Tertiary Dental Care Research Articles

Frequency of Different Dental Irregularities Associated With Cleft Lip and Palate in a Tertiary Care Dental Hospital

BackgroundOro-facial clefts (OFCs) are formed due to a combination of genetic factors and environmental factors. Treatment is usually extensive and lasts till adult age. The treatment also includes a large portion of dental rehabilitation.ObjectiveThis study aims to look at the different dental anomalies associated with OFCs.MethodsA total of 100 participants with OFCs were randomly selected from Clap centre Lahore. They were categorized into cleft lip (CL), cleft palate (CP), and both. Dental anomalies were recorded clinically and family history for OFCs was also recorded.ResultsOut of the 100 participants, 15 had CL only, 37 had a CP, and 48 had both CL and CP. Missing teeth and hypodontia were significantly associated with all OFCs (p-value > 0.05). Supernumerary teeth were only significantly associated with CP (p-value: 0.04). Other dental anomalies were not significant for OFCs.ConclusionOFCs in all its three forms are associated with dental irregularities. They can either be missing teeth or extra teeth. There is a strong need for dentists to be a part of the treatment planning of OFCs and to treat dental anomalies alongside the clefts.

Management of dental emergencies at tertiary dental care center, Rohtak during COVID-19 pandemic

Aim: To assess the pattern of emergency dental services provided at the tertiary dental care center, Rohtak during COVID-19 pandemic. Method: Retrospective data analysis was done from the Out-Patient Data registers of the Department treating emergency dental services during COVID-19 pandemic i.e. Department of Oral Medicine and Radiology, Oral and Maxillofacial Surgery, Pedodontics and Conservative and Endodontics from March 2020 till October 2020. Data was entered into Microsoft Excel. Results: It was retrieved that maximum patients during the study period seek treatment due to pulpal and periapical pain (43.53%), periodontal pain (7.5%), infected root stumps and mobile teeth (7.18%). Major emergency services were provided in form of extractions (29%), RCTs (21%), restorations (10%), and inter-maxillary fixations (4.2%). Conclusion: The study concludes that most patients in dental emergency were provided with adequate treatment in accordance with the COVID-19 guidelines. The actions now should aim towards assessing the barriers faced by people on account of not receiving dental care and for the consequences that may arise in the light of rapid increase of infection or subsequent wave of reinfection.

Periodontal Disease in Patients Visiting a Tertiary Care Dental Hospital: A Descriptive Cross-sectional Study.

Periodontitis is chronic disease leading to tooth loss. Oral hygiene practices combined with regular dental examinations keep oral cavity disease free and maintain periodontal health. The primary objective was to find out the prevalence of periodontal disease of patients measured by the Simplified Oral Hygiene Index and Community Periodontal Index. This descriptive cross-sectional study was conducted in department of Periodontics of a tertiary care dental hospital from April to June 2019 after obtaining ethical clearance and informed consent. Participants were recruited by convenience sampling and 183 sample size was calculated. Proforma included demographics, Simplified Oral Hygiene Index, Community Periodontal Index, body mass index, and smoking status. Data were entered in Statistical Package for Social Sciences version 23 and descriptive statistics were presented as frequency, percentage, mean, and standard deviation. Prevalence of periodontal disease corresponding to loss of attachment 1, 2, 3, and 4 was found to in 104 (56.83%) participants. Simplified Oral Hygiene Index score was 1.67±0.89 with "fair" status in majority 114 (62.30%). Gingivitis (Community Periodontal Index 1, 2) was seen in 136 (74.32%). The mean age was 36.37±14.43 years of which 92 (50.27%) were female but smoking was more in males. This study suggests deteriorating periodontal health related to age, sex, oral hygiene, smoking, and BMI. As updated information on oral and periodontal health in Nepal is limited, this assessment would help the national policy makers on oral health intervention measures to prevent periodontitis and develop future programs to improve oral health.

Oral Pyogenic granuloma: Retrospective Review of 49 Cases in a Tertiary Care Dental Institution of Odisha

Pyogenic granuloma (PG) also known as “Lobular capillary hemangioma,” appears as an overgrowth oftissue due to irritation, physical trauma, or hormonal changes in the oral cavity. this present study is on aseries of cases comprising of 49 cases of pyogenic granuloma is the first of its kind reported from EasternIndia. Even though patients usually do not report the hospital for pyogenic granuloma unless the lesionis large and incapacitating, such number in four years is not very less. Therefore it may be deduced thatpyogenic granuloma is not rare in this part of India.

Comparison of Accuracy of Gonial Angle of Orthopantomogram and Lateral Cephalogram for Mandibular Measurements among Orthodontic Patients Attending Tertiary Care Dental Hospital in Kathmandu

Introduction: Gonial angle is an important parameter of the craniofacial complex which is generally used to evaluate the vertical parameters and symmetry of the facial skeleton. Gonial angle can be measured in both orthopantomogram (OPG) and lateral cephalograms. Due to the superimpositions seen while measuring the bilateral strucuture on lateral cephalograms, reliable measurement of the gonial angle becomes difficult. This study is done to clarify the possible application of orthopantomogram (OPG) for evaluating angular measurement of the mandible specifically gonial angle by comparing with lateral cephalogram.
 Materials and Method: All the patients (104) being treated from January 2018 to August 2020 in department of Orthodontics in Nepal Medical College were included in the study. Gonial angle measurements were made on lateral cephalograms and orthopantomograms of 104 patients – 54 males and 50 females with mean age of 22.20 ± 3.25 years. Patients aged 15-35 years were included in the study. Data was processed in SPSS version 16.0.
 Result: Mean Gonial angle in lateral cephalogram was greater than mean gonial angle in OPG and this difference was found to be statistically significant (p-value < 0.05). The difference in mean gonial angle was found to be statistically significant when compared between right gonial angle in OPG and gonial angle in lateral cephalogram (p-value < 0.05) and also between left gonial angle in OPG and gonial angle in lateral cephalogram (p-value < 0.05).
 Conclusion: When gonial angle values obtained from both sides of OPG were compared, no statistically significant difference was found. Significant differences were found when gonial angle values obtained from OPG right and left sides were compared with that of lateral cephalogram.

Prevalence of odontogenic cysts in patients visiting a tertiary Dental Care Hospital in North India- An 8 year experience

Aims and Objectives: The present study aims at evaluation of age, sex and site of occurrence related prevalence of Radicular cyst, Dentigerous cyst, Odontogenic keratocyst (OKC), Lateral Periodontal cyst, Residual cyst, Adult Gingival cyst, Calcifying odontogenic cysts. Materials and Methods: During 8 year period (From 2010 to 2017), 1000 patients with cystic lesions of the jaws were analysed. All patients underwent clinical examination and plain film radiography (panoramic, periapical, and occlusal views). Some of them were referred for CBCT or computed tomography (CT) with a multiplanar reconstruction program (MPR). Age, sex, type of cyst and location were recorded in designed performa. The treatment modalities used for the management of cysts are marsupialization, enucleation, enucleation with bone grafting or resection under local or general anaesthesia depending on the case. Results: Radicular cyst(45.2%) is most common cyst followed by dentigerous cyst(23.2%),Odontogenic keratocyst (13.4%), lateral periodontal cyst(8.9%), residual cyst(4.5%),Calcifying odontogenic cyst (4.4%) followed by the least common occurring adult gingival cyst (1.1%). The mandibular posterior region (41.3%) is most predilected site of occurrence of cysts in orofacial region however maxillary anterior region (17.7%) is least predilected site of occurrence. Conclusion: The radicular cyst is most common cyst of oral cavity while adult gingival cyst is least common cyst. Keywords: Cyst, Jaw bone, Prevalence, Odontogenic, Nonodontogenic.

Knowledge and awareness of dental implants among undergraduate dental students

Introduction: As we know that students doing graduation in dentistry will be future dentists, they should have thorough knowledge about latest technologies in dentistry for treatment of missing teeth. It is the responsibility of these budding dentists for educating the common man about new technologies in dentistry. Thus this study was done to find that how many dental students know about dental implants. Materials and Methods: Our study was a cross-sectional one to find out how many dental students were aware about dental implants from first and second year of a tertiary care Dental College and Research Institute at Bahadurgarh, Haryana. A total of 200 dental students were included in the study. Self-explanatory questionnaire forms which included 5 questions about implants were used for evaluation. Percentage of different responses was calculated to show the results. Results: The present study gives information about dental undergraduates of first and second year students’ knowledge and awareness about dental implants for the treatment of missing teeth. Out of a total of 200 students, 187 returned the completely filled questionnaire. Out of them only 11(5.88%) did not know about implants, rest 176 (94.12%) were aware of implants. Out of these 176 subjects the rest of the questions were asked and percentage calculated as depicted in table. Conclusion: After conducting the present study, it is recommended that the knowledge about dental implants in the curriculum of first and second year dental students needs to be increased, if we want the future dentists to be well informed and confident regarding dental implant therapy. Keywords: Implants, knowledge, awareness, missing teeth.

Impact of pain, psychological-distress, SARS-CoV2 fear on adults' OHRQOL during COVID-19 pandemic.

Corona virus disease (COVID-19) has crippled life, families and oral health care delivery. Hence, we assessed the impact of dental pain, fear of COVID-19 and psychological distress during lockdown on the oral health related quality of life of individuals visiting a tertiary dental care center during COVID-19 pandemic. Cross sectional study conducted among patients between 18 and 60 years. Demographics, access to pain killers, dental care (yes/no), duration (</> 15 days) and intensity of pain were self reported. Fear of COVID-19 was assessed using fear of corona virus scale (FCV-19S); psychological distress in the last 30 days and oral health related quality of life was evaluated. Oral examination was performed and dental caries status (DMFT) was assessed using the world health organization method. Univariate and multivariate regression analysis was conducted to evaluate significant predictors and 5% was set as level of significance. 2966 patients visited our dental emergency due to painful decayed tooth between March-June 2020. Mean age was 42.7 years, 53.97% were males and most common cause of painful teeth was upper right third molar (7.7%). 73.4% reported lack of pain medication; 95% reported closure of dental clinics close to home. Almost 79% suffered from dental pain for >15 days. Higher self reported pain (OR 2.1; 95% CI 1.36–14.71), >15 days of suffering from pain (OR 6.8; 95% CI 2.18–23.14), greater fear of COVID-19 (OR 4.14; 95% CI 1.98–16.07) and psychological distress (OR 4.41; 95% CI 1.09–16.76) were associated with poorer OHRQOL of adults during COVID-19 pandemic. Our findings strongly suggest that COVID-19 pandemic negatively impacts the mental and oral health of individuals affecting their overall health.

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English

Prevalence and Pattern of Canine Impaction and Its Associated Anomalies among Orthodontic Patients Attending Tertiary Care Dental Hospital in Kathmandu

Introduction: Permanent canines are considered as the cornerstone of mouth. Canines are important for esthetics and function as they are located in the anterior segment of the mouth and help in tearing of food. An impacted tooth is that tooth that cannot or will not erupt into its normal functional occlusion due to some circumstances. Those impacted tooth are considered pathologic as they might lead to various problems like resorption of roots of adjacent teeth, cystic formation, and infection with partial eruption leading to pain and trismus.&#x0D; Materials &amp; Method: All the patients (550) being treated in department of Orthodontics in Nepal Medical College from January 2017 to December 2019 were included in the study. Patients aged 13-30 years were included in the study. Clinical examinations and panoramic radiographs of patients were taken. Anterior occlusal view was done in those patients having canine impaction to determine the patterns of impaction. Data was processed in SPSS version 16.0.&#x0D; Result: Among 550 orthodontic patients, 31 patients were found to have canine impaction. Among them 18 (58.1%) were females and 13 (41.9%) were males. The overall prevalence of canine impaction was found to be 5.6%. Various dental anomalies were observed in the participants’ radiographs, the most common being the retained deciduous teeth (54.8%) followed by dilacerations of adjacent teeth (51.6%). Peg shaped lateral incisors and root resorption of adjacent tooth were almost equal (22.6%) with least being the odontomas and other impacted teeth.&#x0D; Conclusion: The prevalence of canine impaction in tertiary care dental hospital in Kathmandu was found to be 5.6%. Patients with impacted canines also had other dental anomalies. Knowing the prevalence of impacted canines, will encourage the community to be aware about canine impaction and educate the population about the clinical implications and the importance of performing preventive and interceptive procedures.

Evaluation of Normal Morphology of Mandibular Condyle: A Radiographic Survey.

Objectives:The temporomandibular joint (TMJ) is a complex, highly specialized joint. Along with the teeth, these joints are considered to be a “tri-joint complex.” Mandibular condyle morphology is characterized by a rounded bone projection with an upper biconvex and oval surface in axial plane. Anatomical knowledge of the TMJ is one of the basic foundations of clinical practice, allowing the understanding of TMJ pathologies and fabrication of condylar prostheses. The cross-sectional descriptive study was undertaken to evaluate normal variation in the condylar morphology on radiographs in persons without TMJ symptomatology and its relation to age, gender, dentition status, chewing habits, parafunctional habits, history of orthodontic treatment, and denture wearing was assessed.Material and Methods:A total of 350 subjects without TMJ symptomatology included in the study were further grouped by age, gender, dentition status, chewing habits, parafunctional habits, history of orthodontic treatment, and denture wearing history. Panoramic radiograph was taken for the assessment of condylar morphology.Results:A significant association between dentition status and bilaterally similar condylar morphology was noticed. Bilaterally similar condyles were seen in 81.4% of subjects. Round-shaped condyles were seen in 176 (62%) persons. Loss of bilateral occlusion tends to alter the condylar morphology. Association between normal chewing habits and bilaterally similar condyle shapes was significant.Conclusion:The study describes the normal morphology of mandibular condyles in a population attending the tertiary dental care center, Kozhikode. The dentition status and chewing habits of individuals had a significant role in determining condylar morphology.

Treatment Approaches During Coronavirus (COVID-19) Outbreak: A Literature Review and Tertiary Care Dental Hospital

Treatment Approaches During Coronavirus (COVID-19) Outbreak: A Literature Review and Tertiary Care Dental Hospital

General Approach for Dental-Oral-Radiographic Examination During New Coronavirus Pandemic and Triage Protocol in a Tertiary Care Dental Hospital

General Approach for Dental-Oral-Radiographic Examination During New Coronavirus Pandemic and Triage Protocol in a Tertiary Care Dental Hospital

Incidence of mid facial fractures in armed forces personnel and their families: a retrospective five year study

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Incidences of mid facial fractures in armed forces personnel and their families is rising due to increase in motorized population and high speed road traffic. The aim of this retrospective study was to determine the incidence, etiology, diagnosis, management and complication of mid facial fractures.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A 5 year retrospective study was conducted at tertiary dental care center at Pathankot, Bathinda and Kolkata. Total of 511 cases of midfacial fractures were managed at this centre. 87% of patients were managed with open reduction and internal fixation and 13% indirect reduction and conservative management. All patients were followed up for at least 1 year. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; 96% patients recovered uneventfully, while 4% patients had post-operative complications such as malocclusion, paraesthesia, enophthalmos, diplopia, facial asymmetry, palpability and exposure of implants.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; The midface is composed of wafer thin sheets of cortical bones which get fractured easily. It is very important to obtain near to facial form, function and aesthetics by reconstructing the horizontal and vertical buttresses of face.&lt;/p&gt;&lt;p class="abstract"&gt; &lt;/p&gt;

Dental Anxiety and its Associated Factors Among Patients Visiting Outpatient Department of Different Tertiary Care Dental Hospitals of Karachi

Objective: To assess dental anxiety and its associated factors among patients visiting OPD of differ- ent tertiary care dental hospitals of Karachi.&#x0D; Methods: A cross-sectional study was conducted from April 2018 to November 2018 in two public and two private dental colleges of Karachi namely Karachi Medical and Dental College, Dr. Ishrat-ul-Ibal Khan Institute of Oral Health Sciences, Hamdard Dental College and Baqai Dental College. Being aged ³ 18 years of either gender were the inclusion criteria whereas refusal for a written informed consent was the exclusion criterion.After checking eligibility and taking written informed consent, a total of 247 participants were interviewed by the principal investigator using a questionnaire which included Corah's Dental Anxiety Scale and Dental Concerns Assessment. Data were entered and analyzed on SPSS version 20. Inferential analysis was performed using chi-square test and Mann-Whitney U test after checking normality. The significance level was kept at 0.05.&#x0D; Results: The study findings revealed that 2.4% of the patients interviewed were severely anxious, 8.1% were highly anxious, 37.2% were moderately anxious while 54.3% were not at all anxious. Moreover, patients with younger age and monthly household income between 16000 and 75000 ru- pees had significantly higher mean dental anxiety scores.&#x0D; Conclusion: The study findings revealed that up to 45.7% patients were anxious up to some degree. There is a need for better understanding of factors potentially increasing anxiety in dental patients in order to avoid them as negative experiences in past are known to trigger dental anxiety in future.

The accuracy of torque wrenches used in a tertiary dental care centre in the UK

The accuracy of torque wrenches used in a tertiary dental care centre in the UK

Children's Oral Health and Barriers to Seeking Care: Perspectives of Caregivers Seeking Pediatric Hospital Dental Treatment.

Objectives:To investigate the demographics of children (and their caregivers) requiring hospital-based tertiary dental care, oral health services use and perceptions of and barriers to oral healthcare in Nova Scotia.Method:A questionnaire was administered to caregivers (N = 62) on behalf of their child (N = 62).Results:Nearly half (45.8%, N = 27) of the caregivers experienced difficulty seeking oral healthcare for both themselves and their children. Less than a quarter (23.2%, N = 13) of the caregivers sought care for their child by the recommended age of one (mean age of first visit = 2.69 years). Alternate delivery in a school, community or primary healthcare setting was preferred by 53.3% (n = 32) of the caregivers for children's oral healthcare. Low-income families (53.8%, n = 28), rural areas (47.4%, n = 27) and Indigenous children (9.7%, n = 6) were over-represented in the study's sample.Conclusion:Socio-economically disadvantaged populations are more vulnerable to oral diseases. Oral health of priority populations in Nova Scotia appears to be inadequately addressed.

Patterns of Tobacco Consumption among Oral Squamous Cell Carcinoma Cases Attending a Tertiary Care Dental Hospital in Coastal Karnataka of India

Patterns of Tobacco Consumption among Oral Squamous Cell Carcinoma Cases Attending a Tertiary Care Dental Hospital in Coastal Karnataka of India

Early childhood caries and dental treatment need in low socio-economic communities in Cape Town, South Africa.

BackgroundEarly childhood caries (ECC) is a particularly severe problem in low socio-economic communities which impacts the overall health and well-being of children. The extensive waiting lists for general anaesthesia and sedation services at the only tertiary dental care centre in the study area for the treatment of children with ECC were an indication of the extent of the problem. The true extent of the problem in this area was, however, not known. This information is crucial in order to plan and execute remedial measures.AimTo assess the prevalence of oral and dental problems, especially ECC, in children under six years of age in the study population, and ascertain their need for dental treatment.MethodsA cross-sectional survey of 659 children from selected schools and clinics in the study area was carried out between 2010 and 2013.ResultsA caries prevalence of 71.6% (472/659) was recorded. Of these, 67.5% (445/659) of children were in need of dental treatment.ConclusionOver the last decade, there has been no improvement in the caries status of children in the study population, and no organised measures have been put in place to address this problem. Awareness needs to be raised so that governments, especially in developing countries, can take appropriate measures to alleviate this public health problem. Time and resources have to be invested in the education of all health professionals dealing with children, by raising their awareness of the early stages of the disease so that timeous referrals can be made.

Practical Skills of Dentists Regarding Medical Conditions Assessment in Dental Offices of A Tertiary Care Dental Hospital, Karachi

Practical Skills of Dentists Regarding Medical Conditions Assessment in Dental Offices of A Tertiary Care Dental Hospital, Karachi