Challenges for dental professionals during COVID-19 pandemic: Are we prepared?

BACKGROUND: With the emerging knowledge and understanding of novel coronavirus infection, dentists must be capable of resuming their practice with necessary precautions in near future; hence, the aim of the present study was to evaluate the knowledge, attitude, and practices along with felt challenges by the dentists concerning practicing dentistry during pandemic in India. MATERIALS AND METHODS: An online cross-sectional questionnaire study was conducted on the dental practitioners of Uttarakhand, India. The dentists were approached by obtaining their E-mail address from the heads of dental institutions or dental association branches in the state. The knowledge, attitude, and practices along with apparent challenges of practicing during pandemic were assessed using closed-ended questionnaire. The relationship between the mean scores and demographic variables was determined using Student's unpaired t-test by keeping the significance level below 0.05. RESULTS: Out of 759 respondents, a total of 458 respondents were male (60%), whereas 301 (40%) were female. The mean knowledge scores were higher in females (11.06 ± 2.12) compared to males (9.72 ± 4.53), which was statistically significant (P < 0.05). The mean practice score was lower in males (17.49 ± 6.47) compared to females (19.26 ± 6.69) and likewise lower scores were seen in graduates compared to specialists and these differences were again statistically significant (P < 0.05). Majority of the study participants felt that following various safety guidelines were not feasible (96.97%) and too expensive (96.44%) and considered them as a challenge. CONCLUSION: It is imperative that dentists should be fully prepared before resuming their services and reach the right kind of awareness to limit the spread of the disease.

Comparison of Postoperative Pain Management after Third Molar Extraction with Two Anti-Inflammatory Drugs.

Background: The present study was aimed to investigate the pre-emptive analgesia attained with oral celecoxib compared with oral acetaminophen post mandibular third molar surgery. Methodology: A double-blinded, randomized, placebo-controlled clinical trial was performed in order to examine patients having a mandibular third molar for extraction under local anesthesia. The patients were randomized for receiving a preoperative oral dosage of celecoxib or acetaminophen as the predictor parameter. The primary outcome parameter was postoperative pain assessed through a visual analog scale (VAS) at different time points. The secondary outcome parameter was the quantity of postoperative analgesics taken in both groups. Statistical analyses included descriptive statistics, the t test, and the Pearson c2 test. Significance was set at P < .05. Results: 60 patients were divided randomly into either celecoxib receiving group or acetaminophen receiving group. The postoperative pain scores in the celecoxib group receiving were significantly lower than those in the acetaminophen receiving group at 4, 6, 8, and 12 hours (P = .078, P = .0012, P = .0211, and P = .011, respectively). The number of patients who didn't require any analgesics in the celecoxib receiving group was less than that in the acetaminophen receiving group (P =.0186). The average amount of rescue analgesic medication in the celecoxib group (0.6 0.8 dose) was significantly lower than that in the acetaminophen group (1.3 1.0 doses) (P = .002). The Kaplan-Meier curve (KM curve) was indicative of long-term survival of the patient's receiving celecoxib compared to those who did not receive any rescue analgesic medication (P = .0055). Conclusions: Celecoxib, as the study reflects, has a significant pre-emptive analgesic effect, thus helpful in reducing the usage of postoperative analgesics after removal of the third molar.

Preparedness among dental professionals towards COVID-19 in India.

INTRODUCTION: novel corona virus infection has become a public health crisis leading the world to a standstill including dentistry. However, since the dental services cannot be stopped for a long period it is important that dentist be fully prepared before resuming their services. Therefore, the current study was carried out for evaluating knowledge, attitude and practices (KAP) along with perceived barriers to practice dentistry during pandemic. METHODS: this cross-sectional study was conducted through an online survey questionnaire on dentists of India. Dentists were enquired for demographics, KAP and perceived barriers regarding practicing dentistry during pandemic. The knowledge was assessed based on 16 items in true or false or multiple choice questions format getting score of 1 or 0. The attitude and practices by 8 items each, on 5-point Likert scale and 4 items perceived barriers were enquired. The differences between the median scores among demographic variables were determined by applying student's t-test and keeping level of significance at below 0.05. RESULTS: out of 500 dentists who were approached through email, a total of 296 dentists returned the questionnaire (response rate, 59.2%) among which 22 questionnaires were incomplete and thus excluded making 274 as final study participants. Overall poor median scores of knowledge and practices were obtained whereas for attitude total median score was good. Median practice scores were significantly higher among female respondents (20(6)). Median knowledge and practice scores were significantly better in study participants with age <40 years (6(4) and 19(5), respectively). CONCLUSION: with the recent claims of authorities that virus is going to stay in world for quite some time it is essential that dentists must be fully prepared before resuming their services and must attain proper awareness to limit the disease spread.

Clinical Evaluation of Proclination of Lower Anterior Teeth during Alignment using a Single Width Bracket-A Pilot Study.

INTRODUCTION: The pre-adjusted brackets are available in various prescriptions and sizes; nevertheless there are still many controversies as to which pre-adjusted edgewise bracket offers the maximum clinical efficiency. AIM: This study was conducted to determine and compare the amount of lower incisor proclination during de-crowding if any of the Mini-Uni Twin Brackets with that of the standard double width brackets. MATERIALS AND METHODS: A total of 20 patients i.e., 10 patients in each group both males and females were randomly selected for the study from subjects seeking treatment, the selected samples were grouped as follows. Group I - Double Width Brackets (3M Unitek Gemini Series) 0.018" slot with Roth prescription. Group II - Mini Uni-Twin Bracket (3M Unitek) 0.018" slot with Roth prescription. RESULTS: The Mini-Uni Twin Brackets had statistically significant (p = 0.01) amount of proclination of the lower anteriors (0.8(o)± 0.3(o)) after de-crowding as compared to the standard Double Width Brackets and since the mean change in the Incisor Mandibular Plane Angle (IMPA) was lesser than 1(o), its clinical significance could be questionable. CONCLUSION: The Mini Uni Twin brackets are comparatively efficient in the lower anterior decrowding but further comparative clinical studies need to be performed on these Mini Uni Twin brackets, with an increase in the sample size and also the number of parameters to prove its total clinical efficiency.

Lymphoepithelial carcinoma arising from the maxillary antrum: a clinicopathological report of a rare lesion in an unusual site.

Lymphoepithelial carcinoma (LEC) of the maxillary sinus is an exceedingly rare malignancy. It may be asymptomatic or present with non-specific obstructive nasal symptoms which makes its pre-operative diagnosis very challenging. This report describes our clinical and radiological findings in a 45-year-old Indian female patient with locally-advanced LEC of the right maxillary antrum. Histopathological and immunohistochemical results are also discussed. The case was effectively managed by external beam radiotherapy and the patient has remained disease-free at 20-month follow-up.

Gingival angioleiomyoma-infrequent lesion of oral cavity at a rare site.

Gingival angioleiomyoma are rarely encountered lesions and most of these lesions are excised in toto in view of reactive gingival epulitic lesions. However, due to the vascular nature of these lesions, many a times surgeons experience unexpected hemorrhage and require extensive hemostatic management. A preoperative diagnosis is a must for these lesions and at least color imaging techniques can be utilized to know its vascular nature and preoperative tumor embolization can be done to be on the safer side. Also histopathological dilemma can occur due to the varied types of vascular arrangement in angioleiomyoma or due to simulation of other vascular lesion like hemangiomas, as well as due to similarity with other spindle cell neoplasms. We advocate the use of immunohistochemistry (IHC) to establish the exact diagnosis in such cases. Also due to infrequent reports of angioleiomyoma in such unusual location, we want to record this case for further reference in future.

A rare case of odontome in a 65-year-old lady.

Odontomes are considered to be hamartomas rather than a true neoplasm. They are comparatively common odontogenic tumors, and may lead to interference with eruption of associated tooth. Compound odontomes are commonly seen in young adults, but if they occur in children they are usually associated with permanent dentition and prevent eruption of the associated tooth. We hereby report a case of large compound odontome in the mandibular body region of a 65-year-old woman. Because of difficulty in denture fabrication and associated pain on mastication, surgical removal of the lesion was done.

Chronic suppurative osteomyelitis of maxilla mimicking actinimycotic osteomyelitis: A rare case report.

Osteomyelitis is a disease which is heterogeneous in its pathophysiology, clinical presentation and management. It is considered to be one of the most difficult-to-treat infectious diseases. Progressive bony destruction and the formation of sequestra are hallmarks of osteomyelitis. We hereby report a rare case of maxillary osteomyelitis, which had actinomycotic osteomyelitis like presentation but was histopathologically diagnosed as a severe form of chronic suppurative osteomyelitis.

Adenoid cystic carcinoma of buccal mucosa.

Adenoid cystic carcinoma is a malignant neoplasm most commonly originating in salivary glands of head and neck region. Here we present a case report of a 50 year old male who was diagnosed with adenoid cystic carcinoma of the right buccal mucosa. The peculiarity of the lesion and the approach we made is the key factor in the presentation.