen synthesis (P < 0.03). These data support the notion that the local, as well as the systemic, effects of alcohol are important in mediating delayed healing in alcoholic patients.

Cutaneous Rosai-Dorfman Disease of the Face: A Comprehensive Literature Review and Case Report

PURPOSE Cutaneous Rosai-Dorfman disease (C-RDD) is a rare, benign, non-Langerhans cell histiocytosis that can affect any skin area. The purpose of this study was to characterize C-RDD of the face through a literature review of published case reports of this lesion and present a new case of C-RDD. MATERIALS AND METHODS An English-language search of 3 databases (PubMed, Scopus, and EBSCO Search) was conducted for cases of C-RDD of any skin area that had been published since 1969. Repeated citations of the same article in more than 1 database were deleted. Cases of C-RDD with solely facial involvement or involving the face and other skin parts were included and analyzed. Details of C-RDD cases (demographic features, regional distribution, clinical presentation, treatment, and follow-up course) were methodically reviewed and collected in Excel spreadsheets. Simple statistical analyses were conducted using Excel. RESULTS The literature search yielded 578 published cases of C-RDD affecting any skin area; of these, 65 cases (11.2%) had facial skin involvement. The male-to-female ratio was 1:1.5, and the average age at presentation was 43.5 years (standard deviation, 12.4 yr). The racial distribution of facial C-RDD was, in descending order, 74.5% in Asians, 20% in Caucasians, and 5.5% in blacks. The most commonly affected facial skin regions were the cheeks and periorbital area, and most lesions were multiple in number and bilaterally distributed. The vast majority of facial C-RDD lesions presented as asymptomatic, nonulcerative, red, nodular plaques with durations ranging from 1 month to a few years. Many methods have been attempted for the treatment of facial C-RDD. However, the combined cure rate for all published treatment methods was only 28.6%. Surgical excision was the most effective treatment method, and corticosteroids were the least effective. CONCLUSION This article has tried to characterize facial C-RDD lesions for easier management by maxillofacial surgeons.

Mineralization of the Stylohyoid Ligament Complex in a Jordanian Sample: A Clinicoradiographic Study

PURPOSE To record the prevalence of anatomic variations and the associated symptoms of mineralized stylohyoid complex (MSHC) in a Jordanian sample, and to investigate the possible factors responsible for mineralization. PATIENTS AND METHODS This study was conducted at the Dental Teaching Clinics of Jordan University of Science and Technology in patients referred for panoramic radiographs. The MSHC, on either side of panoramic radiographs, was mapped out on tracing paper, the length directly measured, and the true length calculated. The true length of the MSHC was used to classify every side into short, long, or elongated, and the radiographic type of long and elongated MSHCs was determined as elongated, pseudoarticulated, or segmented. RESULTS A total of 867 MSHCs were traced with an overall average length of the 23.1 mm. The most frequent class and type were long (53.3%) and elongated (41.6%), respectively. There was a significantly (P < .05) progressive increase in the length of the MSHC. The frequency of both of elongated and pseudoarticulated types increased and that of the segmented type decreased with aging. The mean length of the MSHC for patients with a history of tonsillectomy (26.29 mm) was significantly higher (P < .05) than its value in patients without a history of tonsillectomy (22.70). There was also a significantly (P < .05) progressive increase in the length of the MSHC as the age when tonsillectomy was performed increased. The mean length of the MSHC for cases with history of recurrent tonsillitis (6.99 mm) was significantly higher (P < .05) than for those without (2.42 mm). The mean length of the MSHC for patients with a history of head-and-neck or whole-body trauma was not statistically significantly different (P > .05) from the value for the nontraumatized patients. The mean length of the MSHC for patients with arthritis (27.70 mm) was significantly higher (P < .05) than that in patients without arthritis (22.53 mm). The highest frequency of MSHC palpated in the tonsillar fossa was significantly (P < .05) related to the elongated class (44; 64.8%) and type (100; 52%). The mean length of the MSHC was significantly higher in patients who reported having 4 symptoms, but only 1 symptom had a significant association with the type of MSHC. CONCLUSION History of recurrent tonsillitis has a major effect on the true length of the MSHC, and trauma is not a significant factor for the development of longer MSHC.