Volume 19 – Issue 3 (July – Sep 2010)

BACKGROUND:

Whether root canal treatment (RCT) is performed in single or in multiple sessions, infection control and elimination or reducing postobturation pain is a key factor for the success of RCT. Single visit RCT is now being considered as a good alternative to multiple visit RCT.

The objective of this study was to assess the frequency of post-obturation pain after single visit root canal treatment in teeth with pulpal necrosis along with the effect of age, gender and arch on pain severity after single visit endodontics.

METHODOLOGY:

A total of 70 pulpally necrosed teeth of patients requiring RCT were treated at Operative Department of Altamash Institute of Dental Medicine, Karachi; from July 2008 to Feb 2009. 7 patients did not return for followup, therefore 63 patients were included in the study. The study design was Interventional Quasi experimental. Pre and Postobturation pain was recorded according to verbal rating scale before RCT, after 1st day, one week and after one month. Data was analyzed using the Chi-square test.

RESULT:

Preoperative pain was observed in 57% of patients. While at first day follow up, postoperative pain was observed in 58% of patients. After seventh day pain existed in 14% (p=0.0001) of patients, after one month 8% (p=0.0001) patients remained painful. There was significant difference in severity of post-obturation pain in 16 to 35 year age group as compared to 36 to 40 year age group Severity of pain significantly decreased in 16 to 25 and 26 to 35 age group at 1st, 7th and 1 month recall (p=0.001). Male gender in contrast to female gender had a significantly reduced severity of pain 1st month post operatively(p=0.001). Severity of pain was significantly decreased in maxillary teeth as compared to madibular arch (pre vs. 1 days p=0.006) and (1st day vs. 1st month; p=0.0001).

CONCLUSION:

The lack of post-obturation pain was found to be positively co-related with single visit endodontics in age group of 16-35 years, male gender and maxillary teeth.

OBJECTIVE:

Dental caries and its sequel pulpitis, is one of the most common complaint with which the patient attends a dental office. The diagnosis of pulpitis involves distinguishing the two types, i.e.; the reversible and irreversible pulpitis, through objective and subjective testing. This process is usually straightforward but can at times be difficult due to anatomical, physiological and psychological factors. The Purpose of this questionnaire based survey was to find out the ability of dentists in diagnosing irreversible pulpitis.

METHODOLOGY:

The study design was cross sectional. Two hundred single clinical scenario based questionnaires were distributed among 3 dental colleges. Totally 142 questionnaires were received back. Respondents were the clinical staff (consultants, senior registrar, residents, demonstrator, house officers and final year students) of the 3 dental colleges. The respondents were asked to diagnose the clinical scenario as either reversible or irreversible pulpitis

RESULT:

Most of the participants (81.7%) gave a wrong diagnosis. Worst response was from the final year student category (88.6%) whereas best response was in the resident category (44.4%). The difference was statistically significant (p<0.05).

CONCLUSION:

The ability of participants in diagnosing the clinical scenario correctly was poor in all categories.

KEY WORDS:

Irreversible pulpitis, carious lesion, diagnosis, lingering pain.

OBJECTIVE:

To determine the effect of a chemo mechanical caries removal (CMCR) gel Carisolv™ on shear bond strength (SBS) of conventional glass ionomer cement bonded to human permanent dentin.

METHODOLOGY:

One conventional glass ionomer cement (Fuji IX, GC Co. Tokyo Japan) was used. Sixty four teeth were sectioned occlusally; exposed coronal dentin was polished with silicon papers. Teeth in the control groups (C) were directly bonded to respective glass ionomer cements (GIC). For test groups (T) the polished dentin surface was pre-treated with Carisolv™ (Singlemix Uncoloured Gel, Medi Team, Sweden) prior to bonding. Bonded specimens were stored for 24 hours and stressed to failure in the shear mode.

RESULT:

SBS of Fuji IX, test group (4.97 ± 0.82 MPa) was significantly higher (P = .001) than its control group (3.98 ± 0.67 MPa).

CONCLUSION:

Carisolv™ pre-treatment significantly increased the shear bond strength of conventional glass ionomer cement to dentin.

KEY WORDS:

Shear bond strength; Carisolv™, Chemo-mechanical caries removal, Glass ionomer cements.

OBJECTIVE:

The purpose of this study was to document the characteristics of maxillofacial fractures resulting from road traffic accidents.

METHODOLOGY:

The study was carried on 250 patients presenting with maxillofacial fractures resulting from road traffic accidents. On the basis of history, clinical and radiological examination, fractures were classified as dentoalveolar fracture, mandibular fracture, maxillary fracture (Lefort I, II and III), isolated zygomatic arch fracture, zygomatic complex fracture, nasal bone and orbital fractures. Data was analysed by statistical analysis tool using SPSS version 17.

RESULT:

Males in their 2nd and 3rd decades were the most common victims. Among the isolated bone fractures (n=208), mandible was the most commonly fractured bone (n=104) followed by zygomatic complex (n=50). The frequently observed pattern among mandibular fracture was parasymphysis (31.6%), among zygomatic complex was Group IV (n=29) while maxillary fractures showed a pattern of combined Lefort I, II and III (n=21).

CONCLUSION:

Road traffic accidents are predictable and preventable. Basic knowledge regarding road safety measures and its implementation is necessary. It can be concluded from this study that majority of the patients were young adult males. The most common bone fractured was mandible both in isolation and combination.

KEY WORDS:

Maxillofacial Fractures, Road Traffic Accidents, Facial Trauma.

Abstract

Successful continued growth of infected pulpless immature roots may occur with normal procedure of CaOH placement and minimal disinfection. This case report demonstrates the evidence of continued root growth by the process of revascularization after going through a period of Ca(OH)₂ apexification.

Keywords

Root growth, Revascularization, Necrosed Pulp, Ca(OH)₂

OBJECTIVE:

To find out the most suitable and reliable method for estimation of age of Saudi female children at the time of eruption of a permanent tooth.

METHODOLOGY:

The population used for this cross-sectional study was comprised of female schoolchildren from kindergarten to intermediate schools (pre-school to grade 9) of Riyadh, Saudi Arabia. A total of 4836 children were examined and only 1599 children showed at least one tooth ‘just’ erupted. Height and weight of the selected sample were recorded after the clinical examination. The demographic information was recorded from their personal files of the school record. Number of teeth present at the time of eruption of a new permanent tooth (Method 1) and linear regression (Method 2) were employed to estimate the calendar age.

RESULT:

On average time of 5 years and 9 months, two teeth are erupted in Saudi female children and about 13 years of age all the teeth except third molars are erupted. The regression equation of age (Y) with height(X1), weight(X2) and total number of teeth(X3) erupted was as follows:

2
Ŷ = -6.008 + 0.182 X1 + 0.096 X2 – 0.013 X3 R = 0.847;

Results showed that calendar age of 63% and 70.8% of the Saudi females can be estimated accurately within ± 1 year by Method 1 and Method 2, respectively. Furthermore, age of 38.5% and 39.4% of Saudi female children can be accurately estimated within ±0.5 years by these two methods, respectively.

CONCLUSION:

Regression method showed better age estimation procedure than simply counting the number of teeth at the time eruption.

KEY WORDS:

Saudi Arabia, Age estimation, time of eruption, regression analysis.

OBJECTIVE:

The aim of this study was to determine the incidence, cause and characteristics of the zygomaticomaxillary complex fractures, modalities of treatment used and analysis of post operative complaints at tertiary care teaching hospital in Multan Pakistan and compare the findings with similar studies.

METHODOLOGY:

Study was conducted on 97 patients treated for zygomatic complex fractures during the period of January 2006 to June 2008 in the oral and maxillofacial surgery unit and trauma centre of a tertiary care, Nishter (teaching) hospital in Multan Pakistan.

Out of 277 maxillofacial injuries received at this teaching hospital, 97 individuals were treated for zygomatic fractures. Patients according to treatment modalities were classified into two basic groups; Group-I: open reduction and rigid fixation with mini or micro plates, Group-II: open reduction and fixation with soft stainless steel wire sutures. Data, regarding age, sex, location, etiology of zygomatic complex fracture, modality of treatment used and post operative complaints of patients, were collected, tabulated, analyzed and compared with similar other studies.

RESULT:

Total of 97 patients were treated for Zygomaticomaxillary fractures, male to female ratio was 13:1, majority (53.6%) of patients belonged to age group of 16-30 years, isolated zygomatic complex fractures were 35.1% followed by associated fractures with mandible (33%) and with maxilla (25.8%), majority of patients (74.2%) were treated in G-I and (25.8%) were treated in G-II. Uneventful recovery was there in 93 individuals (95.9%), four patients (4.2%) had post operative complications in the form of enophthalmos, limited opening of mouth, facial asymmetry and infection at surgery site. These complications were subsequently treated successfully as a secondary procedure for all the patients.

CONCLUSION:

This study has shown that road traffic accidents are responsible for most zygomatic complex fractures in our environment. Zygomatic fractures are commonly associated with other facial fractures mainly mandible, open precise reduction and reliable internal miniplate fixation optimized the esthetic and functional results in treating such fractures

KEY WORDS:

Zygomaticomaxillary fractures; maxillofacial injury; ORIF; miniplate osteosynthesis; Road Traffic Accidents (RTA) etiology; pattern.

OBJECTIVE:

This study was done to assess the efficacy of saliva as a screening tool in Hepatitis C infection when collected in a sterile test tube by simple spitting process. Anti Hepatitis C Virus antibodies (Anti-HCV) were detected in salivary samples of patients and healthy controls without using any special salivary collection device

METHODOLOGY:

Paired serum and oral fluid collections were obtained from 50 HCV positive cases and twenty five negative individuals. Saliva samples were collected in a sterile disposable plastic test tube by simple spitting of un-stimulated saliva by the study subjects. A modification of the serum HCV ELISA assay was developed to improve test accuracy for an oral fluid substrate. The presence or absence of anti-HCV antibodies in the blood serum was taken as gold standard against which anti-HCV levels in saliva were compared.

RESULT:

Overall sensitivity of saliva to detect Anti HCV antibodies was found to be 94.2% while specificity was 100%.

CONCLUSION:

This simple method of oral fluid collection proved to be an effective alternative to special collection Saliva can be used as a cost effective screening tool for initial screening of Hepatitis C infection in high risk populations.

KEY WORDS:

Hepatitis C infection, Anti HCV Antibodies, Saliva, Screening, Pakistan.

OBJECTIVE:

The objective of our study was to identify the different histological patterns of Oral Squamous cell carcinoma (OSCC) in relevance to demographic variables and to evaluate histological patterns according to various clinical presentations at the joint department of Oral Surgery, Karachi Medical and Dental College and Abbasi Shaheed Hospital Karachi.

METHODOLOGY:

This descriptive study was conducted from December 2005 to November 2006 at Oral Surgery Department of Karachi Medical & Dental College and Abbasi Shaheed Hospital Karachi. A total of 60 cases presenting with OSCC were included in this study. Their demographic details, habit profile, clinical information of lesion were recorded on a proforma. All the patients underwent biopsy and their histological information was also noted on the same proforma.

RESULT:

This study included 60 patients of OSCC. Fifty eight percent of patients were from age group between 41-60 years. Approximately 63.3 % males and 36.7 % females were affected and male to female ratio was 1.7: 1. Approximately 48.3 % of lesions involved alveolus. Nearly 86.7 % of patients were indulged in habits of tobacco chewing. Clinical appearance of lesion showed that 66.7% of lesions were ulcerative type and histologically 48.3% were well-differentiated OSCC.

CONCLUSION:

Majority of patients were indulged in habit of tobacco chewing. Ulcerative type was the dominant clinical presentation whereas histologically well-differentiated OSCC was the most common presentation. Infiltration was a consistent finding in all cases.

KEY WORDS:

Oral Squamous cell carcinoma, ulcerative type, well- differentiated, oral cancer.