Pattern of third molar impaction: frequency and types among patients attending urban teaching hospital of Karachi

The aims of this study was to determine the frequency and type of third molar impaction between 15 years and above age group of patients attending the outpatient's department of Bahria University Dental Hospital. This is a cross sectional study conducted from January 2012 to November 2013. The subjects were investigated and examined for third molar position, angle and impaction were re-corded. Chi Square test was used to analyze the association of impaction of third molar with respect to gender. A total 169 patients participated in the study; out of which majority were male that is 130 [76.9%] and 39 [23.1%] were females. The overall prevalence of impacted third molar was 169 [26%] with mean age of 29.17 +/- years and [STD] +/- 10.7. Study results showed that majority of the impacted teeth were present in mandible 32 [72.7%] than in the maxilla 12 [27.27%]. Majority of the impacted third molars were present in both maxillary and mandibular arch in the age group of 15-25 years. Furthermore, mesioangular impaction was the most common of all impacted third molars. It is concluded that impacted third molar is predominantly seen in mandibular arch than maxillary. The mesioangular impaction was the most common

Expression of integrin alphavbeta6 [alphavbeta6] in oral submucous fibrosis: a potentially malignant condition of oral cavity

Oral submucous fibrosis [OSF] is a chronic progressive fibrosing disorder of the oral cavity. A common finding in tissue fibrosis is that stromal fibroblasts become 'activated' myofibroblasts and express a-smooth muscle actin [SMA]. TGF-beta1 is considered to have a central role in inducing this myofibroblastic phenotype, and its expression is increased in numerous fibrotic conditions. The epithelial-specific integrin alphavbeta 6 is not detectable on normal oral keratinocytes but is upregulated during tissue remodelling. alphavbeta 6 is a key activator of TGF-b1 through its interaction with the latency-associated peptide [LAP] of the cytokine. The objective of the study was to investigate the role of alphavbeta 6 integrin in the pathogenesis of OSF. We used immunochemistry to examine expressionn of alphavbeta 6 in 41 cases of OSF compared with 14 cases of fibroepithelial hyperplasia, and found significantly higher expression in OSF [p=0.009]. We carried out a TGF- b1 bioassay using a keratinocyte cell line genetically modified to express high levels of alphavbeta 6 [VB6], and found that inhibition of alphavbeta 6 significantly reduced TGF-b1 activation [p<0.0001]. Co-culture of HFFF2 fibroblasts with VB6 cells induced myofibroblast transdifferentiation, producing a marked increase in SMA expression. This was inhibited using anti- alphavbeta 6 antibodies, confirming that myofbroblast generation was alphavbeta 6-dependent. In conclusion, these data show that alphavbeta 6-dependent TGF-b1 activation promotes myofibroblast transdifferentiation, and may be responsible, in part, for the chronic fibrosis seen in OSF

Assessment of oral cavity lesions by the patients through self-examination

There is a significant lack in the awareness of oral cancer and its risk factors among the community. The objective of this study was to determine whether those at risk of developing oral cancer are able to correctly detect oral cancers through mouth self-examination [MSE], if given adequate oral health education. 100 Participants received an oral mucosal examination by the dentist to check the presence or absence of potentially malignant oral lesions, then patients performed MSE after education through a self-read leaflet. Following MSE, participants were requested to complete a brief questionnaire. The prevalence of disease was found to be 34%.The sensitivity of MSE was 70%, and the specificity was 93%. MSE had positive predictive value [PPV] of 77% and a negative predictive value [NPV] was 91%. Mouth self-examination can be used as an effective tool to improve the awareness of oral cancer and for the early detection of lesions

Assessment of patient's satisfaction about dental treatment/ facilities provided by Bahria dental college hospital, Karachi

The study was carried out to know the attitude and satisfaction level of patients who came to dental OPD of Bahria Dental College and Hospital for treatment. This was a descriptive cross-sectional study conducted from March 2013 to August 2013. The patients were asked to fill the proformas which contained 10 questions to assess the areas which needed to be rectified. 392 patients were included in the study from both sexes, 147 were males and 245 were females with the mean age of 32.20 years with standard deviation +/- 11.03. Association between both genders and various aspects of Dental OPD were analyzed using Chi-Square test, at 95% CI that is < 0.05. Males were less satisfied in three areas as compared to females; 10 out of 147 males felt that operator or staff showed apathy towards them [p-value 0.009], 13.6% males did not want to refer their nearest kith and kin to Bahria Dental College and Hospital as compared to females [p-value 0.000], 19.04% males experienced delay in treatment due to power or water cut down or lack of materials as compared to females [p-value 0.000]. Females faced difficulty in two areas; 2% females felt problem in payment at the cash counter [p-value 0.094], 32.65% females thought there should be more signboards to guide the patients in finding respective departments as compared to males [p-value 0.000]. This study showed that majority of patients were satisfied about the dental treatment and facilities provided at this hospital

Oral hygiene habits among patients attending tertiary care dental unit

The aim of the study was to find out the oral hygiene habits of students, professionals and domestic staff at Bahria University Karachi Campus and to compare the association between the oral hygiene practices, oral health status, gender, age, educational status and occupation of the study group. Oral mucosal examination was carried out in 872 walk in patients. Oral hygiene Habits were determined by asking type of tooth cleaning devices used for cleaning teeth, frequency of tooth brushing and timings of toot brushing. Caries were detected by the criteria given in 'WHO Oral Health Survey 1981'. Out of 872 patients in out patient department of Bahria Dental Hospital, there were 551 males [63%] and 321 females [37%] with average age of 26 years. 833 [95.5%] used tooth brush, 799 [91.6%] participants brushed once daily or occasionally. Mean DMFT [Decayed, Missing, Filled Teeth] of the study group was 1.36. Those who were not cleaning their teeth at all had DMFT 1.87. DMFT increased with increasing age, with p-value of 0.00 which is statistically significant

levels of cytokines - the effect of betel quid/areca nut on oral epithelium

The objectives of this study were to investigate the in vitro effect of betel quid and its components on a stratified epithelium and to evaluate whether there was evidence of a site specific response to their effect. The reconstituted human buccal epithelium model and human gingival epithelium model used in the study which was prepared and supplied by Skin ethic Laboratories, Nice, France. It is a three-dimensional tissue culture model obtained by culturing transformed oral keratinocytes [TR146] derived from a buccal carcinoma and oral keratinocytes derived from healthy gingival. 50 micro ml of freshly prepared aqueous extract of paan, areca, lime, areca/lime mixture, tobacco and PBS [as control] was applied to the surface of the epithelium and the tissue incubated for upto 48 hours at 37 [degree sign] C in 5%. CO[2] in a humidified atmosphere. The tissue was used to access the viability by MTT assay. The culture medium was also collected at 4 and 48 hours and used for the measurement of cytokines /chemokines release using ELISA technique. In this study application of paan and its components caused up-regulation of cytokines and chemokines. On the buccal epithelium model after 4 hours of treatment lime caused increased release of IL-1 alpha [26.9 +/- 14.3 pg/ml] compared to PBS Control [9.5 +/- 4.5 pg/ml], IL-6 [24.9 +/- 8.4 pg/ml] compared to PBS control [8.2 +/- 1.8 pg/ml], IL-8 [437.5 +/- 227.8 pg/ml] compared to PBS control [194 +/- 58.1pg/ml] and TGF-beta after 24 hours [71.3 +/- 10.8 pg/ml] compared to PBS control [49.3 +/- 2.7 pg/ml]. In gingival epithelial model only paan caused increased IL-8 release [305.5 +/- 221.1 pg/ml] compared to PBS control [48.3 +/- 19.4] after 48 hours of treatment. Areca caused increased of IL-1 alpha [81.2 +/- 11.3 pg/ml] compared to PBS control [11.2 +/- 5.9 pg/ml] after 48 hours of treatment, whereas paan caused increased release of IL-6 [16.3 +/- 4.3 pg/ml] compared to PBS control [8.2 +/- 1.7 pg/ml], IL-8 [2333.7 +/- 1252.3 pg/ml] compared to PBS control [294.8 +/- 126.5pg/ml] and TGF-beta [35.8 +/- 0.9, 41.4 +/- 1.4 pg/ml] compared to PBS control [62 +/- 4.2] after 48 hours of treatment. Areca inhibited the viability of buccal epithelial cells. This study has confirmed that lime, areca and paan caused significant changes in cytokine release, viability and histology of the tissue. The release of pro-inflammatory cytokines may suggest that in the initial event of OSF these cytokines can act as a constant source of irritation to underlying tissue. The increase in TGF-beta release suggests that it may act on the underlying fibroblasts and result in increased collagen synthesis, a feature of OSF

analysis of maxillofacial fractures in AKUH

A retrospective study was undertaken to assess the maxillofacial fractures occurring over a period of 18 months [i.e. from January 1, 1989 to June 30. 1989 and from January 1, 1990 to December 31. 1990], at the Aga Khan University Hospital. Data collected included age, sex, etiology, anatomical site of the fracture, associated medical problems, morbidity and mortality. One hundred and fifty fractures in 108 patients were analyzed. The patients were divided into groups according to age. Highest incidence of fractures occurred between 21 to 30 years of age. The male to female ratio was 5.7:1. The main etiological factor was road traffic accidents [65%], followed by falls [16.6%] and assault [7.4%]. The middle third of the facial skeleton alone was mainly involved [54.6%]. The incidence of mandibular fractures was 31%. While a combination of mandible and mid facial fractures occurred in 14.0% of cases. Closed reduction was undertaken in 43.5% of cases, a combination of closed and open approach using direct bone wiring and/or bone plates was employed in 9.2% of cases. Open reduction and fixation was performed in 5.5% cases while conservative management was adopted in 35% of cases