Pattern and management of palatine bone fractures

The aim of this study was to determine pattern of palatal fractures, review management options and find out other injuries associated with it. This retrospective study was carried out in the Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Peshawar over a period of three years. All the patients having maxillofacial injuries were evaluated for the presence of palatal fractures. Orthopantomogram [OPG] and Para Nasal sinus [PNS] views were advised to each patient. CT scan and 3D CT scan were advised in cases with pan facial trauma and comminuted fractures. All the data were entered in specially designed proforma. A diagnosis of palatal fracture was made after correlating clinical and radiographic signs. The pattern of palatal fractures was determined along with associated facial injuries. A total of 65 cases of palatal fractures were found in this study. Majority of patients [33.8%] were in the 3rd decade of life. Regarding the pattern of fracture, majority [65%] were sagittal fractures. Most of these fractures [54%] occurred with maxillary Le Fort fractures, regarding management, 9% of the cases were treated with open reduction while 81% were managed with closed reduction techniques. Palatal fracture is often overlooked and is a cause of post op malocclusion in trauma patients. Patients with palatal bone fractures were mostly males in their 3rd decade of life. Sagittal fractures were common and the Le Fort fractures were associated with it. Closed reduction was done in most of the cases of palatal bone fractures

Determining the oral surgery confidence and factors influencing non compliance with pre-prosthetic surgery

The objective of this study is to determine the factors responsible for noncompliance in pursuing preprosthetic surgery and baseline oral surgery confidence amongst patients reporting to Khyber College of Dentistry, Peshawar. This cross sectional analytical study was carried out at the Department of Prosthodontics at Khyber College of Dentistry, Peshawar. Informed consent was taken from the patients participating in the study. A custom made proforma was made to note demographic variables for comparison with the Litt's Oral Surgery Confidence Questionaire [OSCQ], the type of preprosthetic surgery required and factors influencing noncompliance with the said procedure namely increased treatment duration, local and systemic morbidity, associated expenses, failure of surgery and myths heard or believed. Scoring of the OSCQ was done from 0-9 on 11 items and total score calculated. T-test was used to determine significance of gender and level of education with OSCQ score [p-value <0.05]. One way ANOVA was utilized to determine significance of age and required procedure with OSCQ score [p-value <0.05]. 105 patients comprised the study sample with a M:F ratio of 1:1.05. The mean age of the sample was 58.06 +/- 11.22 years. Illiterate patients accounted for 82.9%. Alveoloplasty was the most commonly prescribed procedure [56.2%]. Local and systemic morbidity was the most common factor leading to noncompliance in undergoing preprosthetic surgery [29.5%]. The mean OSCQ score was 46.61 +/- 11.91. Gender and level of education were found to have a significant relationship with OSCQ scores [[p-value <0.05] whereas age and procedure required did not show the same with OSCQ scores [p-value >0.05]. Illiteracy was the predominant educational state amongst the sample and alveoloplasty was the most commonly prescribed procedure alone and also in combination with other procedures. Moderate confidence level was noted in undergoing oral preprosthetic surgery. Gender and educational levels showed a significant relationship with OSCQ scores and these are the areas that should be focussed on to improve compliance in pursuing pre-prosthetic surgery which in turn can improve satisfaction with the use of complete dentures

Professional hazards among dentists of the two public sector teaching hospitals of khyber pakhtunkhwa province of Pakistan

Professional Hazards are becoming an impending health problem in various specialties and dentists are no exception because of the nature of the stressful work they perform. A study was carried out among dental professionals working in two teaching hospitals, Khyber College of Dentistry, Peshawar and Ayub Medical College, Abbottabad, to find out prevalence of professional hazards including psychological, muscuoskeletal, biological and allergic problems. Questionnaires were distributed among 150 dentists having BDS degree and registered with Pakistan Medical and Dental Council [PMDC]. Questions pertaining to psychological, musculoskel-etal, biological and allergic hazards were included in the questionnaire. Data collected were analyzed using SPSS version 17. Out of 150, 113 questionnaires were returned. Among the dental professionals, 50% were dental graduates, 35% post graduate trainees and the rest were either Members or Fellows of the College of Physicians and Surgeons i.e., MCPS, FCPS respectively or MSc. Work experience was < 5 years among 61% of the dentists while only 9.7% had work experience of > 20 years. When asked about any current psychologically traumatic condition, 42% dentists answered with yes. For psychological stress, 18.6% stated it had negative influence on the working environment. Regarding various I musculoskeletal disorders, 33.6% of the dentists had no complaints, while 9.7% suffered from back ache, headache, knee ache, and neck pain. About the approach for treating maxillary teeth, 48.7% used direct approach [direct vision for dental procedures], while 45.1% treated patients using sitting posture. When inquired about frequency of needle stick injuries, 54% were pricked <5 time. Also 46.9% had eye splash from infected saliva and 43.4% had experienced glove puncture during surgical procedure < 5 times during their work. 82.3% dentists were immunized against Hepatitis B. Concerning allergic reactions, 17% suffered from latex allergy and 8% had allergy from acrylic resin, An increased prevalence of psychological and musculoskeletal problems were found among dentists. Majority of dentists came across eye splash, needle stick injury and glove puncture during-their practice. Rate of immunization was effective but use of universal precautions was found to be inadequate among them

Mucosal venous hemangiomas of the oral cavity - an analysis of 43 cases and literature review

To study the gender predilection, age group and affected site distribution of Mucosal venous hemangiomas of the oral cavity in patients reporting to Department of Oral and Maxillofacial Surgery at Khyber College of Dentistry, Peshawar, Khyber Pakhtunkhwa. Forty three patients were included in this descriptive study after a diagnosis was confirmed on the basis of clinical examination and "Blanching" test, carried out at Department of Oral and Maxillofacial Surgery at Khyber College of Dentistry, Peshawar, Khyber Pakhtunkhwa over a period of 3 years and 3 months. All patients with only mucosal hemangiomas were considered and those with intra-osseous, intramuscular, with or without soft tissue extensions of the condition, were excluded from the sample. Pertinent variables such as age, gender and affected site were noted and analyzed using Microsoft Excel 2007. Majority of the patients in this study were male [62.8%] whereas females constituted the remaining 37.2% of the sample. 11-20 years was the most prevalent age group whereas 41-50 years was the least prevalent age group in this study. Amongst the study sample, the tongue was found to be the most affected site, comprising 32.6% of cases and the maxillary gingival was the least affected site, accounting for only 2.3% of our study samples. Mucosal venous hemangiomas show a marked male predilection in our study sample. Patients falling in 11-20 year age range are affected mostly by the condition and the tongue is the most common affected site in patients from Khyber Pakhtunkhwa

in vivo study to evaluate the efficacy of electronic apex locators in the determination of working length

The aim of this study was to determine whether the performance of electronic apex locators can equal or outdo the radiographic technique and establish itself as a standard baseline entity for the determination of working length. One hundred and seventy five canals of 84 patients were included in this study at the Department of Operative Dentistry, Khyber College of Dentistry for the preparation phase of root canal treatment. The canals were dried and the Joypex 5 apex locator was used to record the working length. The patients were sent for aperiapical radiograph and radiographic working length was calculated. Both values were recorded on specially designed proforma; the difference was noted and subjected to statistical analysis using a Paired-samples T test with a critical p-value of<0.05. Out of 175 canals measured, the radiographic working length coincided with the electronic working length in 101 [60.0%] cases. In 31 cases [17.7%], the electronic working length was short by 0.5mm and in 24 cases [13.7%,] the electronic working length was over by 0.5mm. In 7 cases [4%,] the electronic working length was short by 1mm and over by 1mm in 4 cases [2.3%]. In 2 cases each, the apex locator underestimated the working length by 2 and 3mm [1.1% each]. Overall, the difference between the working lengths measured by the two methods was statistically insignificant [p=0.294]. The difference between the two working lengths obtained was not significant [b=0.294,]. The apex locator was able to locate the apical foramen to within +/- 0.5mm in 91. 1% of the cases. However its solo application for determining working length is discouraged and must be used in tandem with conventional radiography

Evaluation of age, gender and parental factors affecting child behavior in the dental surgery

The aim of this study was to know the effect of gender, age, parental education [literacy] and parental socioeconomic status on child behavior in dental surgery. One hundred and twenty six children who reported to Department of Paedodontics Khyber College of Dentistry, Peshawar for various dental problems were included in this study. A specially designed proforma was used to collect information from parents anage, gender, parental education [literacy], socioeconomic status. Frankl behavior rating scale was used to record child behavior in dental surgery. The data was then subjected to statistical analysis using SPSS version 16. Majority of the children [44.4%] belonged to low socio economic group followed by middle [29.4%] and high [26.2%] socio-economic groups. The parents of 55 children [43.7%] had college/university education followed by 39 parents [31%] having up to high school education. Third two parents [25.4%] were uneducated According to Frank/behavior rating scale, majority of the children [34.1%] showed definitely positive behavior followed by positive behavior [31.7%] and negative behavior [25.4%]. Only a few children [807%] exhibited definitely negative behavior. The effect of all the study variables on child behavior was not significant except age [p=0.033]. However, there were trends showing more children from higher socioeconomic group and those belonging to paretits with college/ university education behaving positively. Parental literacy Socio-economic status and Gender of the child did not affect child behavior significantly. The age of the child was significantly related to the behavior of the child. Therefore more negative behavior should be expected from younger children. Each and every child should be assessed and managed individually and no generalizations should be made

Cleidocranial dysplasia- literature review and an evidence based clinical report

Cleidocranial dysplasia is an autosomal dominant disorder affecting the craniofacial region and clavicles along with other skeletal abnormalities. The Dental surgeon, is usually the first professional whom patients look for to solve the problem, since there is a delay in the eruption or an absence of permanent teeth. This peculiar case has been reported along with literature review to focus on the unusual findings so that the dental professionals become familiar with such features on confronting subjects with Cleidocranial Dysplasia