Dental health status and oral health behaviours of patients with facial burn in Pakistan.

BACKGROUND: There is a limited understanding about the oral health of patients with facial burn, hence the aim was to describe the oral health status and the related risks factors. METHODS: This cross-sectional study had randomly and systematically recruited facial burn patients from the Burn Care Center, Pakistan Institute of Medical Sciences, Islamabad, from June of 2016 to July of 2017. Intraoral examination recorded the DMFT, CPI and OHI-S. Information on the socio-demographic status, self-perceived oral health, oral health behaviours were collected using a self-administered questionnaire and; the burn characteristics were obtained from the patients' medical record. The t-test, ANOVA, SLR, and chi-square test were used to examine the relationship between oral health and each factor. A parameter was derived from the clinical indices using the principal component analysis and used in the multiple linear regression analysis to determine the important factors associated with oral health status. RESULTS: A total of 271 burn patients (69% female and 31% male) had participated in the study. All of the participants had caries with mean DMFT = 10.96 (95%CI: 10.67, 11.25). There were 59.0% (95%CI: 53.15, 64.93%) and 66.1% (95%CI: 60.38, 71.73%) of the participants who had periodontitis and poor oral hygiene respectively. About 79 and 80% of the participants rated their dental and periodontal status as poor. About 78% reported brushing once daily and 89% did not practice regular dental visit. The DMFT, CPI and OHI-S were associated with the burn characteristics and oral health behaviours (p < 0.05). Dental anxiety, cost and social issues were the most cited reasons for not utilising oral health services. Greater burn severity, the longer time elapsed since the burn incident, and dental anxiety were associated with poorer oral health status and; brushing twice or more and regular dental visit, with better status (p < 0.01). CONCLUSION: Patients with oro-facial burn injury had a generally poor oral health and, the risks are greater in those with a more severe and wider area of injury, the longer time elapsed since the burn incident and dental anxiety; but a good oral hygiene practice and regular dental visits were protective against the risk.

Integrated undergraduate dental curriculum.

OBJECTIVE: To develop a blueprint for producing an integrated undergraduate curriculum for dental schools in the region. METHODS: The study framework was designed at Islamic International Dental College- Riphah International University, Islamabad during May 2016-January 2017. Integrated curriculum was developed by using themes described as modules, such as organs, science of oral diagnosis, aesthetics and dental rehabilitation. Contents or topics from different disciplines having similar focussed learning outcomes were united in one particular module. Horizontal and vertical homogenisations of various modules were achieved by displaying them in a specific way on Bloom's ladder . RESULTS: All modules were free of boundaries of traditional subjects. For example, dental emergency was a theme (module) which carried assorted contents associated with dental emergency from endodontic, oral surgery, prosthetic disciplines etc. CONCLUSIONS: The framework provided an outline and pattern to develop integrated undergraduate curriculum for dental schools.

Comparison of in-vivo failure of single-thread and dual-thread temporary anchorage devices over 18 months: A split-mouth randomized controlled trial.

INTRODUCTION: The purpose of this study was to compare the in-vivo failure rates of single-thread and dual-thread temporary anchorage device (TAD) designs over 18 months. METHODS: Thirty patients with skeletal Class II Division 1 malocclusion requiring anchorage from TADs for retraction of maxillary incisors into the extracted premolar space were recruited in this parallel group, split-mouth, randomized controlled trial. A block randomization sequence was generated with Random Allocation Software (version 2.0; Isfahan, Iran) with the allocations concealed in sequentially numbered, opaque, sealed envelopes. A total of 60 TADs (diameter, 2 mm; length, 10 mm) were placed in the maxillary arches of these patients with random allocation of the 2 types to the left and the right sides in a 1:1 ratio. All TADs were placed between the roots of the second premolar and the first molar and were immediately loaded. Patients were followed for a minimum of 12 months and a maximum of 18 months for the failure of the TADs. Data were analyzed blindly on an intention-to-treat basis. RESULTS: Four TADs (13.3%) failed in the single-thread group, and 6 TADs (20%) failed in the dual-thread group. The McNemar test showed an insignificant difference (P = 0.72) between the 2 groups. An odds ratio of 1.6 (95% confidence interval, 0.39-6.97) showed no significant associations among the variables. Most TADs failed in the first month after insertion (50%). CONCLUSIONS: The failure rate of dual-thread TADs compared with single-thread TADs is statistically insignificant when placed in the maxilla for retraction of the anterior segment. Registration: The trial was not registered before commencement. PROTOCOL: The protocol was not published before the trial.

DENTAL ANXIETY AMONG CHILDREN OF AGE BETWEEN 5 TO 10 YEARS VISITING A TEACHING DENTAL HOSPITAL IN ISLAMABAD, PAKISTAN.

BACKGROUND: The assessment of dental anxiety among children will aid in dealing with management issues related to dental treatment. There is no study available from Pakistan on dental anxiety in children. The aim of this study was to assess the prevalence of dental anxiety in children attending a teaching dental hospital in Islamabad, Pakistan. METHODS: A cross-sectional study was conducted on 252 children aged between 5-10 years attending a dental clinic in a dental hospital in Islamabad, Pakistan. Dental anxiety was assessed by using the Faces Version of the Modified Child Dental Anxiety Scale. This scale uses faces as pictograms to indicate the levels of dental anxiety making it easier for children to answer the questionnaire. RESULTS: A total of 252 children were observed for assessment of dental anxiety having mean age of 7.88±1.55 years with 123 (48.8%) males and 129 (51.2%) females. Out of these children 150 (59.5%) had previously visited a dentist and 102 (40.5%) had no experience with a dentist before; 38% (95/252) of children had moderate and severe dental anxiety. Dental anxiety decreased significantly with age (p=0.0003). The difference in anxiety levels was not statistically significant between males and females and in different socio-economic status. CONCLUSION: This study has highlighted dental anxiety as a potential public health concern regarding children in Pakistan. Assessment of dental anxiety is a useful way to identify anxious dental patients.

Predicting Success: A Comprehensive Analysis of High School and Admission Test Scores on Future Academic Performance of Dental Students.

Introduction Dental school admissions in Pakistan traditionally rely on Higher Secondary School Certificate (HSSC), University of Health Sciences (UHS), and National Testing Service (NTS) scores, with limited research available on their predictive validity for dental school performance. This study aims to investigate the correlation between a student's first-year dental school performance and their HSSC, UHS, and NTS scores. Methods A total of 282 records, spanning the years 2016 to 2020, were obtained from a single private dental institution. The data included HSSC, UHS, and/or NTS scores, with the first professional examination results as the dependent variable. Statistical analysis was conducted using the Statistical Package for the Social Sciences (IBM SPSS Statistics for Windows, IBM Corp., Version 25.0, Armonk, NY), encompassing descriptive statistics, Pearson's correlation coefficients, and multiple regression analysis. Results Pearson's coefficients revealed weak to moderate positive correlations between the first professional examination and HSSC (r=0.209, p<.01), UHS (r=0.344, p<.01), and NTS (r=0.350, p<.01), all statistically significant at p < 0.01. Multiple regression analysis indicated that UHS scores contributed the highest explanatory power (R² = 0.146) in predicting first professional examination results. Conclusion A positive correlation between HSSC, UHS, and NTS scores with dental students' performance in the first professional examination is observed. However, the correlations are moderate, highlighting the importance of incorporating assessments that consider cognitive, behavioral, and skill-related aspects in admissions processes. Given the evolving landscape of dental education, these findings underscore the need for a holistic approach to identify candidates better equipped to serve the healthcare sector.

Utilization of three-dimensional framework theory in identifying the motivational factors for selecting a postgraduate dental specialty-A pilot study.

OBJECTIVES: Three-dimensional framework theory classifies factors influencing career selection into intrinsic, extrinsic, and interpersonal dimensions. The objectives of this pilot research were to assess the psychometric properties of a scale encompassing factors affecting post-graduation specialty selection according to three-dimensional framework theory and identify motivational factors that affect dental students' and interns' choice of post-graduation specialty. METHODOLOGY: A closed-ended self-structured research instrument consisting of a list of 19 factors was presented to dental students and dental interns at Margalla Dental College, Rawalpindi, Pakistan, and Islamic International Dental College, Islamabad, Pakistan (n = 235). Exploratory factor analysis and Cronbach-alpha (α) were used to assess the construct validity and reliability (internal consistency) of the scale respectively. Descriptive analysis and non-parametric tests were used for data analysis with a level of significance at ≤0.05. RESULTS: A 3-factor solution with 11 items was stabilized. Cronbach-alpha of the pilot study turned out to be 0.72. With a response rate of 92.15%, the most common motivational factor affecting post-graduation specialty selection was the Intrinsic factor "personnel joy and motivation to work hard." Dental interns and male participants were more likely to select the post-graduation specialty due to intrinsic motivational factors (p < 0.05). Inspiration from the family member and supporting the family also influenced male participants and interns respectively (p < 0.05). Female participants preferred to choose a less saturated field (p < 0.05). A medium positive statistically significant correlation was observed between the interpersonal motivational factor "inspiration by a teacher" and the choice of "basic sciences" as a post-graduation specialty (p < 0.01). CONCLUSION: This pilot study resulted in the development of a scale with a 3-factor solution stabilized at 11 items. The internal consistency of the scale turned out to be 0.72. Oral and maxillofacial surgery was the first choice of post-graduation chosen by 35.5% of the respondents. Fellowship was chosen as the preferred type of post-graduation by 46% of the respondents. Irrespective of gender and designation, the top most influential factor, chosen by 88.5% of the respondents, was the intrinsic motivational factor "personal joy and motivation to work hard."

Fabrication and evaluation of Bis-GMA/TEGDMA resin with various amounts of silane-coated silica for orthodontic use.

The objective of this research was to fabricate a composite with an optimum filler level in a bisphenol-A-glycidyldimethacrylate (Bis-GMA) triethylene glycidal dimethacrylate (TEGDMA) resin for bonding of metallic orthodontic brackets to achieve the best handling characteristics with optimum bond strength and without compromising the mechanical properties of the adhesive. One-hundred and sixty extracted human premolars free of any detectable pathology or buccal surface alterations were collected and divided into four groups. In group 1 (control), the teeth were bonded with stainless steel brackets using Transbond XT. In groups 2, 3, and 4, the teeth were bonded with metal brackets using a Bis-GMA/TEGDMA resin with 80, 60, and 20 per cent by weight silane-coated silica of a spherical shape with a mean size of 0.01 µm. Shear bond strength (SBS) of the composites was determined and the adhesive remnant index (ARI) and enamel fracture post-debonding were assessed. According to one-way analysis of variance and Tukey's honestly significant difference (HSD) multiple comparison tests, the SBS of group 4 (10.54 MPa) was considerably less than that of groups 1 (26.1 MPa), 2 (25.5 MPa), and 3 (24.6 MPa). Chi-square analysis revealed that there was an insignificant difference in the incidence of enamel fracture between groups 1 and 2, while a significant difference was present between groups 1 and 2 and 3 and 4. An insignificant difference was also observed in the location of the adhesive failure between the four groups. While all the bonding adhesives tested can be safely used for bonding of brackets, 60 per cent filled Bis-GMA/TEGDMA was superior clinically due to its ease of handling and superior bond strength.

Custom made nickel titanium intrusion arch, fabrication and evaluation.

UNLABELLED: Correction of deep bite by intrusion of incisors is an important and cumbersome target to achieve. This article describes an easy and rapid method of fabricating a custom made nickel titanium intrusion arch to achieve this objective. CLINICAL RELEVANCE: A custom made intrusion arch is more effective, comfortable, easily available and cost effective than a preformed one.

Professionalism development of undergraduate medical students: Effect of time and transition.

ABSTRACT: Changeover phases are essential and inevitable times in professional life, which let the learners adapt and grasp emerging opportunities for learning based on the past experiences with the catering of novel creativity as required in the present as well as emerging time. This study was carried out to examine the effectiveness of a professionalism course, during the transition from a non-clinical to clinical setting, within the context of undergraduate medical education.This observational study was conducted during 2019 to 2020, with pre- and post-professionalism course evaluation. We used the Dundee Poly-professionalism inventory-1: Academic Integrity, among the undergraduate medical students.Our results are based on the medical student's professional progress with the transition from 2nd year to 3rd year. During the 1st phase of the study, the participants at their Pre-Professionalism Course (PrPC) level in their 2nd medical year (only attended the introductory lectures for professionalism), showed a good understanding of professionalism. For the 2nd phase, when the same students, at their Post-Professionalism Course (PoPC) level, in their 3rd year (completed professionalism course) filled the same survey and it was found that there was no decline in their understanding of the topic, even after more than a year. They were even more aware of the significance of professionalism in their clinical settings.Despite a year gap, the understanding of professionalism among students was stable. Results helped us infer that time laps did not affect the professionalism concept learned earlier; rather during clinical settings, students become more aware of professionalism.

Iatrogenic damage in orthodontics: aetiology and prevention.

UNLABELLED: The purpose of this article was to analyze the various factors responsible for iatrogenic damage to a patient in an orthodontic practice and to advise precautions to prevent such damage. METHODS: All case reports describing iatrogenic damage published in all orthodontic journals indexed on PubMed and the related articles of all these case reports published in any journal. CONCLUSIONS: Good preventive practices can reduce and even completely eliminate the damage produced by the orthodontic operator.

Lesson plan on new method of teeth identification introduced at dental schools in Malaysia and Pakistan.

This article describes a new tooth notation system designed to be implemented for educational purposes in dental schools in Malaysia and Pakistan for identification of teeth and subsequently dental communication for wellness of dental patients. Its format is constructed as a lesson plan to present an uncomplicated tooth notation system by first letter of each tooth class (I-incisor, C-canine, P-premolar, and M-molar) to describe and communicate dental information. The new system is a promising and potential educational lesson that is innovative in its contents, easily understandable, and usable in dental charting as indicated by the results of a pilot study. However, further studies are required to investigate the strength of this new system.