comparative study of gap and interpositional arthroplasty with temporalis myofacial flap for TMJ ankylosis treatment

The objects of this study were to evaluate the effectiveness of gap and interpositional arthroplasty with temporalis myofascial flap in the treatment of the temporomandibular joint [TMJ] ankylosis. This descriptive case series study consisted of twenty five patients. It was carried out at Oral and Maxillofacial Surgical Department, Liaquat University of Medical and Health Sciences, Jamshoro, Sindh from January 2010 to December 2012. Orthopantomogram [OPG] and 3-D Scan was the standard radiograph and was taken in every case. Nineteen had unilateral and six bilateral TMJ ankylosis. Most patients were in 2nd decade of life age group [16]; followed by 3rd decade [05] and 1st decade of life [04]. 18 were female and 7 were male; Major etiological factor was fall [21] followed by forceps delivery [03] and ear infection [01]. Inter-incisal distance [IID]/mouth opening were noted preoperatively, immediately after completion of operation that was 35mm and postoperatively at follow-up. The incidence of TMJ ankylosis varies from country to country and closely related to the social and financial issues of the patients. TMJ ankylosis is challenging problem for the patient, as for the surgeon. Over the years many modifications were made in TMJ surgery for better results and Gap arthoplasty with temporalis myofascial flap as the interpositional graft is one of common treatment modality which is done at our center

Risk factors in spreading odontogenic infection

Spreading odontogenic infection is the extension of infection from its original site and can create potential life threatening situations. There are several risk factor reported for spreading odontogenic infection in literature including systemic health, virulence of organism and anatomical site. Apart from these factors odentogenic infection also observed in normal individuals. The objective of this study is to identify Risk factors in spreading odontogenic infection. Descriptive Case Series Study. This study was conducted in Department of Oral and Maxillofacial Surgery, Institute of Dentistry, LUMHS from January 2011 to February 2012. A descriptive case series study on 60 patients of spreading odontogenic infection was conducted. Male female ratio was 2.3:1, 2[nd] and 3[rd] decade was common presentation. The most frequent clinical findings were pain, swelling, trimus. The Buccal space was the most frequent location for a single space infection [53.3%], followed by Submandibular space [35%], Canine space [5%]. Three patients presented with multi space involvement [6.6%]. The most common involved tooth was mandibular third molar 26 [43.3%].The most common cause of the infection was periapical infection followed by pericronitis. 83.3% patient were healthy patients with no co morbid, only 16.7% patients were with co morbid like DM, hypertension and pregnancy. There was also no difference for mean WBC count. This study shows that lower molars were the most common involved teeth and buccal space was frequent space to be involved. The site of infection is important risk factors. We observed Odentognic infection in common in healthy individual than non-healthy individuals

In vitro comparison of the apical microleakage of mineral trioxide aggregate [MTA] with amalgam as a retrograde filling material

The objective of this study was to compare apical microleakage of MTA with Amalgam following retrograde root filling. Experimental study. This study was conducted at the Department of Operative Dentistry, Fatima Jinnah Dental College and Hospital, Karachi March 2006-March 2007. One hundred twenty extracted human single rooted teeth were randomly assigned into four groups of 30 teeth each. The root canal filling carried out and retropreparations were cut in each root using round bur to a depth of 2-3 mm. Cavity varnish applied prior to retrofillings. Group I retrofilled with amalgam. In group II MTA was used, Group III served as negative control and group IV as a positive control. Roots were suspended in 2% methylene blue and placed into incubator at 37°C for 7 days. Teeth were split and chosen halve evaluated using a dissecting microscope at 10[x] magnification. The roots were evaluated and scored as either acceptable or unacceptable. The results showed that MTA displayed significantly less dye leakage than Amalgam. 24 samples [83%] out of 29 samples of MTA scored as acceptable, where as 4 specimens [16%] out of 28 samples of Amalgam showed acceptable score. MTA was found to be superior to Amalgam in providing apical seal when used as a root-end filling material. Favorable results were obtained with MTA in leakage study and it was concluded that MTA provided a better apical seal than Amalgam

Freeway space measurement by Willis gauge and sprung divider

To compare the accuracy of Willis gauge and Sprung divider in determination of freeway space in dentate subjects. Cross-sectional comparative study. This study was carried out at Department of Prosthodontics, Lahore Medical and Dental College, Lahore from March 2010 to August 2010. Three hundred dentate subjects were included in this study. Both Willis gauge and Sprung divider methods were performed on same subject to measure the freeway space. Subjects were seated in comfortable upright position with unsupported head. Freeway space was measured by both Willis gauge and Sprung divider. The difference between the two measurements of rest position and maximum intercuspation was taken as freeway space. The collected data was entered in proforma. SPSS version 17 was used to analyze the data. Mean and SD was taken for age and gender. The measurement of both methods were compared through chi square test p value < 0.05 was considered significant. Out of 300 subjects, freeway space was achieved 217 [72.33%] with Willis Gauge and in 247 [82.33%] subjects freeway space was achieved with Sprung Divider. Although the achievement rate was slightly high with Sprig Divider as compare to Willis gauge method but it was non-significant [p-value = 0.078]. Sprung Divider measurement of freeway space is somewhat superior to Willis gauge

guide for bucco-lingual position of posterior teeth arrangement in complete dentures

To see the relationship between intercondylar distance and the maxillary and mandibular intermolar distances in dental students. Cross-sectional comparative study. This study was conducted at Institute of Dentistry, Liaquat University of Medical and Health Sciences Jamshoro/Hyderabad, from August 2009 to January 2010. One hundred fully dentate BDS students with age ranging from 21 to 25 years, free from facial and dental deformities were examined. Upper and lower arch impressions were taken using stock trays. Dental cast were made using dental stone type IV. Vernier Caliper was used to measure the linear distances between mesiobuccal cusp tips of the maxillary and mandibular 1[st] molars on the cast. Intercondylar distance was measured using arbitrary face bow [Hanau-H2] at rest position. Fork was attached to the teeth with silicone impression material. Hing axis marks were made 13 mm anterior to the upper border on the tragus canthus lines on both sides of the face. The mark was confirmed by placing the middle fingers of both hands over the marks and students were advised to open and close the jaw by 20 mm, the tactile sensation of rotating condyle confirmed the hinge axis location. The face bow was assembled by inserting the fork intraorally and placing the condylar rods over the hinge axis marks. Thereafter, face bow is removed from the face without changing the position of condylar rods and the distance between the two condylar rods was measured in millimeters with the help of Vernier Caliper. Every distance was measured three times to ensure the accuracy and mean taken. The statistically significant result of this study proved that the highest correlation was found between the intercondylar distance and Maxillary Intermolar Distance [r = 0.261, p = 0.009], while the lowest correlation was found between Intercondylar Distance and Mandibular Intermolar Distance [r = 0.202, P=0.04]. The observed relationship between the intercondylar and Maxillary Intermolar Distance could prove a useful guide for the buccolingual position of aritificial posterior teeth in edentulous patients

Prevention of alveolar osteitis in surgical removal of lower third molar

The purpose of this study was to evaluate and compare the efficacy of chlorhexidine [CHX] and amoxicillin plus clavulanic acid combination with control and Chlorhexidine CHX rinse alone for prevention of alveolar ostitis following the extraction of mandibular third molar. This clinical double blind randomized control trial was carried out in the Department of Oral and Maxillofacial Surgery at Liaquat University Hospital, Hyderabad for a period of two years from February 2008 to December 2009. A total of 214 patients were included in the study using non- probability purposive sampling technique. Informed consent was taken for participation in study and all treatment options, risks, benefits and complications were discussed before any intervention. The study was approved by university ethical review committee. All the patients were randomly divided into three groups by using random number table. After written informed consent extraction of 3[rd] mandibular molar was performed. Group 1 rinsed with 15 ml of 0.2% Chlorhexidine solution for 30 seconds twice daily for seven days. Group 2 patients in addition to 0.2% Chlorhexidine solution were prescribed Augmentin [amoxicillin trihydrate 500 mg plus, clavulanic acid [125 mg]] twice daily for 7 days. The patients of Group 3 used normal saline solution [0.09% NaCl]. Patients were scheduled on third and seventh day postoperatively for postoperative follow-up and were evaluated for the presence or absence of alveolar osteitis. The diagnosis of alveolar osteitis was made on the basis of collaborative clinical and subjective findings. The results of this study showed significant reduction in the incidence of alveolar osteitis in patients who received 0.2% CHX rinse in combination with oral amoxicillin and clavulanic acid

Crown fractures: frequency and associated causative factors among school children in district Khairpur-Sindh

In dentistry, crown fracture [CF] is a constant source of concern, hence in order to recommend suitable preventive measures it is essential to recognize its etiological factors beside its frequency and characteristics. The purpose of this study is to identify causative factors and treatment needs of Crown Fracture among school going children. This study was conducted from October 2010 to December 2010 to record the cause of dental trauma in relation to age and gender of school going children in rural areas of Sind province. The population in this study was 9-18 years old attending primary and higher secondary school students studying in 9 public and 4 private schools in district Khairpur. Crown Fracture ranging from normal crown to fractured crown involving pulp was observed. Root fracture was not recorded as no radiographs were taken, trauma reasons were asked and treatment taken or not was recorded. SPSS version 16 was used to analyze the available qualitative variables for results. Chi square test was used for testing the statistical differences between cause of crown fractures in relation to gender and age. Most common cause of coronal trauma was recorded as fall followed by road traffic accident, assault and sports related injury 51.3%, 15.7%, 13.1% and 6.5% respectively. Risk factors of CF almost identical as cited in dental literature by majority of authors

assessment of maxillofacial gunshot injuries and emergency management

Firearm injuries constitute a major challenging problem in maxillofacial surgery, causing major deformities of human body, and financial Burden to our society. Violent crimes are the major cause. Unemployed youth and socioeconomic deprivations are factors which contribute towards violence. There are few important steps in management of head and neck gunshot injuries, obtaining an airway, control hemorrhage, recognizing additional injuries and finally definitive repair facial deformities. The objective of this study was to report the causes, and patterns of maxillofacial gunshot injuries. A retrospective assessment of patients treated for gunshot injuries at Mayo hospital Lahore from May 2007 to July 2009 and February 2010 to January 2011 at Liaquat University Hospital Hyderabad was conducted, and data was collected with special emphasis on the patient's demographics, mode of injury, initial airway management, and bone injuries The sample consisted of 120 patients. [78.3%] males, in third and fourth decade of age were the most common group, violent crime [62.5%] was the predominant cause, and mandible [58.3%] was the most common site of injury. From this Available information provided in this study, is concluded that violent crime was major cause of facial gunshot injuries. Male gender and young adults were the most commonly victimized patients