Occurrence and clinical characteristics of trigeminal neuralgia: a study

To evaluate and analyze the occurrence and clinical characteristics of trigeminal neuralgia in the population of Mardan, Khyber Pukhtunkhwa. Data of 190 patients with trigeminal neuralgia reported to the department of Oral and Maxillofacial Surgery, Bacha Khan Medical College Mardan, from Jan 2013 to Dec 2014 were reviewed. History, clinical examination and investigations were carried out for diagnosis. Data regarding the age, gender, site, division and branch of nerve involved and severity of pain was evaluated and analyzed. Females outnumbered the males. The most common age group involved was 51-60 years. Right side [72.63%] was involved more than left side. Single nerve [92.20%] involvement was more common than multiple nerves. Mandibular division was involved in 46.30% cases. Infraorbital nerve was the most common peripheral nerve involved in 42.6% cases and presented with moderate pain. This study showed that TN was more common in aged females. It occurred more on the right side and mainly affected mandibular division. The common peripheral nerve involved was infra-orbital and many patients presented with moderate pain

Clinical characteristics and treatment of dry socket - a study

The objective of this study was to evaluate and analyze clinical characteristics and treatment outcome in dry socket patients. This study was undertaken on 90 patients having the clinical features of dry socket, at the private clinic of the author at Mardan, Khyeber Pakhtunkhwa, from Jan 2008 to Mar 2011. Data regarding the age, gender, site of dry socket, time lapsed from extraction until diagnosis and treatment outcome was evaluated and reviewed. The age ranged from 17-69 years with a mean value 34.3 years, with high frequency occurring in 4[th] decade. The male to female ratio was 1.21:1. Sixty six patients presented dry socket in mandible, while 24 in maxilla. Dry socket was more common at 3[rd] molar is mandible and 1[st] molar in maxilla. Twenty six patients presented with dry sockets after three days. Surgical intervention was successful in all cases without any major complication

Treatment of oroantral fistula - a study

The aim of this study was to evaluate and analyze the occurrence, characteristics and treatment outcome of oroantral fistula in 29 patients from Sept 2004 to Nov 2009. These patients were examined both clinically and radio-logically for oroantral fistula. Data regarding the age, gender, cause and site of fistula and treatment outcome was evaluated and reviewed. The age range was 18-60 years with high frequency occurring in 31-40 years. Male outnumbered female. The common cause of OAF was extraction of teeth [n=25, 86.5%] followed by cysts [n=2, 6.7%]. The most common involved tooth in the causation of OAF was upper first molar [n=13, 52%]. Surgical technique used to close the fistula was buccal advancement flap. Recurrence of fistula occurred in 2 patients [6.7%] and were re-operated using the palatal flap. The merits and demerits of the procedure are discussed

Impacted mandibular third molars: pattern of presentation and postoperative complications

The purpose of this prospective study was to evaluate the occurrence, characteristics and postoperative complications of impacted mandibular third molars in 260 patients from Oct 2008 to July 2010. Clinical and radiographic examinations were carried out. Data regarding the age, gender, angulations type, depth and width of impactions and postoperative complications were evaluated and analyzed. The age ranged from 17 to 59 years with high frequency occurring in 3rd decade. The common cause for extraction was pericoronitis. Mesioangular impaction was most common [n=124, 48%] followed by vertical [n=90, 34%]. Majority of the patients presented with Class IIA [n=84, 32.3%] followed by IA [n=61, 23.5%]. Postoperative complications included persistent pain and swelling [16.5%] followed by dry socket [4.2%] and trismus [4.2%]. There was a greater risk of developing complications in horizontal and distoangular types, and in Class IIIC and IIIA impactions

Oral verruca vulgaris: a rare case with transformation of papilloma to well differentiated oral squamous cell carcinoma

Variety of verrucous and papillary lesions affect the oral mucosa. These are either benign or reactive, for example, papilloma, verruca vulgaris, fibroepithelial polyp and verruciform xanthoma, which usually present with little diagnostic difficulty. However, dysplastic and malignant verrucous present with much greater diagnostic challenges. There is evidence of some carcinomatous changes in oral lesions with some pre existing predisposing factors. The common wart or verruca vulgaris are lesions of childhood. These are benign, elevated, firm nodules with characteristic papillomatous surface projections. The most common site of occurrence is the fingers. Oral lesions are relatively rare, and are usually caused by auto inoculation from lesions on the fingers and hands. This report describes a lesion which was histopathologically diagnosed as oral verruca vulgaris that occurred in a middle-aged woman without any history of wart like lesions elsewhere in the body. But later on expanded in size, became indurated involving entire lower lip, labial sulcus, alveolar ridge and floor of the mouth. It was histopathologically confirmed as well differentiated oral squamous cell carcinoma

Effects of pre operative administration of diclofenac potassium on pain intensity following impacted mandibular third molar surgery

To evaluate the effect of pre operatively administered Diclofenac potassium, on the postoperative management of pain following removal of impacted lower third molars. The study was carried out in the Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Peshawar, from Jan 2009 to June 2009. Fifty patients were recruited in this study who were equally distributed into group I and group II. Post operative pain was assessed using a four-point Category bating Scale. In this study more males were recruited than females and the ratio of male to female was 2:1. Majority of the patients [56%] recruited were in 3[rd] decade of life followed by 4[th] decade [32%]. In group I, 80% were those who had no post operative pain after 48 hours while in group II 86% of the patients showed moderate to severe pain postoperatively. This study illustrated the enhanced effects of pre operative administration of Diclofenac potassium on short-term postoperative pain, compared to those patients who do not receive diclofenac potassium prior to third molar surgery

Clinical characteristics and treatment outcome in the burning mouth syndrome

To evaluate and analyse the occurrence, clinical characteristics and treatment outcomes in patients with burning mouth syndrome. Data of sixty patients with burning mouth syndrome reported to the private clinic of the author from January 2003 to March 2008 were reviewed. Clinical examination and treatment follow up was carried out. Data regarding the age, gender, main site of involvement, associated symptoms and treatment outcome were evaluated and analysed. Females outnumbered the males. The most common age group involved was 41 -50years. Main sites of involvement were anterior 213[rd] of tongue [58.6%], followed by labial mucosa [13.3%]. The common complaint associated with burning mouth was dry mouth [90%] followed by taste loss [63.3%]. Significant improvement [91.3%] was noticed in patients managed with the combination of systemic antidepressants, clonazepam and strong reassurance. Burning mouth syndrome was more common in aged females. Common site of involvement was anterior 213[rd] of tongue. Improvements in symptoms were more significant when antidepresssants were combined with clona

pam and strong reassurance

Odontogenic keratocysts: a clinical and radiographic study

This descriptive study was carried out, at Khyber College of Dentistry, Peshawar from Sept 2005 to Jan 2007, on 40 patients having histopathologically confirmed odontogenic keratocysts.. Maximum patients [62.5%] presented in the 2nd and 3rd decades. 21 were male while 19 were female. Seventy five percent cases occurred in the mandible, with the posterior region involved in maximum number of cases in both the jaws. Facial asymmetry, pain and cheesy aspirate were 75%, 50% and 82.5% respectively. Radiographic findings were well defined borders, multilocularity, impacted tooth and root resorption, in 45%, 55%, 50% and 7.5% of cases respectively. The objective of the study was to list the common modes of presentations of odontogenic keratocysts and educate the general dental practitioners about the aggressive nature of this lesion. As a prophylactic measure, routine dental check up will help a lot in the prevention and timely diagnosis of odontogenic keratocysts

Occurrence and characteristics of maxillofacial injuries - a study

This descriptive study was undertaken to evaluate and analyze the pattern of maxillofacial fractures in 340 patients reported to the Department of Oral and Maxillofacial Surgery, Khyber College of Dentistry, Peshawar from Oct 2005 to May 2007. These patients were examined both clinically and radiologically for maxillofacial fractures. Data regarding the age, gender, cause of fracture and site of fracture were evaluated and reviewed. The age range was 2-28 years [mean 25 +/- 16.4years] with high frequency occurring in 21-30 years age group. The male to female ratio was 3:1. The leading cause of maxillofacial fracture was road traffic accident [RTA [n=154; 45.2%]], followed by accidental fall [n=101; 29.7%] and firearm injury [FAI [n=49; 14.4%]]. It was noted that road traffic accident and fall caused most of the parasymphyseal [n=90] and condylar fractures [n=65] in mandible, while firearm injury and assault caused more body [n=18] and angle [n=20] fractures. Maxillary bone fractures [55.5%] were common followed by zygomatic bone [38.8%]. This study can guide us to formulate strategies and policies to prevent maxillofacial fractures

comparative analysis of rigid and non rigid fixation in mandibular fractures: a prospective study

The aim of this prospective study was to compare the postoperative outcome in 80 mandibular fractures patients, treated by open reduction and internal fixation [ORIF] and intermaxillary fixation [IMF] at Oral and Maxillofacial Surgery Unit, Khyber College of Dentistry, Peshawar from 10th February 2006 to 9th February 2007. The most common age group involved was 21-30 years and the common cause of fractures was road traffic accidents [38.75%], followed by fall [31.25%]. Most common site of fractures was parasymphysis [41.24%] followed by angle [25%]. Patients were divided in two treatment groups, having 40 patients in each group. Rigid internal fixation was assigned as group A and intermaxillary fixation as group B. Data regarding the study was evaluated and reviewed. Two patient groups were not significantly different in relation to postoperative normal occlusion [p=0.45], malocclusion [p=0.45], mAl union [p=0.45], delayed union [p=0.07], non union, infection [p=0.28] and sensory disturbances [p=0.07]. The result was significant in relation to mouth opening [p=0.0001]. This study will help us regarding the measures to be taken in prevention of postoperative complications

Outcome of rigid internal fixation of mandibular fractures: a prospective study

This prospective study was undertaken to analyze the postoperative outcome in 80 mandibular fracture patients treated by open reduction and internal fixation at Oral and Maxillofacial Surgery Unit, Khyber College of Dentistry, Peshawar from Jan 2006 to June 2007. Data regarding the pattern of fracture and postoperative outcome was evaluated and reviewed. The most common cause of fracture was road traffic accident and common site was parasymphysis. Sixty two patients [n=62; 77%] had successful uneventful postoperative outcome. Infection was the common complication [n=7; 8.7%] followed by malocclusion [n=5; 6.2%]

Vaccination status against hepatitis b in doctors and final year clinical students working at Khyber college of dentistry and Sardar begum dental college, Peshawar

This is a descriptive study conducted from February, 2006 to april, 2006 The purpose of this study was to assess the vaccination status of dental health care workers at Khyber college of dentistry and Sardar begum dental college Peshawar. Eighty three doctors and fifty six students were interviewed. Sixty seven doctors and forty three students had vaccinated themselves. Sixteen doctors and twenty five students had booster dose of vaccination as well, while seven doctors and six students had checked their antibody level. The commonest reason for non-vaccination was financial factor [cost] and lack of motivation. Two of the participants thought it was not necessary [including one consultant] while seven other participants had other reasons. Among one hundred and thirty nine participants one student and two doctors did not get the 3rd dose of vaccination. Ten students and fifteen doctors had habit of patient screening for HBsAg and anti HCVAb. Sixty five doctors and forty seven students were aware of the importance of antibody titre

Hepatitis in dental practice - A study conducted on 1498 patients

The purpose of this study was to determine the carrier status of hepatitis Band C in those patients who were admitted in the surgical unit of Khyber College of Dentistry, Peshawar for the treatment of miscellaneous oral and maxillofacial pathologies, including fractures, cystic lesions, tumors, neurec-tomies, impactions and biopsies. All the patients were operated under general anesthesia and were screened for hepatitis B and C virus. This is the retrospective study conducted from September 2002 to December 2004. There were 1498 patients. Out of these, 44 were diagnosed as positive for the viral pathology. Some infected patients presented with a known history of jaundice, blood transfusions, major and minor dental surgeries in the past. The percentage of patients positive for HBsAg and HCVAb was 1.66 and 1.26 respectively.

Treatment modalities of mandibular ameloblastoma a study

The purpose of the study was to find the occurrence of the tumour in the mandible in relation to age, sex, site, clinical, radiological presentation and to compare treatment modalities and their success

The study was carried out on 32 patients withAmeloblastoma of mandible during the period 1996 to 2003, who reported at the Maxillo Facial unit of Khyber College of Dentistry, University Campus Peshawar. Aproforma was designed to record information about these patients withAmeloblastoma of mandible in relation to age, sex, site, clinical and radiological findings. The diagnosis was confirmed by histopathology in each case. The treatment was decided and done depending on clinical and radiological findings and extension of tumour. Patients were followed up to nine years and on every review clinical and radiological examination was done and any recurrences found were treated accordingly

The age range was from 10 years to greater than 51 years with mean age 33.9 years. There were 8 males [25%] and 24 females [75%] with male to female ratio of 1:3. The most common site waspremolar to ramus region 28.1% [9] where as tumour extending from molar to ramus region was in 21.8% [7]. Clinically 15 [46.8%] patients presented with swelling without pain. In 10 [31.1%] patients there was swelling along with loosening of teeth. Five patients [15.6%] had swelling and pain together. There were 2 [6.2%] patients who had a chance finding on x-ray. Radiologically there were 19 [59.3%] patients with multi locular radiolucency and 9 [28.1%] patients with uni cystic appearance. Four patients [12.5%] had the typical honeycomb appearance. Excision of the tumour along with bone skimming was done in 14[43.7%] patients. Wide excision of the tumour along with healthy bone margins sparing lower mandibular border was done in 8 [25%] patients. Segmental resection with reconstruction was done in only 4 [12.5%] patients. Hemimandibulectomy with reconstruction was done in 6 [18.7%] patients. In review and follow up only 25 patients out of 32 patients came regularly

There were 3 [9.3%] patients with recurrence were in the group where only excision and bone skimming was done. There were also 2 [6.2%] patients who had recurrence and belonged to the group of treatment where wide excision along with healthy margins was made but lower mandibular border was spared

It is concluded from our study that whatever the size of tumour its complete excision is necessary

Retrospective analysis of 268 cases of fractures of mandible

The purpose of the study was to determine the causes of fractures of mandible, age groups and gender involvement in North West Frontier Province of Pakistan. This study was conducted at Khyber College of Dentistry, Peshawar University Campus from 1[st] January to 31[st] December 2002. 268 patients with mandibular fractures were recorded in this study. The patients age range was from 2 to 70 years

Out of 268 cases of mandibular fractures, 118 patients [44%] were the result of road traffic accidents. Interpersonal violence was responsible for 67 cases [25%] while 43 cases [16%] were due to fall. 35 patients [13%] were found due to gun shot injuries and 5 cases [2%] were due to other injuries.213 patients [79.4%] were male, thus male to female ratio was 3.87:1

Causes of dental extractions among 2000 patients -a study conducted at oral and maxillofacial surgical unit, khyber college of dentistry, Peshawar - Pakistan

The purpose of this study was to determine different causes of dental extractions. Two thousand patients were examined thoroughly. Among 2000 patients 1188 were male, 812 were female. Grossly Carious teeth remain the dominant cause contributing to 61.50% of all extractions followed by trauma [9.86%], miscellaneous group [9.70%], abscesses I granulomas [7.60%], impactions [3.60%],periodontal diseases [3.00%] and cystic lesions [3.00%]. The least possible cause of dental extractions was orthodontic purpose [1.94%]

comparison of sealing capabilities of amalgum, GIC and zinc oxide eugenol cement when used as retro grade filling materials [in vitro study]

The objective of this study was to compare sealing capabilities of different filling materials when used as retrograde filling materials following apiceotomy [to check their sealing abilities as retro filling]. In this study apical seal obtained following reverse retrograde root filling with amalgam, was compared with those obtained with, Glassinomer [GIC] and Zinc oxide eugonal [ZnO2E] cement. The root canals of 50 extracted single rooted upper anterior human teeth were used in this study. The root canals were instrumented and obturated with laterally condensed, gutta-percha and zinc oxide sealer. Each tooth was apically resected at 90 degrees to its long axis and the root surface isolated with two coats of nail polish. Teeth were divided into 4 groups, the 1st group received amalgam retrograde filling, the 2nd and 3rd group was retro filled with GIC and ZnO2E cement respectively and the 4th control group received no retrograde root filling. All these teeth were suspended in 1% methylene blue dye at room temperature for 72 hours, the roots were sectioned and dye penetration measured by using [stereomicroscope] microscope. The sealing abilities of these materials were determined by their ability to inhibit dye penetration. The result of this study has shown that GIC is just as effective as amalgam but ZnO2E cement showed poor sealing abilities. GIC is just as effective as Amalgam as a retro-sealer and on some instance, better then it, but a long term in vivo study is required to prove it