Journal of The Pakistan Dental Association
Title Abbreviation: J Pak Dent Assoc
ISSN (Print): 1680-2292
ISSN (Online): 2306-5885
Table of Contents
Volume 21, Issue 2 (April - June 2012)
Ayyaz Ali Khan, Saima Chaudhry, Syed Akhter Hussain Shah Bokhari
Junaid Sarfraz Khan, Saima Tabasum, Osama Mukhtar
(Pages 71 - 77)
The objective of this studywas the validation of competencies by all stakeholders and to group them intomanageable,measurable, reproducible and identifiable dental graduate capabilities.METHODOLOGY
Dental faculty, students of all academic years in institutions affiliated with University of Health Sciences and the public were administered a 30 item questionnaire listing the graduate dental competencies in 2011. Data was entered into Statistical Package for Social Sciences (SPSS) v.16 and nalyzed by using Confirmatory FactorAnalysis (CFA)withVarimaxRotation under the conditions of Eigenvalues > 1 and loadings ≥ 0.2. Parametric tests were applied to the responses of all stakeholders. ‘Agree’ response was given a score of ‘1’ and ‘disagree’ was given a score of ‘0’ for each uestion/characteristic. These scores were added up to compute a new variable as total score of the respondents. p 0.05was considered as significant.
2037 questionnaires were collected (1789 from students, 88 from faculty and 160 from the public. The value ofKaiser-Meyer-Olkin (KMO) was 0.924, where Bartlett’s Test of Sphericitywas significant (p-value<0.05). In Confirmatory Factor analysis (CFA), five components were extracted with Kaiser Eigenvalues greater than 1 accounting for 40.58% of variance. Total 30 items had internal consistency reliability of 0.876 (Cronbach'sAlpha). Analysis of Variance (ANOVA) showed a significant difference in Response scores of various stakeholders (F=113.2, p<0.05). Post Hoc Tukey Test revealed that General public scored significantly lower than the students and faculty.
Graduate dental outcomes are not wholly generic; there are cultural, societal and structural variations that affect the desired regional final competencies. It is therefore important for Pakistan to design its own outcomes for the programrather than to import themfromtheWest.
Competency-based dental education, outcome-based curriculum, competencies, baccalaureate of dental surgery
Bushra Ayaz, Nadia Zaib, Sajid Mushtaq, Nadira Mamoon, Noreen Akhter, Sabben Abbas, M. Tahir Khadim
(Pages 78 - 84)
To analyze the pathological spectrum of jaw lesions at Armed Forces Institute of Pathology, Rawalpindi.
A retrospective observational study was conducted of 178 jaw lesions diagnosed at Armed Forces Institute of Pathology (AFIP), Rawalpindi All cases diagnosed during the period jan 2003 to dec 2006were included in the study through non-purposive convenience sampling.The datawas analyzed by SPSS version 10.
The commonest lesion were odontogenic cysts making upto 73 cases, followed by 29 cases of odontogenic tumors, 29 cases of non-odontogenic tumors, 23 fibro-osseous lesions, 13 giant cell lesions, 8 infectious lesions and 3 non-odontogenic cysts.The overall peak age of incidencewas the second decade of life and male to female ratio was 1.5:1. The mandible was involved in 83 cases and the maxilla in 70 cases, while no information regarding sitewas provided in 25 cases.
Odontogenic cysts were found to be the commonest among the jaw lesions. The mandible was more commonly involved than themaxilla
Odontogenic tumors, radicular cyst, ameloblastoma.
Jehan Alam, Kashif Ali Channar, Noor ul Wahab, Abdul Qadir Dal, Riaz Ahmed warriach, ZafarAli Khan
(Pages 85 - 89)
The objective of this studywas to evaluate themajor clinical findings of trigeminal neuralgia.
This was a Descriptive Case Series. The cases were selected from OPD of oral/maxillofacial surgery department Mayo hospital Lahore from 1st April 2006 to 30th July 2009, Jinnah Postgraduate edical Centre Karachi from 1stAugust 2009 to 30th January 2011, and Liaquat university ofMedical and Health Science Jamshoro from 1st February 2010 to 5th June 2011 after taking written approval fromMedical ethical board of the concerned hospitals. Patient with Age 20 years to 80 years, irrespective of gender and Trigeminal neuralgia involving mandibular andmaxillary branches of trigeminal nerve were the inclusion criteria and Exclusion criteria wereTrigeminal neuralgiawith secondary causes tumors,multiple sclerosis) and Patients having other neuralgia in associationwith trigeminal neuralgia
ATotal number of 180 patients of TN reported during the study period. The average age of patients was 64years ( 11.45). Themost common age group for TNwas 60-80 years in our study. Female tomale ratio was 1.6:1.Mandibular branch is involved in 63.3%cases andmaxillary branchwas involved in 36.7%cases.The ratio of mandibular nerve andmaxillary nerve involvedwithTNwas 1.72:1
From available data we conclude that TN is common in female patients above 60 years of age. The most frequently affected nerve was the mental nerve.Right side involvement was four times greater than left.
Trigeminal neuralgia,mental nerve, inferior alveolar nerve, infra-orbital nerve.
Noor Ahmed Khoso, Kashif Ali Channar, Abdul Qadir Dal, Abdul Bari Memon
(Pages 90 - 93)
The objective of this study was to evaluate themost important clinical and radiological features of Ossifying Fibroma (OF)&associated surgical difficulties.
The current study was descriptive case series conducted at the Department of Oral and Maxillofacial surgery. Institute of Dentistry, liaquat University of Medical and Health Sciences Jamshoro Hyderabad fromFebruary 2010 to September 2010.Thirteen newand two recurrent patientswith ossifying Fibroma of either genderwere selected for surgery&treated.Clinical&radiographical (OPGand CTscan) examination was performed on each patient with special emphasis on site of lesion, jaw involvement, extent of disease, facial asymmetry, pain, paresthesia, tooth displacement, root resorption, inferior alveolar nerve position, and bowing of mandible.The histopathological examinationswere performed to reach the diagnosis
Surgical intervention was performed on all fifteen patients. Posterior location of tumor was seen in 86.6% cases. Radiographically lesion was well demarcated and was distinguishable from normal bones. Classic picture of mixed appearance with radiolucent background with radio-opaque flaks and sclerotic margin on plain radiographs andCTscanwas documented in 10 (66.6%) cases.
This study confirms the female gender predilection & was more common in 2nd & 4th decade. Maxillawas themost frequent affected sitewith facial asymmetry.MostOFs can be treated by conservative surgical excisionwith peripheral ostectomy.
Ossifying Fibroma, Fibro-osseous lesion.
Fahad Ata Siddiqui, Abubakar Sheikh, Syed Ajlal Akhtar, Saqib Rashid, Zohaib Khurshid, Shariq Najeeb
(Pages 99 - 102)
To radiographically measure the thickness of dentin and width of pulp space for different age groups.
Non-pathological mandibular 2nd premolars with closed apices of 200 patients were evaluated radiographically using the Digora®radiographic imaging system. The sample was categorized into three groups; 15-29 years, 30-44 years and 45-59 years old. The dentin thickness and pulp space width were measured at different levels and recorded. SPSS version 13.0 was used for statistical analysis. One way ANOVA testing was done to statistically test the results. Level of significancewas kept at p value <0.05.
It was observed that the mean dentin thickness was highest at levelA; 4.45mm+-0.54 in the 15-29 year age group.Whereas, the dentin thickness was highest at level B for the other age groups i.e., 4.59mm +- 0.56mm (30-44 years) and 4.69mm+- 0.39 (45-59 years) respectively.However, the lowestmean dentine thickness of all age groups was found at level E. Moreover, readings at levels B, C and E were statistically significant p<0.05, suggesting continuous dentin deposition with age in all age groups. The results of pulp space analysis revealed that the highestmeanwidth of pulp space for age groups, 15-29 and 30-44was at level B; 1.13mm+-0.43 and 1.03mm+- 0.34 respectively.Whereas, the oldest age group (45-59) had the highest width of pulp space at levelA; 0.84mm+- 0.42. Furthermore, the lowestmeanwidth of pulp space of all the age groupswas seen at level Eand the resultswere statistically significant for all levels p<0.05 suggesting a reduction in pulp spacewidthwith age.
In this study dentin thickness and pulp space width have shown variation with age due to continued dentin depositionwhich can be a factor effecting the success of treatment for different groups, hence agespecific treatment tools should be developed.
Muhammad Adeel Ahmed, Abdul Qadir Dall, NoorAhmed Khoso, Rizwan Jouhar
(Pages 0 - 107)
To compare the frequency of postoperative pain after ProTaper (NiTi) rotary andmanual step-back root canal preparation techniques in single visit endodontics.
Randomized control trial was conducted at Out Patient Department of Operative Dentistry, Altamash Institute of DentalMedicine, Karachi From Sep 2009 toMarch 2010, according to the inclusion criteria. Exclusion criteria were strictly maintained and confounding variables were taken care by random allocation. Patients after selection were randomly divided in to two groups by lottery method. GroupA: Root canals prepared by ProTaper (NiTi) rotary (Dentsply,Maillefer, Ballaigues, Switzerland). Group B:Were prepared by manual stepback technique. The Visual Analogue Scale (VAS) was explained to patients and instructions were given that, if patients experience pain then they ought tomark the severity of pain onVAS and then take Paracetamol (1gm). The dose could then be repeated every 6 hours if necessary.All patientswere appointed after 48 hours and evaluated for postoperative pain during 48 hours byVisualAnalogue Scale.
Frequency of postoperative pain noted after 48 hourswas 13.3% (7/51) inGroupAwhile 15.7%(8/51) inGroupB.
No statistically significant difference (P=0.78) was noted in the frequency of postoperative pain between patients treated by ProTaper (NiTi) rotary andmanual step-back root canal preparation technique in single visit endodontics
Pain, ProTaper (NiTi) Rotary, Manual Step-Back Technique, Single Visit Endodontics.
Kefi Iqbal, Maria Asmat, Naresh Kumar, Fareed Mohsin, Feroze Ali, Sajid Hanif
(Pages 108 - 111)
To evaluate the procedure for disposing of amalgam waste in dental teaching hospitals in Karachi according toAmericanDentalAssociation (ADA) and International StandardOrganization Standards (ISO).
A questionnaire was sent to eleven teaching dental hospitals in Karachi regarding the dispensing procedure to control the waste amalgam and dental amalgam restorations performed and removed per month.
According to the result of our survey, none of the dental teaching hospital inKarachi followed the ADA and ISO standard to dispose and recycle the amalgam waste, only 9.9% claimed that they use chair side traps and install amalgamseparator at chair side.Majority of hospitals (70%) preferred to use the handmixing alloy/mercury ratio. Numbers of amalgam fillings performed and removed by ten dental hospitals per month were 600 and 400 respectively.
Our results showthe lack of proper amalgam waste management in all the dental hospital of Karachi surveyed
Maqsood Ahmed Soomro, Shahida Maqsood, Ashar Afaq, Quratul-Ain Maqsood
(Pages 112 - 115)
The commonest pathological reasons for tooth extraction are tooth decay and periodontal infections. It also hampers the quality of life of an individual and restricts social interaction and communication. However, loss of teeth is not only a pathological condition, in addition diet intake,malnutrition, socioeconomic loss of self-sufficiency, and deterioration in quality of life may also contribute to the tooth loss. The objective of the study was to: Evaluate the prevalence of smoking among Pakistani adult population, Explore the association of smoking status and tooth loss
It is a cross sectional study and data collected from one sixty four subjects with age ranges from18 to 63 years over a period of two years (2009-2011).Both genderswere included in the study and their sociodemographic data were also collected which includes age, education, socioeconomic condition and habit of smoking and tooth loss. Data was entered into SPSS version 17.0 and frequency distribution was established. Chisquare testwas employed to explore the association of smoking status and tooth loss.
Responses from one hundred and sixty four adults male and female were collected. There were 97 (59%)males and 67 (41%) female respondents of age ranges from 18 to 63 years. The studywas completed in two years commencing from 2009 and finished in 2011. Ninety three (57%) respondents marked yes for smoking cigarettes.Missing teeth was notably increased in smokers 59 (65%; p>0.05) and also found higher in poor socioeconomic class, illiterates andmales.
Our study strengthens the need of awareness of general and dental health care among adult populationCessation of smoking habit can be significantly reduced the tooth loss.
Smoking,Tobacco,Tooth loss, Periodontitis,Extraction.
Himanshi Aggarwal, Sunit Kumar Jurel, Pradeep Kumar, Raghuwar Dayal Singh, Durga Shanker Gupta
(Pages 116 - 120)
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. Rehabilitating an anophthalmic patient requires a multidisciplinary approach involving the combined and timely efforts of an ophthalmologist, a plastic surgeon and a skilled maxillofacial prosthodontist. Custom made prostheses provide more esthetic and precise result when compared to stock eye prosthesis. The objective of this article is to reveal the final rehabilitation of uniocular phthisis bulbi, a clinical case treatedwith a scleral shell in a female patient.