Attitudes of final year dental students towards postgraduate specialization

Objective: The aim of this study was to understand the preferences of final year dentistry students in postgraduate specialization and explore the factors which influence them in making decisions regarding their future in pursuing postgraduate studies

Methodology: A cross-sectional survey was carried out between August 2017- January 2018 at four dental colleges across Karachi, including, three private sector and one public sector institution. A multiple choice, closed-ended questionnaire consisting of 8 statements was prepared and distributed among all the final year BDS students. 225 used and 200 student responses were recorded. Data was analyzed using SPSS version 23 and Chi Square was applied to achieve the results

Results: 81% of the respondents were females. 79% were in the age range of 22-23years. 63% age of students had parents that came from a professional background. 75% of the total respondents wanted to pursue postgraduate studies. The link between the age of the student, gender and the willingness to pursue postgraduate studies was found to be insignificant whereas with parental profession, it was significant [p value=0.016]. 60% students believed that they had received enough specialty exposure and encouragement from their institutions to be able to decide on their postgraduate plans. The first choice of specialty for 28% students was Oral Surgery followed by Orthodontics and Endodontics for 22% respondents. The second choice of specialty for the students was Operative Dentistry for 30% of the students followed by 17% who preferred Orthodontics. The rest were divided among the other subjects. 36% of the students cited their aptitude for a specific field as the most common factor for affecting their decision on specialization. 28% cited job status/ prospects and financial reasons as the factor most likely to influence their decision on specialization

Conclusion: According to the study, there was no significant association between the age, gender and the preferences of the student towards postgraduate specialization. However, parental occupation was bound to play a role. The choices of the students as regards specialty selection and influencing factors are varied. As the trend towards postgraduate specialization in dentistry is gaining momentum, it is imperative to research this area more for better planning and allowing students to make informed decisions

Endodontic therapy of mandibular canines with two canals in a single root

Mandibular canines have less anatomical diversities than other teeth.Mandibular canine is generally asingle rooted tooth with one wide root canal.This case describes the root canal treatment of a mandibular canine with two completely separate root canals in a single root. Clinical and radiographic examination revealed a mandibular canine with carious lesion and pulp exposure, tender to percussion.The precise understanding of the dental endocanalicular system's anatomy is critical in the success of the root canal management

Association between pulp exposure on clinical and radiographic examination in first permanent molars with class II carious lesions

This study was conducted to assess association between clinical and radiographic exposure of the pulp in class II carious lesion in first permanent molars. This observational study was carried out in the Operative Department of Bahria Dental College during the period of January -December 2014. Two hundred fifty eight patients with class II carious lesion were examined clinically and radio-graphically to confirm either pulp was involved or not by a single operator. Data were entered in SPSS [statistical packages of social science, version 17] for descriptive analysis and to check statistically significant relationship between clinical and radiographic pulp exposure. There were 154 males and 104 females. Frequency of left mandibular first molars was 52.7%, high among all molars. This study showed, out of 258 patients, 150 had exposed pulp on clinical examination and 108 were not having exposed pulp on clinical observation. Radiographic analysis of same teeth showed different result. Out of 258 patients, 216 had pulp exposure on radiograph and 42 teeth did not have pulp exposure. About pulp exposure, significant relationship was found between clinical and radiographic examination with p-value 0.000

Depth of the cavity and its relationship with the post-operative sensitivity in class I posterior resin composite restorations on molars

This study was conducted to assess the post-operative sensitivity in different depths of Class I cavities in molars restored with posterior composite resin. It was an Experimental study and was conduct-ed in Fatima Jinnah Dental Hospital, Karachi from May 2010 to October 2010. One hundred and thirty one patients had Class I cavities [depth of cavities between 3-4mm] were selected after clinical and radiographic examination. After rubber dam isolation, Class 1 cavity prepared on molars teeth. Incremental technique was used to restore cavity with posterior composite resin. After finishing the filling, patient was recalled at day 7 to assess post-operative sensitivity with cold and hot stimuli. Data were collected using data collection proforma, were computerized and analyzed by using SPSS [Statistical Package of Social Sciences] version 17. One hundred thirty one patients, 61 male and 70 female formed the study group. The mean age was 29.6 [ +/- 9.004] years. The mean score of post-operative sensitivity was 1.05 for cold [ +/- 0.226] and 1.04 [ +/- 0.192] for hot. The chi-Square test revealed significant results with p- value < 0.000 for cold and < 0.009 for hot, when both stimuli were analyzed with different cavities depths. Deeper cavities in Class I composite resin restorations showed more post-restoration sensitivity as compared to cavities with lesser depth in dentine

Occlusal reduction reduces postoperative pain after endodontic instrumentation

Pain management after root canal treatment is a very important issue in clinical practice. The purpose of this study was to evaluate the effect of occlusal reduction on postoperative pain in teeth with irreversible pulpitis and tenderness to percussion. This was a prospective, randomized study conducted in Operative Department of dental section of Bahria Dental College and Hospital from June 2013 to May 2014. One hundred and ten posterior teeth with no or mild preoperative pain, sensitive to percussion requiring endodontic treatment were included in this study. After administration of local anesthesia, the root canals were instrumented, and an intracanal calcium hydroxide dressing was placed. The patients were randomly divided into 2 groups of 55 each. In 1 group the occlusal surface was reduced [OR group], whereas in the other group the occlusal surface was not modified [no occlusal reduction, NOR group]. The patients were recalled after 24 hour, 2nd day and 3rd day to record their postoperative pain on the visual analogue scale. Data was analyzed by using Chi-square test. There was no significant difference in postoperative pain between the 2 groups [P > .05] after root canal preparation and calcium hydroxide dressing. Occlusal surface reduction did not provide any further reduction in postoperative pain for teeth with irreversible pulpitis and mild tenderness to percussion compared with no occlusal reduction

Antimicrobial solutions used for root canal disinfection

This article discusses the significance of root canal disinfectants and comments on how these can be used professionally. The complex root canal system is inhabited with different microbes in periapical periodontitis. There is no particular disinfectant that alone satisfactorily fulfills the entire functions essential for irrigation. Best possible irrigation is found on the combined use of two or more disinfectant, in a particular sequence. Sodium hypochlorite is the most commonly recommended endodontic irrigant, in spite of some adverse reactions. Chlorhexidine, Iodine and Chelators are successful against several bacteria and viruses, mainly in retreatment cases. Newer root canal irrigants like MTAD [Mixture of Tetracycline, Acid and Detergent], Tetraclean, Photo-activated disinfection, Electronically Activated Water, Ozonated water and lasers have potential to maximize root canal disinfection. Currently these newer irrigants could be used as an adjunct to NaOCl, while investigators are continuously looking for the subtle ideal root canal irrigant

Caries prevalence among school children age 6-14 years in Gadap town Karachi in relation to the awareness of their parents toward oral health

The aim of this cross sectional study was to determine the prevalence of caries among school children age 6-14 years in Gadap Town, Karachi in relation to the level of knowledge of their parents to the oral health. Total sample size was 265 children from both sexes. Self-administered questionnaire and oral examination was carried out by a single operator. There were 135 boys and 130 girls. The prevalence of dental caries was 71.7%. The mean DMFT score was 2.22 +/- 2.19. The mean DMFT score for male was 2.17 +/- 2.08 whereas the mean DMFT score for female was 2.27 +/- 2.30. Mean DMFT scores recorded for children of parents having poor, satisfactory and good knowledge of oral health was 4.07 +/- 2.17, 1.56 +/- 1.6 and 0.88 +/- 1.53 respectively. Association between Mean DMFT scores and parents knowledge grades was analyzed using Chi-Square test, the results were significant with p- value = 0.000 at 95% CI that is < 0.05

Regenerative pulp therapy

Regenerative Endodontics is a new treatment modality that offers a predictable result in teeth with pulpal necrosis and open apex. This case report describes the treatment of a necrotic immature permanent central incisor with complicated crown fracture, in which a regenerative approach was used. Revascularization procedures may provide a more predicable outcome, while rendering mature root formation at the same time. This article describes an ongoing case of revascularization

Replacement of resin-based composite restorations in permanent teeth

To determine the reasons for replacement of composite resin restorations and evaluate the association between the reasons for replacement of restorations with gender, duration of failure and different class of cavities. Cross-sectional study. Operative Department of Fatima Jinnah Dental Hospital, Karachi, from January to May 2009. Patients were selected randomly who had presented with post restoration complaint after composite filling. Specially designed proformas were used to get the information such as the name of the patient, age, gender, teeth in need for replacement of restorations, age of the replaced restorations, and the reasons for replacement. The criteria for replacement of composite restorations were secondary caries, discoloration, improper proximal contact, fractured restoration and gingival irritation due to overhang. The significance of results was obtained by applying chi-square test. A total of 413 patients ranging in age from 17 to 63 years were examined; 263 were males while 150 were females. Secondary caries [52.3%] was the most frequent reason for replacement of restorations in permanent teeth followed by discoloration [16.9%] and fracture of fillings [12.6%]. Chi-square test shows significant relationship between gender and reasons for replacement [p < 0.001]. Highly significant difference was found between different class of cavities and reasons for replacement of composite fillings [p < 0.001]. The median longevity of the replaced composite restorations was about 3 years. Secondary caries was the most common reason for replacement of composite fillings. The median longevity in this sample was calculated to be 3.0 years

Mechanical versus chemical retention in complex restoration

The aims of this study were: [a] to investigate, by questionnaires, the selection and use of materials and techniques to restore complex restorations in vital teeth. [b] Can adhesive resin liners provide retention that is the same as dentinal pins and slots when restoring complex restorations in vital teeth? A self administered questionnaire was developed. Four hundred questionnaires were distributed to senior and junior general dental practitioners employed in hospitals and private sectors of Karachi city. A total of 359 questionnaires were returned, giving a response rate of 89.75%. Amalgam was the most popular material used by general dental practitioners to restore complex restorations in vital teeth followed by glass ionomer plus composite. In vital teeth retentive slots were used the most and retentive pins were the least popular. ways of mechanical retention. The results also showed respondents were using adhesive resin liners exclusively when restoring complex restorations. This study showed that adhesive resin liners may he used as an alternative or adjunct to mechanical retention. Because of the improvements of bonding strength of adhesive resin liners, dentinal pins and slots should not be the only methods considered to restore complex restorations