Ashraf Abukaraky - Academia.edu (original) (raw)

Papers by Ashraf Abukaraky

BMC Pediatrics, 2022

Background The Syrian conflict has had a massive impact on the dental health of refugees. Dental ... more Background The Syrian conflict has had a massive impact on the dental health of refugees. Dental extraction is a good indicator of socioeconomic position and degree of oral hygiene, however there is a scarcity of evidence in the scientific literature that characterizes the reasons for extraction in refugees. Aims and methods The current study looked at the extraction causes and related sociodemographic variables of 322 Syrian refugees (46.3% females, 53.7% males) who were treated in a dental clinic in Zaatari camp (Jordan), from September to December 2019. All child Syrian refugees (aged 4–16) visiting the facility were eligible to participate. A validated semi-structured survey was used to collect clinical and sociodemographic data from the research sample. Chi-square test, Independent sample t-test, and ANOVA test were used to examine associations between the different variables. The significance level was set at P < 0.05. Results The total number of teeth extracted was 397: 25...

Journal of Oral and Maxillofacial Surgery, 2020

PURPOSE We aimed to investigate whether cone-beam computed tomography (CBCT) alters the treatment... more 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 < .05) and on CBCT (odds ratio, 5.0; P < .005). 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.

Medicina Oral Patología Oral y Cirugia Bucal, 2018

Background: Patients search YouTube for health-care information. Purpose: To examine what YouTube... more Background: Patients search YouTube for health-care information. Purpose: To examine what YouTube offers patients seeking information on dental implants, and to evaluate the quality of provided information. Material and Methods: A systematic search of YouTube for videos containing information on dental implants was performed using the key words "Dental implant" and "Tooth replacement". Videos were examined by two senior Oral and Maxillofacial Surgery residents who were trained and calibrated to perform the search. Initial assessment was performed to exclude non-English language videos, duplicate videos, conference lectures, and irrelevant videos. Included videos were analyzed with regard to demographics and content's usefulness. "Information for patients" available from the American Academy of Implant Dentistry, European Association of Osseointegration, and British Society of Restorative Dentistry were used for benchmarking. Results: A total of 117 videos were analyzed. The most commonly discussed topics were related to procedures involved in dental implantology (76.1%, n=89), and to the indications for dental implants (58.1%, n=78). The mean usefulness score of videos was poor (6.02 ±4.7 [range 0-21]), and misleading content was common (30.1% of videos); mainly in topics related to prognosis and maintenance of dental implants. Most videos (83.1%, n=97) failed to mention the source of information presented in the video or where to find more about dental implants. Conclusions: Information about dental implants on YouTube is limited in quality and quantity. YouTube videos can have a potentially important role in modulating patients' attitude and treatment decision regarding dental implants.

International Journal of Morphology, 2019

Deep lingual undercut (LU) is commonly encountered in the posterior mandible, and is considered a... more Deep lingual undercut (LU) is commonly encountered in the posterior mandible, and is considered a risk factor in dental implants. In this study we investigated the value of data extracted from OPGs in predicting LU depth. Such predictors might be valuable in reducing the chance of lingual plate perforation (LPP) by recommending CBCTs prior to dental implant insertion when deep LU is anticipated We aimed at assessing the following variables as potential predictors of LU depth: 1) alveolar process height (measured on OPGs), 2) alveolar process width (measured on CBCTs), and 3) the distance from apical region of dental alveoli to superior margin of IAN canal (measured on OPGs). 128 CBCTs and corresponding OPGs of posterior mandibles of 128 patients (70 females, 58 males; age range=18-87 years, mean age=45.8 years, SD=17.0 years) were used. Only dentate sites of lower first (LM1) and second molars (LM2) were considered. Four predictors of LU depth were found, the strongest was the ratio between alveolar process width (which could be assessed clinically) and alveolar process height as measured on OPGs (r=.454 at LM1 site, r=.592 at LM2 site). Predictors derived from OPG measurements might be valuable in anticipating LU depth and might be more valuable when combined with alveolar process width (which might be assessed clinically). We recommend considering the suggested predictors in assessing the need of CBCT prior to immediate dental implant insertion in posterior mandible.

Odonto-stomatologie tropicale = Tropical dental journal, 2012

Central muco epidermoid carcinomas (CMC) are rare tumours, representing about 2 to 3% of all muco... more Central muco epidermoid carcinomas (CMC) are rare tumours, representing about 2 to 3% of all mucoepidermoid carcinomas. Usually affecting the mandible, they appear as uni- or multilocular radiolucent lesions. We report a case of CMC in a 52-year-old Middle Eastern woman who presented with pain, limitation of jaw movement and tingling sensation of the tongue, related to a radiolucent lesion in the angle of the mandible. The lesion was first detected but not diagnosed in another hospital three years earlier. We describe the progression of the lesion over the past three years and describe the clinical, radiographic, histopathological, and surgical aspects of the case.

Nuclear Medicine Communications, 2014

Objectives The aim of the study was to evaluate the diagnostic accuracy of various single photon ... more Objectives The aim of the study was to evaluate the diagnostic accuracy of various single photon emission computed tomography (SPECT) quantitative methods in patients with condylar hyperplasia (CH) and to investigate whether normal condylar activity changes with age. Patients and methods We analyzed the SPECT images of 33 patients with CH and those of 16 control individuals. Regions of interest (ROIs) were drawn on whole condyle, or fixed-size ROIs were drawn on both condyles and the clivus on the slice with higher activity [a two-dimensional (2D) approach] and on the summation of five adjacent transaxial slices [a three-dimensional (3D) approach]. A percentage difference between both condyles of above 10% or a cutoff value of 1.44 or 1.88 for abnormal condyle/clivus ratio was considered abnormal. Results Seventeen patients with active CH, 16 with inactive CH, and 16 control individuals were evaluated. The highest sensitivity and highest specificity were observed for the whole-condyle approach (88 and 87%, respectively), followed by the percentage 2D maximum condyle/total (82.4 and 81.3%, respectively). The condyle/clivus ratio yielded low sensitivity for both 2D and 3D approaches. No effect of age on condylar activity was demonstrated. No statistically significant difference in condyle/clivus ratio was evident between patients with active and those with inactive CH. Conclusion Use of 2D maximum fixed-size ROI and percentual difference in condylar activity offers optimal diagnostic accuracy in patients with CH and should be encouraged in future studies. The condyle/clivus ratio offers suboptimal results and cannot, therefore, be recommended. No effect of age on normal condylar activity was demonstrated. Nucl Med Commun

Medical Principles and Practice, 2009

Objective: To assess the extent of self-medication with antibiotics (SMA) in a Jordanian populati... more Objective: To assess the extent of self-medication with antibiotics (SMA) in a Jordanian population, and to evaluate the sociodemographic factors affecting this behaviour. Subjects and Methods: Face-to-face interviews were conducted with 477 patients aged 16–65 years attending the Department of Dentistry, University of Jordan Hospital. Socio-demographic data were collected and interviewees were asked about their SMA behaviour during the last 6 months, the reasons and motives for this behaviour, and the source and dose of the antibiotics were noted. Results: The prevalence rate of SMA in the sample during the 6 months preceding the interview was 40.7% (194/477). Patients aged 36–55 years and those in the middle-class income group were most likely to perform SMA. SMA was mainly for sore throats, common colds and dental infections, and community pharmacies were the major source (104, 53.6% cases). Amoxicillin was the most commonly used antibiotic, and only 73 (37.6%) patients followed ...

Medical Principles and Practice, 2010

Objective: The objective of this study was to estimate the frequency of postoperative lingual ner... more Objective: The objective of this study was to estimate the frequency of postoperative lingual nerve (LN) impairment after the surgical removal of mandibular third molars (M3) and to identify potential risk indicators. Subjects and Methods: A prospective cohort study involving 321 subjects who had 443 mandibular M3 surgically extracted at the University Hospital, Amman, Jordan. Predictor variables were categorized as patient-, anatomy- and operation-specific. The outcome variable was the presence or absence of LN impairment. Bivariate and multivariate analyses were performed to identify independent predictors. Results: The prevalence of temporary LN hypoesthesia was 2.5% and all 11 cases resolved within 6 months. Factors that predicted LN injury by univariate analysis were horizontal and mesioangular tooth angulation, bone removal, tooth sectioning, longer operations, lingual flap retraction and bleeding into the socket. In the multivariate logistic regression model, lingual flap ret...

Journal of Oral and Maxillofacial Surgery, 2009

To determine the postoperative morbidity of harvesting cancellous bone from the anterior iliac cr... more 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 Ϯ 4.1 years (mean Ϯ SD), and follow-up was 23.2 Ϯ 19.3 months. Patients spent a median of 3 days in hospital (range ϭ 2-4 days), patients walked normally after 10.4 Ϯ 13.2 days and resumed normal activities, including sports, after a mean of 16.0 Ϯ 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 welltolerated, allows early resumption of normal activities, has no effect on growth, has minimal morbidity, and a reasonable esthetic outcome.

Journal of Oral and Maxillofacial Surgery, 2008

The aim of this study was to estimate the frequency of postoperative complications after mandibul... more 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 Ϯ 3.32 years; 64.9% were females. In the multivariate logistic regression model, age (P ϭ .033, odds ratio [OR] ϭ 1.178), M3 side in relation to the handedness of the operator (P ϭ .048, OR ϭ 4.078), and lingual retraction (P ϭ .001, OR ϭ 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 Ͻ .001, OR ϭ 1.085). Conclusion: Postoperative morbidity increases with older age, deeper impaction, M3 side differing from the handedness of the operator, and longer procedures.

Clinical Implant Dentistry and Related Research, 2009

Background: Cholesterol granuloma (CG) is a foreign-body reaction to the deposition of cholestero... more Background: Cholesterol granuloma (CG) is a foreign-body reaction to the deposition of cholesterol crystals. Its occurrence in the paranasal sinuses is very rare. Purpose: This report describes a new case of maxillary sinus CG discovered incidentally during sinus-floor augmentation for dental implant placement in a 60-year-old female patient. Materials and Methods: The preoperative clinical and radiological examinations revealed a normal maxillary antrum with no evidence of sinus pathology. After lateral osteotomy, a dark-green, viscous soft tissue mass appeared through the thin mucous membrane inside the sinus. Enucleation and curettage of the sinus contents including the sinus membrane were performed for histopathologic analysis. The augmentation and implant placement procedures were postponed. Results: Histopathologic analysis showed several fragments of granulation tissue containing diffuse cholesterol clefts surrounded by mixed chronic inflammatory cell infiltrate including plasma cells and lymphocytes. These features were compatible with the diagnosis of CG. The patient was followed up for 3 months after the first procedure, and a second attempt of sinus augmentation and dental implant insertion was then carried out. The inserted dental implants were followed up for 6 months without any complications. Conclusions: CG of maxillary sinus can be an incidental finding. For this reason, the final diagnosis can only be achieved after examination of the material under the microscope.

BMC Research Notes, 2011

Background: In oral implantology, there is no consensus on the most appropriate regimen for antib... more Background: In oral implantology, there is no consensus on the most appropriate regimen for antibiotics prescribing, the decision to prescribe antibiotic is usually based on procedure, patient and clinician related factors. The aim of this study was to investigate the rationale of antibiotic prescribing among Jordanian clinicians who practice oral implantology. Findings: The target sample for the study was the 250 Jordan Dental Implant Group members. A five page questionnaire contained 41 questions, both closed and open questions were used to collect data. Statistical analysis was performed using SPSS Windows 16.0 (SPSS Inc., Chicago, IL, USA). Descriptive statistics were generated. The response rate was (70.4%) 176/250. Mean age was 37.2 yrs, 49.4% always prescribe antibiotics mainly oral amoxicillin and amoxicillin with clavulinic acid. Antibiotics prescribing increased with flap raising, multiple implants and sinus or bone augmentation. Patient medical condition, periodontitis and oral hygiene were the most important clinical factors in antibiotic prescribing, non-clinical factors were; reading scientific materials, courses and lectures, knowledge gained during training, and the effectiveness and previous experience with the drug. Conclusions: Wide variations in antibiotics types, routes, dose and duration of administration were found. Recommendations on antibiotic prescribing are needed to prevent antibiotic overprescribing and misuse.

The British Journal of Radiology, 2010

International Journal of Oral and Maxillofacial Surgery

Pseudoaneurysms in the external carotid artery system are rare, mostly reported in the superficia... more Pseudoaneurysms in the external carotid artery system are rare, mostly reported in the superficial temporal and facial arteries. The bilateral sagittal split osteotomy has a low incidence of complications requiring emergency interventions. We report the case of a patient with acute bleeding from a pseudoaneurysm of the inferior alveolar artery diagnosed by angiography and treated successfully by super-selective embolization.