Volume 20 – Issue 2 (Apr – Jun 2011)

OBJECTIVE:

The aim of the study was to investigate canine impactions in Jinnah Medical and Dental College, Karachi.

METHODOLOGY:

A total of 67 patients were examined with canine impactions. Clinical naked-eye intra-oral examination was performed with dental mirrors and tweezers to confirm the absence or presence of permanent maxillary canines. Orthopantomogram and standard anterior occlusal radiographs were done to confirm the position, presence or absence of maxillary canines. Furthermore, all patients selected for the study had no dental anomalies, hypodontia or any associated syndromes.

RESULT:

There were 28 males and 39 females in this study with canine impactions with a mean age of 13.4 years. 23 patients had skeletal class I, 32 had skeletal class II and 13 had skeletal class III malocclusions. The patients were divided into 4 age groups namely A (8-10 years), B (11-13 years), C (14-16 years) and D (>18 years). Males had greater buccal canine impaction while females showed more palatal canine impactions. Both Group B (11-13 years age) male and group D (> 18 years age) females demonstrated greater canine impactions.

CONCLUSION:

Both sexes had affinity for canine impactions. Furthermore, class I malocclusions demonstrated greater canine impactions, followed by class III malocclusions, while class II showed the least prevalence value. Further studies are necessary to determine the contribution of dental anomalies in the etiology of canine impactions .

KEYWORDS:

Canine, Dental, Impactions, Malocclusion, Orthodontics, Teeth.

OBJECTIVE:

To assess the expectation of the patients seeking treatment in the orthodontic clinic of the College of Dentistry at King Saud University in Riyadh, SaudiArabia.

METHODOLOGY:

A self administrated questionnaire was distributed to the patients by one investigator in a non- clinical setting. The questions called for several category choices (yes / no / do not know), and a tick box layout was used for provision of the appropriate answer.

RESULT:

Two hundred subjects (100 males, 100 females) completed the questionnaire. Around 95% of the sample expected to have a checkup and diagnosis. Only 17.5% of the participants expected to have a brace fitted during the initial appointment. Over half of the patients (55%) expected to wear a fixed appliance, and only 2.5% expected to require a head gear. Around one out of five patients (22%) had no idea about the duration of the orthodontic treatment. Statistically significant differences were found between males and females in relation to the expected frequency of orthodontic appointments (P= 0.04), as a higher percentage of male patients expected more frequent appointments compared to their female counterparts. There were significant differences between males and females in two of the expected short term risks. “Sores or cuts in mouth during treatment”. (P=0.01), and “pain during the appointment” (P=0.01). In addition, such significant differences were found in two of the expected long term risks “gum diseases” (P=0.04) and damage to the roots (P=0.001), as more females expected to encounter these risks compared to male patients.

CONCLUSION:

The respondents had realistic expectations regarding the procedures undertaken during the initial appointment. They lacked information about the duration of orthodontic treatment and the frequency of orthodontic visits. Expectations of risks of orthodontic treatment were very limited compared to the expected benefits from the treatment.

KEYWORDS:

expectations, questionnaire, orthodontic patients.

OBJECTIVE:

To estimate the pattern of alveolar bone loss among smokers and non smokers.

METHODOLOGY:

One hundred and forty medically healthy male patients aged 30 to 55 years participated in the study. Parameters such as periodontal pocket depth (PPD), clinical attachment loss (CAL), bleeding on probing (BOP), and plaque index (PI) were measured clinically and bone loss was measured radiographically using Scion Image Analysis Software. Statistical analysis was performed with the SPSS version 17.0 (Statistical Package for Social Sciences for Windows, SPSS Inc., Chicago, IL USA). P values <0.05 were considered significant.

RESULT:

Clinical parameters such as PPD, attachment loss, BOP, and PI were significantly high among smokers. Radiographically, bone loss for smokers was higher than that observed in nonsmokers (p < 0.05). The maxillary anterior teeth showed significantly higher PPD and CAL than the posterior sextant in smokers when compared to nonsmokers. Percentage of sites with probing depth greater than or equal to 4 mm was high among the smoker group. Higher probing depth and CAL were noticed in the maxillary palatal area than in the facial sites and the mandibular regions. Alveolar bone loss was higher among the smoker group.

CONCLUSION:

The results of the present study indicate that smokers seem to have a greater bone loss compared to nonsmokers. Cigarette smoking may aggravate bone loss resulting from periodontitis.

KEYWORDS:

Periodontitis; Attachment Loss, Bone Loss, Pocket Depth; Radiography; Smoking.

OBJECTIVE

The prime objective of the study was to determine the prevalence of practices in children under six years of age, which are known to affect occurrence of dental caries.

METHODOLOGY:

This was a cross-sectional study. Data was collected using questionnaire, sent to the parents of preschool children through school administration. Total 630 questionnaires were sent out. Parents were addressed for fact finding. Various risk factors were identified during literature review. We added certain other factors based on our local experience, and finally selected the most relevant factors. Subjects were included based on age and parental consent to share information

RESULT:

We found a mixed prevalence of flawed and beneficial practices among the subjects of our study. However, most were comparable or encouraging when compared to the international literature, including studies from more developed nations.

CONCLUSION:

In conclusion, we could recommend that in a mixed prevalence of practices, awareness programs emphasizing the good practices and discouraging the unhealthy practices could play a significant role in practice improvement at this age .

KEYWORDS:

Dental caries, children, practices, preschool, risk factors .

OBJECTIVE:

The aim of this study was to evaluate the opinion of dental students and dentists regarding the dental treatment of patients with Special Needs and if the teaching provided during the undergraduate course concerning such patients is adequate.

METHODOLOGY:

A Questionnaire including 10 main items was developed and distributed at the College of Dentistry; Male (Darriyah Campus) and Female (Malaz Campus) in Riyadh, King Saud University. The results were analysed using Statistical Package for Social Sciences) SPSS version 16. The questionnaire included socio-demographic variables, opinion regarding current knowledge and experience in treating Special Care Dentistry patients. Finally, opinion regarding starting a new course for Special Care Dentistry at King Saud University was sought.

RESULT:

Out of the 300 questionnaires 250 were returned, giving a response rate of 83.3%. Regarding opinion about the theoretical information provided during the course with respect to dentistry for Special Needs patients, most of the respondents either reported it as ‘Inadequate’ or ‘Very Inadequate’. However, there was no statistically significant difference of opinion among the gender. Although exposure to such patients in clinical practice was reported to be ‘very few’ or ‘occasionally’ by most of the respondents (71.2 %) more than three quarter of the respondents (76.4% ) agreed that the treatment of such patients is ‘Challenging’ as compared to the general population. However the majority of the respondents (86.4 %) agreed that a specific Course on Special Care Dentistry would be beneficial for the treatment of such patients; out of which 53 % expressed their opinion to ‘Provide more practice’ for Special Care Dentistry course.

CONCLUSION:

Among the Special Care group fewer patients are seen at College of Dentistry, Riyadh, King Saud University; when compared to the general population. Most respondents feel that the present amount of theoretical knowledge and practical experience in treating Special Needs patients is insufficient. Majority of the respondents thought that a course designed to deal with the treatment needs of special care dentistry patients would be beneficial in the treatment of such a group.

KEYWORDS:

Special Needs Patients, Dental Treatment, Dentists’ Opinion.

OBJECTIVE:

To assess the causes, incidence and management of zygomatic bone fractures.

METHODOLOGY:

This study was carried out at the department of oral & maxillofacial surgery Liaquat University Hospital, Hyderabad. Total 67 cases were studied. Diagnosis of fractures was done by obtaining information from history, examination and appropriate investigations. Treatment of zygomatic bone fractures was done by techniques appropriate for every case. Etiology of trauma, incidence and other factors like age and gender were also observed.

RESULT:

The most common cause of Zygomatic bone fracture was found to be assault 46.26% (n=31), followed by road traffic accident (RTA) 37.31% (n=25), fall 13.43% (n=09) and others 2.98% (n=2) respectively. Left side (57.31%) was found to be involved more than right side (42.68%) in fractures.Most prevalent age of Zygomatic bone fracture was 21-30 years, and male to female ratio was 2.7:1. In our center upper buccal sulcus approach (Keen approach) was commonly used for reduction, whereas fixation for unstable fractures was done by wire or miniplates Osteosynthesis.

CONCLUSION:

The most common cause of Zygomatic bone fracture was found to be assault, the left side fractures being more common and males were more involved than females.The results of this study will help the goverenment to take safty measures, and make implimentation of by-laws to minimize the incidence of facial trauma due to stated causes .

KEYWORDS:

Zygomatic bone fractures, Road Traffic Accident, Assault, Upper buccal sulcus approach, Miniplates, Percutaneous Hook approach.

OBJECTIVE:

The aim of this study was to find out the isolation of Methicillin Resistant Staphylococcus aureus (MRSA) in dental patients undergoing various oral surgical procedures.

METHODOLOGY:

For this study 250 patients between 20-50 years of age were selected, who underwent different oral surgical procedures. 224 (90%) patient had bacteremia (spontaneous or transient) and 26 (10%) patients cultures were negative for bacterial growth. Blood samples were taken immediately after minor oral or dental procedures. To determine the frequency of bacteremia before the surgical procedures (baseline bacteremia), 5ml of blood was obtained from 25% of patients after the administration of local anesthesia, Blood sample were inoculated in the blood culture bottles filled with Tryptic Soya broth (diaphasic media) and incubated at 37°C for 7 days..Then subcultured on blood agar and MacConkey’s agar. The plates were incubated at 37°C aerobically, after 24 hours growth was observed. Colonies were identify by gram’s staining and standard biochemical test. 114 isolated strains of S. aureus were used for detection of Methicillin Resistant S.aureus. Detection of MRSA was done by using ORSA (Oxacillin resistant screening agar base) media , Sensitivity to cefoxitin was also done by disc diffusion method.

RESULT:

114 (58%) isolates were S.aureus, Out of 114 S.aureus strains, MRSA were present in 55(48.24%) and cefoxitin resistance was found in 52 % isolates of S.aureus.

CONCLUSION:

Bacteria capable of causing serious diseases are present in the oral cavity and saliva of different patients without any symptoms. S.aureus and MRSA most frequently spread via dental unit water supply, transiently contaminated hands of health care professionals, improper sterilization technique. Simple infection control precautions such as use of gloves, mask and effective hand hygiene practice, proper strelization of dental equipment, use of sterilized water in dental units and standard infection control precautions should be enforced in dental offices to prevent transmission of MRSA to community and dental practitioner.

KEYWORDS:

Dental patients, Bacteremia , MRSA.

OBJECTIVE:

The purpose of our study was to review the current trend of dental practitioners in Karachi about stopping or not, low dose aspirin before tooth extraction.

METHODOLOGY:

A total of 68 Dentists were included in the study, belonging to private clinics (n = 34) and working in two of the dental college hospitals of Karachi (n = 34). Data was collected with the help of a close ended questionnaire containing two questions: Do you stop aspirin before tooth extraction? Is it due to fear of bleeding?

RESULT:

Out of a total of 68 dentists, 22.1% were in favour of continuing aspirin while 77.9% practiced to stop it before tooth extraction. In the individual groups, 9 (26.5%) private dental practitioners were in favour of continuing low dose aspirin and the remaining 25 (73.5%) were not in favour of that. Out of 34 practitioners working in hospitals only 6 (17.6%) continued to use aspirin during tooth extraction whereas 28 (77.9%) were in favor of discontinuation before the procedure. The reason given for stopping the drug by all those in favor of this practice was fear of perioperative bleeding.

CONCLUSION:

Majority of dental practitioners in Karachi still consider stopping low dose aspirin before tooth extractions, a practice that needs to be discouraged at all levels.

KEYWORDS:

Aspirin, Bleeding, Tooth extraction.

OBJECTIVE:

The aim of this investigation was to evaluate the etiological factors of Oral Burning with limited clinical findings in group of patients suffering from this syndrome.

METHODOLOGY:

This study was conducted at the Department of Oral Medicine, Khyber college of Dentistry, Peshawar on thirty Six patients suffering from Burring mouth syndrome over a period of 6 months. The diagnosis was made on the basis of history, clinical examination special investigations and specially designed proforma.

RESULT:

Thirty two females (88%)and four males (12%)with a mean age of 47 years (range 20-70 years) were studied over the period of six months .There were 16 patients(44%) diagnosed as suffering from essential burning mouth disorder,7 patients (19%) as diabetic,6 patients (16%) nutritional deficiencies,5 patients(13%) Candidiasis and 2 patients (5%) were diagnosed as drug induced burning mouth disorder.

CONCLUSION:

Essential burning mouth disorder is mostly present in patients without any evident lesion. The other etiological factors such as Candidiasis, nutritional deficiencies and drug reactions also cause oral burning.

KEYWORDS:

Essential Burning Mouth Disorder (EBMD), Scaled mouth syndrome Xerostomia,.

Fibrous dysplasia is a non-neoplastic developmental disorder of bone. This report discusses a case of swelling of right maxilla for past five years..

CASE PRESENTATION:

A 47-year-old female presented to the Oral and Maxillofacial department, Khyber College of Dentistry Peshawar with mild pain and swelling on right the side of maxilla since 5 years. Presentation was preceded by a history of multiple extractions in the past. Examination extra orally had no significant facial asymmetry. Intra orally there was significant bony hard swelling and bicortical bony expansion with dimensions of 3x5cm. Plain radiograph showed a radioopaque bony mass involving right maxillary alveolus and maxillary tuberosity. The incisional biopsy of bony mass diagnosed histologically as fibrous dysplasia. Fibrous dysplasia should be considered in the differential diagnosis of slowly progressing bony mass with associated pain in old age adults.

KEYWORDS:

Fibrous dysplasia, Maxillary bone fibrous dysplasia, Occurrence.