Five-Year follow-up of a coronally advanced flap over grafted bone and restorative composite in maxillary recession defect

Periodontal plastic surgery has become a predictable method of managing gingival recession defects. In the current case report, a five-year follow-up of a coronally advanced flap surgery with bone graft along with endodontics and fixed prosthodontic rehabilitation is reported in the maxillary anterior sextant of a middle aged female. The present case demonstrates that deep and wide gingival defects can be treated with coronally positioned surgical flap without a connective tissue graft

A multidisciplinary management approach was adopted in this case that yielded predictable outcome

Comparison of micro-leakage around temporary restorative materials placed in complex endodontic access cavities: an in-vitro study

Objective: To compare mean micro-leakage around 3 types of temporary restorative materials in-vitro, when placed adjacent to permanent restorations [amalgam] in complex endodontic access cavities. Study Design: Randomized controlled trial. Place and Duration of Study: Dental Clinics, Dental Laboratory and Research Laboratory at The Aga Khan University Hospital, Karachi, from January to June 2014

Methodology: After random allocation of 60 teeth into 3 experimental groups, each group had conventional class II cavities prepared and amalgam placed. After 14 days, endodontic access cavities were made in these teeth, followed by placement of Cavit, IRM and CLIP [depth of 4 mm each]. After thermo-cycling and immersion in 0.5% methylene blue dye, the teeth were sectioned mesio-distally and observed under stereoscopic microscope [magnification x4] along 2 interfaces 'a' and 'b' [tooth-temporary restoration and temporary restoration-primary restoration], respectively. Depth of dye penetration was measured in millimeters

Results: IRM was leakiest at interface 'a', cavit had highest dye penetration at interface 'b', while CLIP exhibited least micro-leakage at 'a' and 'b'. The mean dye penetration for Cavit was 0.80 +/- 0.23 mm at 'a', and 2.24 +/- 0.48 mm at 'b'. For IRM, it was 1.82 +/- 0.09 mm at 'a', and 0.44 +/- 0.13 mm at 'b'. For CLIP, the mean dye penetration was 0.43 +/- 0.05 mm at 'a', and 0.32 +/- 0.12 mm at 'b'. The difference in dye penetration observed between the 3 groups at both interfaces was statistically significant

Conclusion: In a complex access cavity made adjacent to a pre-existing amalgam restoration, CLIP exhibits the least micro-leakage, followed by IRM and Cavit

Assessing the perception of smile attractiveness in young adults, a pilot study

To assess the perception of dental, art and business students on the importance of smile attractiveness and the understanding on effect of skin tone on tooth shade value as perceived by the 3 groups. It was a cross sectional, analytical study conducted in Art, Business and Dental Schools. Ninety 90 students [3 groups of 30 each]were selected by non probability, purposive sampling. 24 pictures were run in front of the participants as power point presentations. The pictures were of two individual smiles, a male and a female, with changes made to colour of teeth and skin, in Adobe Photoshop. The participants were asked to grade each picture on a rating scale. SPSS 17.0 was used for data analysis. Frequency distribution of all variables was determined. Association of smile attractiveness with gender and profession was determined using Chi-square test. Mean ranks and score [of the 24 pictures] of smile attractiveness as perceived by the 3 groups were compared using Kruskall-Wallis test. Level of significance was set at 0.05. The sample size consisted of 34.1%males and 64.8%females. For the dental group smile attractiveness was very important as opposed to the business and art students. For females, smile attractiveness was more important than their male counterparts. Fair skin with bright and moderately bright teeth rated as the most attractive smile, whereas fair skin with dark teeth rated as the least attractive smile. There is a difference in perception of smile attractiveness between males and females. Art, business and dental students also have different perceptions of smile attractiveness with respect to skin tones and tooth shade values

Teaching and practice of repair of resin composite restorations in dental institutions of Karachi

1.To determine the proportion of dental institutions' faculty teaching repair of composite restorations to dental students [undergraduate]. 2.To evaluate the factors that affect the decision making process of Resin Composite restoration repair. An 11 item questionnaire was presented to the faculty members of all the dental institutions in Karachi. Nine out of ten dental institutions participated in the survey and a total of 38 faculty members from the department of Operative Dentistry filled the questionnaire. About 90% of the respondents stated that composite repair is advisable whereas 70% of the respondents stated that they have performed such type of interventions and have achieved success. Around 40% stated that they teach such procedures to students and60%stated that the course of instruction is at clinical level. 1.The findings of the present study indicate that the teaching of the repair of defective composites has found a place in primary dental degree curricula in almost all the dental institutions in the Karachi. 2.Occlusal relationship and patient's existing oral hygiene appeared to be the most important factors in decision making process

survey of the composite curing units used in the dental institutions of Karachi, Pakistan

To evaluate the light intensity output of the composite curing units used in the dental institutions of Karachi. It was a cross sectional study in which a total of 29 halogen composite curing units were examined. The light intensity output was measured using Cure-Rite meter. A cut off of 300mW/cm was taken as adequate light output. ANOVA and Kruskal-Wallis test were applied. Level of significance was kept at 0.05. The mean light output intensity was 345.2 mW/cm [SD 251.1 mW/cm]. Out of 18 units at undergraduate institutions, 11 had poor light output while 3 out of 11 at postgraduate institutions had poor light output. The condition of light cure unit's casing had a significant association with the light output [p-value of 0.011]. About half of the curing units at the dental institutions have poor light intensity output which may result in an inadequate quality of dental service. This is an alarming situation for the clinicians. As mishandling of the equipment is a leading cause of its poor performance, the external casing of the light cure unit can be taken as a proxy for its light output

Reliability of landmark identification among orthodontic residents using traditional and indirect digital cephalometry

To determine the inter examiner reliability of landmark identification among Orthodontic Residents using Traditional and Indirect Digital Cephalometry and to determine the intra examiner reliability of landmark identification. A cross-sectional study of six months duration done at Orthodontics Department of KMDC. One conventional Lateral Cephalometric radiograph was randomly selected. Study subjects were 8 residents with mean age was 28.8 years, with a range of 27.5 to 31 years. Cephalometeric tracing was done and landmarks S or Sella, N or Nasion A or Point A, B or Point B, Pog or Pogonion, Gn or Gnathion, Go or Gonion, Me or Menton, Or or Orbitale, Ba or Basion, API or apex of upper incisor, APT or apex of lower incisor were identified using traditional method by an Orthodontic consultant and then tracing was scanned and digitized to obtain the Indirect Digital Cepha image. The same cepha was asked to trace by all 8 study subjects. Kappa statistics was applied to see the agreement between the residents for landmarks identification in conventional and indirect digital cephalograph. Results: The study subjects were 8 orthodontic residents [3 males and 5 females]. Residents had excellent agreement for landmark identification on the conventional and the indirect digital cephalogram. The value of agreement for inter-examiner and intra-examiner reliability was found to be 0.80 [CI: 0.71, 0.89] and 0.83 [CI: 0.79, 0.87] respectively. The reliability of landmark identification was good among residents for both the conventional and the indirect digital cephalometery

Frequency of class-III malocclusion reported in dental OPD, Karachi medical dental college

To determine the frequency of Class-III malocclusion reported Orthodontic department in Karachi Medical Dental College, Pakistan. It was a cross sectional study of orthodontic patients. With convenience sampling a total of 384 patients [267 girls, 117 boys] referred to the Department of Orthodontics, Karachi Medical Dental College, were evaluated in this study. The mean age of the patients was 11.86 +/- 3.16 years. There malocclusion were classified from I, II [Div-1 and Div-2 with sub division right and left], and III, and recorded according to angle classifications. Class-III malocclusion was the least common malocclusion present in the major category of malocclusion and found 8.1% of the samples. Class-III malocclusion requires very early treatment then class-II and Class I malocclusion and has totally reverse treatment philosophy. Having the lower frequency of Class-III malocclusion in the population makes doctor to focus more in later age group and puts less burden on health resources as more patients of Class-II and I can be treated using the same resources. The type of malocclusion, also an important factor that affects a patient's motivation to seek treatment

survey of knowledge of dentists in diagnosing irreversible pulpitis

Dental caries and its sequel pulpitis, is one of the most common complaint with which the patient attends a dental office. The diagnosis of of puplitis involves distinguishing the two types, i.e.; the reversible and irreversible pulpitis, through objective and subjective testing. This process is usually straightforward but can at times be difficult due to anatomical, physiological and psychological factors. The Purpose of this questionnaire based survey was to find out the ability of dentists in diagnosing irreversible pupitis. The study design was cross sectional. Two hundred signle clinical scenario based questionnaires were distributed among 3 dental colleges. Totally 142 questionnaires were received back. Respondents were the clinical staff [consultants, senior registrar residents, demonstrator, house officers and final year students] of the 3 dentil college. The respondents were asked to diagnose the clinical scenario as either reversible or irreversible pulpitis. Most of the participants [81.7%] gave a wrong diagnosis. Worst response was from the final year student category [88.6%] whereas best response was in the resident category [44.4%]. The deference was statistically significant [p<0.05]. The ability of participants in diagnosis the clinical scenario correctly was poor in all categories