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Background: Evaluating the level of dental students' competence is crucial for validating their preparedness for graduation. Confidence has a significant role in achieving competence. There are limited studies that assess the level of self-perceived confidence among final-year dental students regarding their ability to conduct key dental procedures. This study aims to assess the self-perceived confidence level of final-year dental students in performing essential dental procedures across various dental disciplines and to assess the effect of implementing competencies in the curriculum on the self-perceived confidence level of students by comparing two cohorts of final-year students in two different years 2016 (Traditional Cohort) and 2019 (Competencies Cohort)., Materials and Methods: An questionnaire was answered by two cohorts of final-year dental students: one group in 2016 before the implementation of the competency-based assessment system (group 1, n  = 153), and the other in 2019 after the implementation of this system (group 2, n  = 199), the same questionnaire was used for both cohorts. The results from the two groups were compared regarding the degree of self-perceived confidence in conducting key dental procedures. The data were analysed using SPSS statistics and Levene's Test for Equality of Variances and t -test for Equality of Means calculated., Results: Group 1 showed a significantly higher means of self-perceived confidence levels than group 2 in the ability to conduct seven out of the 20 prosthodontics procedures studied: providing patients with Cobalt-Chromium (Co-Cr) removable partial dentures (RPD) (3.77 vs. 3.56), providing the patient with Acrylic RPD (3.70 vs. 3.23), treatment planning for partially edentulous patients (3.83 vs. 3.34), giving OHIs for denture patients (4.17 vs. 3.95), dealing with CD postinsertion complaints (3.97 vs. 3.76), giving postinsertion instructions for removable prostheses cases (4.12 vs. 3.82), and providing patients with immediate dentures (2.67 vs. 2.32). The same applies to 6 out of 16 conservative dentistry procedures: placing anterior composite (4.41 vs. 4.12), placing posterior composite (4.43 vs. 3.88), placing posterior amalgam (4.29 vs. 4.02), placing matrix band for Class II restorations (4.24 vs. 3.71), placing a prefabricated post (3.34 vs. 2.88), and placing fiber post (3.45 vs. 3.34). On the other hand, group 2 shows higher means of self-perceived confidence than group 1 in only two conservative dentistry procedures: onlay restorations (2.18 vs. 2.76) and inlay restorations (2.22 vs. 2.75). No significant differences in means of self-perceived confidence were found between the two groups in the remaining 21 procedures studied., Conclusions: This study has shown that final-year dental students have high self-perceived confidence levels in doing simple dental procedures yet less confidence in more complex ones. Although, students' self-perceived confidence decreases after the introduction of a competency-based assessment system. Competency implementation and execution criteria may differ between schools which may have an impact on final outcomes. Hence, there is a need for regular evaluation of competencies being assessed to maintain a curriculum that is up to date., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2023 Wijdan R. Elmanaseer et al.)

The outcomes of clinical studies utilizing Photobiomodulation on tendon disorders are not homogeneous and since its design depends on preclinical studies utilizing animal models as a prerequisite, this review investigates the literature to help extrapolate preclinical evidence-based outcomes (safety and efficacy) into clinical treatment options. PubMed and Embase databases were searched for tendinopathy, Photobiomodulation and preclinical studies with inclusion criteria were restricted to in vivo animal studies using rat's models subjected to partially injured tendons. Data extracted were methodology quality and design, light parameters, study methods, and outcomes. Twenty two articles were included, half of them were partially transected, while the other half were partially traumatized. The most common wavelengths used were 660, 830, and 904 nm with energy density range between 1 and 17 J/cm 2 and applied mostly daily. Fourteen studies (64%) relied merely on a single assessment. Histological measurements were the most common method of evaluation (75%) and 35% of studies used chemical measures. Mechanical outcomes were reported in four, and two studies demonstrate significant effects. Photobiomodulation has the potential to enhance tendon structure and function, however, inevitable embedded heterogeneity related to study design and quality of methods, light parameters delivered, and evaluations methods renders the ability to establish unified treatment parameters difficult. Adjustments for variability within preclinical studies might lead to better designing of clinical studies. It is recommended to embrace a protocol for designing and performing preclinical studies to improve its quality. Moreover, it is recommended to prove efficacy using at least two evaluation methods and apply Photobiomodulation as a combined varying energy/wavelength protocol (several energies with several wavelengths). Clinical relevance: Establishing a proof of concept for Photobiomodulation that may lead to further high-quality clinical studies, in which the applicable parameters can be determined.

Patients with viral illness are at higher risk of secondary infections-whether bacterial, viral, or parasitic-that usually lead to a worse prognosis. In the setting of Corona Virus Disease 2019 (COVID-19), the Severe Acute Respiratory Syndrome Coronavirus-type 2 (SARS-CoV-2) infection may be preceded by a prior microbial infection or has a concurrent or superinfection. Previous reports documented a significantly higher risk of microbial coinfection in SARS-CoV-2-positive patients. Initial results from the United States (U.S.) and Europe found a significantly higher risk of mortality and severe illness among hospitalized patients with SARS-CoV-2 and bacterial coinfection. However, later studies found contradictory results concerning the impact of coinfection on the outcomes of COVID-19. Thus, we conducted the present literature review to provide updated evidence regarding the prevalence of coinfection and superinfection amongst patients with SARS-CoV-2, possible mechanisms underlying the higher risk of coinfection and superinfection in SARS-CoV-2 patients, and the impact of coinfection and superinfection on the outcomes of patients with COVID-19.

Objectives: Infertility is one of the major concerns for male patients following spinal cord injury (SCI). Although the severity of the injury has a large impact on extent of infertility, the effect of exact injury extent (with specific affected spinal tracts) on fertility is not studied yet., Materials and Methods: In the present study, sperm parameters, locomotion scores, and hormonal changes were evaluated following dorsal one third SCI (1/3 SCI), dorsal two third SCI (2/3 SCI), and complete spinal cord transection (TX) at T8 spinal level in male rats., Results: Sperm count decreased significantly following 1/3 SCI and Tx compered to normal (control and sham). In addition, sperm count decreased significantly in Tx compared to 1/3 SCI and 2/3 SCI. Concerning sperm motility, although, percentage of motile sperms decreased significantly in Tx group in comparison to all other groups, the percentage of rapid progressive motile sperms (RPM) decreased significantly in all SCI groups compared to normal. Meanwhile, locomotion score (BBB-score) showed a significant progressive decrease following SCI compared to normal or within SCI groups. However, there was no significant changes in the serum hormonal and seminal fructose concentrations following SCI compared to normal., Conclusions: These results show that understanding the extent of SCI, the affected spinal tracts, and the resultant locomotion deficits may help to predict the deficits in sperm parameters and hence fertility potentials.

Introduction: Excessive fluoride intake during tooth development causes dental fluorosis., Aim: This study aimed to (1) determine the prevalence of dental fluorosis in association with fluoride concentrations in drinking water, (2) explore the effects of altitude on the severity of fluorosis in two towns with high fluoride levels in the drinking water, and (3) assess decayed, missing, and filled teeth (DMFT) and oral hygiene practices among participants., Material and Methods: The sample consisted of 100 and 141 schoolchildren, aged 15.3 ± 1.4 and 16.1 ± 1.3 years, living in Ruwaished and Kuraymah, respectively. Oral examinations were carried out, and dental fluorosis was assessed using the Dean's index. The DMFT index was also used for assessment. Samples of drinking water were analyzed using a fluoride-ion selective electrode. SPSS was used to analyze the data., Results: Two-thirds (68.8%) of adults from Kuraymah had moderate to severe fluorosis, with only 7% being unaffected. In Ruwaished, 50% of the sample had severe fluorosis, 22% showed moderate fluorosis, and none were unaffected. The average DMFT scores were 3.18 ± 1.81 and 3.81 ± 1.41 for Kuraymah and Ruwaished, respectively. In both towns, males had significantly higher caries scores than females. Oral hygiene was poor, as 64% and 57% of the participants from Kuraymah and Ruwaished, respectively, did not brush their teeth. A significant correlation was found between poor oral hygiene and increased DMFT scores., Conclusions: This study concluded that higher fluorosis incidence and severity were present in the higher-altitude location (Ruwaished). Moreover, this study also indicated that fluorosed teeth are not immune to caries, and the preventive management of dental fluorosis should be directed to de-fluoridation of drinking water in endemic areas., Competing Interests: The authors declare no potential conflicts of interest in the present study., (© 2020 The Authors.)

Introduction: Age-at-death estimation is an essential part of the identification process of individuals in many forensic dentistry cases where identity of the individual cannot be resolved by visual recognition or other means. Dental age estimation in adults is more of a challenge as most teeth complete their development by the age of 18 years., Aim: This study aims at using the mesio-distal (MD) pulp-to-tooth ratio taken at the cervix of upper third molars (UM3) to estimate age at the time of radiographic imaging., Materials and Methods: A set of 135 Cone-beam computed tomography (CBCT) radiographs of UM3s for a random sample of 135 Jordanian adults (65 females, 70 males; age range = 18-63 years, mean age = 34.4 years, SD = 11.2 years) were used. Both pulp and tooth MD diameters were measured at the cervix. MD pulp-to-tooth ratios for UM3s were correlated with age., Results: Statistically significant negative moderate correlation was found between the age of the individual and the cervix MD pulp/tooth ratio (r = -0.516). This indicates that only 26.6% of the variation in age can be explained by the cervix MD pulp-to-tooth ratio., Conclusions: This study concludes that cervix MD pulp-to-tooth ratio of UM3s, although apparently stronger than that of lower M3s (r = -0.361), is not a sufficiently reliable estimator of age in adults, and this is perhaps attributed to the greater variability in the time line of third molars development., Competing Interests: The authors declare no potential conflicts of interest in the present study., (© 2020 The Authors.)

Sexual dysfunction, following spinal cord injury (SCI), is highly dependent on the extent of injury. SCI disrupts the supraspinal innervation of the reproductive organs; resulting in structural and functional deficits. Relating the extent of SCI to these changes could eventually improve diagnoses and treatment planning of sexual dysfunction following SCI. In the present study, following chronic SCI of different severities (1/3 dorsal SCI (1/3 SCI), 2/3 dorsal SCI (2/3 SCI), and complete transection (Tx)) at T8 spinal level, histological changes of seminiferous tubules parameters in testis were examined. The diameter of seminiferous tubules (DST) and epithelial height of seminiferous tubules (HST) were significantly decreased in all SCI groups compared to control and sham. In addition, DST in 2/3 SCI and Tx groups and HST in Tx group were significantly decreased in comparison with 1/3 SCI animals. Nonetheless, the diameter of seminiferous tubules' lumen decreased significantly in 2/3 SCI and Tx compared to control, sham, and 1/3 SCI groups. Concerning cellular component, the number of spermatocytes and spermatids layers significantly decreased in both 1/3 and 2/3 SCI in comparison to normal. However, Tx had the most prominent deteriorating effect on these layers; indicating impairment in the process of spermatogenesis. These results show that the spinal tracts are part of the neural circuitries innervating the testis and responsible for their structural support. These tracts are mainly distributed between the lateral and ventral funiculi at T8 spinal level. Consequently, sparing ventral funiculi in the SCI prevents the severe decline in spermatogenesis., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Objectives: The purpose of the study was to examine hearing thresholds among dental personnel. The secondary aim was to evaluate sound levels among dental equipment that dental personnel are exposed to., Methods: Two hundred forty-four dentists, dental technicians, dental assistants, and dental students participated. Sixty-two participated as a control group. Audiological thresholds for the test groups were compared to the control group. All participants were from Jordan University Hospital. Participants completed a questionnaire in addition to their audiometric testing. Otoscopy, tympanometry, and pure tone audiometry were included in their assessment. Three-factor ANOVA and t tests were utilized to assess the statistical differences of hearing thresholds among the groups and between the two ears. Pearson correlation test was used to assess the effect of age, experience, and duration of exposure on the degree of hearing loss in the test groups for both ears., Results: The authors reported statistically significant differences among hearing thresholds between the control group and others. Left hearing thresholds were noted to be significantly poorer in the left versus right ear at 1000, 2000, 4000, and 8000 Hz in dental assistants. The authors also reported a significant relationship between the degree of hearing impairment among dental assistants and the daily duration of exposure to dental occupational noise, followed by age., Conclusion: Hearing impairment was higher among dental professionals than the control group and especially among dental assistants and technicians. The authors recommended screening guidelines and adapting hearing protection methods for dental professionals and particularly for dental assistants and technicians., (© 2019 The Authors. Journal of Occupational Health published by John Wiley & Sons Australia, Ltd on behalf of The Japan Society for Occupational Health.)

Objectives: To investigate the prevalence and nature of oral health problems among workers exposed to acid fumes in two industries in Jordan., Setting: Jordan's Phosphate Mining Company and a main private battery factory., Design: Comparison of general and oral health conditions between workers exposed to acid fumes and control group from the same workplace., Subjects and Methods: The sample consisted of 68 subjects from the phosphate industry (37 acid workers and 31 controls) drawn as a sample of convenience and 39 subjects from a battery factory (24 acid workers and 15 controls). Structured questionnaires on medical and dental histories were completed by interview. Clinical examinations were carried out to assess dental erosion, oral hygiene, and gingival health using the appropriate indices. Data were statistically analysed using Wilcoxon rank-sum test to assess the significance of differences between results attained by acid workers and control groups for the investigated parameters., Results: Differences in the erosion scores between acid workers in both industries and their controls were highly significant (P<0.05). In both industries, acid workers showed significantly higher oral hygiene scores, obtained by adding the debris and calculus scores, and gingival index scores than their controls (P<0.05). The single most common complaint was tooth hypersensitivity (80%) followed by dry mouth (77%) on average., Conclusion: Exposure to acid fumes in the work place was significantly associated with dental erosion and deteriorated oral health status. Such exposure was also detrimental to general health. Findings pointed to the need of establishing appropriate educational, preventive and treatment measures coupled with efficient surveillance and environmental monitoring for detection of acid fumes in the workplace atmosphere.