Foundation University Journal of Dentistry

Multicenter, Cross-sectional Survey on Oral and Maxillofacial Surgery Cases and its Management in Pakistan during the COVID-19 Pandemic: A National Perspective

Mor Khan Shar — 2025-07-30

Objective: The objective of this study was to perform a multicenter, cross-sectional analysis to assess the maxillofacial cases presented and their management in a Pakistani population during the COVID-19 Pandemic along with academic activities.
Materials and Methods: The study was conducted from April 30, 2020, to Oct 30, 2020, in different maxillofacial centers across the country. The questionnaire aimed to elicit information regarding the maxillofacial services provided during the pandemic, the use of personal protective equipment, the effect on academic activities, the development of new standard operating procedures, and other aspects. All these data were collected through an online Performa and data was analyzed through SPSS 23.0v.
Results: The results showed that the COVID-19 pandemic has adversely affected maxillofacial services provided in Pakistan. Elective surgeries have been largely reduced whereas emergency services are being delivered in all centers. Academic activities have been negatively impacted, and alternate means of communication are being employed. The provision of personal protective equipment has become the focal point in delivering health services along with the formation of standard operating procedures for managing patients during the pandemic.
Conclusion: Maxillofacial surgeons must remain updated to use the information and inform new guidelines to help patients in a way that minimizes the risk to the operating team and provides the best level of care to the patients during this crisis.

Frequency and Risk Indicators of Dental Caries in Schoolchildren of Rawalakot, Azad Jammu and Kashmir

Shahid Iqbal — 2025-07-30

Objective: The study evaluated the frequency of dental caries and their risk indicators among schoolchildren elevated and living in areas of low fluoridated. These indicators included socioeconomic status, toothbrushing habits, sweets consumption, pattern of dental visits, and salivary mutans streptococci levels (assessed only in 12-year-olds).
Materials and Methods: This community survey was conducted in schoolchildren of Rawalakot, Azad Jammu and Kashmir (AJK). The study children included a random sample of three age groups: 6 years (n=450), 12 years (n=230), and 15 years (n=180) from randomly selected schools in Rawalakot, AJK. For the study conducted between February and May 2023. The dmft (decayed, missing, and filled primary teeth) and DMFT (decayed, missing, and filled permanent teeth) and decay-missing-filled surfaces (dmfs/DMFS) indices were employed to document the frequency of caries.
Results: In 6-year-olds, the caries-free frequency in primary dentition was 58%. The dmft and dmfs mean was 1.9 and 3.7 respectively, while the score of DMFT and DMFS was 0.5. Nearly 90% of dmft score was due to active decay. Children with lower socioeconomic status had significant high dmft and dmfs scores, as well as a greater proportion of individuals with a combined dmft + DMFT score of ? 1. Among 12-year-olds, 55% had caries history, with mean DMFT and DMFS scores of 1.5 and 2.2, respectively. The filled component constituted the majority of scores. Children were mostly caries-free and had lower DMFT, DMFS, and DT scores if they regularly visited dentist for routine checkups, had higher socioeconomic status (although this not being associated to DMFT), frequently less consumed sweets, and had lower levels of streptococcus mutans. Among 15-year-olds, 70% had a history of caries, with mean of 1.7 DMFT and 3.5 DMFS scores, and a high frequency of the filled teeth (FT).
Conclusion: Children who regularly visited dentist for routine checkups had significant low caries experience, as well as low DMFT, DMFS, and DT scores, compared to those who attended irregularly. Additionally, children from lower socioeconomic backgrounds mostly have high DMFS scores.

Comparison and Assessment of Communication Skills in Traditional and Integrated Undergraduate Dental Education

Warda Zafar — 2025-07-30

Objective: To compare and assess the communication skills of undergraduate dental students of traditional and integrated system of education.
Materials and Methods: Verbal and written consent was taken from dental students. They were then observed while interacting with patients during their clinical rotation using Kalamazoo Essential Communication Checklist (adapted) KEECC-A. KEECC-A consists of seven items scale on which scoring was done and these items corresponds to seven elements of a doctor’s communication. All the obtained data was then put into SPSS to obtain comparison of Means and Levene’s test. Results were derived based on data obtained.

Result: A total 100 of dental students were observed during their clinical rotations, and were assessed using Kalamazoo Essentials Elements Communication Checklist(adapted) KEECC-A. It consists of seven items, the means of item 1: Builds a relationship, for group-a and group-b is same whereas the means of item 2: Opens the discussion, item 3: Gathers information, item 4: Understands the patient’s perspective, item 5: Share information, item 6: Reaches agreement, item 7: Provides closure, have significant difference in their values. Group-b has higher means, which shows the students in this group have done better. Levene’s test result shows only Item-1 have a value of p higher than 0.05, whereas (item-2) to (item-7) have value of p less than 0.05, which shows significant difference between both groups.
Conclusion: The conclusion of this study is that dental students from integrated system have done well in (item 2) to (item-7) and performance of item-1 in both group-a and group-b is similar. Therefore, it is concluded that an integrated system is better than a traditional system.

Pre-Operative Anxiety Patterns in Patients Undergoing Impacted Lower Third Molar Extraction

Erum Riaz — 2025-07-30

Objective: This study aims to determine the correlation between the State-Trait Anxiety Inventory (STAI-S) and the Amsterdam Preoperative Anxiety and Information Scale (APAIS) before the extraction of impacted third molars.
Materials and Methods: Patients reported to the OMFS department for the extraction of impacted third molars were selected based on a thorough history, clinical examination, and radiographic evaluation. During their initial visit, patients completed the STAI-S and STAI-T scales to measure their anxiety levels. Following the completion of these scales, detailed information about the surgical and anesthetic procedures, as well as potential complications, was provided. Informed consent was obtained. Prior to the surgery, patients completed the APAIS to measure their dental anxiety.
Results: A total of 50 patients, comprising 13 males and 37 females, having a mean age of 28.86 ± 5.85 years. The average scores on the APAIS and STAI-S scales were 17.06 ± 2.49 and 23.48 ± 2.35, respectively. A positive correlation (r = 0.606) was observed between the APAIS and STAI-S scales before the removal of impacted third molars.
Conclusion: The study concludes that there is a positive correlation between the STAI-S and APAIS scales in patients before the extraction of impacted third molars.

The Correlation between Chronological Age and Cervical Vertebral Maturation Stages in Adolescent Female Orthodontic Patients of South Punjab

Anam Akram — 2025-07-30

Objective: The aim of this study was to assess the correlation between the chronological age at menarche and peak of skeletal maturity using cervical vertebral maturation stages (CS) on lateral cephalometric radiograph in the female orthodontic patients of south Punjab.
Materials and Methods: Lateral cephalograms of 100 female patients (9-15 years) were collected from the outpatient department (OPD) of Orthodontics department, CIMS Dental College, Multan. CS stages were determined on lateral cephalometric radiograph using the latest Bacetti’s CS method. The patients self-reported their menarcheal ages and were confirmed by the patients’ mothers. The association between CS and chronological age at menarche was evaluated.
Results: In this study, menarche was observed to occur between the ages of 12 and 13 years, corresponding to CS3 and CS4. The correlation coefficient between chronological age and CS was found to be 0.588, indicating a moderate to strong positive correlation
Conclusion: Cervical Vertebral Maturation is correlated moderately with the chronological age. For a better assessment of peak pubertal growth in females, history of menarche should be considered.

Formulation of Dispersible Tablet Based on Extract from Cassia Fistula Leaves and Evaluation of its Anti-Fungal Effect on Heat Cure Acrylic Resin

Uzma Hasan — 2025-07-30

Objective: The objective of this research paper was to investigate the antifungal outcome of dispersible tablets based on cassia fistula leaf extract on acrylic resin infected with candida albicans.
Materials and Methods: This cross-sectional analysis was piloted at the G7 campus of Riphah International University from January 2017–January 2019. For this, the ethanolic extract of cassia fistula leaves was obtained and the excipients for the tablet along with the extract obtained were mixed. This mixture was then proceeded through a sieve to acquire granules which were dried and compressed. Afterward, acrylic discs were prepared and inoculated with candida albicans. These discs were then soaked overnight in three different tablet solutions including the placebo tablet solution. The discs were removed after 24 hours and inoculated into a specific media, Sabouraud Dextrose Agar.
Results: The formulated tablet based on cassia fistula leaf extract was found to be equally effective when compared to the commercially available tablet (Poligrip) showing no growth of candida albicans on the SDA plates
Conclusion: The study concluded that the formulated denture cleansing tablets based on extract obtained from cassia fistula leaves could be used as a prophylactic denture hygiene measure against candida albicans and staphylococcus aureus. Denture cleansing tablets based on natural sources can be equally effective as compared to chemical-based formulations in addition to being not only non-toxic, and non-irritant, but also cost-effective.

Frequency of Autoimmune Disorders in Patients of Alopecia Areata: A Cross sectional Survey

Furqan Haider — 2025-07-30

Objective: To evaluate the frequency of autoimmune disorders in alopecia areata patients.
Materials and Methods: The study enrolled 200 patients diagnosed with alopecia areata, ranging in age from 18 to 65 years. Each participant was evaluated for the presence of autoimmune conditions such as autoimmune thyroid disorders, vitiligo, systemic lupus erythematosus (SLE), and psoriasis—using both clinical examination and relevant laboratory investigations.
Results: Out of the 200 patients of alopecia areata, autoimmune disorders were identified in 25% (n=50). The most frequent disorder was hypothyroidism, observed in 30 patients (15%). Other disorders included vitiligo in 11 patients (5.5%), systemic lupus erythematosus (SLE) in 5 patients (2.5%), hyperthyroidism in 4 patients (2%) and psoriasis in 3 patients (1.5%).
Conclusion: Alopecia areata is commonly linked with various autoimmune conditions, with hypothyroidism being the most prevalent. These findings underscore the importance of screening alopecia areata patients for autoimmune comorbidities, particularly thyroid disorders.

Comparative Analysis of Post-Dental Surgery Outcomes: Focus on Dry Socket and Mouthwash Practices

Yosra Saeed — 2025-07-30

Objective: Dry socket, alveolar osteitis, or alveolitis also called fibrinolytic alveolitis is a common complication subsequent to tooth extractions, leading towards significant post-operative pain. While its particular cause remains indistinct, factors such as bacterial contamination and infection, smoking, traumatic extractions, and fibrinolytic activity contribute to its incidence. In this study it is intended to assess the effectiveness of 0.12% chlorhexidine mouthwash in pre-op extraction is effective in reducing the incidence of dry socket and post extraction pain.
Materials and Methods: A total of 200 patients which required tooth extraction were included in study, with 102 assigned to the test group (mouthwash users) and 98 to the control group (non-mouthwash users). The test group rinsed with 10 mL of 0.12% chlorhexidine mouthwash 2x, twice daily for four weeks before the procedure of extraction. Pain was measured/ evaluated using the Visual Analogue Scale (VAS) at 72 hours post extraction. Chi-square tests were used for statistical analysis (?=0.05).
Results: Dry socket frequency was significantly reduced/ lower in the mouthwash group by (13.7%) compared to the control group (71.4%) (p=0.001). Pain levels were also reduced, with approximately 53.9% of mouthwash users pre-op extraction were reporting no pain (VAS=0) versus 13.3% in the control group. Smoking and spitting were significantly associated with dry sockets (p=0.001), but there was no correlation found with respect to gender, age, extraction site, or extraction type.
Conclusion: Chlorhexidine mouthwash usage suggestively and significantly reduces alveolar osteitis/dry socket and therefore post-extraction pain. Smoking remains a chief risk factor, accentuating the importance of patient education on discarding smoking and usage of antiseptic mouthwash for improved healing.

Evaluating the Competency of Dental Students and House Officers in Inferior Alveolar Nerve Block with Clinical Training Reinforcement

Aman Ahmad — 2025-07-30

Objective: This study aims to assess the competency of dental students and house officers in performing the inferior alveolar nerve block, focusing on the impact of reinforced clinical training.
Materials and Methods: A cross-sectional study was conducted using non-probability consecutive sampling. A total of 90 dental students and house officers were evaluated before and after clinical reinforcement to assess their proficiency in performing inferior alveolar nerve block (IANB). Data analysis was conducted using SPSS version 25.
Results: The results revealed a significant improvement in the participants’ ability to correctly identify anatomical landmarks after clinical reinforcement, which contributed to more effective IANB administration.
Conclusion: Focused clinical reinforcement significantly enhances the competency of dental practitioners in performing the IANB, leading to improved outcomes for both practitioners and their patients.

Fractured Systems and Fading Funds: Rebuilding Resilient Health Systems in Low Middle-Income Countries amidst Economic, Security and Policy Instability

Sanaa Masood Aslam — 2025-07-30