Effectiveness of basic life support training course intervention among dental practitioners and students - An experimental study.

Aim: To determine the level of knowledge and skill of basic life support (BLS) among undergraduate, postgraduate students, and general practitioners with and without regular attendance of the BLS Healthcare Provider course. Methodology: The study was carried out at two intervals with two groups. A random sample involving undergraduate students, postgraduate students, and dental professionals was selected for both study groups. Group 1 with 440 participants had not attended BLS for Healthcare Providers Course in the last two years. Group 2 with 410 participants had attended the BLS for Healthcare Providers course regularly once a year. First, participants in Group 1 were evaluated using an MCQ test with 30 questions about their knowledge and skills in BLS. Then, a well-trained BLS instructor team from Dental College & Hospital offered BLS healthcare provider courses to students and dentists. Subsequently, Group 2 participants who had completed a BLS course for healthcare providers last year were also assessed for their knowledge and skills in BLS using another MCQ test. Results: The marks obtained in the tests were tabulated and analyzed. To determine the association between variables with respect to mean knowledge score, t-test was employed. Multiple group comparison was made using analysis of variance and P < 0.05 was considered statistically significant. The group 1 participants score a mean of 5.7 marks against the Group 2 with a mean score of 27.4 marks out of 30 marks. Knowledge and skill in BLS skills among those in Group 1 without prior BLS training was mainly low. Dental practitioners performed marginally better than students in both groups. Conclusions: Based on the results, we make the following observations. With the introduction of BLS training into the academic curriculum and routine BLS hands-on workshops, all healthcare providers will be familiar with the BLS skills to effectively manage the life-threatening emergencies.

Exploring the Changing Diagnostic Criteria of Gorlin-Goltz Syndrome: A Case Report.

Gorlin-Goltz syndrome, also known as Gorlin syndrome, basal cell nevus syndrome, and nevoid basal cell carcinoma syndrome, is an autosomal dominant genetic disorder. Its hallmark is an early onset of basal cell carcinoma. Additionally, the syndrome is characterized by a spectrum of distinct clinical attributes encompassing oral, skeletal, ophthalmic, neurological, and developmental aberrations. This condition arises due to anomalies in the Hedgehog signaling pathway, leading to constant pathway activity and uncontrolled growth of tumor cells. Early identification of the disorder through available diagnostic methods and clinical and radiological findings is crucial for accurate diagnosis, which subsequently leads to the formulation of an effective treatment regimen. The purpose of this case report is to discuss the role of a dentist in early detection based on various author-prescribed criteria and the need for a multidisciplinary approach to the treatment of patients with this syndrome.

Development of a lead foil crown delineation technique for implant rehabilitations to generate patient specific finite element model of occlusal loading points.

Understanding the clinical biomechanical basis of dental implant supported functional rehabilitation of edentulous jaws improves precision, longevity and overall success of a planned treatment. Stress distribution pattern around dental implants is an important determinant for rate of bone resorption around them. During planning the treatment for most prosthetic rehabilitations, the surgeon uses a software to virtually plan the dimension, position and angulation of the implants considering only the quantity of available bone in the area of interest but does not usually consider the strain generated around the implants after prosthetically loading them. We hence hypothesise that dental implants not be subjected to abnormal strain they should be positioned and angulated not only based on volume of bone available but also based on the vector of occlusal load. The virtual FEA model to analyse the stress distribution would hence require alveolar bone with future tooth/ teeth in centric relation to be modelled. This paper proposes a simple innovative technique to develop a 3D FE model of occlusal loading surface by using a radio-opaque malleable lead foil to generate a patient specific FE model. This would greatly minimise modelling errors and also help determine the best position of the dental implant based on both the volume of bone in the CT scan and the results of FE analyses.•Functional rehabilitation using dental implant supported prosthesis needs to be biomechanically analysed to know and understand the stress distribution pattern around the implant.•When teeth (Loading points) are missing, patient specific virtual model of occlusal loading points cannot be generated.•'Lead foil crown delineation technique' helps to generate patient specific 3D model of occlusal surface for load application.

Inferior alveolar nerve dysfunction in mandibular fractures: a prospective cohort study.

OBJECTIVES: To assess the prevalence and recovery of inferior alveolar nerve dysfunction (IAND) in mandibular fractures. MATERIALS AND METHODS: : This was a prospective cohort study. Clinical neurosensory testing was done preoperatively and the IAND was categorized as mild, moderate or severe. Postoperatively, neurosensory testing was repeated at 1 day, 1 week, 1 month, 3 months and every 3 months thereafter. RESULTS: : A total of 257 patients with 420 fractures were included in the study with a mean age of 31.7 years. Body fractures (95.9%) had the highest incidence of IAND, followed by the angle fractures (90.1%) and symphysis fractures (27.6%). The condyle and coronoid fractures did not have any IAND and hence were excluded from further study. After eliminating those cases, 232 patients remained in the study with 293 fractures. The overall prevalence of IAND in fractures occurring distal to the mandibular foramen was 56.3%. The changes until 1 week were minimal. From 1 month to 6 months, there was a significant reduction in the severity of IAND. A significant number of cases (60.0%) were lost to follow-up between 6 and 9 months. At 6 months, 23.9% of cases still had some form of IAND and 95.0% of the symphysis, 59.0% of the angle and 34.8% of the body fractures with IAND had become normal. CONCLUSION: This study documents the reduction in the degree of severity of IAND in the first six months and provides the basis for future studies with longer periods of follow-up.

Primary Malignant Melanoma of Oral Mucosa - Report of Two Cases.

Primary malignant melanoma of oral mucosa is a rare and aggressive tumor. It is usually seen in the 5th and 6th decades of life. Its mainstay of treatment is surgery. It has a very poor prognosis, which is attributed to its late detection and distant metastasis. Dentists are often the first clinicians to come across these lesions and need to be able to identify them at the earliest for a better prognosis. In this article, we present two cases of extensive primary malignant melanoma of the oral cavity. Clinically, both the cases had a similar appearance of grayish-black pigmented nodular swelling on the buccal aspect and grayish-black discoloration on the palatal aspect. There were no significant radiological changes in both cases, indicating the superficial spread of the lesion. A positron emission tomography scan was performed in the second patient, which did not show any distant metastasis. Surgery was advised as a treatment for both the patients.

Assessment of the Need for Routine Distolingual Local Anesthetic Infiltration in Addition to Traditional Inferior Alveolar, Lingual and Long Buccal Nerve Blocks in Mandibular Third Molar Extractions.

BACKGROUND AND OBJECTIVES: Persistent pain during the removal of mandibular third molars is often due to accessory nerve supply causing inadequate local anesthesia. This study aims to assess the requirement of routine distolingual infiltration anesthesia in addition to traditional inferior alveolar, lingual, and long buccal nerve block in mandibular third molar extractions. METHODOLOGY: Sixty patients requiring mandibular third molar extraction were randomly divided into two equal groups; Group A (Classic inferior alveolar, lingual, and buccal nerve block) and Group B (with an additional 0.2 ml distolingual infiltration). During various steps of the procedure, any complaint of pain was recorded and graded on a subjective Visual Analog Scale (VAS). RESULTS: There was no significant difference between the two groups in regard to age (P = 0.666) and sex (P = 0.432). And also, no difference was found in angulation (P = 0.757), class (P = 0.417) and position (P = 1.000) of third molars. Mean VAS scores in Group B (0.153) were significantly lower (P = 0.004) than that of Group A (0.600). VAS scores during procedural steps were significantly lower in Group B during mucoperiosteal elevation (P = 0.050), bone guttering (P = 0.037), and tooth splitting (P = 0.052). CONCLUSION: Routine distolingual infiltration anesthesia, in addition to classic inferior alveolar, lingual, and long buccal nerve block, is recommended for the extraction of mandibular third molars.

Assessment of Healing Using Alvogyl and Platelet Rich Fibrin in Patients with Dry Socket - An Evaluative Study.

INTRODUCTION: Dry socket is one of the most common postoperative complications following the extraction of permanent teeth, which is characterized by pain and exposed bone. The usual protocol followed for its management is irrigation of the socket and packing of the socket with medicated gel or paste to provide relatively faster pain relief and allow normal wound healing. In this study, we evaluated the outcome of management of dry socket with platelet-rich fibrin (PRF) and intraalveolar alvogyl dressing, in terms of improvement in pain and socket epithelialization after the treatment. METHODOLOGY: Thirty participants with established dry socket were randomly divided into two groups: Group A and Group B. The participants in Group A were treated with alvogyl and those in Group B were treated with PRF. Clinical parameters were assessed for both groups on the 1st day of the procedure and on the 3rd and 10th-day postoperatively for the reduction in pain and wound healing. RESULTS: There was a significant decrease in pain and the number of socket wall exposure in both the groups by the 3rd postoperative day. In both the groups, the pain had completely resolved and socket fully epithelialized by the 10th postoperative day. DISCUSSION: The use of PRF in the present study yielded promising results in terms of both pain reduction and improved wound healing which was comparable to the conventional alvogyl dressing. It may be concluded that PRF is an effective modality for the management of dry socket.