Mahmoud Al-Dajani

Bio: Mahmoud Al-Dajani is an academic researcher from University of Toronto. The author has contributed to research in topics: Perforation (oil well) & Sinus lift. The author has an hindex of 8, co-authored 12 publications receiving 232 citations. Previous affiliations of Mahmoud Al-Dajani include Boston University & International University, Cambodia.

Incidence, Risk Factors, and Complications of Schneiderian Membrane Perforation in Sinus Lift Surgery: A Meta-Analysis.

Abstract: Objectives To evaluate the incidence of Schneiderian membrane perforation occurring during sinus lift surgery, and to investigate possible risk factors and associated complications. Materials and methods A systematic search for papers published between 1975 and 2015 was performed in MEDLINE, EMBASE, Scopus, Web of Science, Trip, Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses. The quality assessment of each study was performed using the GRADE system. All extracted data were synthesized using either fixed or random effect models as indicated. Results Out of 1652 sinus lift surgeries reported in 12 studies, 388 membrane perforations occurred. The weighted incidence rate of perforation was 23.5% ranging from 3.6% to 41.8%. Both reduced membrane thickness and sinus septa increased the risk of perforation. The difference in the weighted implant survival rates between perforated and nonperforated side was not significant (P = 0.24). The use of piezoelectric instrumentation appears to reduce the perforation risk. Conclusions With an incidence ratio of 1:4, membrane perforation is a common surgical complication during sinus lift surgery. We should keep in mind that appropriately handled and treated membrane perforation tends to show comparable implant survival when compared with intact membrane.

Recent Trends in Sinus Lift Surgery and Their Clinical Implications.

Abstract: Background Sinus lift procedures are used to allow residual bone to accommodate functional implants in atrophic posterior maxilla. Numerous anatomical and surgical advancements in sinus lift surgery are still inspiring clinicians. Purpose The purpose of this study was to describe the recent trends in sinus lift surgery focusing on implant survival, bone grafting, anatomical and surgical considerations, and their clinical implications on the practice of implant dentistry in atrophic posterior maxilla. Materials and Methods We performed an extensive search in MEDLINE, Embase, Scopus, Web of Science, Trip, Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses. Articles were critically reviewed to determine the level of evidence as per the Canadian Task Force on Preventive Health Care. Results Comprehensive assessment of sinus septa, sinus pathology, and bone quality and quantity using three-dimensional cone beam computed tomography radiographs is important before placing implants in posterior maxilla. With a residual bone height of less than 5 mm, the survival rate of implant decreases substantially. Lateral window approach can increase the vertical bone height to greater than 9 mm, while osteotome approach can increase this height from 3 to 9 mm. The perforation of Schneiderian membrane doubles the risk for the incidence of sinusitis or infection. The use of piezoelectric surgery allows adequate sinus lift while protecting soft tissues and minimizing patient discomfort. Conclusions Although both osteotome and lateral window procedures can help clinicians in overcoming the challenges of placing implants in atrophic posterior maxilla, pre-implant residual bone height is crucial in determining the survival of these implants. Future research directions should consider study designs grounded on longitudinal randomized controlled trials of large sample size.

Comparison of Dental Caries Prevalence in Patients With Cleft Lip and/or Palate and Their Sibling Controls

Abstract: Objective: To evaluate the prevalence of dental caries in patients with cleft lip and/or palate and their cleft-free sibling controls. Methods: The two subject groups (patient and control) comprised 106 participants. The former group consisted of 53 patients with cleft lip and/or palate, aged 12 to 29 years, who visited the Oral and Maxillofacial Surgery Hospital at Damascus University of Syria. The control group consisted of the patients' siblings who had no clefts, and they were sex matched to the patient group. Dental caries were examined clinically and were reported using the decayed, missing, and filled permanent teeth (DMFT) index. The DMFT scores were compared between the two groups. Results: The author found an overall association of dental caries with the presence of cleft lip and/or palate (odds ratio = 2.52; 95% confidence interval = 1.389–4.574; p < .05). The DMFT index scores were proportionally higher in patients with cleft lip and/or palate compared with the control group (p < ...

A Cohort Study of the Patterns of Third Molar Impaction in Panoramic Radiographs in Saudi Population.

Abstract: Objectives To evaluate the epidemiological patterns of third molar impaction in a cohort of patients living in the north of Saudi Arabia. Materials and Methods A retrospective cohort study comprised of analysing 2550 Orthopantomograms (OPGs) belonging to patients who attended Aljouf University College of Dentistry between September 2013 and December 2015. OPGs were examined to determine the frequency of third molar impaction, their levels of eruption and angulations. Mixed effects logistic regression analysis was performed to calculate adjusted odds ratios. Data were weighted by age and sex based on population regional estimates. Results 1551 patients (60.8%) with a mean age of 33.5 years-old (95%CI: 32.9 to 34) demonstrated 2650 impacted third molars. Third molars were more likely present in patients aged from 20 to 39 years-old (p<0.001); and in mandible more than maxilla (p<0.001). It showed highest vertical impaction and higher impaction rate in mandible than maxilla. Level A impaction was the most common among other levels by 1365 (53.5%). Vertical impaction was the most common pattern (1354 patients; 53.1%). Mesioangular impaction ranked second in mandible, while distoangular impaction ranked second in maxilla. There was no statistically significant difference between males and females concerning impaction frequency, depth levels and angulations. Conclusion Impacted third molars is still a public health concern among youth and young adults. Vertically impacted mandibular third molars with their occlusal plane at the same level as the occlusal plane of adjacent tooth is the most prevalent pattern of third molar impaction in the northern region of Saudi Arabia.

An assessment of maxillofacial fractures: a 5-year study of 237 patients an assessment of maxillofacial fractures: a 5-year study of 237 patients an assessment of maxillofacial fractures: a 5-year study of 237 patients

Abstract: PURPOSE This descriptive analytical study assesses the cause, type, incidence, demographic, and treatment data of maxillofacial fractures managed at our medical center during a 5-year period and compares them with the existing body of literature on the subject. PATIENTS AND METHODS A 5-year retrospective clinical and epidemiologic study evaluated 237 patients treated for maxillofacial fractures from 1996 to 2001 at one medical center. There were 211 male patients (89%) and 26 (11%) female patients. The patients ranged in age from 3 to 73 years, with 59.0% (140 patients) in the 20- to 29-year age group. A number of parameters, including age, gender, cause of injury, site of injury, type of injury, treatment modalities, and complications, were evaluated. All maxillofacial injuries were assessed and treated by a single oral and maxillofacial surgeon. Other concomitant bodily injuries were treated by appropriate consultant specialists. RESULTS There were 173 (72.9%) mandibular, 33 (13.9%) maxillary, 32 (13.5%) zygomatic, 57 (24.0%) zygomatico-orbital, 5 (2.1%) cranial, 5 (2.1%) nasal, and 4 (1.6%) frontal injuries. Car accidents caused 73 (30.8%), motorcycle accidents caused 55 (23.2%), altercations 23 (9.7%), sports 15 (6.3%), and warfare caused 23 (9.7%) of the maxillofacial injuries. Regarding distribution of mandibular fractures, 32% were seen in the condylar region, 29.3% in the symphyseal-parasymphyseal region, 20% in the angle region, 12.5% in the body, 3.1% in the ramus, 1.9% in the dentoalveolar, and 1.2% in the coronoid region. The distribution of maxillary fractures was Le Fort II in 18 (54.6%), Le Fort I in 8 (24.2%), Le Fort III in 4 (12.1%), and alveolar in 3 (9.1%). Of the 173 mandibular fractures, 56.9% were treated by closed reduction, 39.8% by open reduction, and 3.5% by observation only. Of 33 maxillary fractures, 54.6% were treated using closed reduction, 40.9% using open reduction, and 4.5% with observation only. Approximately 52.1% of the patients were treated under general anesthesia, and 47.9% were treated under local anesthesia and sedation. Postsurgical complications were recorded in 5% of patients. These complications included infection, asymmetry, and malocclusion. Overall mortality in this series was 0.84% (2 patients); mortality was caused by pulmonary infection. CONCLUSION The findings of this study, compared with similar studies reported in the literature, support the view that the causes and incidence of maxillofacial injuries vary from 1 country to another.

Hospital-based emergency department visits involving dental conditions: profile and predictors of poor outcomes and resource utilization.

Abstract: Background Untreated dental conditions may progress to lesions that are severe enough to necessitate emergency visits to hospitals. The authors conducted a study to investigate nationally representative trends in U.S. hospital-based emergency department (ED) visits involving dental conditions and to examine patient-related characteristics associated with ED charges. Methods The authors used the Nationwide Emergency Department Sample of the Healthcare Cost and Utilization Project, sponsored by the Agency for Healthcare Research and Quality, for the years 2008 through 2010. They selected all ED visits involving patients with a diagnosis of either dental caries, pulpal or periapical lesions, gingival or periodontal conditions, or mouth cellulitis or abscess. Outcomes examined included post-ED disposition status and hospital ED charges. Results During the study period, 4,049,361 ED visits involved diagnosis of a dental condition, which is about 1 percent of all ED visits occurring in the entire United States. Uninsured patients made about 40.5 percent of all dental condition–related ED visits. One hundred one patients in the study died in EDs. The mean hospital ED charge per visit was approximately $760 (adjusted to 2010 dollars), and the total ED charges across the entire United States during the three-year study period was $2.7 billion. Conclusions Patients without insurance are a cohort at high risk of seeking dental care in hospital-based ED settings. A substantial amount of hospital resources are used to treat dental conditions in ED settings. Patients with mouth cellulitis, periodontal conditions and numerous comorbidities are likely to incur higher ED charges. Practical Implications Dental conditions can be treated more effectively in a dental office setting than in hospital-based settings.

Genome-wide Association Scan for Childhood Caries Implicates Novel Genes

Abstract: Dental caries is the most common chronic disease in children and a major public health concern due to its increasing incidence, serious health and social co-morbidities, and socio-demographic disparities in disease burden. We performed the first genome-wide association scan for dental caries to identify associated genetic loci and nominate candidate genes affecting tooth decay in 1305 US children ages 3-12 yrs. Affection status was defined as 1 or more primary teeth with evidence of decay based on intra-oral examination. No associations met strict criteria for genome-wide significance (p < 10E-7); however, several loci (ACTN2, MTR, and EDARADD, MPPED2, and LPO) with plausible biological roles in dental caries exhibited suggestive evidence for association. Analyses stratified by home fluoride level yielded additional suggestive loci, including TFIP11 in the low-fluoride group, and EPHA7 and ZMPSTE24 in the sufficient-fluoride group. Suggestive loci were tested but not significantly replicated in an independent sample (N = 1695, ages 2-7 yrs) after adjustment for multiple comparisons. This study reinforces the complexity of dental caries, suggesting that numerous loci, mostly having small effects, are involved in cariogenesis. Verification/replication of suggestive loci may highlight biological mechanisms and/or pathways leading to a fuller understanding of the genetic risks for dental caries.

Incidence, Risk Factors, and Complications of Schneiderian Membrane Perforation in Sinus Lift Surgery: A Meta-Analysis.

Abstract: Objectives To evaluate the incidence of Schneiderian membrane perforation occurring during sinus lift surgery, and to investigate possible risk factors and associated complications. Materials and methods A systematic search for papers published between 1975 and 2015 was performed in MEDLINE, EMBASE, Scopus, Web of Science, Trip, Cochrane Oral Health Group's Trials Register, Cochrane Central Register of Controlled Trials, and ProQuest Dissertations & Theses. The quality assessment of each study was performed using the GRADE system. All extracted data were synthesized using either fixed or random effect models as indicated. Results Out of 1652 sinus lift surgeries reported in 12 studies, 388 membrane perforations occurred. The weighted incidence rate of perforation was 23.5% ranging from 3.6% to 41.8%. Both reduced membrane thickness and sinus septa increased the risk of perforation. The difference in the weighted implant survival rates between perforated and nonperforated side was not significant (P = 0.24). The use of piezoelectric instrumentation appears to reduce the perforation risk. Conclusions With an incidence ratio of 1:4, membrane perforation is a common surgical complication during sinus lift surgery. We should keep in mind that appropriately handled and treated membrane perforation tends to show comparable implant survival when compared with intact membrane.

Caries prevalence in non-syndromic patients with cleft lip and/or palate: a meta-analysis.

Abstract: Aim: To evaluate caries prevalence in non-syndromic patients with cleft lip and/or palate (CLP) in comparison with a matched non-CLP population. Methods: A literature search was conducted in order to identify articles reporting on the prevalence of caries in CLP versus non-CLP individuals. The related citations function in PubMed and reference lists of retrieved articles were used to expand the search. Only studies with a suitable matched control group were included. From each included study, study and sample characteristics were extracted, as were results. The main outcome was the score given for caries prevalence in each study, using a well-defined index. The data were entered into meta-analysis software and a meta-analysis performed using the random-effects model. Results: From the 592 articles initially identified, 7 were chosen according to preset inclusion and exclusion criteria. All of the studies were cross-sectional in nature, and used the decayed, missing, and filled (DMF/dmf) indices as the final outcomes. The included studies involved a total of 474 CLP patients aged 1.5-29 years. When looking at permanent teeth, data from 5 studies suggest that CLP patients have a higher number of DMF teeth than the controls (mean difference 1.38; p = 0.003). For deciduous teeth, data from 4 studies suggest that CLP patients have a higher number of dmf teeth than the controls (mean difference 1.51; p = 0.03). Conclusion: Non-syndromic patients with CLP tend to have higher caries prevalence, both in the permanent and the deciduous dentition, in comparison with matched non-CLP controls.