Volume 19 – Issue 4 (Oct – Dec 2010)

OBJECTIVE:

The purpose of this study is to determine present frequency of temporomandibular disorders among dental students of de’Montmorency College of Dentistry, Lahore and to identify referral need for early management.

METHODOLOGY:

This was a cross-sectional survey conducted on 400 dental students selected randomly through convenient sampling from Department of Prosthodontics, de’ Montmorency College of Dentistry/Punjab Dental Hospital, Lahore between July 2006 to January 2007. Subjects complaining of two or more symptoms were classified as those suffering from temporomandibular disorders. Subjects were advised regarding their management of the related dysfunctions.

RESULT:

Out of these 400 subjects, 241 were females and 159 males between 18-25 years of age . Among 400 dental students, the least frequent complain was temporomandibular joint pain (8.4%) while the most frequent sign was temporomandibular joint sound (42.3%). Muscle tenderness, opening deviation of temporomandibular disorders were more frequent in females than males. Opening deviation was 12.8% and 9.6% for females and males respectively

CONCLUSION:

More than 40% of the dental students were having more than 2 signs & symptoms of TMD these students need further evaluation & treatment to avoid future complications.

KEYWORDS:

Temporomandibular disorder, Masticator musculature, Temporomandibular joint, Facial pain..

OBJECTIVE:

Subjects reporting for prosthodontic treatment require referral to specialists’ dental and medical departments for various adjunctive treatments prior to the provision of prostheses. It is aimed to investigate referral trends and types of adjunctive treatments needed in subjects reporting to the Prosthodontics Department, Khyber College of Dentistry Peshawar.

METHODOLOGY:

Using the methods of comprehensive history recording, clinical examination and a pre-structured data collection form, data from each of 155 subjects, randomly selected was recorded. These included subjects’ age, gender, consultation reasons, socio-economic status (SES), dental status, carious and restorative status, oral hygiene status, over-jet and overbite, bony defects and exostoses, size of tongue, salivary gland hypo-function (SGH), medication use, range of mouth-opening, presence of pain, TMJ click and presence of risk factors for temporo-mandibular disorders (TMD). Subsequently, diagnosis, treatment plan and a decision for referral and of the needed adjunctive treatment was made.

RESULT:

Females were 61 (39%) and males 94 (61%). The age range of 72% subjects was 17 – 50 years. Some 88% had poor-to-satisfactory socio-economic status. In 97 % subjects, restoration of aesthetics and mastication were the main reasons for prosthodontic therapy. The percentages of subjects who were fully dentate, partially dentate, edentulous and those having one jaw edentulous and other fully or partly dentate respectively were 16, 60, 19 and 5. Overjet and overbite were unacceptable in 13.5% and 12.3% subjects. Oral hygiene was poor in 13%. Restorations of unacceptable quality were seen in 13% subjects. Ridge defects and exostoses were seen in 20 subjects. More than two-third were taking medications with 2.3% suffering from SGH. Mouth-opening was adequate in 98 % with 6% having pain in the oro-facial region. No opening or closing click was seen in 79% subjects. Despite the presence of TMD risk factors, none had TMD. The need for referrals was seen in 70% subjects. The proportions of subjects requiring referral to various inter-disciplinary dental and medical specialists, respectively, were; prosthodontics (4%), periodontics (39%), orthodontics (7%), conservative dentistry (32%), oral surgery-oral medicine (35%) and medical specialists (6%)

CONCLUSION:

In many subjects, need for referral and provision of adjunctive therapy prior to prosthodontic therapy was seen.

KEYWORDS:

Referral Trends, Referral Types, Prosthodontic Treatment, Adjunctive therapies, Comprehensive dental-care, Integrated dental treatment.

OBJECTIVE:

To evaluate the antibacterial activity of 0.2% aqueous chlorhexidine digluoconate mixed with alginate or used as mouth rinse before taking impression and to compare with conventional type of impression mixed with distilled water.

METHODOLOGY:

A total of 3 impressions of each subject were taken using alginate impression material with the interval of 24 hrs between them. First impression (IMP 1) was made by mixing alginate with distilled water which served as control. Second impression (IMP 2) was made after the subjects rinsed with 0.2% chlorhexidine digluconate containing mouthwash and third impression (IMP 3) was made with alginate mixed with 0.2% aqueous chlorhexidine digluconate. Impressions were cultured immediately for 4 strains of bacteria i.e. Streptococcus Viridans, Staphylococcus Epidermidis, Streptococcus Pneumonia and Staphylococcus Aureus. Based on the number of bacterial colonies observed microscopically, all the three categories of impressions were compared statistically using Wilcoxon signed rank test.

RESULT:

Marked number of bacterial colonies were observed in control specimen while significant reduction in bacterial count was seen in other experimental groups (p<0.05). No significant difference was observed amongst both the experimental groups (p=0.617)

CONCLUSION:

0.2% chlorhexidine digluconate proved to be an efficient impression disinfectant when used as a pre-procedural mouth rinse or as an alternate to water while mixing with alginate

KEYWORDS:

Irreversible hydrocolloid; disinfectant; internal disinfection; Pre-procedural rinse.

OBJECTIVE:

This cross-sectional study was done to evaluate tooth brushing and oral addictive habits of primary school children (aged 5-10 years) .

METHODOLOGY:

This was a cross-sectional study, conducted in 2000, across Pakistan in three major cities. Data was collected using simplified WHO Oral Health Assessment Form (1997), with questions regarding oral hygiene practices such as brushing and use of areca nut. The participating dental surgeons were initially trained for data collection using WHO guidelines and then evaluated and calibrated. After satisfactory results from a pilot study, it was extended to three major cities of Pakistan. 7005 students studying in classes 1 to 3 (age 5-10 years) were included in the study. Data was collected from 22 schools of upper socio-economic class (SEC)

RESULT:

There were 56.77% boys and 43.23% girls in the study group, with an average age of 7.2 years. Almost all the children (99.22%) were brushing their teeth, most (92.96%) using toothpaste. Once, twice, and thrice daily brushing was 37.53%, 54.29%, and 7.45%, respectively, with more boys brushing once and more girls brushing twice daily. Regarding addictive oral habits, 13.38% children were addicted to areca nuts. Family history revealed that 23.38% and 19.41% parents were addicted to quid/pan and smoking, respectively

CONCLUSION:

Correct tooth brushing technique and frequency, removes dental plaque and prevents dental caries effectively. Parents should start educating their children at a very young age to maintain proper oral hygiene, such as, tooth-brushing and keeping a check on oral addictives. The need of the hour is to promote oral health awareness through parents, teachers, and community based oral health surveys, with media playing an important role in it.

KEYWORDS:

Tooth brushing, Oral health awareness, Areca nut.

Ocular prosthesis is an artificial replacement of the eye. After enucleation, evisceration and exenteration of the eye, the goal is to replace the missing tissues with an artificial prosthesis and restore the facial symmetry and normal appearance of the anophthalmic patient. Eye loss causes disfigurement of the face due to which individual become emotionally weak and conscious and avoid taking part in social events, which in turn causes anxiety, stress and depression at an early age in life. Recovery after the loss of an eye requires an adjustment to monocular vision and improvement of the appearance with the use of artificial eyes . The custom made ocular prostheses are very comfortable and help individual improve their appearances, which in turn, encourages them to build up their self-confidence to return back to their social life.

OBJECTIVE:

To report the management and treatment protocol of Ludwig’s angina at a tertiary care hospital Hyerabad Sindh.

METHODOLOGY:

A Retrospective & non-comparative study was undertaken on total 101 patients of both gender were included, who received medical, airway management and surgical treatment. Etiology, microbiology, Culture & Sensivity, associated systemic diseases, duration of hospital stay and outcome were reviewed. Material was collected from Oral & Maxillofacial Surgery Department, Institute of Dentistry, Liaquat University of Medical & Health Sciences, Jamshoro from January 1994 to December 2008.

RESULT:

A total 101 cases of Ludwig’s angina were included, 43 (42.6%) patients were female and 58(57.4%) were male. All the patients were managed with surgical drainage within the first 12 hours after hospital admission. Maximum hospital stay was up to 2 weeks. Common symptoms found were Neck swelling, Breathing difficulty, Fever, Pain & Redness (In all patients). Dental problem was more common in 71(69.3%) cases, Dental problem associated with Diabetes mellitus was found in 21(20.7%) and tonsillar infections in 07(6.9%) and sunmandibular sailadenitis 2(1.9%) patients. Maximum complications were Mediastinitis 10(9.9%), Sepsis 9(8.9%) and Death 5(4.8%)

CONCLUSION:

Incision and drainage and close monitoring promote good outcomes in majority of patients.

KEYWORDS:

Submandibular incisions, Ludwig’s Angina, Incision and drainage.

OBJECTIVE:

The aim of this study was to determine the relationship between periodontal pocket depth (PD) and status of diabetes mellitus (DM) in type 2 diabetic patient.

METHODOLOGY:

The periodontal status was measured by using the Community Periodontal Index of Treatment Needs (CPITN) and condition of diabetes mellitus status was measured by determining glycated haemoglobin (HbA1c), fasting blood glucose level (FBGL) at the base line before giving any treatment and after three months of receiving periodontal therapy .

RESULT:

The results showed that the periodontal disease severity was high among diabetic subjects. The mean CPITN score was compared with mean blood glucose level and the severity of periodontal disease. There was a steady increase in blood glucose level with increase in CPITN scores, corresponded with HbA1c and FBGL among diabetic subjects.

CONCLUSION:

Poor glycemic control is a major risk factor related with periodontal disease, non surgical periodontal treatment shows improved glycemic control in type 2 diabetes.

KEYWORDS:

Periodontal disease, diabetes mellitus, blood glucose level, glycated haemoglobin (HbA1c), oral hygiene.

OBJECTIVE:

The aim of the study was to investigate the prevalence of periodontal diseases with regards to the age and sex in rural and the urban population, and to compare the results with national and international studies.

METHODOLOGY:

A cross sectional prevalence study was initiated to characterize the demographic, oral health behavior. Prevalence of different types of periodontal diseases was evaluated in the diagnostic clinic and the out patients department of Baqai Dental Hospital assessed in the year 2008. Investigation was determined by taking the history and with oral examination, using examination instruments, CPITN probe and with the help of radiographs.

RESULT:

Out of 746 patients, 222 were diagnosed, as suffering from Periodontal diseases. Prevalence was revealed more in the rural population, and more in males than the females

CONCLUSION:

Prevalence of periodontal diseases appeared elevated in rural population, in males as compared to the females.

KEYWORDS:

Prevalence, Chronic Perodontitis, Aggressive Perodontitis.