Frequency of common factors responsible for non-treatment of partial edentulism

There are number of patient related factors which result in non-treatment of missing teeth despite having favorable conditions for replacement. the study was done to determine the frequency of the common factors responsible for non-treatment of partial edentulism.This descriptive cross-sectional study was conducted at Bacha Khan Medical college, Mardan on 385 participants. Patiens with partial edentulism, both genders, Pakistani nationals were included. Patients using/having history of fixed or removable prostheses and patients with cognitive impairment, reduced intelligence and uncooperative behavior were excluded from the study. Personal data like age, genders including the patient socioeconomic status were recorded. Socioeconomic status were taken as the subject's present financial condition, education and occupation using the modified Kuppuswamy classification. Common factors for not replacing missing teeth were documented.. Statistical analysis of the data were done using Software Package for Social Sciences [SPSS] version 20.0. Descriptive statistics were calculated. Effect modifiers and genders were controlled by stratification using Chi-square test. P<0.05 was considered significant.Most of the participants [n=223, 57.9%] had no knowledge about the replacement of missing teeth. Most of the participants [53.8 %] had middle socio-economic level [Kuppuswamy level III]. Age and gender were not a significant factor for not replacing missing teeth [P>0.05]. The most significant factor for not replacing missing teeth was socio-economic status

Conclusion: The findings of this study showed that most of the participants belong to middle socio-economic class. Socioeconomic status is most important factor for non-replacing missing teeth

Frequency of complications with conventional dentures

The objective of 'this study was to determine the frequency of 'complications with complete dentures

A total of 45 completely edentulous patients wearing conventional complete denture for more than one year were included in this study. These dentures were fabricated by private practioners, undergraduate and postgraduate students in dental institutes. The complications associated with these dentures recorded by taking a detailed history and examination of the prosthesis and mouth of the patients. The data were analyzed by SPSS version 20.0

Twenty were females while the remaining 25 were males with mean age of61.06 +/- 9.4 years. The complications observed in the patients with regards to their frequency were; loss of denture retention [80%], developed of ulcers [37. 7%], loss of denture teeth due tofracture [26.6%], fractures of the denture base [22.2%] and denture stomatitis [6.6%]. The difference between males and females were not significant

Prevalence of hepatitis B and C seropositivity in patients presenting for dental treatment

The objective of this study was to determine the prevalence of hepatitis B and C among the patients who came for dental treatment to Bacha Khan Medical and Dental College, Mardan. Four hundred patients formed the study group. The blood samples of all these patients were taken in the hospital laboratory and were screened for HBsAg and Anti HCV using immunochromatography [ICT] method. The blood was collected by authorized technician and the sera were separated from the coagulated blood by centrifugation at 5000 rpm[revolution per minute] for 10 minutes at 4[degree]C and stored at -20[degree]C for further use. The HBV screening was based on the detection of antibodies against the related virus in the sera using enzyme immunoassays. HCV test is based on detecting viral specific antibodies in serum samples. Of 400 patients examined, 180 [45%] were females and 220[55%] were males. Their ages ranged from 15 to 60 years with a mean age of 33.61 +/- 15.41 years. The highest prevalence was found in lab. technicians and drivers [HCV=18% HBS=12%]. The prevalence of HCV and HBV was nearly equal [HCV=7.75% and HBV = 7.0%]. There was no statistical significant difference in prevalence of HCV and HBV in male and females

Prevalence of temporomandibular dysfunction [TMD] among university students

Temporomandibular disorders [TMD] refers to group of disorders characterized by pain in the temporomandibular joint [TMJ], the periauricular area, or the muscles of mastication; TMJ noises [sounds] during mandibular function; and deviations or restriction in mandibular range of motion. Temporomandibular disorders are common among all ages. Symptoms have been found more frequently in females than males. The aim of this study was to use a cross sectional epidemiological study to investigate the prevalence of signs and symptoms of TMD among university students in the permanent dentition, males and females, through clinical examination and self-reported questionnaire. Data were collected using a pre-structured proforma from 500 students from the Abdul Wall Khan University, Mar dan. Meaning and terms used in the proforma were explained to each student by the investigator. Age, gender and history for symptoms of the TMDs like pain in preauricular region, clicking sound, limited mouth opening[less than 40 mm], and chewing difficulty; were filled by the students. Detailed examination for signs of TMDs was done by two investigators. The collected were analyzed using SPSS 16.0. Frequencies and percentages were calculated for all variables. Chi-square test was applied for comparison the variables [TMDs signs and symptoms] gender wise. P<0.005 was considered significant. Out of 500 participants 50% were males and 50% were females. Only 19% students had signs and symptoms of TMDs. Clicking sound was the most common sign of TMD in both genders. There was no statistical difference between the two genders [p> 0.005]. Headache and TMJ sound were the most common symptoms in both genders. There was also no statistical difference in symptoms of TMDs between the two genders [p> 0.005]

Oral complaints and level of satisfaction among the removable denture wearers - a study

Prosthodontics treatments are associated with oral complaints like speech, mastication, pain, esthetics etc. Oral complaints vary among removable partial denture and complete denture wearers. The objective of this study was to investigate the common oral complaints and level of satisfaction in removable denture wearers seen to Department of Prosthodontics, Bacha Khan Medical College, Mardan. Data of oral complaints and level of satisfaction from 100 patients; fifty complete dentures and 50 removable partial dentures were recorded on specially designed proforma. Demographics [age and gender], details of dentures [presence and type of dentures; removable partial denture or complete denture], problems with dentures [wearing, eating, communication, aesthetics, psychological], and satisfaction with dentures were recorded. The eating and wearing problems were more significant with complete denture as compared to removable partial denture p<0.005. Speaking were more difficult with removeable as compared to complete dentures p=0.004. No statistically significant difference was found for psychological between both types of wearers CD wearers were less satisfied with quality and shape of teeth than RPD wearers. Females are less satisfied than males

Clinical crown length, width and the width/length ratio in the maxillary anterior region in a sample of Mardan population

The objective of this study was to determine clinical crowns length, width and width/length ratios of the maxillary anterior teeth and to determine standard of ideal tooth dimensions. Crown length, width and width/length ratio was measured of 100 casts of patients. All of the 6 maxillary anterior teeth present, anatomically whole, without restorations that altered their dimensions, from which good diagnostic casts could be obtained, and where the anatomic elements were well defined were included in the study. The data were analyzed by using SPSS 20.0 version. Mean and standard deviation were calculated for numerical variables like age, tooth width, length and width/length ratio. Pearson correlation test was applied for symmetry of teeth sizes between left and right of arch. The sample composed of 50% males and 50% females with gender ratio 1: 1. The mean age was 23 +/- 2.3 years. The mean crown length was 10.22 mm for right central incisor, 7.96 mm for right lateral incisor and 8.88 mm right canine. The left side teeth crown width was close to right side. The mean crown width was 7.99 mm for right central incisor, 7.96 mm for right lateral incisor and 8.28 mm right canine. The left side teeth crown length was nearly equal to right side crown width. The mean crown width/length ratio was 0.91 for right central incisor, 0.72 for right lateral incisor and 0.71 right canines. The left side teeth crown width/length was nearly equal to right side crown width. Interclass correlation was almost perfect and statistically significant. The tooth dimension showed less variation [low standard deviation value] for crown length, width, and width/length ratio; so it will help the clinician in restorative procedures

Reversal of Loperamide Induced Intestinal Smooth Muscle Relaxation by Glibenclamide and Repaglinide in Vitro

Objective: To compare the inhibitory effects of Glibenclamide and Repaglinide on loperamide induced relaxation of isolated ileum of Rabbit. Study Design: Comparative controlled in-vitro experimental Study. Place and Duration of Study: This study was conducted at Department of Pharmacology, Yusra Medical and Dental College Islamabad from February to April 2014. Materials and Methods: Isolated pieces of small intestine of rabbits placed in freshly prepared Tyrode nutritional solution. Six groups were designed. In group I, effect of Acetylcholine on the intestine was observed. In group I1 ileum was exposed to serial dilutions of acetyl choline in the presence of fixed concentration of loperamide dose response curve was plotted. In group 111 fixed dose of Glibenclamide 1u6 was given and dose response curve was plotted with Acetylcholine. In group IV fixed dose of Repaglinide was given and dose response curve was lotted with Acetylcholine. Group V was given Loperamidffilibenclamide and dose responce curve was plotted with Acetylcholine, while group VI was given Loperamide+Repaglinide and dose response curve was plotted with Acetylcholine. The effects were observed and recorded on Power lab. Results: Acetyl choline has produced dose dependent increase in force of contraction from 4.9 to 7.2 mN. In the presence of glibenclamide the force of intestinal smooth muscle contraction increase from 6.4 to 7.8mN and in the presence of loperamide the force decreased from 4.8 to 3.03mN. In the end effect observed with acetyl choline in the presence of loperamide and glibenclamide is 6.5 to 7.7mN. Similarly with repaglinide alone the force of contraction increased from 5.4 to 9.6mN and with repaglindie + loperamide from 4.3 to 21.5 mN. On statistical analysis 't' test as applied and P value was found to be significant that is PK0.05. The dose response curve of acetylcholine on intestinal smooth muscle of rabbit shifted towards left side with glibenclarnide and rapaglinide alone. In the presence of Loperamide the curve shifted towards right side. Glibenclamide and repaglinide when given together with loperamide respectively lead to leftwards shift of the dose response curve. Conclusion: Hence sulfonylurea glibenclamide and repaglinide, the oral anti-diabetics effectively reversed the relaxation of intestinal smooth muscle by loperamide

Type and location of unfavorable clinical findings in mandibular complete denture supporting tissues

Aims and Objectives: The rehabilitation of resorbed edentulous mandibles with conventional complete dentures can be a challenge due to presence of unfavourable local factors. This necessitates accurate diagnosis and knowledge of local anatomy, physiology and pathology as well as knowledge of the relative prognostic difficulties involved in the treatment. The aim of this study is to assess the type and location of unfavorable clinical findings in mandibular complete denture supporting tissues in patients reporting to the Prosthodontics Department, Dental Section, Bacha Khan Medical College [BMC], Mardan, Pakistan

Methods: A total of 102 subjects with edentulous mandibular arches who reported to BMC were included in this cross-sectional study. With the patient seated in the dental chair, a detailed history was recorded. They were also clinically examined to document the unfavourable clinical findings related to mandibular ridge using a mouth mirror, dental probe, tweezer and standard lighting condition. The unfavourable clinical findings, if any were limited to; residual ridge height, residual ridge width, ridge defects, status of mucosa [thin, ulcerated, flabby and inflamed], frenal attachment and tender areas of ridge. The collected data were analyzed using SPSS version 17.0

Results: Subjects [N= 102, 48 males and 54 females] had a mean age of 60.4 +/- 8.6 [SD] years. Some 80% subjects were older than 50 years with more than 42% above the age of 60 years. The duration of edentulism ranged from one month to 8.1 years. Common unfavorable clinical findings were; reduced ridge height in 76%, reduced ridge width in 30%, sharp bony spicules in more than 40% and undercut ridge in 59%. Mandibular tori/exostoses were seen in only 66% subjects. Among the unfavourable aspects related to soft tissues were; flabby mucosa [25%], thin atrophic mucosa [24%] abnormal frenal attachments in 46% and painful/ tender ridges in 42% subjects

Conclusions: The existence of multiple unfavourable clinical findings in many patients highlights the need for treatments of these patients with mandibular edentulism in specialist clinical set-ups

Missing teeth, edentulous areas and socio-demographic status adversely affect the quality of life

To explore, in local subjects, the effect, on oral-health-impact-profile [OHIP] scores, of missing teeth, edentulous areas and some socio-demographic factors. During the period from June to November 2007, a cross-sectional study involving 243 partially dentate subjects was conducted at Khyber College of Dentistry, Peshawar [Pakistan]. With the method of interviewing and clinical examination and using a 33-OHIP-statements sheet, OHIP scores for subjects were determined. Socio-demographic as well as data for the number of missing teeth and edentulous areas were also recorded. OHIP scores were positively correlated with the number of missing teeth [r = 0.29] and the number of edentulous spaces [r = 0.37]. Subject's age and socio-economic status were more important co-variables influencing OHIP scores as compared to gender and educational level. Generally, higher OHIP scores were recorded for subjects who had anterior edentulous spaces, distal extension spaces or multiple and larger bounded spaces. Also much higher scores were recorded in those having bounded and distal extension spaces in addition to anterior spaces. OHIP-statements with high scores as an indication of adversely affecting QoL were those related to the function of chewing and esthetics. Some OHIP-statements that had been tested in other countries were found un-important for determining oral-health-related-quality-of-life [OHRQoL] in the present subjects. With their varying influence, missing teeth, edentulous spaces, age and socio-economic status proved important variables influencing both the OHIP scores and OHRQoL

Traumatic injuries of the permanent maxillory incisors at dental department, Pakistan institute of Medical Sciences Islamabad: a retrospective study

The study aims to ascertain the prevalence of traumatic dental injures of the maxillary permanent incisors at Dental Department, Pakistan Institute of Medical Sciences Islamabad during the years 2003-2005. Information concerning age, sex, cause, type of tooth, number of injured teeth and patterns of tooth injury were recorded retrospectively from 336 patients aged between 8-40 years, comprising 498 traumatized teeth. The dental records of all the patients presenting with dental trauma were examined for collection of data relating to age, sex, cause, number of injured teeth, type of tooth and type of tooth trauma. Type of tooth trauma was recorded according to the Andreason classification. The data was subsequently processed and analyzed using the SPSS statistical software programme. The statistical significance level was set at 5%. Of the 336 patients, 227 were males [67.6%] and 109 were females [32.4%]. The gender difference was statistically significant [P < 0.0001]. The patients had a total of 498 traumatized teeth. A large number of dental trauma occurred in patients aged between 9-11 years. Most injuries involved one tooth in 227 patients [67.6%]. However two teeth in 90 patients [26.7%], three teeth in 11 patients [3.2%] and only in 8 patients [2.3%] four teeth were involved. Fractures in enamel only occurred in 74 teeth [14.6%]. Uncomplicated crown fractures in 208 teeth [41.9%] were the most commonly encountered dental trauma. 137 teeth [27.6%] suffered complicated crown fractures, 44 teeth [8.9%] uncomplicated crown-root fractures, 19 teeth [3.8%] complicated crown-root fractures and avulsion in 16 teeth [3.2%] only. The main causes were falls in 225 patients [66.9%], collision with objects in 40 patients [11.9%], road traffic accident in31 patients [9.2%] violence in 21 patients [6.2%], and sports in 19 patients [5.6%]. The maxillary central incisor was traumatized in 384 teeth showing a high percentage of 77%. Raising public dental awareness regarding the serious outcome of traumatic dental injuries is mandatory to improve the prognosis of dental trauma and to avoid complications

Compliance, frequency of target INR achievement and complications in patients on long term oral anticoagulant therapy

To assess compliance and achievement of target international normalized ratio [INR] in patients with a broad range of indications for long term oral anticoagulant therapy [OAT] with warfarin. Case-review of 50 patients on long term OAT. Department of Cardiology, Shifa International Hospital, July 2004-Dec 2004. Medical records of 50 patients on long term OAT for at least six months and being followed in the cardiology outpatient department [OPD] were reviewed. Data was collected and analyzed for indication for OAT, frequency of INR check, target INR achievement and subsequent complications. Descriptive statistics were used to detect frequencies. Out of a total of 50 patients, 30 [60%] were male and 20 [40%] were female. Majority of the patients [61%] belonged to the cities of Islamabad and Rawalpindi. 40.9% of the patients were getting their INR checked every 1-2 months. 20.5% were getting it checked every 2-4 months and a third [38.6%] was having their INR checked more than 4 months apart. Commonest indications for OAT were atrial fibrillation alone [25%], prosthetic heart valve alone [29.5%] or both [20%]. Average INR values were between 1-2 in 17 [38.6%], between 2-3 in 22 [50%] and more than 3 in 5 [11.4%] patients. Major complications occurred in 2 [4.6%] patients only. Majority of the patients on long term OAT were getting their INR checked latter than recommended with a third of the patients with INR checks more than 4 months apart. More than a third of the patients did not achieve their target INR. However, despite these suboptimal results, major complications occurred very infrequently

Fistulae in ano following anorectal abscesses

This study was carried out to determine whether primary fistulotomy should be performed at the time of incision and drainage of anorectal abscesses and what% age of patients would develop fistula-in-ano or recurrent abscess. The record of 77 patients was reviewed who underwent incision and drainage of anorectal abscesses. Out of 77 patients, thirteen [16%] developed recurrent abscesses and 26 [34%] developed persistent fistulain-ano, with combined recurrence rate of 51%. This supports the policy of fistulotomy in the second sitting especially to prevent any complications and also of the fact that 59% would not need it