Prevalence of partial edentulism, complete edentulism and single complete opposing partial edentulism in relation to the age groups and gender in the local population of Hyderabad

Objective: This study was carried out to evaluate the prevalence of partial edentulism, complete edentulism and complete edentulous arch opposing the partial edentulous arches in relation to the various age groups and gender in local population of Hyderabad

Materials and Methods: A cross-sectional study was conducted at the Department of Prosthodontic, Isra Dental College, Hyderabad. Duration of the study was 6 months, from January 2016 to June, 2016. A total 504 patients were selected for this study on the basis of history and clinical examination. The selected subjects were divided into six age groups. Data was statistically analysed by SPSS statistics software version 21. Descriptive statistics such as frequencies, percentages, mean and cross tabulation were applied to test the variables. The level of statistical significance was set to 0.5%

Results: The results showed that out of 504 selected subjects 426 [84.5%] subjects were partially edentulous, as compared to completely edentulous patients who numbered only 66 [13.1%] whereas 7 [1.4%] subjects had complete edentulous upper ridge and partially edentulous lower ridge, only 5 [1%] subjects had complete edentulous lower ridge and partially edentulous upper ridge. Partially edentulous jaws were more prevalent in females and in middle aged patients ranging from 31-40 years and completely edentulous jaws were more prevalent among male subjects in old age subjects who were above 60 years of age. Single complete denture opposing partially edentulous ridges were more common in females and in patients who were above 30 years of age

Conclusion: This study concluded that the partially edentulous jaws were more prevalent as compared to completely edentulous jaws. Partially edentulous jaws were more prevalent in females and in middle aged patients while completely edentulous jaws were more prevalent among male subjects and in old age subjects of either age, whereas single complete denture opposing partially edentulous ridges were more common in females and in patients who were above 30 years of age

Supernumerary tooth: a common odontostomatologic anomaly of number of teeth

Supernumerary tooth [ST] is a developmental disturbance of number of teeth characterized by teeth present in excess of normal dental formula of deciduous or permanent dentition.[1, 2, 3, 4] It may occur in either dental arch, maxillary or mandibular.[5] Literature has shown marked predilection in maxilla over mandible.[6, 7] The first documented report of supernumerary teeth has been revealed in human fossils that are approximately 11,000 years old.[8]

giant asymptomatic submandibular salivary gland calculus reported at Bahria university dental hospital

Sialolithiasis is a common salivary gland disease which has highest predilection rate in submandibular followed by parotid and sublingual glands. It results in mechanical obstruction of the salivary gland duct. The unique anatomy of the submandibular gland duct facilitates the deposition of mineral salts and leads to the formation of stones. We are presenting a unique case of submandibular calculus which was completely asymptomatic. On 2[nd] day after a mandibular incisor tooth extraction, patient presented with some hard object in her mouth. The stone was removed intraorally through the duct opening under local anaesthesia

Frequency and shape of torus palatinus in relation to age and gender in karachi

Objective: The aim of this study was to determine the frequency and shape of torus palatinus and to assess its gender and age-related differences in the population of Karachi, the metropolitan city of Pakistan

Methodology: This was a cross sectional study with non-probability convenience sampling method conducted at Bahria University Medical and Dental College [BUMDC], Karachi. The presence of tori was observed by clinical examination and palpation. The shape was also investigated by presence or absence and classified as flat, spindle and nodular shaped tori. The data was analyzed by using Statistical Package for Social Science version 23. The Chi-square test was used to test for group differences of sex and age association with the prevalence of tori. Difference between groups with P <0.05 was considered significant

Results: A total of 1203 patients were screened in which torus palatinus was found in 141 [11.7%] patients. Present study findings showed torus palatinus was more prevalent in males 76 [53.9%]. It was dominant in 31-60 years of age group [47.5%] with significant P=0.000. Shapes of torus palatinus were compared with gender in which flat shape was more frequent in both male and female with significant P-value of 0.015

Conclusion: Torus Palatinus is a rare bony exostosis of the oral cavity. Even though, it is an asymptomatic anatomical variation it expresses itself in unique shapes and patterns. The prevalence varies with respect to age and gender

Etiology, patterns and treatment modalities for mandibular fractures

Objective: The objective of current study was to evaluate the etiology, patterns of presentation, frequency and different treatment modalities for mandibular fractures in patients treated at Lahore Medical and Dental College/Ghurki Trust Teaching Hospital [LMDC/GTTH]

Methodology: This descriptive – cross sectional study was conducted at Lahore Medical and Dental College, Lahore/Ghurki Trust Teaching Hospital [LMDC/GTTH] from March 2015 to September 2017. The current study included one hundred and twelve [112] patients who were indentified having mandibular fractures. Data were collected regarding patient's age, gender, etiology, site of fracture, patterns and treatment modalities and analyzed using SPSS version 20

Results: The patients' ages were between 3 to 55 years [24.87+/-10.867, mean/SD]. The majority of fractures occurred amongst 21-30 years of age group having female to male ratio of 1:5.6. Road traffic accident [RTA] was the most frequent etiological factor for mandibular fractures in 89 [79.47%] of patients, followed by assaults 11[09.82%] and fall 07 [06.25%]. A total of 189 fractures were recorded in 112 patients giving a mean of 1.7 fractures per patient. Out of 189 fractures, the parasymphysis was the most prominent site of mandibular fractures[43.39%], followed by condyle [22.75%] and angle [15.87%]. The treatment modality of open reduction and internal fixation [ORIF/ORIF with IMF] was performed in 88[78.57%] of patients while closed reduction and indirect fixation [IMF with eyelet wiring/arch bar elastics and splint fixation] was done in 24 [21.43%] of patients

Conclusion: As evidenced by the present study, road traffic accidents are the most common cause of mandibular fractures in young adults, mostly due to violation of traffic rules. These findings highlight the need to reinforce legislation for prevention of such injuries both in children and adults

Frequency of oral findings with reference to diabetes mellitus patients: a multi-center cross-sectional study

Objective: Oral pathological findings are often associated with diabetes mellitus. The aim of the study was to assess the frequency of oral findings among diabetic patients of both genders

Materials and Methods: A cross-sectional observational study was conducted from February 2017 to November 2017 at Bahria University Dental Hospital and Mamji Hospital, Karachi. A total of 363 diagnosed patients of diabetes mellitus were selected for the study. A questionnaire was designed and oral clinical examination was performed. The collected data was analyzed by using SPSS version 23

Results: A total number of 363 diagnosed patients of diabetes mellitus were included in the study. Among these 187 [51.52%] were male and 176 [48.48%] were female. The overall oral mucosal findings were predominantly present in male diabetic patients as compared to females

Conclusion: The result of this study shows a high prevalence of oral pathological findings in diabetic patients

Efficacy of gabapentin in trigeminal neuralgia: a non-randomized trial

Objective: To compare the efficacy of Gabapentin with carbamazepine in Trigeminal Neuralgia

Material/Method: The study was conducted in Agha Khan University Hospital and Abbasi Shaheed Hospital for four months. 19 patients of TN were collected through purposive convenience sampling. DN4 questionnaire was used to differentiate between Somatic and Neuropathic pain. Numeric Pain Rating Scale was used to assess the severity of pain

Results: Nine patients of Trigeminal Neuralgia refractory to carbamazepine were put on Gabapentin with male to female ratio of 4:5. All showed favorable response on 800-1600 mg Gabapentin on Numeric Pain Rating Scale. All patients were pain free in three weeks with no side effects. There was significant difference between pain response to carbamazepine and Gabapentin at P< .05. Four patients [44%] had pain relief on 900 mg Gabapentin, three [33%] on 1200 mg, one responded on 800 mg and one on 1600 mg

Conclusion: Gabapentin is effective as first line treatment in Trigeminal Neuralgia

assessment of the shade differences in the anterior teeth according to the age and gender, using commercially available shade guide

Objective: To assess the shade differences in the anterior teeth according to the age and gender using commercially available shade guide in the local populations of Hyderabad

Methodology: This cross sectional study comprised of 200 patients belonging to both genders ranging in age from 15 to 75 years, divided into four groups on the basis of chronological age: Group I: 15 to 30, group II: 31 to 45 , group III: 46 to 60 and group IV: 61 and onwards. Shade of the middle third of the labial surface of the anterior teeth was recorded visually using Vitapan® classical shade guide. Data was analyzed via SPSS version 21. Descriptive statistics such as percentage, frequency distribution, cross tabulation and descriptive were included in Data analysis. The level of significance was set at <0.05

Results: This study revealed that the most common shade recorded was A2 [45%], followed by B2 [20%] and A3 [10%].Younger patients had lighter tooth shades. Shades were darker with increasing age. The most common shade selected in age group I and group II was A2 which were represented as 52.8% and 52.9% respectively. Among males, the most common shade was A2 [47.6%], followed by B2 [19.5%] and A3 [15.9%] whereas in females most common shade was A2 [43.2%], followed by B2 [20.3%] and A1 [10.2%]

Conclusion: This study concluded that the tooth shade selection was strongly associated with both age and gender. Most common classical shade selected was A2. Shades were darker with the advancing age. Women's teeth were lighter than the men's. This information can be effective for fabrication of more life-like prosthesis

Frequency and motive behind shisha smoking among students of private universities of Karachi

Objective: To determine the frequency and primary motive behind the initiation of smoking Shisha [waterpipe] among the students of private universities of Karachi

Methodology: It was a Cross sectional study conducted in three private universities of Karachi comprising of 400 students of different disciplines. The study was questionnaire based. Data was entered on SPSS version 23 to derive results

Results: Our study consisted of 400 subjects, out of which 261 [65.3%] were male and 139[34.8%] were female. The mean age of the students was 21.12 [STD+/- 3.07]. 195[74.7%] male and 87[64%] female students agreed that they had tried Shisha smoking. The students of Engineering [n= 125, 31.33%] were found more into the practice of smoking Shisha. Pleasure was the primary motive for initiation of Shisha smoking [29.75%]. Mint flavour was highest in demand recommended by 69% male students [n=199/288]. Regarding knowledge related to harms, 212 students out of 363 agreed upon the fact that smoking Shisha is more harmful as compared to cigarettes, whereas 37 students [9. 25%] did not respond to the question. Also 282 [70.5%] agreed to the fact that Shisha is less addictive

Conclusion: High prevalence of Shisha smoking was observed among engineering students due to pleasure and socialization.Interventions should be implemented in order to promote awareness concerning health hazards and necessary measures ought to be carried out to extricate youth from this trend

Frequency of dental caries and status of permanent mandibular first molar in young adults

Objectives: To determine [a] the frequency of dental caries [b] existing status including the presence of broken down roots[BDRs], missing and filled or unfilled status of permanent mandibular first molar in young adults

Materials and Methods: This study was conducted at out-patients clinics of Bahria University Medical and Dental College [BUMDC] from 1stJanuary 2014 to 30th November 2014. The total numbers of subjects were 1529. Out of which 928 were males[60.7%] and 601 were females [39.3%]. The sample was collected through convenience sampling and the performa was designed which comprised of demographic data including age, gender, carious and filled/unfilled status of left and right permanent mandibular molar [36,46] and informed verbal consent was taken

Results: The study findings showed that higher caries incidence was present in left mandibular 1st molar [tooth # 36] as 232 individuals [15.17%] were affected by caries, compared to right mandibular 1st molar [tooth # 46] in which the affected individuals were only 209 [13.66%].Regarding the gender distribution, caries was present more in the males then the females as 179 males had caries and only 125 females were affected. Examined individuals have a better knowledge and awareness about oral hygiene practice as affected individuals were only 304 [19.9%]. Least contribution was of filled teeth probably because of lack of availability of dental services, poor socioeconomic status and high treatment cost

Conclusion:Frequency of dental caries in left and right mandibular first molars in young adults was low with least contribution of filled teeth

Role of different functional parameters in gratification of denture wearing patients

Objective:To assess the overall satisfaction and to evaluate complications in removable denture patients, during different functional movements

Materials and Methods: This descriptive study was done on 180 patients who were restored with removable complete and partial prosthesis. They were analyzed on the basis of a specific questionnaire related to the use of denture and post-insertion follow-ups. For each patient, relevant history was recorded along with oral and a thorough examination of prosthesis they were using. A four-grade scale criteria was used for evaluation and standardization of the study, in terms of different functions and level of comfort

Result:Most of the examined patients showed their satisfaction from their prosthesis.The degree of satisfaction seemed to be directly related to the duration of denture wearing that is the older the denture got, more satisfactory the results were shown.Patients with shorter duration of treatment or those who were recently given the prosthesis, presented with more dissatisfaction and complain about their functional abilities with dentures, while the complains were gradually resolved with passage time as patients got used to them

Conclusion:Majority of the patients showed their gratification with their dentures, which were judged as satisfactory by the dentist. There was a difference between the retention of the upper and lower dentures however in a level of satisfaction with their dentures in different functions like chewing and speaking

Benign migratory glossitis - A neglected oral health issue in pakistan

Objective: To investigate the frequency of benign migratory glossitis [BMG] and its association with medical conditions

Materials and Methods: This descriptive cross-sectional and multicenter study was carried out in Karachi and Hyderabad city.A total of 2022 dental patients of 10-80 years of age were included. After taking verbal informed consent, clinical examinations and proforma was filled chair side. Descriptive and comparative analysis were done using SPSS version 23 and Chi-square test was the choice of analysis to test the significance of the undertaken objectives

Results: Frequency of BMG was found to be 33[1.6%]. Higher predilection was seen in females 21[1.03%] as compared to males 12 [0.59%]. 10[5.8%] cases were found in 51-60 years of age group followed by 9 cases in 31-40 years. The most common affected site was dorsal surface of the tongue 29 [87.88%]. Cross tabulation of BMG with medical condition revealed presence of BMG in 3hypertensives and 1 diabetes mellitus patient. Remaining 29 cases were not suffering from any medical condition.The association of BMG with fissured tongue was also investigated and found statistically significant in 11[33.3%] cases with a p-value [P<0.001]

Conclusion: Frequency of BMG was found to be 1.6%. Majority of cases of BMG did not have any association with medical conditions. Fissured tongue was found in statistically significant number of BMG cases

Awareness, knowledge and practice of evidence-based dentistry amongest dentists in Karachi

The purpose of this study was to determine the understanding, awareness and practice of Evidence Based Dentistry [EBD] amongst dentists working at dental colleges in Karachi. Total participants in this study were 200 who were randomly selected from different dental colleges in Karachi. Participants completed a pre-tested self administered questionnaire. 87% of the participants were graduates and were either trainees or had completed post-graduation. Data analysis was done by SPSS version 16. One-way ANOVA was applied. P- value < 0.05 were considered statistically significant. Only 23% of the participants reported that they always practiced Evidence based dentistry. Lack of training on EBD was considered as a barrier to Evidence Based Dentistry and the second most common cause reported was lack of access to resources. Majority of the participants 69% were not taught or trained earlier to practice Evidence Based Dentistry. Interestingly 87% of the participants showed their willingness to be trained for Evidence-Based Dentistry. With respect to barriers in EBD Education level [0.018] and field of specialty of dentist [0.014] were found to be statistically significant. Therefore more emphasis should be given in training students as well as faculty members in Evidence Based Dentistry. It should also be ensured that all possible resources for accessing current dental research should be provided in Dental colleges

Natal and neonatal teeth- an uncommon oral finding: a cross sectional study in Pakistani subjects

The objective of this study was to determine the frequency, types of teeth present at the time of birth and reasons for extraction of natal and neonatal teeth in Pakistani neonates. This cross sectional hospital based study was carried out during the period February 2011 to May 2013 at different dental colleges of Karachi and Hyderabad. All neonates with natal and neonatal teeth referred from different dental sections of Karachi and Hyderabad were included in the study. Their characteristics, common sites of eruptions, complications and reasons for extractions were observed and analyzed. A total of 22 patients were selected for data analysis out of which 8 [36.4%] were males and 14 [63.6%] were females and standard deviation was SD +/- 9.74. Out of 22 subjects studied, 17[77.3%] had natal and 05[22.7%] neonatal teeth which were uncomfortable both for the mother and the neonate. The most common teeth present at the time of birth were mandibular central incisors. It was concluded that it was a benign but rare condition of oral cavity among Pakistani neonates which requires special attention when causing feeding problems for mothers and children

Facial nerve morbidity following surgery for benign parotid tumours

To determine the frequency and severity of facial nerve dysfunction following surgery for benign parotid gland tumours. A case series. ENT Department, Karachi Medical and Dental College and Abbasi Shaheed Hospital and Ziauddin University Hospital, from 1990 to 2010. Data was collected of all patients who were surgically managed for benign parotid tumours from 1990 to 2010. Data was reviewed for presentation of tumour, age and gender of the patient, site of tumour, nature and morphology of the tumour, primary or recurrent, surgical procedure adopted and the complications of the surgery especially the facial nerve dysfunction, its severity, complete or partial paresis and transient or permanent and time of recovery. Results were described as frequency percentages. Out of 235 patients, 159 [67.65%] were female and 76 [32.35%] were male. Age ranged from 18 to 70 years. Pleomorphic adenoma was the most common tumour [n=194, 82.6%], followed by Warthin's tumour. Superficial parotidectomy was done in 188 cases and extended parotidectomy in 47 cases. In the immediate postoperative period facial nerve function was normal in 169 [72%] patients and nerve dysfunction was observed in 66 [28%] patients. Complete paresis involving all the branches of facial nerve was seen in 25 [10.6%] patients and 41 [17.4%] patients were having incomplete dysfunction. Of these, 62 [26.3%] recovered and 04 [1.7%] had permanent facial nerve dysfunction. Marginal mandibular branch of facial nerve was involved in 57 [86.3%] cases. The frequency of temporary and permanent facial nerve dysfunction was 26.3% and 1.7% respectively in 235 consecutive parotidectomies for benign parotid gland tumours. Higher frequency of facial nerve dysfunction was found in recurrent and deep lobe tumours

Pattern of missing teeth in patients seen in prosthodontic department in a teaching hospital of Karachi

The objective of the study was to determine the frequency and pattern of missing teeth and to establish its relationship with gender. The study was conducted in the Prosthodontics Department of Hamdard Medical and Dental College, Hamdard University, Karachi. A cross sectional study comprised of 500 subjects were selected using utilizing convenience sampling technique. Data were collected through specialized proforma and analyzed using Microsoft Excel Statistical Program. Out of total patients, 262 [52.4%] were males and 238[47.6%] were females. The affected peak age group was 61-70years in males and 41-50 years in females. First molar in maxilla [28.38%] and in mandible [21.45%] was the most commonly missing tooth while canine being the least one with [5.42%] in maxilla and [9.09%] in mandible. Insignificant differences noted between right and left side of the arch. Hence the current study shows the base line data to depict the frequency and pattern of missing teeth in context to the local population of Karachi and highlights the oral health care system and rationale behind prosthodontics

Pattern of third molar impaction: frequency and types among patients attending urban teaching hospital of Karachi

The aims of this study was to determine the frequency and type of third molar impaction between 15 years and above age group of patients attending the outpatient's department of Bahria University Dental Hospital. This is a cross sectional study conducted from January 2012 to November 2013. The subjects were investigated and examined for third molar position, angle and impaction were re-corded. Chi Square test was used to analyze the association of impaction of third molar with respect to gender. A total 169 patients participated in the study; out of which majority were male that is 130 [76.9%] and 39 [23.1%] were females. The overall prevalence of impacted third molar was 169 [26%] with mean age of 29.17 +/- years and [STD] +/- 10.7. Study results showed that majority of the impacted teeth were present in mandible 32 [72.7%] than in the maxilla 12 [27.27%]. Majority of the impacted third molars were present in both maxillary and mandibular arch in the age group of 15-25 years. Furthermore, mesioangular impaction was the most common of all impacted third molars. It is concluded that impacted third molar is predominantly seen in mandibular arch than maxillary. The mesioangular impaction was the most common

Expression of integrin alphavbeta6 [alphavbeta6] in oral submucous fibrosis: a potentially malignant condition of oral cavity

Oral submucous fibrosis [OSF] is a chronic progressive fibrosing disorder of the oral cavity. A common finding in tissue fibrosis is that stromal fibroblasts become 'activated' myofibroblasts and express a-smooth muscle actin [SMA]. TGF-beta1 is considered to have a central role in inducing this myofibroblastic phenotype, and its expression is increased in numerous fibrotic conditions. The epithelial-specific integrin alphavbeta 6 is not detectable on normal oral keratinocytes but is upregulated during tissue remodelling. alphavbeta 6 is a key activator of TGF-b1 through its interaction with the latency-associated peptide [LAP] of the cytokine. The objective of the study was to investigate the role of alphavbeta 6 integrin in the pathogenesis of OSF. We used immunochemistry to examine expressionn of alphavbeta 6 in 41 cases of OSF compared with 14 cases of fibroepithelial hyperplasia, and found significantly higher expression in OSF [p=0.009]. We carried out a TGF- b1 bioassay using a keratinocyte cell line genetically modified to express high levels of alphavbeta 6 [VB6], and found that inhibition of alphavbeta 6 significantly reduced TGF-b1 activation [p<0.0001]. Co-culture of HFFF2 fibroblasts with VB6 cells induced myofibroblast transdifferentiation, producing a marked increase in SMA expression. This was inhibited using anti- alphavbeta 6 antibodies, confirming that myofbroblast generation was alphavbeta 6-dependent. In conclusion, these data show that alphavbeta 6-dependent TGF-b1 activation promotes myofibroblast transdifferentiation, and may be responsible, in part, for the chronic fibrosis seen in OSF

Frequency of torus palatinus; a study done in a teaching hospital in Karachi

The objective of the study was to determine the frequency, size and shape of torus palatinus [TP] in a teaching hospital in Karachi. The study further investigated the relationship with age, sex and ethnicity in the study sample. A total of nine hundred and nine [909] subjects were included in the study. The presence or absence of TP was examined by clinical examination and study casts were made for its evaluation. SPSS version 15.0 was used for data analysis. Out of 909 subjects studied, 34[3.7%] had torus palatinus [TP]. The TP was present in 12 [35.3%] males and 22 [64.7%] females. TP was found to be more prevalent in fifth decade of life [23.5%] and was least recorded in the first decade of life [8.8%]. Most of the patients that is 16 [2.4%] showing TP belonged to Urdu speaking community. Out of 34 cases of TP, medium size and spindle shaped tori were more prevalent with a frequency of 15 [44.2%] and 18 [52.9%] respectively