Pattern and presentation of odontogenic jaw cysts: a clinical experience

Objective: To determine the pattern and presentations of odontogenic jaw cysts in patients reporting at the Armed Forces Institute of Dentistry

Study Design: Descriptive study

Place and Duration of Study: Armed Forces Institute of Dentistry, from Jan to Dec 2007

Material and Methods: Hundred patients including 70 males and 30 females with the age range 5-65 years were included in the study. History, clinical examination, radiographic examination and histopathologic examination of lesion were carried out for each patient. A proforma was filled for each patient for all relevant information, presentation and pattern. Diagnosis was confirmed by histopathology. Data were analyzed using SPSS version 10

Results: Out of total 100 patients, 58% were diagnosed with radicular cysts, 25% with dentigerous cysts, 15% with odontogenic keratocyst, 1% patient with calcifying epithelial odontogenic cyst and 1% patient was diagnosed with eruption cyst

Conclusion: The study demonstrates that radicular cyst was the most common odontogenic cysts followed by dentigerous and odontogenic keratocysts respectively in our study sample

Efficacy of peripheral streptomycin injection in the treatment of idiopathic trigeminal neuralgia

To evaluate the efficacy of peripheral streptomycin injection in relieving the pain of idiopathic trigerninal neuralgia. Quasi experimental study. Oral and Maxillofacial Surgery Department, Armed Forces Institute of Dentistry Rawalpindi, from 1[st] June 2006 to 31[st] December 2007. Thirty patients of idiopathic trigerninal neuralgia were selected. They received five consecutive injections of streptomycin Ig in 3 ml of 2% Lignocaine [Septodont] with 1: 100,000 adrenaline at one week interval. Follow up was carried out at one, two and six months after the last injection. Age ranged from 15-78 years [mean 44.67]. Male to female ratio was 1:1.14. Right side of the face was involved in 70% and left side in 30% cases. Mandibular division of trigeminal nerve was involved in 43.3% and maxillary division in 40% of the cases. In the rest both maxillary and mandibular divisions were involved. Pain was significantly decreased from baseline to 1 month [p < 0.001]. The level of pain was increased a bit but the increase was significant at two months [p = 0.006] and at 6 months [p = 0.020]. Best treatment modality for this devastating disease is yet to evolve. Within the confines of the study it can be stated that efficacy combined with low post treatment morbidity makes streptomycin a useful treatment option

Esthetics, functional, and psychosocial satisfaction after orthognathic surgery in patients having dentofacial skeletal deformities

In this study, which was conducted at Armed Forces Institute of Dentistry Rawalpindi, the rate of satisfaction among patients who had dentofacial skeletal discrepancy and under gone orthognathic surgery along with orthodontic treatment from January 2010 till June 2015 was investigated. This retrospective study was conducted among fifty three patients who underwent Orthognathic surgery treatment from oral maxillofacial surgery department formed the study group. Patients were recalled for follow-up for their evaluation and to fill the questionnaire and those patients, who could not come for follow up were called on their personal phone numbers. Forty patients responded to fill the questionnaire. The questionnaire consisted of 19 questions. The survey response rate was 75.4%. Thirty five [87.5%] patients were satisfied with their final facial profile, and 37 [92.5%] were with their final esthetic profile. Related to the function 30 [75%] patients showed improvement in chewing ability, while 35 [87.5%] had no temporomandibular joint problem I pain post-operatively. The perception of patients for psychosocial benefits of treatment was positive, 27 [67.5%] patients stated that their social communication and 30 [75%] patient's self-confidence had improved a lot after treatment. It is concluded that orthognathic surgery was satisfactory and accepted treatment for dento-facial deformity, for improvement of appearance of individuals. On the other hand, any dissatisfaction that occurred in few individuals it was due to unrealistic expectations of the patients and expertise of surgeon and I or orthodontist

Prevalence of radiographic classification of impacted mandibular third molars - an overview

The purpose of this study was to evaluate radiographically the position of mandibular third molars. It is a descriptive study carried out at 1 Military dental Centre, Sialkot Cantt from August to March 2011. The patients who came with the complaints of pain or swelling in the lower third molar area were clinically assessed and advised radiograph [peri apical view or orthopantomograph] for their lower third molar. These radiographs were assessed according to the Winter's classification for angulation and Pell and Gregory classification was used to access the space and depth of impaction. A total of 415 patients were examined. 73.7% patients [n=306] were males and 26.3% [n=109] females. Most of the patients were between 20-29 years of age [n=244]. Mesioangular impaction was the most common found in 38.5% [n=160] patients. Position A 66% [n=274] and class II 55% [n=229] were found to be the most common

Efficacy of intra-alveolar chlorhexidine gel in reducing frequency of alveolar osteitis in mandibular third molar surgery

To determine the efficacy of intra-alveolar administration of chlorhexidine [CHX] gel in reducing the frequency of alveolar osteitis [AO] after impacted mandibular third molar surgery. A randomized control trial study. Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from January to December 2007. One hundred patients including 65 males and 35 females with the age range 18-40 years were divided in two equal groups [50 each in the CHX and the control groups]. Surgical removal of impacted mandibular third molar was carried out and after surgery CHX gel was placed into the alveolus of CHX group. Patients were followed at the first, second and third postoperative days. A proforma indicating presence or absence of pain, blood clot disintegration, halitosis and AO was filled for each patient. Frequencies and percentages were calculated for qualitative data. Chi-square test was applied to compare both subgroups. Eighteen patients [18%] were diagnosed with AO [11 males and 7 females]. Out of these 18 cases, 14 [28%] were found in control group [9 males and 5 females], while 4 cases [8%] in the CHX group [2 males and 2 females]. This was statistically significant p=0.017. Single application of CHX gel was effective in reducing frequency of AO following mandibular third molar surgery

Pattern and presentation of oral white lesions

Oral white lesions are not uncommon and a significant number of patients are asymptomatic. The purpose of this study was to determine the pattern and presentation of oral white lesions in patients reporting at oral and maxillofacial surgery department of AFID. World Health Organization [WHO] guidelines for oral mucosal examination were used to record data of 100 patients who presented with oral white lesions. Biopsies were performed in lesions whose definitive diagnosis was deemed difficult purely on the basis of history and clinical examination. The mean age was 38 +/- 13years with 57[57%] males. Forty two [42%] patients were asymptomatic. The most frequent site was buccal mucosa [64%] and more than half of these lesions appeared white [57%] while others were yellowish white [18%], grey white [15%] and with areas of redness within the lesion [10%]. Among habits, smoking was most common. The most common lesion was lichen planus [28%] followed by frictional keratosis [15%] and oral submucous fibrosis [13%]. Other rare lesions were geographic tongue, mucosal burns, candidiasis. As some of these lesions are premalignant, it is imperative for the dental and medical professionals to familiarize with their pattern and presentation to effect early diagnosis and management

Transpapillary versus palatal injection technique for maxillary tooth extractions

To compare the pain during injection administration and efficacy of transpapillary injection with palatal injection for simple maxillary tooth extractions. Randomized control trial. The oral and maxillofacial surgery department of Armed Forces Institute of Dentistry, Rawalpindi, Pakistan, from July to December 2009. Patients requiring simple extraction in maxilla were randomly divided into two groups each consisting of 100 patients. Group 1 was given conventional palatal injection and served as a control, whereas Group 2 received the transpapillary injection. Two percent Lignocaine with Adrenaline [1:100,000] was used for both groups. Pain during injection and then during the extraction were recorded for both groups using the Visual Analogue Scale and Faces Pain Score Scales on specially designed proformas. The data was analyzed using SPSS version 17.0 and independent t-test was applied to compare pain between both groups. P-value of less than 0.05 was considered to be statistically significant. Group 1 consisted of 61 males and 39 females with an age ranging from 11-73 years [mean= 39.92 + 14.85 years] while Group 2 consisted of 59 males and 41 females with an age ranging from 10-70 years [mean= 39.31 + 18.53 years]. Results of FPS and VAS scores for injection and procedure were analyzed using independent t-test. Difference of scores for pain during injection were found to be significant [p < 0.05] while the scores for the procedure were seen to be statistically insignificant [p > 0.05] showing that transpapillary injection is equally effective for maxillary extractions as palatal injection but with significantly decreased pain during injection. Transpapillary injection is an easy and effective way of eliminating the pain of palatal injection for maxillary extractions

Reasons and pattern of first molar extraction - a study

The aim of this cross sectional prospective study was to determine reasons and patterns of permanent 1[st] molar extraction in patients reporting to oral and maxillofacial surgery department at Armed Forces Institute of Dentistry, Rawalpindi. All patients referred to oral and maxillofacial surgery department for extraction of permanent first molar teeth from 1st of January 2009 till 31[st] of December 2009 were included in the study irrespective of their age and gender. The primary reason of extraction was recorded along with other relevant information. The pattern of extractions of the permanent first molars was also noted. A total of 470 patients were included in the study. Out of these 291 [61.9%] were males [M: F 1.6:1]. Caries was the most common cause with 281 extractions [59.8%] in all age groups in both genders followed by periodontitis, which was responsible for 109 [23.2%] of permanent first molar extractions. Mandibular molars were more frequently extracted [62.7%] as compared to the maxillary molars [37.3%], with the mandibular left molar being the most frequently extracted tooth in the sample population

Inadequacies in history taking and clinical examination by the dentists

History taking and clinical examination are the most important steps in the diagnosis and hence overall patient management in medicine, surgery and dentistry. The purpose of this study was to determine the history taking and clinical examination practices of dentists. Self-administered questionnaires were distributed among two hundred randomly selected dentists of Rawalpindi and Islamabad. The questionnaire assessed how often these dentists recorded all the steps of history and how often they examined their patients thoroughly. While the vast majority of dentists asked most of their patient's demographics, chief complaint and the history of their chief complaint and examined all teeth of their patients, a considerable number of them missed the medical, family and socioeconomic history, did not record vital signs, and did not examine the entire head and neck and oral mucosa of all their patients. This study emphasizes deficiencies and inadequacies in the history taking and clinical examination practices of dentists in the studied sample

Pattern of maxillofacial injuries in the earthquake victims

To observe the pattern of Maxillofacial injuries in Earthquake victims and to discuss their management. Descriptive Study. This study was conducted at the Maxillofacial Surgery Department, Armed Forces Institute of Dentistry [AFID], Rawalpindi over a period of six months following the 8[th] October, 2005 Earthquake. 176 patients who sustained maxillofacial injuries during the earthquake were included in this study. The pattern of maxillofacial injuries and their management was documented. Out of the 176 patients, 141 [80.11%] had fractures of the maxillofacial bones. The remaining 35 [19.89%] patients sustained minor maxillofacial injuries e.g. soft tissue injuries, dentoalveolar fractures and temporomandibular joint arthritis / dislocation. Isolated mandibular fractures were seen in 64 [36.4%] patients. Fifty-seven [32.4%] patients had multiple fractures of the facial bones. Zygomatic bone was fractured in 18 [10.2%] patients whereas 02 [1.1%] patients had isolated fracture of the maxilla. Fifty-nine [41.8%] patients were treated by closed reduction and IMF, 55 [39%] patients by open reduction and transosseous wire fixation in addition to IMF and 27 [19.1%] cases by open reduction and miniplate osteosynthesis. Postoperative complications were noticed in 18 [10.2%] of the patients. Multiple fractures of the facial bones were far more common than the routine trauma cases. The magnitude of the disaster dictated simple and timesaving conventional methods of management in majority of the cases

Functional rehabilitation by gap arthroplasty in temporomandibular joint ankylosis

A study was carried out from Jan 1999 till Dec 2001 at oral and maxillofacial department, AFID, Rawalpindi. The purpose of the study was twofold i.e.; retrospective to determine the cause of temporomandibular joint ankylosis and prospective to see the results of functional rehabilitation by gap arthroplasty with coronoidectomy followed by immediate postoperative mouth opening exercises with Monoblock by Reichenbach. Fifty [50] patients [63 joints] were treated and are regularly followed up. Study showed that major cause of temporomandibular joint ankylosis was trauma [88%] and the mean postoperative IED obtained through operative procedure and postoperative rehabilitation was 30.89 mm