Assessment of Panoramic Radiographic Variables as Predictors of Inferior Alveolar Nerve Injury During Third Molar Extraction

ABSTRACT Objective: To assess the role of radiological predictive markers on orthopantomogram for inferior alveolar nerve (IAN) injury related to the removal of mandibular third molar surgery and the occurrence of post-operative IAN paresthesia. Material and Methods: This prospective observational study was conducted on 60 patients (aged 17-35 years) indicated for extraction and showed one or more of the seven previously known panoramic radiographic risk signs of IAN injury. Variables such as age, sex, tooth angulation, and relationship with the inferior alveolar canal (IAC) were assessed to see their outcome on IAN injury. Data analysis is presented through tables and descriptive methods. Results: Among patients, 26 were male and 34 were female, with a mean age of 26.17 years. Out of seven radiological predictive markers, only six were found in this study, whereas one marker, viz. interruption of white line of the canal was not found. After surgical removal of the lower third molar, only two patients with radiographic signs showing the deflection of roots and darkening of roots continued with sensory deficit 5 weeks post-operatively. Conclusion: The risk of inferior alveolar nerve injury during lower third molar surgery is very low, even in patients with radiological predictive markers.

Submandibular gland extirpation during neck dissection, is it truly justified?

Background: There is no oncologic basis for the extirpation of the submandibular gland (SMG) in early oral squamous cell carcinomas (OSCC) unless the SMG is truly infiltrated by the tumor. The study aimed at assessing the true involvement of SMG in OSCC and to determine whether the gland extirpation in all cases is justified. Methods: This study prospectively evaluated the pathological involvement of SMG by OSCC in 281 patients, who were diagnosed with OSCC and underwent wide local excision of the primary tumor with simultaneous neck dissection. Results: Among 281 patients, 29 (10%) cases underwent bilateral neck dissection. A total of 310 SMG were evaluated. Involvement of SMG was seen in 5 (1.6%) cases. SMG metastases from Level Ib were seen in 3 (0.9%) of cases, whereas 0.6% showed direct SMG infiltration from the primary tumor. The advanced floor of mouth and lower alveolus cases had a higher tendency to infiltrate SMG. In none of the cases, bilateral or contralateral SMG was involved. Conclusion: The findings of this study show that the extirpation of SMG in all cases is truly irrational. Preserving the SMG is justified in early OSCC with no nodal metastasis. However, SMG preservation is case dependent and is an individual preference. Further studies are required to assess the locoregional control rate and salivary flow rate in postradiotherapy cases where SMG is preserved.

Prevalence of Dental Caries and Dental Fluorosis among 7-12-Year-Old School Children in an Indian Subpopulation: A Cross-Sectional Study

ABSTRACT Objective: To assess the prevalence of dental caries and fluorosis among 7-12-year-old school children in Muradnagar, India. An additional objective was to determine the relationship between dental caries and fluorosis in the studied population. Material and Methods: A total of 1500 school children aged between 7 to 12 years, and both genders were randomly selected for the present study. The selected participants were divided into three groups based upon age, viz 7-8 year (group I), 9-10 year (group II) and 11-12 year (group III). Sterile mouth mirrors and explorers were used for the detection of caries. The water samples were collected to assess the fluoride concentration. The data collected were tabulated and statistically analysed using Chi-square, ANOVA, Spearman's correlation and t-test wherever applicable. Results: Out of 1500 participants, 54.1% were females and 45.9% were males. The prevalence of dental caries and fluorosis was 89.3% and 93.7%, respectively. The prevalence of caries increased with age (p<0.05) and females showed a higher prevalence in both the dentitions. Most dental fluorosis was 'very mild' (40.1%). Prevalence of dental fluorosis increased with age and males showed more fluorosis than females. A negative relationship was found between dental caries and fluorosis (p<0.05). Conclusion: Dental caries and fluorosis are the public health problems in Muradnagar; therefore, preventive programs should be organized to increase awareness among the general people.

Personnel Protective Equipment: Forgotten Protocol, Invigorated by COVID-19

Abstract Objective: To make the readers cognizant about the use of Personnel Protective Equipment (PPEs) and infection control practices which should always form a part of basic patient management and not arise with every emerging disease. Material and Methods: Authors personal clinical experiences and existing literature were summed up to infer relevant information related specifically to dentistry. A comprehensive review was done for the last 15 years in an attempt to explain the current state of understanding on the topic. Results: The authors have tried to compile the most probable reasons as to why PPEs have been a forgotten protocol, which can be enumerated as follows: decreased awareness, financial issues, boredom and lethargy, time constraints, unavailability, carelessness, and burnout due to long procedure and patient feeling discomfort/offended. Conclusion: COVID-19 being highly infectious, a dental clinic is a potential and genuine point of source for many new infections, and no confabulation is less to underline the importance of using PPEs during this pandemic or even otherwise.

Awareness, Knowledge, and Attitude of Saudi Students towards Basic Life Support: A Cross-Sectional Study

ABSTRACT Objective: To evaluate the knowledge and attitude in relation to basic life support (BLS) and cardiopulmonary resuscitation (CPR) skills among the dental undergraduates and interns in Sakaka, Saudi Arabia. Material and Methods: This cross-sectional study was undertaken between October 2019 and December 2019 in Sakaka, Saudi Arabia. One hundred and eighty randomly selected dental students aged over 18 years participated in the study. Their knowledge and attitude towards BLS were gathered through a questionnaire. Results: A total of 158 (out of 180) UG students and interns participated in this study, making the responses of 87.8%. The mean age of the participants was 24.6 years. The samples comprised 86 (54.4%) males and 72 (45.6%) females. The assessments showed that overall the participants had average knowledge towards BLS and CPR, with males responding significantly better than the females (p˂0.05). Furthermore, as students climb the academic ladder, their knowledge regarding BLS and CPR tends to rise. Also, their attitude was positive, and they were willing to receive CPR training. Conclusion: Attitude toward acquiring knowledge about CPR was very positive. However, their knowledge about the topic was average. Students should understand the importance of such skills and efficiently involve in these life-saving procedures.

Comparison Between Primary and Secondary Method of Closing Surgical Wound After Tooth Extraction: A Split-Mouth Study

ABSTRACT Objective: To compare and assess the primary and secondary closure techniques following extraction of impacted third molars for post-operative complications. Material and Methods: In total, 30 patients ranging between 18-30 years of age and of either sex who had bilaterally impacted mandibular third molars were randomly selected. Split mouth study method was used so that the participants served as their own control. Group 1 consisted of primary closure of left mandibular impacted third molars and Group 2 consisted of secondary closure of right mandibular impacted third molars. Basement evaluations were recorded for each patient along with subjective and objective evaluations for postoperative 7 days. Data analysis was carried out by SPSS 17.0 software using Mann-Whitney U test, Wilcoxon matched-pairs test and t-test. A p-value ≤ 0.05 was assigned as statistically significant. Results: When compared to group 1, group 2 revealed statistically less pain and swelling following the secondary closure of wound from day 1 to 7. There was a significant improvement in mouth opening in Group 2 at day 1 (p=0.0005) and at day 7 (p=0.00001). Conclusion: Secondary wound closure after disimpaction of mandibular third molar results in better postoperative recovery than primary closure.