Need for Innovations in Maxillofacial Prosthodontics in Pakistan.

Null.

Management of Chronic Atrophic Candidiasis (Denture Stomatitis)-A Narrative Review.

One of the most common oral diseases affecting people wearing dentures is chronic atrophic candidiasis or denture stomatitis (DS). The aim of the paper is to provide an update on the pathogenesis, presentation, and management of DS in general dental practice settings. A comprehensive review of the literature published in the last ten years was undertaken using multiple databases, including PubMed via MEDLINE, EMBASE, and Scopus. The eligible articles were analyzed to identify evidence-based strategies for the management of DS. Despite its multifactorial nature, the leading cause of DS is the development of oral Candida albicans biofilm, which is facilitated by poor oral and denture hygiene, long-term denture wear, ill-fitting dentures, and the porosity of the acrylic resin in the dentures. DS affects between 17 and 75% of the population wearing dentures, with a slight predominance in elderly females. The mucosal denture surfaces and posterior tongue are the common sites of DS, and the affected areas exhibit erythema, the swelling of the palatal mucosa and edema. Oral and denture hygiene protocols, adjusting or re-fabricating poorly adapting dentures, smoking cessation, avoiding nocturnal denture wear, and the administration of topical or systemic antifungals are the mainstay of management. Alternate treatments such as microwave disinfection, phytomedicine, photodynamic therapy, and incorporation of antifungals and nanoparticles into denture resins are being evaluated for the treatment of DS but require further evidence before routine use in clinical practice. In summary, DS is the most common oral inflammatory lesion experienced by denture wearers. Most patients with DS can be managed in general dental practice settings. Effective management by general dental practitioners may be supported by a thorough understanding of the pathogenesis, the recognition of the clinical presentation, and an awareness of contemporary treatment strategies.

Status of Research and Development Within Dental Institutes of Pakistan.

Health sector institutes of Pakistan can play a pivotal part in improving the status of health sciences. This can be achieved by facilitating research and innovation facilities. It is a need of the day to emphasize academicians and institutional administrations to take keen interest in this regard. Knowledge of the present research and development conditions within higher education institutions may help in policy development and fund allocations at the required levels. Therefore, the objective of this study is to evaluate the status of research and development within dental Institutes of Pakistan. A 30 itemed questionnaire was e mailed/posted to all institutional heads of all registered and recognized dental institutes of Pakistan. Response rate was 62% showing lack of administrational interest. Insufficient infrastructure, inadequate research planning, execution and intellectual property management was recorded. It can be concluded that higher education dental institutions of Pakistan are in need of deeper administrational and educational input to gear up the progress of health sector in this direction.

Knowledge, Attitude, and Practices of Dental Practitioners Regarding Domestic Violence in Pakistan.

Domestic violence is a complex social issue worldwide that includes a wide range of physical, sexual, psychological, economic, or emotional trauma to a child or adult. A large proportion of domestic violence cases remain unreported or undocumented. Dentists can play an important role in identifying and reporting these cases, but no such local study is available assessing the dental practitioners' attitudes and knowledge of evaluating physical abuse in Pakistan. The objective of this study was to assess the knowledge and practices of dental practitioners of Pakistan about domestic violence. This cross-sectional study was carried out over 2 months, among 330 dentists across Pakistan, selected by convenience sampling technique. Data was collected via a pre-validated online questionnaire, filled anonymously after taking informed consent. The survey questionnaire collected data about dentists' demographics, awareness, and experiences about domestic violence cases via close-ended questions. Only 10.6% of participating dentists received formal training in the management of domestic violence cases. Approximately 55% of participants knew that physical abuse should be reported in all circumstances; however, half of them could not accurately identify the legal authorities where suspected cases should be reported. Only 20% of the participating dentists had ever suspected a case of physical abuse and 30% of those actually reported it to legal authorities. Participants characterized fear of anger from relatives as the most significant barrier toward reporting suspected cases. The analysis revealed that Pakistan's dentists lack adequate knowledge regarding domestic violence in terms of identification, relevant physical signs/symptoms, and social indicators. Dentists of Pakistan had insufficient knowledge about the identification, management, and reporting of domestic violence cases. However, formal training and dentists' qualification were positively associated with overall awareness and practices regarding domestic violence case management.

Prosthetic Rehabilitation of Nasal Septal Defect with Magnet Retained Nasal Septal Prosthesis.

Nasal septal defects may present with no clinical symptoms to dryness, nasal obstruction, pain, mucosal injury, crusting, epistaxis, rhinorrhea, nasal twang in speech, hyposmia, and breathing difficulties. Prosthetic rehabilitation of these defects may lead to improvement in these conditions. This case report describes the construction of a custom-made two-piece, magnet-retained nasal prosthesis fabricated in heat-cured acrylic resin. Intra-nasal and extra-nasal alginate impressions were splinted with soft plaster. Sequential model pouring was done for convenient access to the complicated intra-nasal anatomy. Two individual nasal stent waxups, containing two magnets with opposing poles facing each other, were well adapted to their respective medial nasal walls and anterior retentive rounded tips. Waxups were processed in heat-cured acrylic resin and delivered after finishing and polishing. Patient's symptoms were relieved, while maintaining the nasal patency. Such inexpensive method with a tissue-friendly material may prove beneficial for rehabilitation of larger nasal septal defects. Key Words: Nasal septal defects, Rehabilitation, Acrylic resin, Prosthesis.

Gaining retention, support and stability of a maxillary obturator.

Construction of a maxillectomy obturator for any surgical defect requires optimum retention, stability and obturation of defect. In the following case a closed hollow bulb obturator was constructed while utilizing surveying and neutral zone impression technique. After insertion, soft liner was applied to record functional impression of the surgical defect. The obturator was resurfaced with heat cure acrylic to improve the outcome. Patient was able to masticate adequately and speak comprehensively. Patient's resonance, speech, retention and stability were markedly improved. Follow-up was done weekly in first month, fortnightly for the next 2 months then after every 3 months. In succeeding years it will be once every year.

Relationship of neutral zone and alveolar ridge with edentulous period.

OBJECTIVE: To estimate the amount of shift in position of the neutral zone and the centre of alveolar ridge crest in different edentulous periods. STUDY DESIGN: Observational study. PLACE AND DURATION OF STUDY: The study was carried out on edentulous patients reporting in Prosthodontics Department of Lahore Medical and Dental College, Lahore, from August 2006 to December 2008. METHODOLOGY: Patients with edentulous period for at least 6 months exhibiting normal range of maximal mouth opening (40-50 mm) and normal temporomandibular joint movements were included and allocated into two groups, according to period of edentulism. Patient with any intra oral soft tissue or bony pathology and reduced intermaxillary space were excluded. The neutral zone was clinically recorded for all patients with impression compound. The shift between neutral zone and ridge crest in different edentulous periods was analyzed radio graphically and compared statistically. RESULTS: In longer edentulous period (> 2 years), neutral zone was lingually shifted by an average of 1.06 mm in anterior, premolar and molar regions. CONCLUSION: Neutral zone may be lingually shifted in relation to alveolar ridge crest in patients with prolonged edentulous period. This may help in arranging the teeth according to the clinical situation.