Wael M. Al-Omari

Dental anxiety among university students and its correlation with their field of study.

Objective: This study was designed to investigate the subjective ratings of dental anxiety levels among university students enrolled at Jordan University of Science and Technology. In addition, the present study aimed to explore the sources of dental anxiety and the impact of gender on the perceived dental anxiety and the correlation between field of study and dental anxiety level. Material and Methods: The Modified Corah Dental Anxiety Scale was used to measure dental anxiety among the study population. Six hundred subjects were recruited into the study from Jordanian undergraduate students from the faculties of Medicine, Engineering, and Dentistry. Results: Five hundred and thirty five complete questionnaires were returned, which accounts for a response rate of 89.2%. The totals of the mean anxiety scores were the following: Medical students, 13.58%; Engineering students, 13.27% and dental students, 11.22%. About 32% of the study population has scored 15 or more. Dental students had the lowest percentage of those who scored 15 or more. Surprisingly, the medical students were responsible for the highest percentage of those who scored 15 or above. Although women demonstrated statistically higher total dental anxiety scores than men (p= 0.03), the difference between both genders was small and could be clinically insignificant. The students were anxious mostly about tooth drilling and local anesthetic injection. Conclusion: Lack of adequate dental health education may result in a high level of dental anxiety among non-dental university students in Jordan. Further studies are required to identify the correlates of dental anxiety among university students.

Porcelain fracture resistance of screw-retained, cement-retained, and screw-cement-retained implant-supported metal ceramic posterior crowns.

PURPOSE The purpose of this in vitro study was to compare the porcelain fracture resistance between screw-retained, cement-retained, and combined screw- and cement-retained metal-ceramic (MC) implant-supported posterior single crowns; and to investigate the effect of offsetting the occlusal screw-access opening on porcelain fracture resistance of screw-retained and cement-retained MC implant-supported posterior single crowns. MATERIALS AND METHODS Forty standardized MC molar-shaped restorations were fabricated. The 40 restorations were divided into four groups (SRC, SRO, CRP, and CSC) of 10 specimens each. Group SRC: screw-retained, screw-access hole placed in the center of the occlusal surface; Group SRO: screw-retained, screw access hole placed 1 mm offset from the center of the occlusal surface toward the buccal cusp; Group CRP: cement-retained, zinc phosphate cement was used; Group CSC: cement-retained with a screw-access hole in the center of the occlusal surface. The screw-retained restorations and abutments were directly attached to 3i implant fixtures embedded in acrylic resin blocks. Subsequently, all test specimens were thermocycled and vertically loaded in a universal testing machine at a crosshead speed of 2 mm/min until fracture. Mean values of load at fracture (in N) were calculated in each group and compared with a one-way ANOVA and Tukeys Studentized test (alpha= 0.05). RESULTS Mean values of loads required to fracture the restorations were as follows (N): Group SRC: 1721 +/- 593; Group SRO: 1885 +/- 491; Group CRP: 3707 +/- 1086; Group CSC: 1700 +/- 526. Groups SRC, SRO, and CSC required a significantly lower force to fracture the porcelain than did the CRP group (p < 0.05). CONCLUSION The cement-retained restorations showed significantly higher mean fracture loads than the restorations having screw-access openings in their occlusal surface. The position of the screw-access hole within the occlusal surface did not significantly affect the porcelain fracture resistance.

Survey of attitudes, materials and methods employed in endodontic treatment by general dental practitioners in North Jordan

BackgroundGeneral dental practitioners provide the majority of endodontic treatment in Jordan. The aim of this study was to gather information on the methods, materials and attitudes employed in root canal treatment by dentists in North Jordan, in order to evaluate and improve the quality of current practice.MethodsA questionnaire was posted to all registered general dental practitioners working in private practice in Irbid Governate in North Jordan (n = 181). The questionnaire included information on methods, materials and techniques used in endodontic treatment.ResultsReply rate was 72% (n = 131). The results demonstrated that only five dentists used rubber dam occasionally and not routinely. The majority used cotton rolls for isolation solely or in combination with a high volume saliva ejector (n = 116). The most widely used irrigants were sodium hypochlorite and hydrogen peroxide, which were used by 32.9% (n = 43) and 33.6% (n = 44) of the respondents, respectively. Forty eight percent of the respondents (n = 61) used the cold lateral condensation technique for canal obturation, 31.3% (n = 41) used single cone, 9.9% (n = 13) used vertical condensation and 12.2% (n = 16) used paste or cement only for the obturation. The majority used zinc oxide eugenol as a sealer (72.5%). All, but one, respondents used hand instruments for canal preparation and the technique of choice was step back (52.7%). More than 50% (n = 70) of the dentists took one radiograph for determining the working length, whilst 22.9% (n = 30) did not take any radiograph at all. Most practitioners performed treatment in three visits for teeth with two or more root canals, and in two visits for teeth with a single root canal.ConclusionsThis study indicates that dentists practicing in North Jordan do not comply with international quality standards and do not use recently introduced techniques. Many clinicians never take a radiograph for determining the working length and never used rubber dam or intra-canal medicaments.

Histological evaluation of rat tissue response to GMTA, Retroplast, and Geristore retrograde filling materials

The aim of the study was to compare the short-term biocompatibility of grey mineral trioxide aggregate (GMTA), Retroplast and Geristore. Silicon tubes filled with the materials and empty control tubes were implanted in the dorsal connective tissue of 30 Wistar albino rats. The tubes and surrounding tissues were excised and prepared for histological examination at 1 week, 1 month and 2 months after implantation. Inflammatory cell counts and the presence or absence of necrosis adjacent to the materials and control tubes were recorded. Data were statistically analysed using one-way anova and Tukeys multiple comparisons tests. The empty control tubes were well tolerated. All tested materials showed a more severe initial reaction than the control group. With time, the reaction became chronic, with variable increase in the numbers of inflammatory cells. Retroplast recorded the most statistically significant increase in the sum of inflammatory cells. Although the increase in the sum of inflammatory cells was statistically significant for Geristore but not for GMTA, the inflammatory cell counts for both were comparable. It was concluded that the three materials continued to irritate tissues throughout the evaluation period. Retroplast was the least biocompatible of the three tested materials at 2 months, followed by Geristore then GMTA.

Reaction of rat connective tissue to mineral trioxide aggregate and diaket

BackgroundThe aim of this study was to compare the reaction of rat connective tissue to two root-end filling materials: white Mineral Trioxide Aggregate (WMTA) and Diaket.MethodsEach of the materials was placed in dentine tubes and implanted subcutaneously in the dorsal connective tissue of 21 Wistar albino rats. Tissue biopsies were collected 7, 30, and 60 days after the implantation procedure. The specimens were processed and stained with hematoxylin and eosin and examined microscopically. After determining inflammatory cell numbers in sections from each specimen, inflammatory reaction scores were defined as follows: 0; no or few inflammatory cells (no reaction), 1; less than 25 cells (mild reaction), 2; 25 to 125 cells, (moderate reaction), and 3; 125 or more cells (severe reaction). Statistical analysis was performed using the Kruskal-Wallis and Mann-Whitney tests.ResultsThere were statistically significant differences in the median inflammatory cell numbers throughout the three test periods, with the most severe degree of inflammation observed at the one-week period. Few cases of necrosis were observed with WMTA. Diaket exhibited the most severe degree of inflammation and necrosis. After 30 days, both materials provoked moderate inflammatory reaction. The eight-week period showed the least severe degree of inflammation in all groups.ConclusionsIt was concluded that WMTA exhibits a more favourable tissue response compared with Diaket which induced more severe inflammatory reaction than WMTA and the control.

The retention of cast metal dowels fabricated by direct and indirect techniques.

PURPOSE To explore the effect of fabrication technique, cement type, and cementation procedure on retention of cast metal dowels. METHODS AND MATERIALS Eighty intact single-rooted teeth were selected. The clinical crown was removed at the cementoenamel junction level. Each root was prepared to receive a cast metal dowel of 10-mm length and 1.45 mm in diameter. The 80 specimens were divided into two major groups of 40 based on fabrication technique (direct and indirect). Each group was further divided into four subgroups of ten based on the cement type (zinc phosphate and glass ionomer), and cementation procedure (with and without lentulo spiral). The dowels were subjected to a constantly increasing tensile force, in a universal Instron testing machine, at crosshead speed of 5 mm/min until failure. RESULTS The most significant factor to affect retention was the cementation procedure, as cementation with lentulo spiral produced greater retention than cementation without the use of lentulo spiral (p < 0.05); however, there seems to be a close interaction between fabrication technique, cement type, and cementation procedure (p= 0.051). The least retentive group was the one fabricated by direct technique, cemented with zinc phosphate without the use of lentulo spiral. CONCLUSION Fabrication technique does not affect retention of cast dowels, except when zinc phosphate was the luting agent and placed in the canal space without using a lentulo spiral. The cementation procedure had a significant effect on retention; thus, it is recommended that cementation should be done using the lentulo spiral.

Higher Maximal Occlusal Bite Force in Endodontically Treated Teeth Versus Vital Contralateral Counterparts

Introduction Decreased sensitivity to occlusal load could lead to a greater risk of damage to endodontically treated teeth. Therefore, this study aims to test whether root canal treatment reduces the sensitivity of the treated teeth to occlusal load. Methods This is a comparative cross‐sectional study of 124 patients who received root canal treatment. Treated teeth were compared with vital teeth on the contralateral side. After interviews with participants, their maximal bite forces (MBFs) of their root canal–treated and contralateral untreated teeth were measured using a digital bite fork force transducer. Data were analyzed by comparing the mean MBF of root canal–treated and control teeth. Results The mean MBF (± standard deviation) was 226.6 N (±168.7) for root canal–treated teeth and 207.93 N (±158.08) for control teeth. Root canal–treated teeth had a significantly higher difference in the mean MBF than the control group (P < .0001) using the paired sample t test. A univariate analysis test showed that differences in the MBF were affected by molar relationship, overbite, and the quality of root filling. Conclusions The difference in the MBF was significantly higher in root canal–treated teeth, which is consistent with the function of dental pulp as a highly sensitive sensor. Therefore, the reduction in the sensitivity of teeth to an applied load after pulp removal may increase the risk of overloading. This may, in turn, increase the frequency of tooth damage after root canal treatment.