Complications and their severity in patients of conventional metal ceramic fixed dental prosthesis: a clinical study

The aim of this study was to present the frequency of biological and technical complications and its severity related with metal ceramic fixed partial dentures [FPDs]. Total 245 abutments of 140 patients presented with complications in their FPDs were examined. The mean age of the patients was 42 years [range 23-83]. 66.1% and 33.8%complication were found in the FPDs provided by qualified and unqualified persons respectively with an average 5.4 years length of services. Among the biological complications caries were present in 21.2% [52] of the abutment teeth; 13.06% [32] had periapical problems, 12.65% [31] periodontal problems and 2.85% [7] had abutment fracture. Sixty eight out of 245 abutments with a decementation problem indicated a the major technical complication, whereas 25 with esthetic problem, 15 had occlusal problems. The primary technical complication decementation was associated with wrong preparation. Varying severity grades of complications, grade I 27.3%, grade II 35.1% and grade III 37.5% were observed. In conclusion majority of the FPDs having complications were provided by unqualified and were of grade II and III. The common complications were de-cementation, dental caries, periodontal disease and periapical problems

Attributes of maxillary complete denture supporting tissues in subjects at a dental hospital

To document anatomical features of maxillary edentulous denture supporting tissues [DSTs] in subjects. From September 2006 to May 2007, a case-series study, involving 100 subjects having maxillary edentulous DSTs was conducted at KCD Peshawar. Using a structured proforma, data were recorded for un-favourable and favourable features of each of the anatomical structures of the DSTs including radiographic findings and need and category of pre-prosthetic surgical procedures. Subjects [70 males: 30 females] had mean age 61.3 +/- 10.7SD with 34% older than 65 years. Majority [69%] subjects were poor. Caries and periodontal disease were reasons for tooth loss in 99% subjects with mean duration of edentulism in months as 19.5 + 38.3 SD]. The percentages of subjects exhibiting unfavourable features for residual alveolar ridge [RAR] height and width, arch size, maxillary tuberosity, alveolar mucosa and presence of retained roots and teeth on radiographs were 47, 70, 81, 25 and 12 respectively. The percentages of subjects having unfavourable hard palate depth, arch form, soft palatal throat morphology, presence of median palatal fissure, unfavourable labial and buccal border tissue attachment levels, presence of palatal tori and unfavourable tuberosity-sinus relationship were 20, 10, 16, 6, 4, 8, 4, 56 respectively. Need for pre-prosthetic surgery was seen in 18% subjects. Chi-square analyses of data showed significant association between age and oral mucosa, gender and arch size and gender and depth of hard palate. The unfavourable nature of the DSTs in many subjects indicates their treatment difficulty in a general practice environment

assessment of incomplete facial basal cell carcinoma excision

To determine the rate and cause[s] of incomplete excision of basal cell carcinoma, occurring on face. Design: A non-interventional, descriptive study. Place and Duration of Study: Plastic Surgery Unit, Hayatabad Medical Complex, Peshawar, from January 2002 to March 2004. Patients and Patients with basal cell carcinoma of the face reporting to the OPD were included in the study and were booked for surgery. After excision, all tumors specimens were marked at 12 o'clock and sent to laboratory for histopathology to confirm the diagnosis and to know the completeness/incompleteness of tumor excision. If biopsy reported residual tumor in any of the margins it was noted and projected as percentage for the purpose of our results. Out of 56 patients, 49 [87.5%] had complete excision of tumor. Six [10.7%] had residual tumor while in one [1.7%] patient, biopsy report failed to mention the involvement/clearance of margins. Six patients with residual tumor were given postoperative radiotherapy. All patients were followed for a minimum of 2-1/2 years [critical period for recurrence] with careful watch on those with residual tumor. So far, only 2 of these 6 had recurrence of lesion. Both of them were greater than 2 cm in diameter and were located on medial canthal and nasolabial region. Chances of incomplete tumor excision are more on the mid face region. Patients with residual tumor are more prone to recurrence