Impact of fixed dental prosthesis on neuroimaging: assessment of artefacts.

Objectives: To determine the frequency and extent of artefacts in magnetic resonance imaging and/or computed tomography scans of head caused by fixed dental prosthesis. METHODS: The retrospective study was conducted at Aga Khan University Hospital from July to December 2021, and comprised magnetic resonance imaging and/or computed tomography scans from January 2015 to December 2020 of the head of individuals with existing fixed dental prosthetic work at the time of exposure. They were analysed for the presence of artefacts. The association between artefacts and the presence of fixed dental prosthesis was explored. Data was analysed using SPSS 23. RESULTS: Of the 297 images evaluated, 173 (58%) were magnetic resonance imaging scans, and 124(42%) were computed tomography scans. The most common artefacts was grade I 148(49.8%), followed by grade II 140(47.1%) and grade III 9(3%). There was no significant association between fixed dental prosthesis and the artefacts (p>0.05). Conclusion: There should be no reservations in placing fixed metal prosthesis in individuals on account of future brain scans.

The Utility Of Pre-Procedural COVID-PCR Testing For Dental Aerosol Generating Procedures Is Questionable.

OBJECTIVE: To compare the number of aerosol-generating procedures performed and the number of coronavirus disease-2019-positive workers in dental practice. METHODS: The audit study was conducted in May 2021 at the Aga Khan University Hospital, Karachi, and comprised data from April 1, 2020, to March 31, 2021, which was retrieved from dental clinics at the main hospital and its Clifton branch as well as in three secondary care hospitals in Garden, Kharadar, Karimabad areas of Karachi, and one in Hyderabad, Pakistan. Data of individuals who followed mandatory pre 20 procedural polymerase chain reaction testing in addition to using personal protective equipment in the main hospital and Clifton branch was placed in group A, and of those using personal protective equipment only at the 4 satellite clinics with no testing was placed in group B. Dental charts of patients who underwent dental aerosol-generating procedures were analysed. Number of dental clinics affected by coronavirus disease 25 2019 and number of dental patients who were reported positive on pre-procedural polymerase chain reaction testing were evaluated. Data was analysed using SPSS 23. RESULTS: Of the 63 dental healthcare workers, 44(69.8%) were in group A and 19(30.2%) were in group B. In group A, 19(43.2%) were affected by coronavirus disease-2019 compared to 2(11%) in group B (p=0.01). Among 782(67.8%) patients who underwent polymerase chain reaction testing, 26(3.3%) turned out positive for coronavirus disease-2019. Due to the mandatory testing imposed on patients, 371/1153(32.2%) refused to get the desired dental treatment. CONCLUSIONS: The benefit of pre-procedural testing in dentistry remained uncertain.

Correlation of index finger length to vertical dimensions of occlusion for edentulous patients and their satisfaction: a randomized controlled trial.

The prevalence of edentulism is pandemic and people resort to complete dentures for the restoration of missing teeth and esthetics. However, the determination of the correct occlusal vertical dimensions (OVD) constitutes to play an important role in overall patient satisfaction. The objective of this study was to apply anthropometric methods to correlate the length of index finger (2D) to measure the OVD from base of the nose to the base of the chin (Sn-Me) and to assess satisfaction by comparing both the methods. A total of 80 edentulous patients were randomized and controlled for this trial into experimental and control groups. A correlation was found between Sn-Me and finger measurements, dentures' satisfaction was assessed after a 1-week follow-up and marked according to the Visual Analog Scale. Our findings established that finger measurements are greater among males, and in both genders, positive, and statistically significant correlations exist between the facial and finger length measurements. Moreover, 97.0% patients from experimental group were satisfied with the use of complete dentures through the new anthropometric method. Hence measuring the length of index finger can be an adjunct method for the restoration of OVD and is a relatively time-effective and simple method with a satisfactory follow-up.Trial registration: ID: NCT05153213 ( https://clinicaltrials.gov/ct2/show/NCT05153213 ).

A bibliometric analysis of the studies on dental implant failure.

OBJECTIVE: To identify top 30 studies related to dental implant failures based on bibliometric analysis. METHODS: The bibliometric study was conducted at Aga Khan University, Karachi from April 2021 to June 2021 and comprised database search on Google Scholar used key words "dental implant failures" for studies published between 1990 and 2020. The selected studies were reviewed based on citation count for which the cut-off date was June 1, 2021. RESULTS: The top 30 papers on dental implant failures had median citation count of 153 (range: 41-1583. Most of the studies were retrospective 11(36.7%), followed by literature reviews 6(20%). The top three contributing journals were the 'International Journal of Oral Maxillofacial Implants' 6(20%), the 'Clinical Oral Implants Research' 5(16.7%) and 'Clinical Implant Dentistry and Related Research' 3(10%). Goteborg University, Sweden, contributed the maximum number of most cited papers 8(26.7%). CONCLUSIONS: Most of the papers in the top-cited on dental implant failures were retrospective studies, and there was only one clinical trial.

Relationship of natural occlusal plane with different anatomical landmarks.

OBJECTIVE: To evaluate the parallelism of natural maxillary occlusal plane with inter-pupillary line and ala-tragus line, and to evaluate the anatomic relationship of natural mandibular occlusal plane with retromolar pad among dentate subjects. METHODS: The cross-sectional study was conducted from September 2017 to February 2018 at Fatima Jinnah Dental College, Karachi, and comprised front and profile photographs of subjects aged 20-28 years while holding the camper's plane against the maxillary occlusal plane. The photographs were imported in a software and an interpupillary line was drawn and the angle with Camper's plane was measured. On both profile pictures, lines were drawn from base of the ala to the superior, middle and inferior points on the tragus. The angle between ala-tragus line and Camper's plane were measured. Intra-orally, height of the mandibular occlusal plane in relation to the retromolar pad was evaluated using a stainless steel scale. Data was analysed using SPSS 23. RESULTS: Of the 109 subjects with a mean age of 23.03±1.36 years, 76(69.72%) were females. Horizontal parallelism of occlusal plane with inter-pupillary line was observed with a mean angle of 1.17±1.27 degrees. The angle between the occlusal plane and the inferior ala-tragus line was 4.25 degrees on the right side, and 4.50 degrees on the left. Intraorally, mandibular occlusal plane coincided with the inferior 48(44%) and the middle third 48(44%) of the retromolar pad. CONCLUSIONS: Inter-pupillary line and retromolar pad area should be used as a guide in the determination of plane of occlusion. The ala-tragus line was not found to be a reliable guide.

Post-residency fellowship training in Maxillofacial Prosthetics is needed in Pakistan.

OBJECTIVE: To determine the spectrum of maxillofacial prosthetics services in Pakistan, to explore the need of a relevant fellowship training programme in the country, and to determine whether they contribute to tumour board of head and neck oncology. METHODS: The cross-sectional online survey was conducted from March to June 2020 and comprised all prosthodontists registered on the portal of the Pakistan Prosthodontics Association. Using Google Forms, the survey questionnaire was sent via email. The survey form was self-generated. Data was analysed using SPSS 23. RESULTS: Of the 84 prosthodontists approached, 44(52.4%) responded. The overall median age was 39 years (range: 30-60 years), and 34(77.3%) subjects were males. Overall, 19(43.2%) subjects were from Punjab, 14(31.8%) Sindh, 6(13.6%) Khyber Pakhtunkhwa, and 5(11.4%) Islamabad. None of the participants had received any formal accredited training in maxillofacial prosthetics. Although 37(84.1%) respondents reported providing maxillofacial prosthetics services to their patients as they had learnt it during their prosthodontics residency. Only 3(6.8%) respondents were contributing to head and neck tumour board. An overwhelming majority 42(95.5%) stressed the need of structured training programmes in maxillofacial prosthetics. CONCLUSIONS: There is no accredited maxillofacial prosthetics training centre and an obvious lack of prosthodontists with formal training in the professional area. The participation of prosthodontists in the head and neck tumour board was negligible.

Teaching the 'Comprehensive Dental Care' in formative years of education and training: A new model for dental internship.

There is a need of a new model of education and training to be implemented in the Bachelors of Dental Surgery curriculum in the relevant Pakistani institutions. The current review article was planned to suggest such a model in the light of literature aimed at building the capacity of dental graduates in a competency-driven approach with the objective of offering safe, efficient and comprehensive care to dental patients. The outcome of the reforms suggested shall prepare dental graduates suitably geared towards providing community-oriented family dental care right from their formative years. Moreover, the suggested internship model can also help to address the issue of inefficiency related to patient-care.