Comparison of sodium hypochlorite and mixture of tetracyline citric acid and detergent as irrigating material in endodontics

The main objectives of root canal therapy are cleaning, shaping and obturating the canal system in three dimensions and preventing reinfection. So the irrigation is important part of a root canal treatment as it allows for cleaning beyond the reach of root canal instruments. Inadequate irrigation or instrumentation without irrigation increases the accumulation of debris on the cutting surfaces of instruments as well as debris and smear layer on root canal walls. In this review article, comparison of MTAD [mixture of tetracycline citric acid and detergent] and sodium hypochlorite [NaOCl] as irrigating material in endodontics is made

Incidence of various kennedy's classes in partially edentulous patients visiting dental OPD Hyderabad/Jamshoro

The purpose of this study was to evaluate the incidence of various Kennedy's classes in partially edentulous patients visiting dental OPD Hyderabad/Jamshoro. A Descriptive study was conducted at Department of Prosthodontics, Liaquat University of medical and health sciences Jamshoro/Hyderabad, Sindh from Jan 2013 to June 2013. Three hundred patients who were fulfilling the inclusion criteria were included in the study. Detailed Clinical examination of the patients were done and recorded in proforma. Out of 300 patients included in this study 173 were male [57.66%] and 127 patients were female [42.33%]; with male to female ratio of 1.3:1. There was wide variation of age ranging from a minimum of 15 year to 75 years. The mean age was 47 +/- 7.8 years. Clinical examination of patients revealed mostly teeth missing in mandibular arch 180 [60%] patients, while in maxillary arch 120[40%] patients. The most common site of missing teeth in our study was left side in 128[42.66%] cases, followed by right side in 144[38%] cases and anterior site in 58[19.33%] cases. Our study revealed class-I in 97[32.33%] cases, class-II in 47[15.66%] cases, class-III in 99[33%] cases and class-IV in 57[19%]. In conclusion, the partially edentulous condition exists common incidence in the in the mandibular as compared with maxillary arch. Kennedy's Class I and III remains the most common [33% and 32.33%] classification

Awareness of diabetic patients regarding their oral hygiene

The study was conducted at Diabetic Clinic ofLiaquat University Hospital Hyderabad from July 2013 to December 2013, with the sample size of 200 patients who fulfilled the inclusion criteria. Data were collected through a self-designed questionnaire through an interview by the investigator. 79.5% patients did not know what type of diabetes they were suffering from 94% of the patients were well aware of the systemic complications of diabetes mellitus whereas 31.5% had no idea that being a diabetic they need to take extra care of their oral hygiene. Around 52% of the patients brushed their teeth once a day and 34% brushed twice a day.69% of the participants did not take any extra measures for maintaining their oral hygiene. Gingivitis was thought to be the most common oral manifestation occurring in the oral cavity of a diabetic patient was the reply of 49.2% of the patients. This study concludes that although diabetic patients seem to have a good knowledge and awareness about systemic complications related to the disease, the accurate awareness about oral hygiene, how to properly maintain it and diabetic related oral manifestations was deficient and there was considerable room for improvement

Retrospective analysis mandibular fractures at abbasi shaheed hospital, Karachi

Objectives of this study were to assess the presentation and management of mandibular fractures. This retrospective study was carried out in the Department of Oral and Maxillofacial Surgery, Abbasi Shaheed Hospital Karachi. Sample size was 263. Male: female ratio 15:1. Audit period was from Jan 2010 to Dec 2012. The road traffic accident was leading cause 80%, while fall 7%, assault represented 7%, fire arm injuries 5% and sports injuries were 1%. Site distribution of mandibular fractures 11.78% occurred in the condyle, 19.39% at angle of jaw. In 23.95% or the body, 27.96% parasymphysis, 8.36% Symphysis, 2.28% ramus and in 6.0% dento-alveolar areas were involved. Different treatment modalities were used for the proper reduction and fixation of the fracture. Majority of the patients were treated with open reduction with miniplates fixation. It was concluded that majority of patients belonged to 2nd decade of life with male predominance, parasymphysis and body were the commonest sites of mandibular fractures and road traffic accident was the leading cause of trauma in the studied subjects

Battery operated and manual tooth brush; comparison for dental plaque removal

Background: Dental plaque may cause oral problems that may include dental caries, periodontal problems, and halitosis. Motivation, awareness and manual dexterity have much effect on tooth brushing. The advantages related with manual and battery operated tooth brushing have been reported different in the literature

Objective: To compare the manual and battery operated tooth brush for plaque removal efficiency

Study Design: Randomized control trial

Setting: The Dental OPD of Department of Community Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro

Period: November 2011 to June 2013

Methods: Total 100 patients of both genders, aged ?18 years were included. Patients were equally divided into manual and battery operated brush groups. The presence of plaque was checked and plaque index was recorded. Wilcoxon sign pair test was applied to compare pre and post plaque score for manual and battery operated tooth brush. Independent sample t test was applied to compare percent reduction of plaque score between groups. The significance level of P-value was up to 0.05

Results: In manual brush group, 27 were male and 23 were female. Mean age was 25.65 +/- 5.87 years. In battery operated brush group, 32 were male, 18 were female. Mean age was 29.92 +/- 10.37 years. Before manual brushing mean plaque score was 1.88 +/- 0.65 while after brushing it was reduced to 1.11 +/- 0.43. Percent reduction was 40.96%, p=0.0005. Mean plaque score was 1.35 +/- 0.37 and 0.69 +/- 0.29 before and after brushing respectively in battery operated brushing. Percent reduction was 48.9%, p=0.0005. Battery operated brushing was significantly more effective than manual [p=0.023]

Conclusion: Battery operated tooth brush was significantly more effective than manual toothbrush. It removes significantly more supragingival plaque than manual tooth brush

Flare-ups following single versus multiple visits in endodontic treatment

The purpose of this study was to analyze the incidence of post-obturation flare-ups in teeth following single visit versus multiple visits in Root Canal Treatment. Two hundred patients were assigned for single-visit versus multiple visits root canal treatment. For each tooth treated, the clinical factors and conditions existing before and after the completion of treatment were recorded. This data included patient's age, gender, type of tooth, pre-operative status of pulp and periapical tissues and recording pain and swelling [flare-ups] postoperatively after 1 day,1 week and 1 month. Statistics analyzed by chi-square test, SPSS 19. Fifteen out of two hundreds cases showed flare-ups after treated single visit versus multiple visits appointments. All patients in this study suffered irrereversible pulpitis 200 patients divided into two equal groups. Group1 Patients were obturated in single visit while group 2 patients were obturated in multiple visits appointments. It was observed that out of total 15[7.5%] cases of flare-up, 6[40%] were visited multiple time and 9[60%] were visited single time. It was concluded that the incidence of flare-up or post obturation pain is related to the number of visits and clinical experience of the dentist

Electronic apex locator versus conventional radiograph; determination of working length: a prospective in-vivo study

For successful endodontic outcome, accurate working length has to be determined. Even with improved systems of working length [WL] measurement, different readings may be recorded in different electrolytes present in the canal

Methodology: total 90 patients were selected for this prospective in vivo study resented at Department of Operative Dentistry, Liaquat University of Medical and Health Sciences, Jamshoro, during 6 months i.e. from 1[st] Sep 2014 to 28[th] Feb 2015, with single rooted permanent mandibular first premolars with matured apices. After extirpated pulp tissue a file was inserted in the canal and WL was obtained by radiograph as well as by electronic apex locator [EAL]. The measurements determined by both methods were compared by applying paired sample t-test. SPSS 18 was used for data analysis

Results: among 90 subjects 37 were males. Mean +/- SD WL obtained radiographically was 19.8 +/- 1.03-m whereas mean +/- SD WL obtained electronically was 18.9 +/- 1.05 mm. Mean difference between measurements of both methods was 0.87-mm, which was statistically significant [P <0.05]

Conclusion: the electronic apex locator was better than the radiograph in determining working length of root canal at statistically significant level

Clinical presentation of dry socket at teaching hospital of Hyderabad city

To find out frequency and clinical presentation of dry socket in Department of Oral and Maxillofacial Surgery Liaquat University of Medical and Health Sciences, Jamshoro. Obseervational study. This study was carried out at Department of Oral and Maxillofacial Surgery, Liaquat University of Medical and Health Sciences, Jamshoro from Jan 2011 to June 2012. Age from 11 to 70 years with both gender groups was included in the study. They were observed for the presence of dry socket. Patients with previous history of two or more days of extraction, pain, sensitivity on gentle probing of the extraction socket and empty/ partially empty socket were included in the study. Data was analyzed using SPSS version-13. Total 2300 extractions were included in study; dry socket was recorded in 66 [3.3%] routine dental extraction except 3[rd] molars and 598 [26%] surgical and non-surgical extraction of 3[rd] molar respectively. Majority of the patients belong to 3[rd] decade of life. In oral Surgery practice dry socket is unavoidable, but oral surgeons must identify additional risk factors in patients with particular medical conditions and include this information as a part of the informed consent

Complications of modified radical neck dissection type III in oral squamous cell carcinoma

Modified radical neck dissection type III is considered as relatively safe procedure for management of metastatic cervical lymphadenopathy, with low complication rate. This Descriptive study was conducted to evaluate complications of modified radial neck dissection type III from April 2007 to March 2010 at Department of ENT-Head and Neck Surgery Civil Hospital, Karachi. The surgical record of 115 patients of oral squamous cell carcinoma who underwent Modified Radical Neck Dissection type III was evaluated for frequencies and pattern of complications. Out of 115 patients, age of the patients was ranging from 26 to 66 years [std Dev: +/- 10.62]. 80% of patients were male and 20% of patients were female and male and female ratio was 4:1. The overall complications were 48.7%. Marginal mandibular nerve palsy [15.7%] and seroma [12.2%] were frequent complications. Although complications may occur despite the best efforts to prevent them, proper preoperative planning, early recognition of perioperative complications, and prompt, effective management can minimize the impact of complications that may occur

Analysis of maxillofacial injuries spread over one year period in Karachi sample

This descriptive case series study assessed the spectrum of maxillofacial injuries seen at the Emergency Department of Abbasi Shaheed Hospital, Karachi, Pakistan from March 2009 to February 2010. A total of 1295 patients with maxillofacial injuries were included in the study, of whom 875 [67.6%] were male and 420 [32.4%] female. Injuries were most common 340 [26.25%] in first decade. The most common cause was road traffic collision [611] patients and fall was second most common cause [415] patients. The mandible was the most common bone fractured [309] patients, followed by dentoalveolar [142] patients. There were 73 patients with fractured maxilla. Isolated soft tissue injuries occurred in 578 patients most commonly occurring in the lower third of the face. Most of the maxillofacial injuries were received between 1500 and 2100 hrs, [665] and Saturdays were the busiest days with [242] patients. The collection of data over the one from emergency department regarding the maxillofacial fractures including soft tissues injuries helps us how to manage on early basis and also may guide us regarding the time and day of the week which is busiest time of the emergency department

Complications associated with intra oral cortical bone fixation screws for intermaxillary fixation in closed reduction of mandibular fractures

The objects of this study were to determine the rate of complications associated with Intra Cortical Bone Fixation Screws for Inter-maxillary fixation [IMF] and as a possible alternative to Arch-Bars in patients with un-displaced mandibular fractures. A descriptive case series study involving 25 adult patients [age range: 16- 60 years] and requiring intra cortical bone fixation screws IMF was conducted from 1[st] August 2011 to 30[th] April 2012] at the Department of Oral and Maxillofacial Surgery, Abbasi Shaheed Hospital / Karachi Medical and Dental College [KMDC] Karachi. The sampling technique was non-probability purposive. Clinical examination and radiograph 1-OPG [Ortho-Pentomogram], 2-PA View of Face were taken for confirmation of un-displaced mandibular fractures. Patients with pre-existing mental nerve injury and / or soft tissue infection were excluded from the study. IMF was done with using intra cortical bone fixation screws, patients were followed over 6-weeks period at regular weekly interval. Postoperative frequencies of complication including mental nerve injury and soft tissue infection were recorded at review. Overall complications were in [3] 12% patients. The distribution of the various complications were; soft tissue infection in [1] 4% and mental nerve injury in [2] 8% patients. The high proportion of 12% complications including those related to nerve injury suggests appropriate selection of both the patients and size of Intra oral cortical bone fixation screw [ICBFS] as well as the use of this technique by surgeons having expertise and skills in the technique

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

Gingivitis and dental caries status among the school going children of Jamshoro city

The purpose of the study is to assess the gingivitis and dental caries status among school going children of Jamshoro city. Descriptive Study This study was conducted at the out patients department of Liaquat University Hospital Jamshoro during the year Jan 2010 to Oct 2011 A descriptive study was conducted among 700 school going children. The general information and the information regarding oral hygiene practice and dental visits were obtained. The gingivitis of the subjects was assessed by using Loe and Silness Gingival Index. The dental caries status was assessed by using International Caries Detection and Assessment System. Out of 700 school children, n=270 [38.57%] were boys and reaiming n=430 [61.42%] were girls, the age distribution was done in three groups and in group one total children were n=101 [14.42%], in group two n=187 [26.71%] and in group three n=432 [58.85%] children, Gingival Index according to Loe and Silness in grade zero were n=322 [46.00%] children, grade one n=165 [23.57%] children, grade two n=143 [20.42%] children and in grade three n=70 [7%] children, Dental Caries Status of school children in relation with age group was in age group one n=199 [28.42%] children, in age group two n=175 [25%] children and in age group three n=115 [16.42%] children. The results of this study indicate that there is a moderate prevalence of gingivitis and dental caries among school going children of Jamshoro city. We the dental care providers, oral hygienist, parents and teachers trying to motivate the school going childrens for to improving the oral health of the oral cavity so that they can prevent themselves from common problems of the oral cavity

Maxillofacial fractures in Hyderabad city: a 1-year study of 448 patients

This descriptive study assesses the cause, type, incidence and treatment modalities of maxillofacial fractures managed at our center during the 1-year of time period. Descriptive Study. This study was carried out at Department of Oral and Maxillofacial surgery Institute of Dentistry LUMHS, Jamshoro. A total 384 cases were studied. A detailed history, clinical examination was performed and finally diagnosis confirmed with the help of radiograph, at least two radiographs were taken. Records of patients enrolled who were either treated in the Emergency Room, Out-Patients Department or in the Ward. A numbers of parameters, including Age, gender, cause, type of injury and treatment provided were assessed. Out of 448 patients, 318 were male and 130 were female. Majority of patients belong to 3[rd] decade [21-30 years] of life. Road traffic accidents 56.91% accounted for the majority of cases of maxillofacial fractures followed by assault 10.49%, fall 19.86%, sports 4.68% Mandible was seen as the most commonly fractured bone 44% [287] followed by maxillary bone 23.92% [156], Zygomatic bone complex 18.40% [120] and majority of the bony maxillofacial injuries were treated by open reduction and internal fixation [ORIF]. Males of age group 21-30 years were more frequently involved in maxillofacial fractures. Road traffic accident was the most common cause of trauma in this part of the country, which requires proper implementation of traffic legislation use of helmet while riding the cycle or motor bike. Mandible was fractured in majority of cases; common treatment modality of maxillofacial fractures at our center was Maxillo-mandibular fixation with miniplates

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

Displacement of maxillary third molar in the infra-temporal fossa

Removal of an impacted maxillary third molar is a simple and easy procedure for an Oral and Maxillofacial Surgeon. Nevertheless, complications are possible and include infection, facial swelling, trismus, wound dehiscence, root fracture or even orosinusal fistula. Iatrogenic displacement into the infratemporal fossa is frequently mentioned but rarely reported. This anatomical fossa includes several important structures such as the internal maxillary artery, the venous pterygoid plexus, the sphenopallatinun nerve, the coronoid process of the mandible and the pterygoid muscles. Recommended treatment includes immediate surgical removal if possible or initial observation and secondary removal, as necessary, because of infection, limited mandibular motion, inability to extract the tooth, or the patient's psychologic unease. Sometimes, the displaced tooth may spontaneously migrate inferiorly and becomes accessible intraorally. A 24 year old male patient presenting with pain and swelling in the left third molar region. History, examination and x-rays confirmed a displaced third molar was present in the infratemporal fossa. The molar was displaced during extraction by a dental practitioner. The tooth was recovered successfully

Radiographic position of mental foramen in selected Pakistani population

To determine the frequency and percentage of different positions of Mental Foramen [ME] in Orthopentomogram [OPG], in horizontal and vertical relation to apices of teeth, in selected Pakistani population. A cross sectional study was undertaken on one thousand Orthopentomograms [OPGs] of adult patients of both gender with permanent dentition at least up to first molar teeth bilaterally having visible mental foramina. Material collected from three different centers of Karachi, namely. Department of Dental Radiology, Karachi Medical and Dental College, and Oral and Maxillofacial Surgery Clinics. Abbasi Shaheed Hospital Karachi and National Institute of oral diseases, Defence Karachi during a period of 1 year [from 15[th] Sep 2006 to 14[th] Sept 2007]. In horizontal axis, position wise MF was located in position 1,0 cases [0%], position 2,45 cases [4.5%]; position 3,404 cases [40.4%]; position 4.472 cases [47.2%]; position 5,71 cases [7.1%], and position 6, 8 cases [0.8%]. In horizontal axis MF is commonly located in area below and between root apex of first premolar tooth and upto below the apex of first molar tooth [position 2-6], when viewed on OPG. There is no evidence of location of mental foramen anterior/ median to the root apex of the first premolar tooth [Position 1]