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

Use of mobile phones while driving and resultingfacial injuries

The purpose of this study was to give an overview of drivers use of mobile phones while driving and its role in motor vehicle crashes and subsequent facial injuries. 200 patients who were either drivers or passengers involved in facial injuries as a result of road traffic crashes between January 2008 and November 2008 were included in this study. They were seen in the Department of Oral and Maxillofacial Surgery at Khyber College of Dentistry, Khyber Pakhtunkhwa, Pakistan. All relevant informations were collected on a specially designed Proforma and analysed using SPSS version 17. Male outnumbered female with a male to female ratio of 6:1. Passengers were injured more frequently [60%] as compared to the drivers [40%]. 32 drivers [40%] out of 80 had used mobile phone at the time of accident. Among those drivers [n=32] who had used mobile phone at the time of accident, the 3rd decade was the most commonly involved age group followed by 2nd decade. Mandible was the most common bone involved in 46.88% of the cases followed by Zygomatic complex fractures [21.88%].This study has highlighted the problem of road traffic injuries among drivers and passengers asa serious public health problem. Mobile phone users commit more errors and lapses than non-mobilephone users. It seems that cellular mobile phone bring extra workload to memory and share attention sources, which causes accidents by distracting the attention of drivers

Post-traumatic stress disorder - a psychological aspect of maxillofacial trauma

The purpose of this study is to find out the incidence of Post-Traumatic Stress Disorder in patients with maxillofacial trauma and to provide a circumstantial evidence for certain precautionary measures which will play a basic role in the prevention and management of Post-Traumatic Stress Disorder amongst such patients. The study was carried out at the Department of Oral and Maxillofacial Surgery, Khyber College with maxillofacial Pakhtunkhwa, Peshawar from June 2009 to May 2010. Two hundred and Ninety patients with maxillofacial trauma were recruited in this study. For the collection of data, Post-Traumatic Stress Disorder Checklist Civilian version consisting of 17 items was used. The collected data and all relevant information were analysed using SPSS Version 17.0. The results of the present study showed that out of 290 patients, 90 patients [31.03%] had Post-Traumatic Stress Disorder symptoms in which 40 [44.44%] were males and 50 [55.56%] were females. The largest age group suffered from Post-Traumatic Stress Disorder symptoms were 16-25 years and 26-35 years [33.33% each]. Thirty four patients [27.78%] scored 50 or above on Check list indicating severe symptoms, where 27 females [30%] had severe symptoms as compared to 7 males [7.78%]. Young patients between ages 16-35 were the most common group who suffered from severe symptoms. The severe symptoms of Post-Traumatic Stress Disorder were seen in victims of road traffic accidents and bomb injuries [22.22% and 13.33% respectively] with poor and middle socioeconomic status. The importance of psychological morbidity after major trauma is continuing to gain attention in trauma outcomes research. Taking into account the burden of psychological consequences of maxillofacial trauma, further research and preventive strategies are needed to cope with this hidden epidemic in our society

Bilateral facial nerve paralysis: a case report and review of literature

Bilateral Facial Nerve Palsy is an exceedingly rare condition with aetiology often heralding the presence of a serious underlying medical illness. Mastication, speech and aesthetics are disturbed. The face is totally immobile and conveys no messages through facial expression. Frequently these patients are treated as if they are emotionally and mentally incompetent. Most patients require oral hygiene maintenance, mouth opening exercises and eliminating the source of possible odontogenic infection. There are many surgical procedures which can be of benefit depending on the patient's particular problem with the goal to support the mouth at rest and provide animation of the mouth and cheek

Effects of pre operative administration of diclofenac potassium on pain intensity following impacted mandibular third molar surgery

To evaluate the effect of pre operatively administered Diclofenac potassium, on the postoperative management of pain following removal of impacted lower third molars. The study was carried out in the Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Peshawar, from Jan 2009 to June 2009. Fifty patients were recruited in this study who were equally distributed into group I and group II. Post operative pain was assessed using a four-point Category bating Scale. In this study more males were recruited than females and the ratio of male to female was 2:1. Majority of the patients [56%] recruited were in 3[rd] decade of life followed by 4[th] decade [32%]. In group I, 80% were those who had no post operative pain after 48 hours while in group II 86% of the patients showed moderate to severe pain postoperatively. This study illustrated the enhanced effects of pre operative administration of Diclofenac potassium on short-term postoperative pain, compared to those patients who do not receive diclofenac potassium prior to third molar surgery

effect of stress on the pain severity in temporomandibular joint dysfunction among college and university students

To evaluate the influence of stress and anxiety on the severity of pain in Temporomandibular joint Dysfunction and on the subjective pain report. The study was carried out in the Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Peshawar, Khyber Pakhtunkhwa, between the period of May 2010 to November 2010. One hundred and ten students reportingfrom universities and colleges with TMJpain were clinically diagnosed as Temporomandibular Joint Dysfunction and were interviewed using specially designed proforma. To measure the level of pain, Visual Analog Scale was used. Variables like gender, age, geography and various stress factors were determined and analysed using statistical tools [SPSS V. 17]. Students in the age group of 26-30years were commonly affected [30%] followed by age group of 16-20 years [22.73%]. Most commonly affected students [68.18%] were those with moderate to very severe pain symptoms. Students belonged to Malakand Division [28.67%] and FATA. [25.67%] were commonly in the low income [n-42, 38.18%] and middle income [n-36, 32.73%] categories. Post Graduate students [40%] showed increased pain intensity during eating [35.45%] and talking [29.1'0%], particularly in their busy academic days, were reported to be the victims of severe painful episodes. A large proportion of students with Temporomandibular Joint Dysfunction have potential psychological problems. Female gender, advanced educational levels and hostel residence as well as poor socioeconomic status are predisposing factors for pain severity in Temporomandibular Joint Dysfunction

Characteristics of maxillofacial fractures resulting from road traffic accidents- an analysis of 250 patients

The purpose of this study was to document the characteristics of maxillofacial fractures resulting from road traffic accidents. The study was carried on 250 patients presenting with maxillofacial fractures resulting from road traffic accidents. On the basis of history, clinical and radiological examination, fractures were classified as dentoalveolar fracture, mandibular fracture, maxillary fracture [Lefort I, II and III], isolated zygomatic arch fracture, zygomatic complex fracture, nasal bone and orbital fractures. Data was analysed by statistical analysis tool using SPSS version 17. Males in their 2[nd] and 3[rd] decades were the most common victims. Among the isolated bone fractures [n=208], mandible was the most commonly fractured bone [n=104] followed by zygomatic complex [n=50]. The frequently observed pattern among mandibular fracture was parasymphysis [31.6%], among zygomatic complex was Group IV [n=29] while maxillary fractures showed a pattern of combined Lefort I, II and III [n=21]. Road traffic accidents are predictable and preventable. Basic knowledge regarding road safety measures and its implementation is necessary. It can be concluded from this study that majority of the patients were young adult males. The most common bone fractured was mandible both in isolation and combination

Pattern of zygomatic bone fractures and treatment modalities: a study

This study was designed to determine the pattern of zygomatic bone fracture, etiology and treatment options. The term pattern in this study was used for the sites/processes of zygomatic bone fracture. The variables evaluated were age, gender, sites of fracture and treatment options. A total of 81 patients with zygomatic bone fracture were treated in Oral and Maxillofacial Surgery unit, Khyber College of Dentistry, Peshawar for a period of one year from July 2007 to June 2008. Majority of patients were young males in 3rd and 4th decade. Male to female ratio was 12.5:1. Road traffic accidents [76.5%] were the most common and interpersonal violence 2.5% as the least common etiology of zygomatic bone fracture. In 28.4% patients, zygomatic bone was fractured at single site while in 71.6% it was fractured at more than one. Fracture at zygomatic buttress and infraorbital rim [27.2%] in combination was most common finding. Twenty three percent patients did not require treatment, 32.1% zygomatic bone fractures were reduced indirectly and 44.4% were reduced directly by open reduction and internal fixation

Frequency and demography of commonly occurring odontogenic cysts in Khyber Pakhtunkhwa [Pakistan]

The objective of the study was to determine the frequency and demography of commonly occurring Odontogenic cysts in Khyber Pukhtun Khwa [province of Pakistan] population. A descriptive [case series] study was carried out from October 11, 2006 to October 10, 2007 at Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Peshawar. The frequency of common Odontogenic cysts was 2.6%. Majority were found in the age range of 11-20 and 21-30 years with a male to female ratio of 1.7:1. 71.4% Radicular and 64.3% Dentigerous cysts were found in the maxilla while 75% of Odontogenic Keratocysts were found in the mandible. The most common site of Radicular cysts in maxilla was Canine to Canine, for Dentigerous cysts it was Incisor/Premolar and Odontogenic Keratocysts were mostly seen in Incisor/Premolar/Molar region. The most common location of Radicular cysts in the mandible was Canine to Canine, Dentigerous cysts Molar and Odontogenic Keratocysts Molar/Ramus region. The present study gives sufficient knowledge about frequency and demography of common Odontogenic cysts in Khyber Pukhtun Khwa population

Maxillofacial injuries in internally displaced persons

This study was conducted to evaluate the incidence of maxillofacial injuries and their causes in Internally Displaced Persons from Swat, Malakand Division, Bajaur and Waziristan .A total of 73 Internally Displaced Persons with various maxillofacial injuries admitted in the oral and maxillofacial surgical unit of Khyber College of Dentistry, Peshawar from May 2009 to October 2009 were included in the study. Males in their second decade of life were more in number. Maxillofacial trauma due to firearms [48%] and RTA [37%] were reported. Most of these patients were injured while they were outside their homes. Mandible [54.80%] was the most common bone fractured. Open reduction internal fixation was employed in 69.86% patients