Volume 22 – Issue 1 (January – March 2013)

OBJECTIVE:

In the last decade, a rapid growth has been observed in the number of dentists due to establishment of number of dental colleges in Karachi, Pakistan. There is an acute dearth of Pediatric Dentistry faculty in Pakistani dental institutions. Similarly, no post graduate Pediatric Dentistry fellowship program exists in the country. The objectives of this study are to map the pattern of pediatric dentistry services provided by the clinicians in teaching institutions and private practices of Karachi.

METHODOLOGY:

A cross sectional study conducted at dental departments of academic institutions and selected dental practices in different parts of Karachi. The sample comprised of 71 subjects in the teaching while 97 subjects in the non-teaching group. Stratified random sampling was carried out. Data were obtained using a structured, self administered questionnaire. Chi square test was used to asses, if pattern of services are different between dentists in the two groups.

RESULTS:

The response rate in teaching group was 94.67% (71 out of 75) while in the practitioners group it was 44.1% (97 out of 220). The groups were different regarding the use of topical fluoride, fissure sealants, and planning for primary teeth root canal treatment.

CONCLUSIONS:

There is a statistically significant difference in preferences, selection of dental materials and pattern of pediatric dentistry services provided by the teaching dentists as compared to the private dental practitioners. Both the teaching and non-teaching dentists need to update themselves in provision of Pediatric Dentistry services such as fluoride application and fissure sealant placement.

KEYWORDS:

Pediatric Dentistry, clinical training, dentist

OBJECTIVE:

Todeterminetheeffectofhoneyinenhancingthesofttissuehealingofthesocketandprevention of infection after tooth extraction

METHODOLOGY:

Total100patientsrequiringextractionofmandibularfirstandsecondmolarfulfillingtheinclusioncriteriawereselectedanddividedintotwogroups, n=50)incontrolgroupand(n=50)inexperimentalgroup.Bothgroupsunderwentforcepsextractionunderlocalanesthesia.Honeyinterventionwasdoneonlyinexperimentalgroup,whereasnointerventionwasperformedincontrolgroup.Nopostoperativeantibioticcoverwasgivenineithergroupandpatientswereinstructedtotakeananalgesicasperneed.Followingparameterswereassessedimmediatepostoperativelyandsubsequentlyatday10and21;distancebetweenmucosaledges,mucosalhealingandsignsofinfection.DatawasanalyzedusingSPSSversion15.0.Categoricalvariableslikegenderandsignsofinfectionwerepresentedaspercentages.Continuousvariableslikeageandclinicaldistanceb/wmucosaledges(mm)werereportedasmean±S.Dandindependent”t”testwasappliedonmainoutcomevariablestocomparethemeandifferencebetweenthegroups.Pvalue< 0.05wasconsideredsignificant.

RESULTS:

Significantdifference(pvalue< 0.05)wasobservedinsignsofinfectionbetweenhoneyandnonhoneygroupsatday10.Whereasotherparametersi.e.signsofinfectionatday21andwoundclosureateitherrecallwasfoundtobenonsignificantinboththegroups.(p>0.05)

CONCLUSION:

Weconcludethattheuseofhoneyreducestheincidenceofwoundinfectionaftertoothextraction,howeveritseffectonhastenedwoundclosurecouldnotbedeterminedwithintheparametersofthisstud .

KEYWORDS:

ToothSocketHealing,AlveolarOsteitis,Honey,woundhealing

Objective:

To determine the pattern, prevalence & severity of malocclusion among university students.

Methodology:

A cross-sectional study was conducted among 521 University students, age ranged from 1724 years while mean age was 19.7 years (SD±1.8). Students were examined for malocclusion using Angle’s Classification and overjet, overbite, crossbite,anterior crowding, smile arc, generalized spacing & midline diastema. Statistical analysis was carried out using chi-square test. Descriptive statistics and Cross tabulations of Malocclusion Traits i.e. Crowding, spacing, overjet, overbite, crossbite, Smile arc and gender differences, with Angle’s Classes were also performed.

Results:

Angle’s Class I Malocclusion was most prevalent (41%). Anterior Crowding in 42% students was a major occlusal finding. Increased overjet was found in 30% of the population. No obvious gender difference was noted, except for increased overbite (more prevalent in boys, P<.001).

Conclusion:

Majority of the university students had malocclusion. Class 1 malocclusion and anterior crowding were the most common finding.

Keywords:

Pattern, Prevalence, Severity, Malocclusion, Angle’s Classification

Objective:

To determine the frequency of occlusal interferences associated with over-erupted posterior teeth and to detect an association between the presence of an occlusal interference and the presence and extent of overeruption of unopposed posterior teeth.

Methodology:

The methodology used has already been given in a previously published article in Pakistan Oral and Dental Journal (2012; 32(1):159-63).

Results:

Twenty four (46.15%) subjects had at least one occlusal interference in one of their unopposed tooth. Protrusive interference was most commonly observed (n=16, 37%) followed by interferences in retruded contact position (n=12, 27%), working (n=9, 19%) and non-working (n=8, 17%) positions. The association of presence and extent of over-eruption and presence of occlusal interference was not significant. (p>0.005)

Conclusion:

Majority of the occlusal interferences were encountered in protrusive excursions followed by retruded contact position. There was no statistical association between presence of occlusal interferences and the presence and extent of over-eruption in unopposed posterior teeth.

Keywords:

Dentition, Occlusal patterns, Spee curve

OBJECTIVE:

This study aimed to assess the effectiveness of Dental-operating microscope (DOM) for detection of second mesiobuccal canal (MB-2) in extracted maxillary first and second molars compared with unaided vision.

METHODOLOGY:

One hundred extracted permanent maxillary first and second molars (50 each) were taken. The location of MB-2 canal was attempted using an endodontic explorer with naked eye. Teeth, in which MB-2 canal was failed to locate, were further explored under DOM. Finally, the mesiobuccal roots of each tooth were sectioned and observed at a magnification of 12X to confirm the actual presence of MB-2 canal. The results were analyzed by screening test.

RESULTS:

In maxillary first molars, 21 (42%) MB-2 canals were identified with naked eye, 9 with DOM making a total of 30 (60%), and additional 3 with sectioned roots under DOM bringing the total to 33 (66%). Whereas, in maxillary second molars total 10 (20%) MB-2 canals were identified with naked eye, while nine were identified with DOM bringing the total to 19 (38%), and additional 2 when observing the sectioned roots under DOM bringing the total to 21 (42%).

CONCLUSION:

The results of this study demonstrate that the adjunctive use of DOM may assist the dental clinician in locating the MB-2 canal orifice.

KEYWORDS:

Dental operating microscope, Magnification, Maxillary molars, Second mesiobuccal canal (MB-2).

OBJECTIVE:

Discoloration is one of the main reasons of replacement of anterior composite restorations. The aim of this in-vitro study was to evaluate the colour stability of two composite resins after being immersed in a coffee solution.

METHODOLOGY:

One hundred and twenty discs samples (10 mm in diameter & 2mm thickness) were prepared and divided into two groups according to restorative material used. For group 1 (n=60) Filtek Z350 nanocomposite was used and Spectrum TPH sub-micron hybrid was used for Group 2 (n=60). All discs were polymerized by a LED light-curing unit according to manufacturer’s instructions. All discs were initially placed in an incubator containing distilled water at 37°C for 24 hours. After 24 hours baseline colorimetric evaluation of specimens was measured with a SF 600 Datacolor Spectrophotometer using CIE L*a*b* system. All the samples in the two groups were immersed in a coffee solution for 7 days in incubator at 37°C. On the 8th day, post immersion colorimetric reading were taken and color change ( E) was measured. SPSS. 16.0 was used for statistical analysis.

Descriptive statistics were shown as Mean ±SD. Student ‘t’ test was applied at a significance level of p=0.05.

RESULTS:

Post immersion discoloration of FiltekTM Z350 ( E=2.78(±0.72) was significantly greater (p<0.001) than spectrum TPH3 ( E=1.96(±0.79). Between the solutions tested, the dis-coloration caused by coffee ( E=2.3(±0.85) was greater (p<0.001) than distilled water ( E=1.0(±0.51).

CONCLUSION:

One week immersion in coffee resulted in significant discoloration in Filtek Z350 Nano-composite restorative material.

KEYWORDS:

Nanocomposite, Discolouration, coffee.

OBJECTIVE:

Objective: The purpose of this study was to investigate the surface roughness of direct composite resin restorative materials after polishing with different polishing systems (diamond finishing and polishing burs, aluminium oxide disks and abrasive impregnated disks).

METHODOLOGY:

The composite resin materials investigated included Clearfil AP -X (hybrid), Filtek Z-250 (hybrid), Definite (Ormocer), and Silux Plus (microfill). Forty disk specimens (10 mm x 2 mm) of each of these composite resin were prepared. Ten mylar cured specimens were assigned for each polishing system and ten were used as controls with no further treatment after curing. A profilometer (Taly Surf 4, Mitotuyo Ltd. Japan) was used to measure the surface roughness (Ra) One way ANOVA was used for statistical analysis.

RESULTS:

There was statistically significant difference between the different composites and the polish groups for surface roughness at p < 0.05. Although Definite had the smoothest surface of the materials tested except when treated with abrasive impregnated disks which left Silux Plus with the best surface finish, Post-hoc Scheffe’s test showed no significant difference between Definite and Z-250 when polished with diamond burs and upon treatment with Soflex the difference was not significant between Definite, Z-250 and AP-X. Among the polishing materials used the smoothest surface was produced on specimens that were cured under the mylar strip and polished with the Soflex disks polishing system. The roughness values for the different test groups were almost identical when cured under the mylar strip. There was no significant difference between the surface roughness values of any material upon treatment with mylar. Upon treatment with diamond burs there was no significant difference between Definite and Filtek Z-250 but there was significant difference (p < 0.05) found between Definite and the other composites.

CONCLUSION:

Among the restorative materials tested, Definite had the lowest surface roughness, whereas alu-minum oxide disks produced smoother surface than other polishing systems. Diamond burs produced highest val-ues of surface roughness.

KEY WORDS:

Composite, surface roughness, polishing, Aluminum oxide disk.

OBJECTIVE:

To compare the effects of powered toothbrush with or without parental assistance and manual toothbrush on plaque and gingivitis in 12-18 yr old mentally challenged children.

METHODOLOGY:

The study was conducted in Kamayani School for Mentally Challenged, Pune, India having IQ level 50-69. A total of 45 subjects were selected and randomly allocated, 15 in each of the following 3 study groups; Manual toothbrush, Powered toothbrush and Powered toothbrush with parental assistance. The Gingival Index (GI) and Turesky- Gilmore- Glickman modification of Quigley Hein Plaque Index (TQHPI) were used. Examination was done at 0,15 and 30 days after the use of respective interventions. ANOVA, ANCOVA, Post-hoc Bonferroni and Post-hoc tukey test were used for statistical analysis.

RESULTS:

Powered toothbrush with parental assistance significantly reduced plaque levels whereas Powered toothbrush significantly reduced gingivitis than manual toothbrush.

CONCLUSION:

Powered toothbrush was more effetve than manual toothbrush in reducing gingivitis.

KEYWORDS:

Powered toothbrush, Manual toothbrush, Quigley Hein Plaque Index, Gingival Index.

OBJECTIVE:

Globally, schools serve as a valuable platform for oral health promotion and preschool teachers can prove to be beneficial in disseminating oral health education among children as during this period children are most prone to dental caries. The study objective was to evaluate the oral health knowledge, attitude and self practices of the preschool teachers.

METHODOLOGY:

A cross-sectional study was conducted on 112 pre-school teachers in Saddar town, Karachi. Two-stage cluster sampling was used to select the sample and the selected teachers were requested to fill the study questionnaire. Descriptive frequencies and One-way ANOVA was utilized for statistical analysis.

RESULTS:

Response rate was 86%. Seventy-seven percent schoolteachers had knowledge about dental caries and 71% knew that it is of bacterial origin. More than 55% schoolteachers correctly identified the risk factors commonly related to dental caries. Education level of teachers was significantly associated with their knowledge regarding dental caries. Ninety-nine percent used toothbrush and toothpaste for maintaining oral hygiene whereas only 16% visited a dentist routinely.

CONCLUSION:

Pre-school teachers possess satisfactory knowledge regarding dental caries and are actively involved in disseminating oral health education. However, they have poor understanding about importance of regular dental visits.

KEYWORDS:

pre-school teachers, oral health, knowledge, attitudes, dental caries, Pakistan

This case report describes a simple but an effective method of rehabilitating partially edentulous arches with a cast removable partial denture. Conventionally, acrylic teeth are attached to the cast frame with acrylic resin. In case of reduced vertical space between the opposing teeth and the edentulous area, this approach may not work as desired. Because of reduced thickness, the acrylic may not be able to sustain the impact of the cyclic loading and thus suffers fractures. In this case, the acrylization has been avoided by using a single- piece cast partial denture with inbuilt cast pontics. The high strength of the metal even in thin sections, ensure longer lasting performance. By designing the framework of the removable partial denture with inbuilt cast pontics, avoided the need for bonding teeth with acrylic resin. Buccal surfaces of the pontics were veneered with porcelain to mask the metal and hence an esthetic-look to the prosthesis. This function of prosthesis has been followed for more than a year without any problem and with full satisfaction of the patient. Thus the approach can be recommended for cases of the kind.

Key words:

Metal pontics, Cast removable partial denture framework with inbuilt pontics, Cast removable partial denture.