Canine retraction using a closed nickel titanium coil spring and an elastic module

Objective: To compare the mean change of tooth movement in canine retraction between elastic module and Ni Ti coil spring

Study Design: Comparative study

Place and Duration of Study: Orthodontics Department, Armed Forces Institute of Dentistry, Rawalpindi, from May 2015 to January 2016

Methodology: Thirty-two patients were inducted. After alignment and extraction of maxillary first premolars, canine retraction was started with closed Ni Ti coil spring on one side of the maxillary arch and with active tie back on the other side. The distance between the lateral incisor and the canine was measured on both sides before starting canine retraction. The same measurements were recorded after four weeks of retraction. The difference between pre and post retraction measurements was recorded. The difference in the rate of canine retraction between both modalities was compared using independent sample t-test

Results: The study included 56% females and 43% males. The mean rate of tooth movement in Ni Ti coil group and in the elastomeric module group was 1.1 mm and 0.7 mm in one month, respectively [p=0.05]

Conclusion: The rate of tooth movement is more rapid with Ni Ti coil spring than with the elastomeric module

Prevalence and patterns of mandibular impacted canines. a cbct based retrospective study

Demographic studies are important for understanding the prevalence and various patterns associ-ated with impacted canine for early diagnosis and success of treatment. The aim of this study was to evaluate prevalence and different patterns of mandibular impacted canines [MIC], using cone beam computed tomography [CBCT].CBCT records of 3469 patients were taken from two different radiological centers. Sorting of data for MIC was done using Romexis viewer 4.6.0. R. Data was analyzed statistically and descriptive statics for age, gender, side and position of impaction were generated. Chi-square test was used to evaluate gender dysmorphism in terms of presence, position and side of MIC. A p-value of <0.05 was taken as significant. 20 patients with MIC were identified with a mean age of 19+2.2 years. 85% of MIC were unilateral while 15% were bilateral. 15 % of MIC were transmigrated and were unilateral with a male to female ratio of 2:1.70% of MIC were labially placed. Bilateral impactions were found only in males. No gender dysmorphism was noted for presence, position and side of impaction [p value >0.05]. The prevalence of impacted mandibular canine was 0.57% while prevalence of transmigration was 0.09%. Unilateral and labial position of impacted canine was more predominant

Prevalence and patterns of impacted maxillary canines: a cbct based retrospective study

Maxillary canines are considered as the cornerstone of the mouth. This study aims to estimate the prevalence and unfold various patterns present in maxillary canine impactions using cone beam computed tomography [CBCT].Digital records of 3469 patient were collected from two different radiological units. Sorting of CBCT data was done for identification of maxillary impacted canine's cases. Data were analyzed statistically, and descriptive statics were generated for age, gender, quadrant, and position of impacted canines. Chi-square test was used to check the difference in the distribution of impacted canines regarding gender, quadrant and position of impacted teeth. A p-value of <0.05 was taken as significant.One hundred and eighty-seven patients were identified with impacted maxillary canines making a prevalence of 5%, with a mean age of 17.9 +2.65 years. 117 impacted canine cases were located in females while 70 impacted canine cases were in males. Female to male ratio was1.67:1. Statistically, a significant difference was noted between genders [p-value =0.00]. No difference was noted between genders regarding quadrant and position of impacted canines.Higher prevalence of impacted canine was noted in females, while left side predominance was found in both genders. Palatal impactions were most common while a higher prevalence of buccal impaction, than previously reported was noted in the present study

Comparison of efficacy of combination of 2 percent Ketoconazole solution wash and topical 1 percent clotrimazole with topical 1percent Clotrimazole alone in C

Objective: Comparison of efficacy of combination comprising 2 percent ketoconazole solution wash plus topical 1 percent clotrimazole versus topical 1 percent clotrimazole alone in management of patients with Pityriasis versicolor

Study Design: Randomized controlled trial

Place and Duration of Study: Dermatology department, Pak Emirates Military Hospital Rawalpindi, from Oct 2016 to Apr 2017

Material and Methods: Sixty patients of Pityriasis versicolor, both male and female were included in study. Diagnosis of Pityriasis versicolor was made clinically and confirmed microscopically by examining skin scrapings for fungal hyphae. Patients with concomitant systemic illnesses or those who had received anti-fungal in last three months were excluded from study. Random number tables were used to allocate patients to the two treatment groups. Group A received 2 percent ketoconazole shampoo twice per week for four weeks plus topical 1 percent clotrimazole twice daily application for 2 weeks. Group B received only topical therapy with 1 percent clotrimazole cream applied twice daily for 2 weeks. Assessment of treatment efficacy was done by clinical examination of patient and microscopy of skin scrapping for fungal hyphaedone at baseline and at end of study [4 weeks of treatment]. A negative clinical examination and negative skin scrapping for fungal hyphae was considered effective therapeutic response

Results: In group A, the mean age of patients was 29.76 +/- 8.89 years and in group B was 27.67 +/- 10.46 years. Efficacy in group A was observed in 22 [73.33 percent] patients while in group B in 14 [46.67 percent] patients

Conclusion: Combination of 2 percent ketoconazole solution wash plus topical 1 percent clotrimazole was found more effective in treatment of patients with Pityriasis versicolor as compared totopical 1 percent clotrimazole alone

Microdontia and Hypodontia in a family: a case report

We have presented here a Dental anomalies, hypodontia/oligodontia and microdontia in a family which reported to us at Armed Forces Institute of Dentistry Rawalpindi. A father along with his two sons presented to us with complaints of small sized dentition and gaps between teeth. On examination it was found that all three of them had concomitantly occurring hypodontia and microdontia which had functional and esthetic implications. It was then planned to adopt multidisciplinary approach to treat the patients involving orthodontics, restorative dentistry and prosthodontics

epidemiological study: assessment of symptomatic osteoarthritis and its management in general population of Karachi with joint pain

Object: to determine the frequency of symptomatic osteoarthritis in general population of Karachi presenting with joint pain

Introduction: people easily get tired due to heavy duty occupations to keep pace with the society. Arthralgia commonly called as "Joint pain" is one of the most frequently observed complain, especially in individuals aged 50 above

Methods: a cross-sectional study was conducted at Jinnah Postgraduate Medical Centre [JPMC] from 1[st] November 2013 to 25[th]November 2013. The data was collected from 316 patients presenting to the department of rheumatology and orthopedics with joint pain. A structured questionnaire was designed based on the clinical symptomatology of osteoarthritis. It was administered to the participants aged above 18 yrs. old. 17.7% of males and 82.3% of females participated in the study

Result: out of 316 patients with joint pain, 71.2% [n=225] was diagnosed osteoarthritis on the basis of symptoms present with a high prevalence in females than males. The most common joints to be involved in osteoarthritis were found to be knee joint [90.2%] and hip joint [55.7%]. The majority of the patients [n=109] had an X-ray of their joint and n=125 was getting analgesics as an effective therapy for osteoarthritis

Conclusion: the frequency of osteoarthritis is increasing in Karachi with globalization due to high level occupational stress along with recreational activity stress and other contributive factors. Female predominance as compare to that of man is quite alarming that needs to be controlled for maintaining future quality of life and providing ease for daily activities

Association of low serum zinc level with multiple viral warts

Objective: to determine the association of low serum zinc levels with multiple viral warts

Methods: comparative case control study was conducted from 28th February 2011 to 28th August 2011 in Department of Dermatology, Services Hospital, and Lahore. 110 cases; 55 in each group calculated with 80% power of test, 5% level of significance and taking expected percentage of low serum zinc level i.e. 56% in patients presenting with warts, 32% in control group. Serum zinc analysis was carried out by atomic absorption spectrometry

Results: age of patients as well as of controls ranged from12- 65 years with a mean of 30.02 + 10.04 years. Serum zinc level was low in 33[60%] patients and 19 [34.5%] controls. Among the patients, serum zinc level ranged from 680 - 1020 microgram/ litre with a mean of 812.33 + 105.57, whereas level ranged from 687-1020 microgram/ liter with a mean of 848.96 + 113.68 among controls. Odds ratio was 2.84

Conclusion: as the Odds ratio is 2.84 [>2] it concludes that there is an association between the low serum zinc level and multiple viral warts. So, low serum zinc level is a risk factor of the multiple viral warts

Dental fear and anxiety among orthodontic patients - a Pakistani sample

Objective of this study was to determine the frequency of anxiety levels among orthodontic patients using Norman Corah's Dental Anxiety Scale, [DAS] and its correlation with gender, age and education of patient. It was a cross sectional study. The study was carried out at Orthodontics Department, Armed Forces Institute of Dentistry [AFID], Rawalpindi from October 2014 to January 2015. A self-reported assessment scale developed by N. Corah, Dental Anxiety Scale [DAS] was used in the study. It was used in the form of a questionnaire containing data on gender, age, education. A total of 350 questionnaires were distributed among consented participants and finally valid 233 questionnaires were recruited in the study. Out of 233 patients, 69 [30%] were male and 164 [70%] were females. 46% participants had mild anxiety score, whereas only 4% participants experienced severe anxiety. With higher education level of patient lesser anxiety score was reported in this study [p= 0.015]. Results showed that patients with higher education were significantly less dentally anxious [p<0.01] about orthodontic treatments than patients with lesser education. Demographic characteristics such as gender and age of the patient had statistically no significant effect on DAS

Screening mammography; anxiety and pain associated, an experience at Benazir Bhutto hospital

Worry about risk for breast cancer and pain are associated with mammography use. Both have been found to be a barrier to mammography use by women. To examine the anxiety and pain associated with mammography use in a sample of women stratified according to breast cancer risk. This prospective observational study. Department of Obstetric and Gynecology, Benazir Bhutto Hospital. August 2011 to June 2012. Patients and Women awaiting screening mammography in the reception area were asked to complete a questionnaire containing demographics for calculation of breast cancer risk and the Likert scale for anxiety before the procedure and VAS for assessment of pain after the procedure. Our study included 100 women undergoing screening mammography with an average age of 53.9 +/- 8.8 years. 15% were classified "higher risk" by the Gail model. The average anxiety level was 4.03 +/- 1.3 on Likert scale and average pain during the procedure was 3.3 +/- 2.18 on VAS. Significant differences [p<0.05] were found between average and higher risk groups. The population of women in this sample appears to have a level of breast cancer worry and procedure related pain that is proportional with their risk for developing breast cancer

Assessment of psychosocial impact of dental aesthetics and self perceived orthodontic treatment need in young adults

The aim of this study was to assess the psychosocial impact of dental aesthetics using the 'Psychosocial Impact of Dental Aesthetics Questionnaire' [PIDAQ] and self-rated Aesthetic Component [AC] of the Index of Orthodontic Treatment Need [IOTN], and individual attitude to own teeth and general appearance. The cross sectional study was conducted among the students of Margalla Institute of Health Sciences [MIHS], Rawalpindi with age ranging from 18-25 years. Students were asked to complete a 'Psychosocial Impact of Dental Aesthetic Questionnaire' [PIDAQ]. Total of five variables 'Dental self-confidence, Social impact, psychosocial impact, Aesthetic concern and Patients Beliefs were evaluated by series of questions, and Dental Aesthetics was assessed by using of IOTN Aesthetic Component. The Kruskal-Wallis test was applied to determine differences between the mean scores for all the subject groups [1 to 4+]. Chi square test was performed for patient beliefs. All the five variables showed significant correlation with perceived severity of malocclusion with p-value of less than 0.01. The association between self-rated IOTN-AC grading and psychosocial well-being was established, signifying that the self-perceived aesthetics may be a significant factor in defining treatment need as the degree of malocclusion itself

Effective learning through multiple choice questions against short essay type of assessment in medical physiology students of Lahore

The present study was carried out to evaluate the advantages of Multiple Choice Questions [MCQ] against short Essay type [SEQ]. longitudinal study. This study was conducted Rashid Latif Medical College, Lahore from December 2011 to March 2013. A total of 200 second year students were involved in the study and their scores in SEQ and MCQ papers were analyzed. Out of them 100 students were girls and 100 were boys. The students were informed that they are going to be accessed via three SEQ examinations and three MCQ examinations and then a survey and viva was conducted. Gender differences in performances were also studied. The result of this study shows that those students who were kept on MCQ type of assessment emerges to be weak students at the end of the session as compared to others who were assessed by SEQs. The SEQ type of assessment was established as a better method of assessment to strengthen student's learning process and helped students to exert and retain more knowledge

Identification of tooth shade in various age groups of pakistani population using vita easyshade

The aim of the present investigation is to identify tooth shade among a group of Pakistani patients. Total number of patients was 227. Participants age ranged from 16 to 65 years, which, was divided into four groups. The tooth included in the study was sound maxillary right or left central incisors. Vita Easyshade was used to select the tooth shade. Most common classical shade was B2 with highest incidence in between ages 26-35 years and shade A spreads widely among the groups. B2 was the most common classical tooth shade in Pakistani population. Health education regarding oral hygiene should be given at school level

Chronic periodontitis, a silent hazardous disease

Chronic periodontitis is a common disease, which occurs as an outcome of tooth supporting tissue's inflammation [periodontal ligament and gums], initiated by the exposure of the periodontium to dental plaque. By the action of various toxic products liberated from pathogenic plaque bacteria there is periodontal destruction, as well as hosts inflammatory responses elicited against plaque bacteria and their products. Inflammatory processes can be considered as the most essential functional part of pathophysiology of atherosclerosis resulting in cardiovascular disease [CVD]. Elevated levels of C -reactive Protein [CRP] have been associated with CVD and regarded as indeperident determinant of atherosclerosis. This study has been carried out to assess the possible relationship between chronic peri-odontitis and CVD determinants. This cross sectional study involved a total of 100 subjects including 50 chronic periodontitis patients and 50 healthy controls between the ages of 35 - 40 years. The patients were obtained from de-Montmorency College of Dentistry, Lahore. A detailed personal history, past medical and dental history was taken. Patients of chronic periodontitis were selected using Community Periodontal Index of Treatment Needs [CPITN], according to inclusion and exclusion criteria. Blood sample were drawn and CRP was measured by using standard enzyme linked immunosorbent assay [EL1SA] method. These parameters were compared in chronic periodontitis patients with age and gender matched healthy controls, to observe the significance of difference. The results of this study showed that serum CRP which was a strong independent risk jnarker of CVD is statistically significantly elevated in chronic periodontitis patients as compared with age and gender matched healthy controls. The correlation between serum CRP and severity of chronic periodontitis was also highly significant. The results of this study suggest that elevated CRP in chronic periodontitis patients may predispose them to the development of early atherosclerosis. Because of the significant association of elevated inflammatory mediators with CVD, their determination may help to improve the prediction and prevention of CVD in chronic periodontitis patients as well as these results is expected to bring awareness in people about oral hygiene

Relationship of gingival disease with ovulation among young girls

The current study was carried out in order to estimate the effects of estrogen levels on gingival health. It was a cross sectional study and it was conducted at de, Montmorency College of Dentistry over a period of one month. A total of two hundred young females with good oral hygiene, in age range of 20-22 years formed the study group. Blood samples were drawn thrice specially at the time of ovulation which was estimated by history. Samples were investigated for serum concentrations of estrogen by using standard ELISA technique. Estradiol [micro grams/ day] levels in Early Follicular phase among 200 young girls was estimated as [34.66 +/- 5.07] and in Preovulatory phase it was calculated as [377 +/- 3.40] where as in Mid Luteal phase it was found to be [246 +/- 4.77]. These values show that the Estradiol [micro grams / day] levels were highest during Preovulatory phase. It was concluded that at time of ovulation the estrogen concentration in serum was significantly higher and at the same time gingivitis and periodontitis were diagnosed in acute form in most of the girls using standard diagnostic tools and techniques

Frequency and etiology of midline diastema in orthodontic patients reporting to armed forces institute of dentistry Rawalpindi

To determine the frequency and etiology of maxillary midline diastema [MMD] in local settings. Descriptive study. The study was carried out on orthodontic patients reporting to Armed Forces Institute of Dentistry Rawalpindi [AFID] from 2001 to 2007 at the Department of Orthodontics, Armed Forces Institute of Dentistry Rawalpindi. A total of 1800 cases of malocclusions, were collected from orthodontic dept of AFID Rawalpindi, during research period. Sample purification resulted in a research sample of 1747 patients. The data of all patients was analysed as regards to age, gender, occlusal traits, and relevant disatema findings. The frequency of MMD turned out to be 12.59%. No single etiological factor was found responsible for MMD, however increased over jet was the most frequently [56.56%] occurring factor related to MMD, followed by high frenum attachment [33.03%] and finally deep bite, 31.6%. Maxillary midline diastema is a common entity associated with multifactorial etiology. Focusing on symptomatic treatment rather than addressing the cause oriented approach will lead to relapse of the already existing problem. Permanent retention should be considered in most cases

Success rate and pain perception in orthodontic patients receiving bone screws for anchorage: a pilot study

Anchorage enhancement through implants has received much consideration in the past decade. Recently small diameter orthodontic mini screws have been used to reinforce anchorage in orthodontic patients. Added discomfort may influence the patients decision to elect screws as alternatives to more conventional reinforcement systems. The purpose of this study was to evaluate the success rate, and pain anticipation before screw placement, and actual perception after placement based on a ten point Visual Analog Scale. 1.4mm diameter Biotech self tapping mini screws were placed in 11 patients selected for implants. Questionnaires were filled by patients on the first post operative appointment. Results showed that the success rate of mini screws was 86.36%. There was no significant different between the level of pain anticipated and that actually perceived by patients. Conclusively, a large scale study may throw further light on the acceptability and success rate of Orthodontic Mini Screws

Frequency of impacted canines in orthodontic patients presenting to armed forces institute of dentistry

The aim of our study was to observe the frequency of patients presenting with impacted canines in our subset of population. This is cross-sectional observational study. The study was conducted in the Orthodontic Department at Armed forces Institute of Dentistry Rawalpindi. Orthopantomographs [OPGs] of 1956 consecutive patients were observed for impacted canines. Thirty two patients were excluded for various reasons. Age and gender was recorded Orthopetomographs [OPGs] and intra-oral photographs were observed to detect the impaction of canines. Out of 1924 orthodontic patients [64] 3.33% were found to have impacted canines. The mean age of the patients presenting with impactions was 18.3 years. The male to female ratio was 1:2. The 87.5% of the impactions were unilateral. Single tooth impactions were the most common followed by two or three impactions in the same patient. The most frequently impacted tooth in 51.56% of the cases was the right maxillary cuspid. The least common was the right mandibular cuspid, 4.7%. A frequency higher than the previously quoted prevalence was found in our study. Racial and ethnic factors may have a role, further large scale studies are required to validate this assumption

Personality improvement through orthodontics

The aim of this study was to assess and compare changes observed in the weights of patients undergoing fixed orthodontic treatment. These measurements were taken at the start of orthodontic treatment and at two next intratreatment appointments at an interval of one month.This study was conducted on patients who came to Orthodontic Department of Armed Forces Institute of Dentistry [AFID], Rawalpindi. Pretreatment Weight [Wl] of 65 patients was taken before starting the treatment and subsequently [W2 and W3] at the next two intra treatment appointments with an interval of one month. Patients who received fixed orthodontic treatment showed significant weight changes during treatment at Wl, W2 and W3, with a weight loss at W2 and gain at W3 phase level. In all 61. 5% females and 54.6% males reported dietary changes during orthodontic treatment. This indicates that Orthodontic treatment can be used as an adjunctive and preventive measure for weight loss

Two dimensional localization of impacted maxillary canines and their correlation

Comprehensive treatment planning is of paramount importance in leveling and aligning the impacted maxillary canines. In such cases, retrieval of all pertinent clinical information leading to proper diagnosis and prediction of treatment complexity weighs utmost importance. There are many factors including modalities of treatment, governing management of impacted canines. The aim of our study was to correlate canine angulation and its vertical position. The study was conducted in the orthodontic department at Armed Forces Institute of Dentistry [AFID] Rawalpindi. Patients presenting to orthodontic department from June 2001 to April 2008 were included in the study.. Orthopantomographs [OPGs] of 1956 consecutive patients were screened for impacted canines. OPGs were traces and angulations of canines to the mid sagital plane [?] and vertical distance from the occlusal plane [d-mm] were determined and a correlation was sought. 47[n] 2.4% patients were found to have 57 impacted canines. 21% patients had bilateral impactions. 33 patients were male and 24 female. The mean angulation was 29.54 degree sign and the mean distance d was 13.1mm. Insignificant correlation was found between these two variables. Though these factors are important in management strategies their influence is deemed independent of each other