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Purpose: We aimed to investigate whether cone-beam computed tomography (CBCT) alters the treatment decision for impacted mandibular third molar (M3M) surgery when the third molars show proximity to the inferior alveolar canal (IAC) on panoramic radiography (OPG) and to examine surgeons' confidence in the various treatment options.Methods: We performed a retrospective study evaluating a series of randomized OPG and CBCT images and answering a set of questions regarding impacted M3Ms. The anatomic risk factors studied included the proximity of M3M roots to the IAC, vertical relationship between the M3M and the IAC, and interruption of the IAC cortex by M3M roots. The primary outcome variable was the treatment decision of whether to observe, extract under local anesthesia, extract under general anesthesia, or perform coronectomy. The secondary outcome variable was confidence in the proposed treatment plan. The χ2 test was used to compare proportions and to test the differences in the treatment plan according to the studied independent variables. Binary logistic regression was used to determine the effect of anatomic factors. P < .05 was considered statistically significant.Results: The study sample consisted of 132 impacted M3Ms in 71 patients. No significant differences in the proposed treatment plan were found when the imaging modalities (OPG and CBCT) were compared (P > .05). Examination of CBCT enabled detection of anatomic risk factors (P < .001). Binary logistic regression showed the absence of IAC cortex interruption to be the most significant determinant toward planning for extraction on OPG (odds ratio, 3.1; P < .005) and on CBCT (odds ratio, 5.0; P < .001). Surgeons were more confident when planning for extraction (P < .001).Conclusions: The use of CBCT provides a better understanding of the anatomic relationship between M3M roots and the IAC. However, experienced surgeons dealing with impacted M3Ms with evidence of proximity to the IAC on OPG can decide on the treatment modality without CBCT. [ABSTRACT FROM AUTHOR]

Abstract: The objective of this prospective study was to estimate the incidence of early loss of dental implants and the potential risk factors. The predictive variables were classified as being patient, implant, anatomical, or operation-specific. The outcome variable was early failure of the implant. The significance of differences was assessed using bivariate analyses, and then a multivariate logistic regression model to identify independent predictors for early loss of implants. A total of 169 patients, 116 women and 53 men, mean age 47 (range 16–80) years, had 399 implants inserted. Fifteen implants were lost in 14 patients (8%). The early loss of dental implants was significantly associated with width of keratinised gingiva (p =0.008), the use polyglactin sutures (p =0.048), and the use of narrow implants (p =0.035). Multivariate logistic regression analysis established the significance of narrow keratinised gingiva (OR=4.7, p =0.005) and the use of polyglactin sutures (OR=3.8, p =0.042), which we conclude are probably the strongest predictors of early failure of implants. [Copyright &y& Elsevier]

Purpose: To determine the postoperative morbidity of harvesting cancellous bone from the anterior iliac crest for treating secondary cleft alveolus patients. Patients and Methods: Twenty-four patients treated for alveolar clefts in the Oral and Maxillofacial Surgery unit at the Jordan University Hospital were included. Medical notes were reviewed for intraoperative and postoperative complications; patients were interviewed to fill a questionnaire on postoperative recovery. The donor site was evaluated for the following factors: chronic pain, neurapraxia of the lateral femoral cutaneous nerve, abnormal gait, altered sensation over the scar, skin tenderness, bone tenderness, deformity of the bony contour, and scar length and width were measured. Results: Age at the time of surgery was 14.0 ± 4.1 years (mean ± SD), and follow-up was 23.2 ± 19.3 months. Patients spent a median of 3 days in hospital (range = 2-4 days), patients walked normally after 10.4 ± 13.2 days and resumed normal activities, including sports, after a mean of 16.0 ± 19.6 days. Two patients had neurapraxia of the lateral femoral cutaneous nerve (8%), 2 reported mild residual scar tenderness (8%) and 1 of the latter complained of tenderness on palpating the iliac crest (4%). Conclusions: Harvesting cancellous bone from the anterior iliac crest in young patients is well-tolerated, allows early resumption of normal activities, has no effect on growth, has minimal morbidity, and a reasonable esthetic outcome. [Copyright &y& Elsevier]

Purpose: The aim of this study was to estimate the frequency of postoperative complications after mandibular third molar (M3) surgery and identify the risk indicators. Patients and Methods: This was a prospective cohort study of a sample of subjects having at least 1 mandibular M3 surgically extracted at a teaching hospital in Jordan. The predictor variables were categorized as patient, anatomic, and operative specific. The outcome variables were postoperative complications recorded as present or absent. Bivariate analyses were computed, then a multivariate logistic regression model was used to identify independent predictors for the common postoperative complications. Results: The study sample was comprised of 149 patients who had 245 extractions. The mean age was 21.6 ± 3.32 years; 64.9% were females. In the multivariate logistic regression model, age (P = .033, odds ratio [OR] = 1.178), M3 side in relation to the handedness of the operator (P = .048, OR = 4.078), and lingual retraction (P = .001, OR = 11.293) were the variables found as independent predictors for alveolar osteitis. The level of impaction had a significant association with trismus, and operation time acted as an independent predictor for pain (P < .001, OR = 1.085). Conclusion: Postoperative morbidity increases with older age, deeper impaction, M3 side differing from the handedness of the operator, and longer procedures. [Copyright &y& Elsevier]

Purpose: To evaluate the long-term functional and esthetic outcomes of using the subtarsal approach for orbital trauma patients in a group of Jordonian patients. Patients and Methods: Twelve patients treated using the subtarsal approach for orbital floor fractures in the Oral and Maxillofacial Surgery unit at the Jordan University Hospital were involved. Aspects evaluated included: the distance between scar and lower lid lash margin, scar length, esthetic appearances of the scar, lid edema, scleral show, ectropion, lagophthalmous, epiphora, subconjunctival injections, and keratoconjunctivitis. Results: Half the cases were the result of road traffic accidents. Follow-up time ranged from 10 to 73 months (mean ± SD, 37.25 ± 23.7 months). The postoperative outcome was favorable; 1 scar was noticeable, but was not hypertrophic. One patient suffered from scleral show that was associated with subconjunctival injections. One patient suffered from mild lid edema and 1 had keratoconjunctivitis. No other complications were recorded and patients were satisfied with the outcome. Conclusions: The subtarsal approach is a safe and simple to perform procedure for treating orbital floor fractures. It results in a good surgical outcome functionally and esthetically. [Copyright &y& Elsevier]

A case on the successful management of acute facial bleeding from the maxillary artery by superselective embolization is described. A 26-year-old male sustained a gunshot wound (GSW) to the face leading to profuse bleeding from the site of bullet entry, the nose and the mouth. Local measures failed to arrest the bleeding. The patient was stabilised haemodynamically, then the source of bleeding was located by angiography and the bleeding was arrested by superselective embolization. [Copyright &y& Elsevier]

Summary: We report a case of a solitary bone cyst in the mandible of an elderly woman who presented with a bilateral radiolucent lesion that caused bony expansion, and which recurred 30 months after enucleation and bone grafting of the cavity. [Copyright &y& Elsevier]