Psychological stress associated with aphthous ulcers and temporomandibular disorders

Objective: To assess the prevalence of stress as an etiological factor for aphthous ulcers and temporomandibular disorders

Study Design: Cross sectional descriptive study

Place and Duration of Study: Armed Forces Institute of Dentistry Rawalpindi, from Oct 2015 to May 2016

Material and Methods: Two groups of patients were selected. Group I included 119 patients presenting with Aphthous Ulcers while group II had 64 subjects with complaints of temporomandibular disorders [TMDs]

After a thorough history, Hospital Anxiety and Depression Scale [HADS] was used to assess stress in the patients. A HADS-A score of 7 was taken as significant anxiety while a HADS-D score of 7 depicted significant depression

Both groups were then subjected to laboratory examinations. Serum cortisol levels were assessed for both groups while Serum Folate, Ferritin and Vitamin B12 level for group I only. Data were analyzed using SPSS version 21 to calculate descriptive statistics including mean and standard deviations as well as frequencies and percentages

Relationship between HADS score and serum cortisol levels was assessed using Pearson's correlation coefficient

A p-value<0.05 was considered significant

Results: For TMDs, 53 [82.8%] patients were found positive for stress while for aphthous ulcers, 61 [51.3%] were positive for stress. The correlation between HADS score and serum cortisol levels was found significant for both groups at a p=<0.001

Conclusions: Patients showed a high prevalence of stress as an etiological factor for aphthous ulcers and temporomandibular disorders in a local setting

Preferred methods for the selection of artificial teeth in a complete denture patient in a tertiary care hospital at Rawalpindi

This study was conducted to find the most convenient method for the selection of teeth for complete denture patients between Consultant, Residents and House officers in prosthetic services. A questionnaire was designed specifically prepared and distributed to 45 dentists working in tertiary care hospitals in the twin cities of Rawalpindi and Islamabad. All participants answered questions and responded to the survey. Majority preferred patient's facial form as a guideline in choosing the shape of anterior denture teeth [40%], the most widely used guide in choosing the color of the front teeth was the tone of the patient's skin [48.9%], and more often appearance used in selecting the size of front teeth were the corners of the mouth [35.5%]. Fifty-one percent of dentists prefer to use anatomical teeth for back teeth in prosthesis. Bulk of the participants [97.8%] preferred acrylic resin material for artificial teeth. It can be accomplished as the preferred method to opt for artificial teeth and general dentist in Rawalpindi and Islamabad agree with the approaches by dentists internationally, as evidenced by the data published on the subject

Awareness about prosthodontic treatment for missing natural teeth among patients seen at afid

Loss of teeth significantly impairs oral functions and masticatory efficiency. Due to lack of awareness about importance of prosthodontic replacement, mostly patients do not seek treatment immediately after tooth loss. Patients with different educational and socioeconomic background may have different reasons for not replacing teeth after extraction such as financial issues, lack of time and lack of motivation. The objective of this study was to determine the awareness level about prosthodontic treatment for missing natural teeth among patients seen at prosthodontic department of AFID in Rawalpindi. The study was carried out on 137 subjects over a period of almost six months. Based on the criteria of awareness defined in methodology, 19 patients [13.9%] had low awareness level, 89 [65%] had medium awareness level and 29 [21.2%] had high level of awareness. There was significant association of awareness level with gender [p=0.009], education [p=0.00] and occupation [p=0.001]. It was concluded that patients visiting AFID have medium level of awareness about prosthodontic treatment options. Dentists were the most common source of information for the patients in terms of education about different treatment options available to replace the missing teeth

Reasons and pattern of first molar extraction - a study

The aim of this cross sectional prospective study was to determine reasons and patterns of permanent 1[st] molar extraction in patients reporting to oral and maxillofacial surgery department at Armed Forces Institute of Dentistry, Rawalpindi. All patients referred to oral and maxillofacial surgery department for extraction of permanent first molar teeth from 1st of January 2009 till 31[st] of December 2009 were included in the study irrespective of their age and gender. The primary reason of extraction was recorded along with other relevant information. The pattern of extractions of the permanent first molars was also noted. A total of 470 patients were included in the study. Out of these 291 [61.9%] were males [M: F 1.6:1]. Caries was the most common cause with 281 extractions [59.8%] in all age groups in both genders followed by periodontitis, which was responsible for 109 [23.2%] of permanent first molar extractions. Mandibular molars were more frequently extracted [62.7%] as compared to the maxillary molars [37.3%], with the mandibular left molar being the most frequently extracted tooth in the sample population

Post cementation sensitivity in vital abutments of metal-ceramic fixed partial dentures

This randomized clinical trial was carried out to compare post cementation sensitivity in vital abutments of metal-ceramic fixed partial dentures using glass ionomer luting cement and resin based luting cement. It analyzed the results of 182 patients whose records were completed during study duration of 09 months at Department of Prosthodontics, AFID, Rawalpindi. Cold sensitivity tests were used to compare post cementation sensitivity in vital abutments of fixed partial dentures using resin based luting cement and glass ionomer luting cement. Sensitivity was assessed on a modified visual analogue scale of 0-10; scores of 1-4 signified mild sensitivity, 5-7 moderate sensitivity, 8-10 severe sensitivity and score of 0 signified no response. The sensitivity results were checked at base line, at 1 week, at 1 month, at 3 months. Data of 182 subjects of mean age 26.15 +/- 3.15 was evaluated. Chi-sqaure test was used to see the association of type of cement used and the postoperative sensitivity. The P values for the chi square test were insignificant P- values [P>0.05] at all appointments in abutments of fixed partial denture with either resin based or glass ionomer luting cement. The study showed that there is no significant difference between resin based luting cements and glass ionomer luting cements in terms of post cementation sensitivity in vital teeth

Management of medical emergencies in dental practices- an audit

To assess the knowledge, preparedness and practices of the dental practitioners to recognize and manage medical emergencies occurring in their dental practices. Descritive; Cross-sectional Study. Carried out in 126 clinics of Pakistan Medical and Dental Council [PMDC] registered dentists in Rawalpindi/ Islamabad over a period of 06 months from September 2009 to March 2010. A questionnaire and an observation Proforma were used for data collection. The questionnaire and observational proformas were distributed among 160 randomly selected dental clinics by the authors out of which 126 completed performas and questionnaires were returned. collected data was analyzed usign SPSS version 17. Majority [73.8%] of the dental practitioners believed that they were appropriately trained either in their undergraduate or postgraduate training in recognition of medical emergencies. However most of these clinicians felt that they were not adequately trained in the management of these emergencies and only 29.4% of the dentists had taken Basic Life Support courses. A good number of the dental clinics had little or no equipment or medicaments for management of common medical emergencies. Only 49.6% of the dental practitioners claimed that they were satisfied with their preparedness regarding management of medical emergencies. Good majority [73.8%] of our dental practitioners are able to recognize medical emergencies, however, their resourcefulness in terms of their management is seriously lacking