Periodontal Lesions among Maxillary Sinus Mucosal Thickening Visiting the Department of Oral Medicine and Radiology of a Tertiary Care Centre.

Introduction: Maxillary sinus due to its proximity to posterior maxillary teeth could be affected by their pathology. Since cone beam computed tomography is the go-to for 3-D imaging in dental set-up. This study aimed to find out the prevalence of periodontal lesions among maxillary sinus mucosal thickening visiting the Department of Oral Medicine and Radiology of a tertiary care centre. Methods: This descriptive cross-sectional study was conducted in the Department of Oral Medicine and Radiology of a tertiary care centre from 01 February 2021 to 30 June 2021 after obtaining ethical approval from the Institutional Review Committee. The medical records from 01 January 2019 to 31 December 2019 were retrieved. The identification of maxillary sinus mucosal thickening of more than 3 mm, in cone beam computed tomography images, was registered separately for the right and left sinuses of each patient. The presence of periodontal lesions of posterior teeth was recorded. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 195 maxillary sinus mucosal thickening, periodontal lesions were found in 74 (37.95%) (31.14-44.76, 95% Confidence Interval) maxillary sinuses of 46 patients. The mean age was 53.67±12.72 years and 30 (65.21%) were males. Conclusions: The prevalence of periodontal lesions among maxillary sinus mucosal thickening in CBCT images was similar to other studies done in similar settings. Keywords: cone beam computed tomography; maxillary sinus; periodontal disease; prevalence.

Artifacts among Cone Beam Computed Tomography Images of Patients of Department of Oral Medicine and Radiology in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Cone beam computed tomography is widely used as a mode of investigation in the field of dentistry. Although presenting a three-dimensional picture of head and neck structures it does carry drawbacks in the form of artifacts which not only degrade image quality but a repeat of the radiograph leading the patient to radiation exposure again. This study aimed to find out the prevalence of artifacts among cone beam computed tomography images of patients visiting tertiary care centre. Methods: A descriptive cross-sectional study was conducted on cone beam computed tomography images of patients in the archives of dental radiology at the Department of Oral Medicine and Radiology wherein all cone beam computed tomography radiographs of patients after taking an ethical approval from Institutional Review Committee from 1 January 2019 to 19 March 2022 were included in the study. The study included 780 image of patients. Convenience sampling was used. The artifact when present was noted and categorised as inherent artifacts, procedure-related artifacts, introduced artifacts and patient motion artifacts. Point estimate and 95% Confidence Interval were calculated. Results: Among 780 cone beam computed tomography image patients, artifacts were seen in 665 (85.25%) (82.76-87.74, 95% Confidence Interval) study images. Conclusions: The prevalence of artifacts among cone beam computed tomography images of patients is similar to the studies done in similar settings. Keywords: artefact; cone beam computed tomography; radiation.

Fissured Tongue among Patients Visiting the Department of Oral Medicine and Radiology in a Tertiary Care Centre.

Introduction: Examination of the tongue and knowledge of its variation can aid clinicians in correctly assessing the cause of a patient's complaint. Despite World Health Organization recommendations to encourage more epidemiological assessment of oral mucosal variations and lesions, the volume of literature in this area is limited. This study aimed to find out the prevalence of fissured tongues among patients visiting the Department of Oral Medicine and Radiology in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted among patients visiting the Department of Oral Medicine and Radiology in a tertiary care centre. Data was collected from 12 March 2023 to 10 May 2023 after obtaining ethical approval from the same institute. A convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Out of 540 patients, the prevalence of fissured tongue was 73 (13.51%) (10.63-16.40, 95% Confidence Interval). A total of 34 (46.57%) were males and 39 (53.42%) were females. Conclusions: The prevalence of fissured tongue among patients visiting the Department of Oral Medicine and Radiology was higher than other studies done in similar settings. Keywords: anatomic variation; fissured tongue; Nepal; oral mucosa; prevalence.

Perceived Stress and Stressors among Medical and Dental Students of Bhairhawa, Nepal: A Descriptive Cross-sectional Study.

INTRODUCTION: Medical school is recognized as a stressful environment that may have a negative effect on a student's academic performance, health, and psychosocial well-being. This could further impact future health professionals' attitudes and compromise patients' care. This study aims to find out various sources of stress for medical and dental students to help prevent many future health problems in a student's life. METHODS: It was a cross-sectional study done in Universal College of Medical Sciences, Bhairhawa, Nepal, among undergraduate final year bachelor of medicine and bachelor of surgery and third and fourth year (phase I and phase II) dental students, using a questionnaire with Likert's scale. Data obtained was tabulated and analyzed using analysis of variance. RESULTS: Results showed that stress during exam 210 (92.9%) and preparation phase 200 (88.5%) stood out as the maximum stressors for our study group. The least stress-causing element was recorded as terms with seniors 45 (19.9%), adjustment with roommates 52 (23.01%), and competing with peers 69 (30.53%). Length of course 187 (82.74%), understanding the course 173 (76.55%), reading several textbooks 171 (75.66%), and work overload 165 (73.01%) amounted to significant stressors. CONCLUSIONS: Stress has a detrimental effect both on health as well as academic performance. The stressors at the campus should be identified and proper coping assistance should be provided to individual students. Systemic efforts are needed to address their concerns and make mental health care easily accessible to them. Counseling and awareness are recommended.

Malignant peripheral nerve sheath tumor: A rare malignancy.

Malignant peripheral nerve sheath tumor (MPNST) is also termed as spindle cell malignancy of the peripheral nerve Schwann cell. It is a rare and highly aggressive, soft-tissue sarcoma of ectomesenchymal origin that accounts for 10% of all sarcomas and only 10%-12% of all lesions occur in the head-and-neck region, thus making it a rare entity. It arises de novo or from the preexisting benign neurofibroma. The diagnosis of MPNST is one of the most elusive among the soft-tissue tumors because of its greater variability in overall presentation both clinically and histologically. This difficulty can be overcome by the use of immunohistochemistry. This article presents a rare case of MPNST of the oral cavity in a 40-year-old female patient with a brief review of the current literature.

Quantitative Assessment of apically Extruded Bacteria using different Instrumentation Techniques and Preparation Taper.

BACKGROUND: Cleaning and shaping of the pulp canal is one of the most important steps of endodontic therapy. Serious complications occur by the apical extrusion of bacteria during the instrumentation procedures. Both crown-down (CD) and full-length linear motion (FM) techniques are routinely used as a component of taper rotary instrument procedures for achievement of thorough cleaning and shaping of the pulp canal space. Hence, we aimed for this study to assess the change in the amount of apically extruded bacteria using CD and FM instrumentation techniques produced by differences in taper between the instruments used during biomechanical preparation of root canals. MATERIALS AND METHODS: The present study included assessments of 132 extracted maxillary central incisor teeth. To achieve a uniform teeth length of 21 mm, the height of the tooth crown was reduced for preserving the coronal portion of teeth. A modified glass vial model was constructed for the estimation of amount of bacterial extrusion through the apical region. For filling of each pulp canal specimen, 20 mL of Enterococcus faecalis suspension was used followed by the use of a number 10 K-file for carrying the bacteria down the lengths of pulp canals. All the contaminated teeth specimens were divided into six study groups with groups I to III containing specimens prepared in the CD manner, while groups IV to VI contained specimens prepared in the FM manner. Six teeth were taken as negative control with three specimens with each technique, and another six specimens were taken as positive controls. Cultivable bacterial counts were determined by evaluating 100 mL saline solution from each vial followed by its inoculation on blood agar. All the colony-forming unit (CFU) values were log-transformed (base 10), and the results were analyzed by Statistical Package for the Social Sciences software. RESULTS: A significantly lower quantity of CFU values was observed during CD instrumentation procedures with 0.02 files in comparison with all other study groups. However, while comparing both the instrumentation procedures when different taper files, other than 0.02 taper, were used for biomechanical preparation of root canal, nonsignificant results were obtained. CONCLUSION: With 0.02 taper preparations, significantly less amount of extrusion of bacteria is associated when done with CD technique. CLINICAL SIGNIFICANCE: No change in the amount of apical extrusion of bacteria will be seen by changing the type of instrumentation procedures. Amount of bacteria extruded can be minimized using 0.02 taper. Key words: Bacteria, Instrumentation, Taper.

Pentraxin-3 Levels in Gingival Crevicular Fluid during Canine Retraction with Nickel-Titanium Coil Spring and Active Tieback.

AIM: Orthodontic treatment is routinely carried out in patients with the purpose of correcting various forms of dental malocclusions. Retraction of the canines can be achieved either individually or along with incisor. Pentraxin-3 (PTX-3) is regarded as the true independent indicator of disease activity. Hence, we undertook the present study to assess and compare the level of PTX-3 in patients undergoing canine retraction with active tieback and Nickel-Titanium (NiTi) coil spring. MATERIALS AND METHODS: The present study included assessment of 25 patients that underwent canine retraction as a part of fixed orthodontic treatment. In the maxillary right and left quadrant, active tieback and NiTi coil spring were used respectively. Gingival crevicular fluid samples were collected 1 hour prior to the commencement of orthodontic canine retraction procedure followed by collection at following time intervals: 1 hour, 1, 7, and 14 days after the start of canine retraction procedure. Enzyme-linked immunosorbent assay kit was used for analysis of the samples as per manufacturer's instructions. All the data were recorded and compiled. All the results were analyzed by Statistical Package for the Social Sciences software. RESULTS: Nonsignificant difference was observed in the values of PTX-3 at baseline and 1 hour. While comparing the mean PTX-3 values between different time intervals in both the study groups, significant difference was observed. CONCLUSION: In comparison to the active tieback, NiTi coil exhibited faster space closure rate. CLINICAL SIGNIFICANCE: In patients undergoing orthodontic treatment, PTX-3 is associated with periodontal remodeling under the effect of orthodontic forces.