Oral myiasis: a case series of 11 patients treated at Khyber College of Dentistry Hospital, Peshawar

In order to determine the clinical presentation and management f 11 patients suffering from Oral myiasis a descriptive case series study was carried out at Khyber College of Dentistry, Peshawar, from June 2008 to December 2011. 11 patients of Oral Myiasis reported over a time period of 5 years. Thorough history was taken from each patient followed by complete clinical examination, relevant radiographs were advised where necessary. Surgical debridement was carried out followed by larvae removal with the help of maggot oil. Two patients were advised systemic therapy with Ivermectin. Mean age of the patient at the time of presentation was 39.72 years SD + 21.5. Majority of patients were males [64%]. Anterior maxilla was found to be the predominant site. Head and neck malignancies were found to be the most common cause of Myiasis. Thus Oral myiasis is a rare but serious condition, involving necrotic and suppurative wounds in patients with deranged systemic conditions. Treatment includes cleaning, debridement, removal of larvae and systemic therapy with Ivermectin

Gap vs interpositional arthroplasty in the management of temporomandibular joint ankylosis

The objectives of the study were to evaluate the outcome of Gap arthroplasty and Interpositional arthroplasty in terms of mouth opening for management of TMJ ankylosis. This Quasi experimental study was carried out in Oral and Maxillofacial Surgical unit, Khyber College of Dentistry, Peshawar from May 2006 to August 2007. Sixty patients of TMJ ankylosis seeking treatment for the first time, irrespective of age and gender were included in the study. Thirty patients were treated by gap arthroplasty [group A], while thirty patients by disc interpositional arthroplasty [group B]. A postoperative jaw opening exercise regimen was followed and interincisal distance/ mouth opening was measured at each follow up visit. Both groups were evaluated for difference in mouth opening. Descriptive statistics and Independent samples T-test was applied with significance level at P < 0.05. After 6-months postoperative follow up, mean interincisal distance was 30.80 mm [+/- 3.17 mm] for group A, and 32.20 mm [+/- 4.14 mm] for group B. Difference between the two groups was not significant [p= 0.147]. Postoperative jaw opening exercises are crucial for lasting success

Odontogenic fascial space infections in pregnancy - a study

Odontogenic infections are the most prevalent disease worldwide. These infections presenting initially as, localized periapical and periodontal abscess then perforate the cortical bone and spread causing facial cellulitis. Odontogenic infections spread along tissue planes involving initially primary and then secondary facial spaces depending upon the tooth involved and muscle attachments. Infections are common in pregnancy due to hormonal changes and altered immunological activity aggravating response to plaque accumulation and caries resulting in serious life threatening condition, like ludwigs angina. The present study carried out on 28 pregnant patients with severe odontogenic infections reporting to oral and maxillofacial unit of Khyber College of Dentistry, Peshawar, Khyber Pakhthunkhawa province of Pakistan. The age range was from 17 to 40 years and mean age of 24.78 SD +/- 5.043. Odontogenic infections were most common in the last trimester [50%] followed by late second trimester [28.5%]. The most common tooth involved is mandibular wisdom tooth [53.5%] and submandibular space [28%] being the most frequently involved. Patients presented with trismus, facial swelling and dysphagia on examination. Most patients were treated with incision and drainage under local or general anaesthesia depending upon the fitness of the patient and extraction of the offending tooth and intravenous antibiotic coverage

Pattern of oral squamous cell carcinoma - a study

The study was carried out on a total of 312 biopsy proved patients of oral squamous cell carcinoma over a period of 3 years i.e., from 1[st] January 2004 to 31[st] December 2006 in Oral and Maxillofacial Surgery Unit of Khyber College of Dentistry, Peshawar. The aim of the study was to evaluate different patterns of oral squamous cell carcinoma in the North West Frontier Province. Amongst these 312 patients 214 were males [68.59%] and 98 [31.41%] were females. Male to female ratio was 2.18:1. The age range was from 11 years to 77years, with the mean age of 58.8 years; SD + 12.69. While the most commonly involved age group was 7[th] decade of life [35.57%] followed by 6th and 8th decade [28.20%] and [15.38%] respectively Mandibular left gingivolabial sulcus was the most commonly involved site i.e., 41.34%., followed by mandibular right gingivolabial sulcus [18.2 7%]. The most common histological grade of the tumour was G1 i.e., well differentiated Squamous Cell Carcinoma [74.68%] followed by G2 i.e., moderately differentiated [21.15%] and G3 i.e., poorly differentiated oral squamous cell carcinoma [4.16%]. 84% of patients had a positive history of Niswar dipping