Current Trends In Complete Denture Education In Undergraduate Dental Colleges Of Pakistan.

Objective: To determine the current trends in complete denture education in undergraduate dental colleges. METHODS: The survey-based study was conducted in April and May 2020 at undergraduate dental colleges of Pakistan, and comprised heads of the Prosthodontics Department at all dental colleges across Pakistan having at least one batch of final year dental students. Data was collected using an online predesigned questionnaire that explored theoretical and practical teaching patterns of complete denture prosthodontics in the undergraduate years, and the materials and practices of students when constructing complete dentures in the clinics. The participants were given the option of choosing more than one option where needed. Data was analysed using SPSS 23. RESULTS: Of the 49 subjects approached, 40(81.6%) returned the forms duly filled; 11(27.5%) from public-sector institutions and 29(72.5%) from the private sector. There were 26(65%) institutions which required that their undergraduate students fabricate 2-4 conventional complete dentures. In all 40(100%) colleges, faculty gave live clinical demonstrations before students fabricated conventional complete dentures in the outpatient departments. Teaching strategy included small group discussions in 25(62.5%) institutions. Green stick 40(100%), zinc oxide eugenol 40(100%) and impression compound 39(97.2%) were the materials of choice for various steps of impression making. In all the 40(100%) institutions, students fabricated conventional complete dentures during their prosthodontics rotation. Immediate, copy and overdentures were constructed by students in 8(20%), 3(7.5%) and 8(20%) institutions, respectively. Conclusion: Majority of the dental schools used similar impression materials and techniques for fabricating conventional complete dentures. Didactic teaching of conventional and unconventional complete dentures was being carried out at a huge majority of the dental institutions studied.

Current Trends in Fixed Prosthodontics Education in Undergraduate Dental Colleges.

OBJECTIVES: The objective of this study was to explore current trends in undergraduate fixed prosthodontics teaching at undergraduate dental level education. METHODS: This cross-sectional descriptive study included close-ended questions to inquire about the teaching practices of fixed prosthodontics at Bachelor of Dental Surgery level education. Electronic copies of the survey forms were sent to the heads or directors of department of prosthodontics responsible for undergraduate dental students teaching and learning in various institutes of Sindh by the help of Google forms in December 2020. The form included questions on sociodemographic details and questions inquiring the theoretical and clinical teaching practices in undergraduate fixed prosthodontics course. Data was entered and analyzed using SPSS 25. Frequency distribution and percentages of categorical variables were recorded. RESULTS: Out of total 18 dental institutes of Sindh, 15 returned the completely filled form, giving a response rate of 83.3%. Seven (46.7%) schools teach various fixed prosthesis in the preclinical years to their students. All 15 colleges carry out didactic teaching and provide exposure by live clinical demonstrations for various fixed prosthesis. Faculty of 12 (80%) dental colleges where fixed prostheses are being constructed in the dental outpatient department mentioned that their students observe or assist the clinical procedures during their clinical rotation; but none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years. CONCLUSION: Didactic teaching and live clinical demonstrations of fixed prosthodontics is being carried out in all dental colleges of Sindh. Almost half of the dental schools teach crown preparation on phantom teeth during their preclinical course. Contrary to this, none of the students fabricate any type of fixed prosthesis in the clinical setting during their undergraduate years. As these procedures are not included in the current undergraduate curriculum, recommendations should be forwarded to governing educational body of the country to include cases of fixed prosthesis in their skill set prior to their graduation.

Regenerative Potential of Enamel Matrix Protein Derivative and Acellular Dermal Matrix for Gingival Recession: A Systematic Review and Meta-Analysis.

OBJECTIVE: The purpose of this study was to assess the clinical effectiveness of using a combination of enamel matrix protein derivative and acellular dermal matrix in comparison to acellular dermal matrix alone for treating gingival recessions. METHODS: The Cochrane Library (Wiley), PubMed by Medline (NLM), Medline (EBSCO), and Embase (Ovid) databases were searched for entries up to April 2020. Only clinical trials were included. Primary outcomes were root coverage (%), changes in keratinized tissue width and recession (mm). Meta-analysis was conducted for root coverage, changes in keratinized tissue width, recession, clinical attachment level and probing depth. RESULTS: Four studies were selected for the analysis. In primary outcomes, root coverage, change in keratinized tissue width and recession analysis showed a mean difference of 4.99% (p = 0.11), 0.20 mm (p = 0.14) and 0.13 mm (p = 0.23) respectively between the two groups. Secondary outcomes analysis also exhibited a statistically insignificant difference between the test and control group with mean difference of 0.11 mm (p = 0.32) in clinical attachment level gain and -0.03 mm (p = 0.29) in probing depth reduction analysis. CONCLUSIONS: Within the limits of this study, enamel matrix protein derivative combined with acellular dermal matrix used for treating gingival recession defects resulted in no beneficial effect clinically than acellular dermal matrix only.

Motivational factors for pursuing dentistry as a profession in colleges of Karachi, Pakistan.

OBJECTIVE: To determine the reasons that motivated students to seek admission in dental colleges, and to assess differences in the reasons between students studying in private and public dental colleges. METHODS: The cross-sectional analytical study was conducted at two public-sector and four privatesector dental colleges in Karachi from June to September, 2018, and comprised students of first to final year of studies. Data was collected using a self-administered questionnaire. Students were asked to mark all reasons that they considered had been an influencing factor on their decision to opt for dentistry. Data was analysed using SPSS 21. RESULTS: Of the 900 forms distributed, 814(90.4%) were collected with complete data; 182(22.4%) males and 632(77.6%) females. The overall mean age was 20.8±1.3 years. Of the total, 324(39.8%) students were from the public sector, while 490(60.2%) were at private colleges. A statistically significant difference was noted in professional and personal reasons cited by the two groups of students (p<0.05). CONCLUSIONS: It is of utmost importance that students shall be very clear regarding their expectations from a career to minimise chances of abandoning it midway or being professionally dissatisfied even after completing a degree.

Fluoride Release From Glass Ionomer Cement Containing Fluoroapatite And Hydroxyapatite.

BACKGROUND: Many investigators reported the amount of fluoride release from glass ionomer cement. However, the work on fluoride release from GIC containing fluoroapatite and hydroxyapatite is scarce. Therefore, this study was conducted to find out the amount of fluoride release from Glass ionomer cement containing fluoroapatite and hydroxyapatite. METHODS: The study was conducted in the Department of Materials, Queen Marry University of London. A total of 108 samples equally divided in to three groups namely fluoroapatite added GIC, Hydroxyapatite added GIC as an experimental group and unmodified GIC as a control group. The specimens were prepared by mixing powder and liquid in the ratio of 1:1. Amount of fluoride released was measured by Ion electrode method at 1, 3, 7, 14, 21 and 28 days. RESULTS: On day 1, the combination of FA +GIC showed the highest amount of fluoride release followed by the control group (GIC) whereas the combination of HA+GIC released the least amount of fluoride. On day 7, the amount of fluoride release started declining in all three groups. The amount of fluoride release continued decreasing on day 21 in which combination of FA +GIC and the control group are shown to release equal amount of fluoride whereas the combination of HA+GIC gave the least activity the amount of fluoride release fall to a minimum level in all three group by day 28. CONCLUSIONS: It is concluded that addition of fluoroapatite into GIC has significant effect on the amount of fluoride release as compared to GIC alone; however, addition of hydroxyapatite into GIC has no additive effect on the amount of fluoride release.

Evaluation of Microleakage in Single-Rooted Teeth Obturated with Thermoplasticized Gutta-Percha Using Various Endodontic Sealers: An In-Vitro Study.

OBJECTIVE: To compare apical microleakage of extracted, single-rooted teeth obturated with thermoplasticized injectable gutta-percha using two different endodontic sealers (calcium-hydroxide and resin based). STUDY DESIGN: An experimental study. PLACE AND DURATION OF STUDY: The Aga Khan University Hospital (AKUH), Dental Clinics and Laboratory from June to September 2015. METHODOLOGY: The study was conducted using extracted teeth. After access cavities were made, cleaning and shaping of root canals was done in 70 teeth. Teeth were randomly allocated into two groups and obturated with thermoplasticized injectable gutta-percha (Obtura II) using two sealers (Sealapex vs. AH plus). After immersing the teeth in 2.0% methylene blue, they were split longitudinally, viewed under light microscope (magnification X4) and images were taken by a camera connected to microscope. The extent of dye penetration was assessed from apex to its coronal part and recorded in millimeters. Independent sample t-test was used to compare microleakage in the two groups. Pearson correlation coefficient was used for inter-examiner reliability of dye penetration measurements. A p-value of <0.05 was taken as statistically significant. RESULTS: Teeth obturated with Obtura II gutta-percha with AH plus sealer had a mean dye penetration of 1.20 ±0.79 mm. This was significantly better than Obtura II with Sealapex sealer (p=0.003). CONCLUSION: Obtura II-AH plus sealer was a better combination for obturation as it showed a lesser degree of microleakage. Obtura II with Sealapex group showed higher microleakage, so this combination should be avoided in single-rooted teeth.

Association of salivary gland hypofunction with diabetes mellitus and drugs among the elderly in Karachi, Pakistan.

AIM: Studies from Pakistan on salivary dysfunction are lacking, and the Pakistani elderly population is rapidly growing. Among the most common problems in the elderly that could have a deleterious impact on their quality of life are salivary gland hypofunction (SGH), diabetes mellitus (DM), and the intake of drugs with adverse effects on salivary function. In the present study, we aimed to find the association of SGH with DM and drugs among the elderly in Karachi, Pakistan. METHODS: The inclusion criterion was affirmative answers to a series of standardized questions related to the symptoms of dry mouth. A total of 110 individuals were selected from a convenience sample of 200 people aged between 60 and 70 years. Diabetes, drug use, and SGH in the participants were determined by detailed medical and drug history, clinical examination, and sialometry. RESULTS: Similar to their international counterparts, the majority of the study participants demonstrated objective evidence of SGH. More importantly SGH was found to be statistically significant with respect to DM and medication (P < 0.05). For participants on medication, the minimum and maximum salivary flow rates were found to be 0.09 mL/min and 0.3 ml/min, respectively, whereas the minimum and maximum salivary flow rates in diabetic participants were 0.01 mL/min and 0.09 mL/min, respectively. CONCLUSION: In the present study, the majority of elderly participants whose presenting complaint was oral dryness was found to have objective evidence of SGH, with a statistically-significant association with DM and drugs.

A SURVEY ON CURRENT TRENDS IN PRIMARY TOOTH PULPOTOMY IN KARACHI.

BACKGROUND: In comparison to USA and United Kingdom where Paediatric Dentistry is considered a separate specialty; there very few formal teaching programs in Pakistan for Paediatric Dentistry. Many surveys have been carried out internationally, but no survey has been carried out locally to ascertain practice of dentists when treating paediatric patients. Therefore, it appears important to map features of Paediatric Dentistry practice in our country. The purpose of this study was to assess practice regarding pulpotomy of primary teeth among dentists of Karachi and to compare difference in pulpotomy practice of primary teeth between private practitioners and teaching dentists. METHODS: Questionnaire was distributed by hand to dentists working in private clinics and teaching hospitals of Karachi, involved in treating primary teeth of children. Questions captured information on aspects related to pulpotomy procedure as carried out by dentists. Descriptive statistics and frequency distribution were computed. Chi-square test was applied to compare difference between dentists working in teaching hospitals versus private practitioners. Level of significance was kept at 0.05. RESULTS: Although majority of dentists use the preferred medicament for pulpotomy, i.e., formocresol, it was seen that only a small proportion reported frequent use of radiographs and rubber dam. There was a significant difference in selecting post pulpotomy restorations for anterior teeth by teaching dentists (Composites) compared to private practitioners (who favoured GIC). Only 20-27% of dentists reported use of stainless steel crown for definitive restoration after pulpotomy. CONCLUSIONS: Although majority of dentists use formocresol as a preferred medicament for pulpotomy, it was seen that only a small proportion of participants reported frequent use of radiographs, rubber dam and stainless steel crowns which is far below the standard of care.