Foundation University Journal of Dentistry

The Essential Role of Patient Safety and Quality of Care Offices in Ensuring Excellence in Dental Institutions

Farhan Raza Khan — Sat, 27 Jan 2024 03:46:33 +0000

Assessing COVID-19 Perceptions, Practices and Vaccine Reluctance Amongst Dental Students and Dentists in Karachi – A Mixed Method Study

Sat, 27 Jan 2024 03:50:38 +0000

Objectives: The coronavirus disease (COVID-19) pandemic has posed a global threat to the lives of many. This mixed-methods study aimed to assess the parameters of knowledge, attitude, and practices concerning the COVID-19 pandemic, along with vaccine hesitancy among the dental fraternity of Karachi, Pakistan.

Materials and Methods: A cross-sectional survey was conducted among 300 dentists, dental students, and faculty of selected dental facilities and institutes in Karachi, Pakistan, from March 2021 to April 2021. A close ended questionnaire evaluated the knowledge, attitude, and practice towards COVID-19. Results were assessed using a scoring system, and a chi-squared test was performed to detect significant (p < 0.05) differences among various variables. To explore the reasons behind the observed attitudes and practices, as well as vaccine hesitancy, semi-structured interviews were conducted with a subset of 21 respondents, selected using purposive sampling. The interview guide was developed to probe participants' understanding of COVID-19, their experiences and challenges in adhering to protocols, and their perceptions and concerns about the COVID-19 vaccine.All interviews were audio-recorded, transcribed, and analysed using thematic analysis.

Results: More than 80% of respondents displayed good knowledge regarding the mode of transmission, diagnostic methods, and symptoms of COVID-19. Less than 50% believed they had adequate training and protocols to treat the affected patients. COVID-19 guidelines on a personal level, like masking and distancing, were followed by almost 90% of the respondents. Several themes emerged from the interviews, including fear and anxiety related to contracting the virus, concerns about the efficacy and safety of the vaccine, perceived lack of support and resources to follow guidelines and scepticism about the government's handling of the pandemic.

Conclusion: We found that the subjects had adequate awareness of COVID-19, but their belief in the government's health policy was negligible. The qualitative findings shed light on the factors contributing to these attitudes and behaviours, including fear, lack of resources, and distrust. Policies should be implemented to improve practices, address fears and misinformation, and enhance the dental fraternity's contribution to the fight against the pandemic.

The Conceptions of Learning: A Qualitative Analysis of Dental Students’ and Teachers’ Perspective at Hamdard University Dental Hospital

Ayesha Basit, Syeda Farhat Bukhari — Sat, 27 Jan 2024 03:53:40 +0000

Objective: To identify learning and teaching conceptions in both students as well as teachers of Dentistry. The spectrum of students’ and teachers’ learning conceptions, presented in this study, is expected to help the teachers better understand their students’ diversified requirements and hence select appropriate teaching strategies.

Materials and Methods: A questionnaire with consent and 5 open ended questions constructed on google forms was distributed to undergraduate students of dentistry, postgraduate trainees, and faculty members. Qualitative analysis of participants’ responses was performed following Association for Medical Education in Europe (AMEE) Guide No 131.

Results: The study participants’ views about a good learner were mainly found to be teacher centred. The undergraduate students were more expressive by using a wide range of words for their learning conceptions and expectations. The main teaching conceptions mentioned by the study participants were behaviour modification in addition to spread of knowledge and facilitation. Teaching was considered an art and a noble profession by the student participants.

Conclusion: The range of conceptions about learning and teaching presented in the study especially by the students, reinforce the need for the teachers to identify them periodically throughout the course. Relating students’ conceptions with one’s own and modifying the teaching strategies, accordingly, contribute to making of an effective teacher.

Maintenance of Dental Hygiene in Various Brushing Practices Among Orthodontic Patients with Multi-Bracket Fixed Appliances

Sat, 27 Jan 2024 03:57:47 +0000

Objectives: To determine the plaque index of orthodontic patients with multibracket fixed appliances in various brushing practices.

Materials and Methods: This cross-sectional study was conducted at the orthodontic department of a tertiary care hospital. The inclusion criteria were patients, aged 15–30 years, of both genders who receive at least six months of treatment with multi-bracket fixed appliances. The patients with restored teeth, mental incompatibility and craniofacial syndromes/anomalies were placed in exclusion criteria. Silness and Loe index for plaque were recorded for each patient. Independent sample t-test and One-way ANOVA were applied to determine the difference in plaque scores for various brushing practices. The level of significance was set at less than or equal to 0.05.

Results: The gender distribution of the study sample came out to be 36.9% males and 63.1% females. Statistically significant differences in plaque scores for the variables like the method of brushing (p = 0.02), practice of brushing (p = 0.009) and timing of brushing (p = 0.001) were seen. Post hoc Bonferroni test showed a statistically significant difference between the variables like once per day and twice per day (p = 0.018), once per day and more than twice per day (p = 0.040) and before breakfast and after breakfast (p = 0.001).

Conclusions: The use of interdental brushing in addition to normal brushing and mouthwash produces minimal improvement in plaque reduction. The male and female subjects comply equally with oral hygiene measures. Brushing twice a day after breakfast and before going to bed significantly reduces plaque in orthodontic patients.

Comparison of Flouride Varnish and Gluma Desensitizer in the management of Dentinal Hypersensitivity

Sat, 27 Jan 2024 03:59:21 +0000

Objectives: Fluoride varnish and Gluma desensitizer have both been used to treat dentinal hypersensitivity and Gluma desensitizer was found more effective than Fluoride varnish. This present study aimed to compare fluoride varnish and Gluma desensitizer in the treatment of dentinal hypersensitivity using a Visual Analogue Scale (VAS).

Materials and Methods: This cross-sectional study was conducted in the Department of Operative Dentistry, Pakistan Institute of Medical Sciences, Islamabad from November 2021 to May 2022. Using a non-probability consecutive sampling technique, sixty patients were included in the study. The total subjects were randomly divided into two groups, group A was to signify Gluma Desensitizer (Heraeus Kulzer, Hanau, Germany) and group B was to signify fluoride varnish (Duraphat, Colgate Oral Pharmaceuticals, New York). After the procedure, patients were clinically evaluated for pain in response to thermal, tactile and air stimuli on VAS at baseline and after 01 month.

Results: Amongst the chosen subjects, 25 years was the minimum age while 70 years was the maximum age with a mean ± standard deviation of 45.18±15.59 years. By using an independent sample t-test, it was observed that effect modifiers like age and gender were not statistically significant at the starting point, but it was statistically significant after treatment for both groups A and B.

Conclusion: Based on the evidence-based findings of the present study, it is concluded that Gluma desensitizer was better at controlling dentinal hypersensitivity than fluoride varnish.

Comparison of Carbamazepine Alone and in Combination with Gabapentin as Medical Therapy to Control Pain Associated with Trigeminal Neuralgia

Sat, 27 Jan 2024 04:02:17 +0000

Objective: To investigate mean pain scores in patients of trigeminal neuralgia treated with Carbamazepine alone and in patients given combination therapy of Carbamazepine with Gabapentin after 4 weeks of starting therapy.

Materials and Methods: A prospective clinical study was undertaken at the Department of Oral and Maxillofacial Surgery, Armed Forces Institute of Dentistry, Rawalpindi from July 2019 to March 2020. The first group received 100 mg of Carbamazepine twice daily and the second group received 100mg of Carbamazepine along with 300mg of Gabapentin twice daily. The patient was instructed to grade the intensity of pain on the Visual Analogue Scale (VAS) every week for four weeks after initiation of therapy. Mean pain scores for the week were calculated and compared.

Results: A total of 80 respondents were recruited with a mean age and standard deviation was 48.69 ± 11.8 years. A comparison of the mean VAS score of 3rd week in both groups revealed that there was a significant difference (p<0.001). Similarly, by week four, the difference between VAS scores of Groups A and B differed significantly (p=0.007). Age and gender did not significantly impact the postoperative VAS pain score at four weeks of follow-up.

Conclusion: The combination of Carbamazepine with Gabapentin resulted in better pain control in patients with trigeminal neuralgia as compared to Carbamazepine. Mean VAS score after 4th week in both groups Group A (Carbamazepine alone), and Group B (Carbamazepine plus Gabapentin), it was found that there was a significant difference between both groups and a significantly lower mean pain score was found in Group B as compared to Group A.

Prevalence of Dens Invaginatus in Maxillary Lateral Incisors in Patients Visiting Peshawar Dental College and Hospital

Iftikhar Akbar, Rizwan Qureshi, Saifa Rashad, Marghalara Noor — Sat, 27 Jan 2024 04:05:17 +0000

Objective: Dens Invaginatus is a developmental abnormality that may be found in any tooth but is most commonly noticed in maxillary lateral incisors. This study aimed to find out the prevalence of Dens Invaginatus in maxillary lateral incisors in patients reporting to Peshawar Dental College.

Materials and Methods: The study design was descriptive cross-sectional and conducted in Peshawar Dental College in the Department of Operative Dentistry and Endodontics from December 2021 to May 2022. Four hundred and twenty-eight patients' maxillary lateral incisors were examined clinically for any pit or groove on the palatal surface. Teeth with any clinically detected pit or groove were then confirmed radiographically and the questionnaire was filled. The chi-square test was used to analyze variables such as gender, type and whether dens invaginatus involvement was unilateral or bilateral. P ≤ 0.05 was set significant.

Results: Dens Invaginatus was found in 25 of 428 subjects, with a prevalence of 5.8%. The age of the patients ranged from 12 to 71 years with a mean age of 35±13 years. There were 11 (4.6%) females and 14 (7%) males with Dens Invaginatus. Type I (71%) was the most frequently seen, type II (16%), and type III was seen in 13% of patients. Dens Invaginatus were noticed on both sides in 14 (7%) patients and on one side in 11(4.6%) patients.

Conclusion: The prevalence of Dens Invaginatus in maxillary lateral incisors was 5.8% in Peshawar region. Lateral Incisors were more bilaterally involved. Type 1 Dens Invaginatus were more commonly involved which requires minimal intervention to seal them.

Self-Perceived Dental Public Health Competencies of Dental Graduates: A Comparison of Traditional and Modified Curricula in Karachi

Sat, 27 Jan 2024 04:08:46 +0000

Objective: To compare self-perceived dental public health competence in fresh dental graduates, learning through traditional and modified dental curricula in private dental colleges of Karachi.

Materials and Methods: Across-sectional study with a self-administered questionnaire (21 items) on a 3-point Likert scale was conducted with dental graduates of four private dental colleges in Karachi. Data were analyzed using SPSS version 23. Mean and SD were reported for age and self-perceived competency scale items were analyzed by applying an independent t-test.

Results: 255 participants completed the survey (response rate=88.5%) with a mean age of 24.02±0.832 (male 24% & female 76%) ranging from 22 to 26 years. The graduates were of almost equal number from both the groups (T=51%, M=49%). Graduates who learnt public health from a traditional curriculum had a higher perception of their competence compared to the modified curriculum group with a significant p-value=0.04.

Conclusion: This study identified that overall fresh dental graduates perceived themselves competent enough to deal with dental public health issues. Moreover, dental graduates who studied from the traditional curriculum perceived themselves as more competent in most aspects of dental public health competency than those who learned from the modified curriculum.

Perception of Pain after Insertion of Mini-Screws in Orthodontic Patients

Ruhamaa Arshad, Amjad Mahmood — Sat, 27 Jan 2024 04:11:19 +0000

Objective: To measure the pain perceived by the patient after the insertion of an orthodontic mini screw.

Materials and Methods: It was a descriptive cross-sectional study conducted in the Out-Patient Department of Orthodontics, Margalla Institute of Health Sciences, Rawalpindi for 8 months. The sample size used was 35. Self-drilling mini-screws (8mm x 1.6mm) were manually inserted. Patients were asked to report pain scores at 1 hour, 12 hours, 24 hours and 1 week on a Visual Analogue Scale. Data was analysed using Statistical Package for Social Sciences (SPSS) 21. Analysis of variance was used to compare the pain score at different time durations. The level of statistical significance was P≤ 0.05.

Results: There were 11 (31.4%) males and 24 (68.6%) females with a mean age of 18.66±3.404 years. The mean pain scores up to 1 hour was 0.83±1.014, from 1-12 hours was 1.06±1.083, from 12–24 hours was 0.14±0.355 and from 24 hours-1 week was 0±0. Out of the total, five (14.3%) patients had to take analgesia in the first hour, while during 1–12 hours, 12–24 hours and 24 hours per week, nine (25.7%), seven (2.9%), and zero took the analgesics respectively.

Conclusion: The pain experienced with mini-screw insertion is low. The greatest pain was recorded in 1-12 hours following insertion, after which it started to decrease.

Assessing the Interrelationship of Obesity Indicators with Periodontal Health in a Cohort of Pakistani Population

Sat, 27 Jan 2024 04:13:19 +0000

Objectives: Obesity is a growing public health concern worldwide, linked to various systemic diseases, including periodontitis. The study aims to evaluate the association between periodontitis and obesity using Body Mass Index and Waist-Hip Ratio.

Materials and Methods: The study was conducted at Bahria University Dental College, recruiting 120 patients (72 females, 48 males) from the dental OPD. Participants were categorized into three groups based on their BMI: Normal, Overweight, and Obese. Periodontal parameters were measured and compared among these groups.

Results: It was observed that the majority of the obese subjects had PPD in the range of 0–3 mm while 9 of the obese subjects had pocket depth in the range of >3 mm and < 6 mm (p=0.02). The values of CAL were also observed more in obese subjects (p=0.01). The BOP was also positive in 23 obese subjects followed by 12 subjects in the overweight category (p=0.03). The calculus deposition and 4-5 mm pocket depth were also observed in 10 and 11 obese subjects, which is higher than the number observed in other groups (p<0.001). No statistically significant correlation between WHR was observed with PPD and BOP. However, CAL had a significant association with WHR (p=0.01). The correlation between CPI and WHR was also statistically significant (p=0.001).

Conclusion: The study demonstrates a positive association between markers of periodontal health and obesity. This suggests that obesity may be a potential causal factor in the development of periodontitis.

Neutral Zone Technique: Patient with a Severely Atrophic Mandibular Ridge

Sat, 27 Jan 2024 04:14:45 +0000

One of the leading issues faced by prosthodontists today is making a prosthesis for a severely resorbed residual ridge. Ridge resorption is a multi-factorial process that is both irreversible and progressive. This condition causes a decrease in the occlusal vertical dimension, sulcular depth and an overall decrease in the lower facial height. To counter this issue, the neutral zone technique is used to construct a removable prosthesis. The aim is to strike a perfect balance between the forces of the lip, cheek, and buccal mucosa. The area where all these forces cancel out is called the neutral zone. Tooth placement is done in this region to achieve optimum stability of the prosthesis to aid in the lack of retention because of the resorbed residual ridge.