Outcomes and impacts of blow-out fractures of the orbit

A blow-out fracture of the orbit is defined as one with orbital wall and or floor fracture without orbital rim involvement. The management of this injury and its timing continue to be a matter of some debate. One of the main reasons for this debate is the lack of unifying objective, quantitative, clinical measures of diplopia severity that encompass both the clinical and patient perspectives. This thesis consists of two distinct studies: one study examines the factors associated with outcome of blow-out fractures, whilst the other examines the patient perspective and experience of this type of fracture. The aim of this thesis is to study the impacts and determine the factors that influence management outcomes with regard to diplopia. A combination of retrospective data and qualitative data was used to help achieve this aim. The retrospective study demonstrated binocular single vision assessment to be a valuable tool in assessing management outcome. In addition, the data demonstrate it has a significant prognostic value in blow-out fractures of the orbit: lower pre-operative diplopia scores, the more chance of improvement in diplopia scores after surgery. Lower pre-operative diplopia scores were associated with a longer follow up time and a greater number of follow up visits required. Demographic factors, surgical timing, type of surgical approach and surgical implant material were shown to have no significant influence on diplopia. Orbital fat herniation in the absence of orbital muscle involvement, as determined by CT scan interpretation, appears to have no significant influence on diplopia when compared to fractures where no tissue herniation was observed on diplopia scores in blow-out fractures. The impact of blow-out fractures from the patient’s perspective was reflected through distress and frustration which negatively influence patients’ daily activities, including their employment. This distress and frustration was reported to centre around the individual’s fear of losing their vision. This misconception appears to be due to potentially ineffective patientclinician communication.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Outcomes and impacts of blow-out fractures of the orbit

A blow-out fracture of the orbit is defined as one with orbital wall and or floor fracture without orbital rim involvement. The management of this injury and its timing continue to be a matter of some debate. One of the main reasons for this debate is the lack of unifying objective, quantitative, clinical measures of diplopia severity that encompass both the clinical and patient perspectives. This thesis consists of two distinct studies: one study examines the factors associated with outcome of blow-out fractures, whilst the other examines the patient perspective and experience of this type of fracture. The aim of this thesis is to study the impacts and determine the factors that influence management outcomes with regard to diplopia. A combination of retrospective data and qualitative data was used to help achieve this aim. The retrospective study demonstrated binocular single vision assessment to be a valuable tool in assessing management outcome. In addition, the data demonstrate it has a significant prognostic value in blow-out fractures of the orbit: lower pre-operative diplopia scores, the more chance of improvement in diplopia scores after surgery. Lower pre-operative diplopia scores were associated with a longer follow up time and a greater number of follow up visits required. Demographic factors, surgical timing, type of surgical approach and surgical implant material were shown to have no significant influence on diplopia. Orbital fat herniation in the absence of orbital muscle involvement, as determined by CT scan interpretation, appears to have no significant influence on diplopia when compared to fractures where no tissue herniation was observed on diplopia scores in blow-out fractures. The impact of blow-out fractures from the patient’s perspective was reflected through distress and frustration which negatively influence patients’ daily activities, including their employment. This distress and frustration was reported to centre around the individual’s fear of losing their vision. This misconception appears to be due to potentially ineffective patientclinician communication.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

The influence of peripheral-bone-removal protocol on bone augmentation in dental implant surgery: 5-year clinical retrospective study

Background: Bone augmentation aims to provide sufficient bone volume around dental implants. Available bone augmentation methods include autogenous bone grafts, xenografts, and alloplastic materials. All have their advantages and disadvantages. However, autogenous bone graft remains the gold standard for bone augmentation. Autogenous bone grafts are usually taken from the patient’s oral donor sites such as the chin and mandibular ramus. However, there is a newly developed implant preparation protocol, known as the peripheral-bone-removal (PBR) technique, which can provide bone augmentation from the dental implant site. Purpose: This study aims to determine the need for bone substitute materials in the PBR technique in dental implant surgery. Methods: This study included 130 patients who were treated for dental implants. These patients were treated between 7.1.2018 and 3.2.2023. Six dental implant systems were used. Five of these systems (ImplantKa®, DeTech®, NeoBiotech®, Easy Implant®, and Dentaurum® Implant) used a conventional method (sequential drilling technique). The sixth (IBS®) system used the PBR protocol. Both descriptive and Chi-Square Test statistics were used for data analysis. Results: The included patients were treated with a total of 198 dental implants. Seventy patients were treated with the PBR protocol, while 60 patients were treated with the sequential drilling protocol. For the PBR protocol, only 2 cases required bone substitute material, whereas 11 cases treated with the sequential drilling protocol required augmentation materials. This difference between both drilling protocols has been statistically confirmed (P=0.008). Conclusion: The PBR technique appears to be less traumatic and more cost-effective for cases that require horizontal bone augmentation

Barriers Toward Better CBCT Knowledge, Attitude, and Practice

Objective: This study attempts to evaluate the knowledge, attitude, and clinical practice of Iraqi dentists toward CBCT use, referral patterns, observed challenges, and the impacts of previous training on its adoption. Material and Methods: A total of 202 Iraqi dentists participated in this study and self-administered questionnaires were distributed to them via Google Forms from 3/2/2025  to 1/4/2025. Participants included both general practitioners (GPs) and specialists regardless of their years of experience in different dental fields. Results: Dental specialists showed significantly higher referral frequency for CBCT compared with GPs (P = 0.002). However, there was no significant relationship between gender and referral frequency for CBCT (P = 0.068), also, there were no statistically significant differences were noticed in the specialists' responses in comparison to GPs about following guidelines for CBCT request (P = 0.167), having formal training on CBCT (P = 0.255), their adequacy of knowledge of CBCT (P = 0.293), and the need for CBCT training (P = 0.058). There was a significant difference in the specialist responses compared to GPs about the necessity of CBCT in daily practice (P = 0.014). While there were no significant differences between both genders and years of practice (P = 0.138, P = 0.091), respectively, regarding the necessity of CBCT. Also, no significant relationship was found between both specialties and age groups (P = 0.14, P = 0.839), respectively regarding the primary purpose of CBCT. A highly significant relationship has been found between being  aspecialist versus GP and CBCT radiation dose compared to CT (P = 0.001). While no significant relationship when CBCT dose compared to orthopantomography (OPG) (P = 0.084). Conclusion: The major barrier toward better CBCT KAP was the lack of undergraduate training to CBCT imaging. Initiating a new educational initiatives program and establishing clear referral guidelines are crucial to fostering the effectiveness and ensuring the appropriate use of CBCT in dental practice across Iraq

Large perforating Submandibular Stone-A Case Report

Salivary stone (sialothiasis) is a calcifying concentration within the ductal system of salivary gland [1]. The majority of salivary calculi occur in the submandibular gland duct because of its length, upward course and the thicker mucus [2]

Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study

         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of  infection  in  some situations  does not outweigh  the risks which  attend the administration of even the safest antibiotic drug. The aim of this study was to compare between 2 prophylactic protocols  in  out  patients  undergoing  oral  surgical  procedures.  Thirty   patients, selected from the attendants of oral surgery clinic in Al-Karamah Dental Center, were subjected to different oral surgical procedures under local  anesthesia. These patients were given single dose antibiotic  prophylaxis in 2 groups; 1st group were 15 patients given 1 million i.u. of procaine  penicillin  I.M. 30 minutes  before oral  surgery, 2nd group were 15 patients given 600mg clindamycin orally 1 hours before oral surgery. The  maximum  time  for  all  procedures  was 2 hours. There  was  no  difference between  procaine  penicillin  (1 million i.u.), and  clindamycin (600mg),  regimens concerning post operative infection in out patient’s oral surgical procedures.&#x0D; Key words: Antibiotic prophylaxis, outpatient oral surgery</jats:p

Single Dose Antibiotic Prophylaxis in Outpatient Oral Surgery Comparative Study

         It is clear that correct application of antibiotic prophylaxis can reduce the incidence of infection  resulting from the bacterial  inoculation in a variety of clinical situations; it cannot   prevent  all  infections  any  more  than it  can   eliminate  all  established infections. Optimum  antibiotic   prophylaxis  depends on:  rational  selection  of the drug(s),  adequate  concentrations  of the  drug  in  the  tissues that  are at risk, and attention to  timing  of  administration.  Moreover,  the  risk  of  infection  in  some situations  does not outweigh  the risks which  attend the administration of even the safest antibiotic drug. The aim of this study was to compare between 2 prophylactic protocols  in  out  patients  undergoing  oral  surgical  procedures.  Thirty   patients, selected from the attendants of oral surgery clinic in Al-Karamah Dental Center, were subjected to different oral surgical procedures under local  anesthesia. These patients were given single dose antibiotic  prophylaxis in 2 groups; 1st group were 15 patients given 1 million i.u. of procaine  penicillin  I.M. 30 minutes  before oral  surgery, 2nd group were 15 patients given 600mg clindamycin orally 1 hours before oral surgery. The  maximum  time  for  all  procedures  was 2 hours. There  was  no  difference between  procaine  penicillin  (1 million i.u.), and  clindamycin (600mg),  regimens concerning post operative infection in out patient’s oral surgical procedures. Key words: Antibiotic prophylaxis, outpatient oral surger

Drawings as learning aid for the human anatomy students’ based evaluation

Introduction: One of the essential requirements for efficient oral and maxillofacial surgeon is comprehensive knowledge in anatomy of head and neck regions. Authors believe that asking students to draw anatomical sketches will assist them to improve their imaginary memory for human anatomy. However, drawing, as learning aid in anatomy, has not been given enough attention as a learning aid for human anatomy. Aim of the study: To determine dental students&rsquo; level of appreciation to drawings as practical learning aid in human anatomy. Materials and methods: Seventy nine first year dental students in Ibn Sina University for Medical and Pharmaceutical Sciences College of Dentistry for the academic year 2016-2017, were requested to complete a questionnaire. The questions were mostly related to the importance of drawing in anatomy and its relation to Anatomy education. The participation in the questionnaire was optional. Results: This study showed highly significant relationship between the ability to understand anatomy subject and the importance of drawing (P=0.006). It also showed highly significant relationship between the importance of drawings and giving clinical examples during lectures or anatomical labs (P=0.006). Furthermore, the results showed no significant relationship between the importance of drawings and the load of anatomical material, introduced in anatomical lectures and labs (P=0.639). Conclusion: Anatomical drawings, from first year dental students&rsquo; perspective, are a useful learning tool and can relate to different aspects of proper education of human anatomy. Drawings can be implemented as practical tool in human anatomy curriculum for undergraduate dental education

Stress Distribution Around Two Dental Implant Materials with New Designs: Comparative Finite Element Analysis Study

Background: The introduction of modified thread designs is one of the research areas of interest in the dental implantology field. Two suggested Buttress and Reverse Buttress thread designs in TiG5 and TiG4 models are tested against a standard TiG5 Fin Thread design (IBS®). Purpose: The study aims to compare stress distribution around the suggested designs and Fin Thread design. Methods: Three dental implant models: Fin Thread design, and newly suggested Buttress and Reverse Buttress designs of both TiG5 and TiG4 models were tested using FEA for stress distribution using static (70N, 0°) and (400N, 30°) occlusal loads. Results: The main difference between the suggested Buttress design and Fin Thread design lies in the overload (400N, 30°) condition. Maximum Von Mises stress is less in Buttress design than Fin Thread design. On the other hand the level of Von Mises stress over the buccolingual slop of the cancellous bone in Fin Thread design liess within the lowest stress level. The suggested Reverse Buttress design, on the other hand showed almost uniform stress distribution in both TiG4 and TiG4 models with maximum Von Mises stress higher than the elastic modulus of cancellous bone in overload (400N, 30°) condition. Conclusion: The suggested TiG4 Buttress design might have a minor advantage of stress level in cases of stress overload. In contrast, Fin Thread design shows minimal stress over the buccolingual slop of the cancellous bone. The suggested Reverse Buttress design might be more suitable for the D1 bone quality region with the advantage of almost uniform stress distribution</jats:p