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COVID-19 is pandemic across the world and with ever growing number of cases in Pakistan, information regarding its transmission, diagnosis and treatment is very important. Dentists are very vulnerable to corona virus infection as shown by WHO data. So it is very important to take stringent preventive measures and only deal dental emergencies to minimize risk to dental health care workers. [ABSTRACT FROM AUTHOR]

Proper hand hygiene is acknowledged as the most critical element of an adequate infection control program in the oral health care setting. This cross-sectional (KAP) study was carried out to assess the self-reported knowledge, attitudes and practices of dentists regarding Hand Hygiene from Various Dental institutes of Pakistan (Armed Forces Institute of Dentistry, Rawalpindi, Islamic International Medical & Dental College Islamabad, Nishtar Institute of Dentistry Multan and Liaquat College of Medicine & Dentistry, Karachi, Pakistan) from July 2014 to December 2015. A total of 187 dentists including consultants, post graduate residents and house surgeons were included in the study by Non probability consecutive sampling. A self reported questionnaire derived from conducted survey by Myers R et al.3 were used to collect data. At the start of the practice day, forty three percent of participants always washed with antimicrobial soap but never disinfected with an alcohol-based hand sanitizer. Thirty six percent often/almost always washed with antimicrobial soap and disinfected with alcohol-based hand sanitizers. About one third were comfortable with their hand hygiene practices, regardless of what the CDC Hand Hygiene guideline Recommends. Most dentists used soap and water for HH frequently, and a smaller number use alcohol-based hand sanitizers for HH frequently. Further education of the dental community is warranted to improve HH compliance, efficacy of HH practices. [ABSTRACT FROM AUTHOR]

Objective: Assessment of the patient knowledge and attitude towards dental Implants at a tertiary care dental hospital. Study Design: A cross sectional descriptive study. Place and Duration of Study: Armed Forces Institute of Dentistry, Rawalpindi from Jan 2014 to Jun 2014. Material and Methods: A survey was conducted on 150 partially dentate male and female patients having age 20 years and above using a self-explanatory questionnaire. Completely dentate and edentulous patients were excluded in study. Age and gender of the patients were noted. Data were analyzed using SPSS 17.0. Frequencies of age, knowledge, sources and limiting factors were calculated. Results: Sixty percent of the patients were aware of dental implants. Dentists were the main sources of information regarding the dental implants followed by friends and relatives. A majority of patients (65%) had objection on the cost of implant therapy. Major disadvantage and deterrent to implant therapy were cost and surgery. Conclusion: The study showed that most of the patients were aware of dental implants. Dentists and electronic advertising media plays an important role in educating patients about dental implants. Cost was a major limitation in provision of dental implants. [ABSTRACT FROM AUTHOR]

A beautiful smile with better dental aesthetics has always been the patient's prime expectation. Like all other fields, the field of cosmetic and restorative dentistry has evolved over time. Worldwide research has been aimed at crafting solutions to provide the patient with minimally invasive, cost effective and yet aesthetic restorations. A number of different stratification techniques for composites have been advocated. A vast majority of clinicians still utilize monochromatic techniques when aesthetically restoring teeth with composites whereas some believe in the use of a polychromatic approach with multiple shades, tints and opaque to create life-like restorations. Unless the clinician is well acquainted with all the available options, choosing the appropriate layering technique and necessary materials can become very tricky and challenging. This paper aims to provide a review of the various composite stratification techniques described in literature and to acquaint the reader with the basic concept working behind these techniques. [ABSTRACT FROM AUTHOR]

Loss of teeth significantly impairs oral functions and masticatory efficiency. Due to lack of awareness about importance of prosthodontic replacement, mostly patients do not seek treatment immediately after tooth loss. Patients with different educational and socioeconomic background may have different reasons for not replacing teeth after extraction such as financial issues, lack of time and lack of motivation. The objective of this study was to determine the awareness level about prosthodontic treatment for missing natural teeth among patients seen at prosthodontic department of AFID in Rawalpindi. The study was carried out on 137 subjects over a period of almost six months. Based on the criteria of awareness defined in methodology, 19 patients (13.9%) had low awareness level, 89 (65%) had medium awareness level and 29 (21.2%) had high level of awareness. There was significant association of awareness level with gender (p=0.009), education (p=0.00) and occupation (p=0.001). It was concluded that patients visiting AFID have medium level of awareness about prosthodontic treatment options. Dentists were the most common source of information for the patients in terms of education about different treatment options available to replace the missing teeth. [ABSTRACT FROM AUTHOR]

This study was conducted to find the most convenient method for the selection of teeth for complete denture patients between Consultant, Residents and House officers in prosthetic services. A questionnaire was designed specifically prepared and distributed to 45 dentists working in tertiary care hospitals in the twin cities of Rawalpindi and Islamabad. All participants answered questions and responded to the survey. Majority preferred patient's facial form as a guideline in choosing the shape of anterior denture teeth (40%), the most widely used guide in choosing the color of the front teeth was the tone of the patient's skin (48.9%), and more often appearance used in selecting the size of front teeth were the corners of the mouth (35.5%). Fifty-one percent of dentists prefer to use anatomical teeth for back teeth in prosthesis. Bulk of the participants (97.8%) preferred acrylic resin material for artificial teeth. It can be accomplished as the preferred method to opt for artificial teeth and general dentist in Rawalpindi and Islamabad agree with the approaches by dentists internationally, as evidenced by the data published on the subject. [ABSTRACT FROM AUTHOR]

Aglossia is a rare malformation resulting in the partial development or complete absence of the tongue. It is commonly associated with craniofacial and limb defects (Oromandibular Limb Hypogenesis Syndrome).The etiology is unknown and various theories have been proposed for this. The objective of presenting the case report and literature review is to discuss the clinical presentation, causative factors and possible management strategies of this rare malformation. [ABSTRACT FROM AUTHOR]

Objective: To determine the factors responsible for and the effectiveness of career counselling on postgraduation preferences. Study Design: Sequential mixed method study. Place and Duration of Study: Army Medical College and Armed Forces Institute of Dentistry Rawalpindi Pakistan. Method: Data was collected by means of a questionnaire. In which questions were asked under different themes. All those participating in the survey were being delivered a series of 2 lectures on career counselling, with 1 week gap between the lectures. After that the same questionnaire, containing some additional questions, were filled up by the participants. Results: A total of 100 students/ house officers participated in this study. Eighty eight percent had knowledge about post-graduation programs in dentistry. McNemar's test showed that difference in choice of postgraduation was not significant (p=0.458). Marginal homogeneity test used for the 1st option of postgraduation before and after counselling session was statistically significant (p=0.046). Factors affecting the choice of specialty were better chances of getting job 62% (n=62), better chances of earning 84% (n=84) and would be less hectic 71% (n=71) and 78% (n=78) were passionate regarding the choice of specialty. Marginal homogeneity test applied for 1st choice of institution for post-graduation was statistically significant. Fifty nine percent (n=59) participants described low income and no stipend as a major barrier for post-graduation. Ninety two percent (n=92) of participants described that the career counselling session has increased their knowledge and broadened their horizon. Conclusion: Career counselling made statistically significant difference in the choice of specialty before and after the session and it was very effective for participants in selecting their preferences. [ABSTRACT FROM AUTHOR]

Metal free ceramic restorations have increased in demand due to their superior esthetics and more resemblance to the natural teeth, more so now that metal-free biocompatible options are preferred. Although porcelain fused to metal crowns are also used owing to less tooth structure loss in their preparation, the metal portion shows through the marginal area giving a blue-gray, cyanotic appearance to the tissue. Margins are one of the most important components in the success of a ceramic restoration. Essential prerequisites for the clinical success of an all-ceramic restoration includes good esthetics, a high resistance to fracture and perfect marginal fit. A poor marginal design or one that is not prepared well may be a source of plaque accumulation, other than being esthetically unpleasing. Different marginal designs have been proposed and the most acceptable ones for all-ceramic restorations are either the rounded shoulder or the large chamfer margin. A major part of the current literature and research done on this subject falls into two broad categories that are affected by the type of marginal finish line – marginal fit and fracture resistance. [ABSTRACT FROM AUTHOR]

This descriptive study was carried out at dental out-patient department of Liaquat medical University Hospital Hyderabad from January 2013 to December 2013. Thirty-five patients wearing auto polymerized (self-cured) fixed partial dentures provided by unqualified and qualified dental practitioners were assessed. Condition of oral health was evaluated on the basis of proper history and clinical examination. Prosthesis condition was also assessed. Oral health of underlying soft and hard tissues was carefully evaluated after removing the prosthesis with the help of slow speed hand piece without jeopardizing oral tissues. It was evident in this study that fixed partial dentures made from auto polymerized (self cure) acrylic resins had adversely affected the oral tissues compelling the patients to visit the qualified dentist for proper treatment of their problems. [ABSTRACT FROM AUTHOR]

This study was conducted to determine the prevalence of stress and burnout among dental practitioners of Rawalpindi and Islamabad. It was a cross-sectional study and was conducted in six dental institutes of Rawalpindi and Islamabad from February to March 2012. A self-administered questionnaire, containing 10 item version of Perceived Stress Scale (PSS), 22 item Maslach Burnout Inventory Survey (MBI) and socio-demographic data were used to determine the prevalence of stress and burnout among dentists. Out of 150 dentists 129 completed their questionnaire with a response rate of 86%. Among them 24 (18.6%) dentists were specialists while 105 (81.4%) did not have any post-graduation qualification. Fifty dentists (38.8%) were found to be severely stressed, 53 (41.1%) were moderately stressed while 26 (20.2%) were not stressed at all. Mean PSS score reported was higher than average (17.8 + 6.2). On MBI, 61 dentists showed moderate or high emotional exhaustion (18.6%), 56 showed moderate or high depersonalization (43.4%) and 41 showed low personal accomplishment (31.8%). Mean scores of emotional exhaustion (17.8+11.2), depersonalization (6.1+5.9) and reduced personal accomplishment (34.2 + 9.7) were in moderate ranges. Female dentists and dentists working less than 40 hours per week had lower levels of burnout (lesser depersonalization score, p < 0.05). Dental practitioners working in institutes of Rawalpindi and Islamabad were subjected to various levels of stress and burnout. Future research needs to focus on its underlying reasons and on stress coping strategies. [ABSTRACT FROM AUTHOR]

The objective of the study was to compare the satisfaction level of edentulous patients provided with complete dentures that were fabricated by either the neutral zone technique or the conventional technique. For this a quasi experimental comparative study (Phase 2 trial) was carried out at Department of Prosthodontics, Armed Forces Institute of Dentistry, Rawalpindi, Pakistan from September 2006 to February 2008. Sixty edentulous patients were included in the study and randomly placed into two groups. Complete dentures were fabricated for these patients; by the neutral zone technique for Group A and by the conventional technique for Group B. The satisfaction level of patients was assessed after six months of denture insertion with the help of a questionnaire. In Group A, 8 were highly satisfied, 19 fairly satisfied and 3 poorly satisfied while in Group B, 3 were highly satisfied, 16 fairly satisfied and 11 poorly satisfied. Chi-square test revealed a significance of 0.03 (P < 0.05) regarding comparison of patient's satisfaction level in both the study groups. It was concluded that dentures fabricated by neutral zone technique were more stable and functionally better than conventional dentures. [ABSTRACT FROM AUTHOR]

Good diet is essential for the development and maintenance of healthy teeth, but healthy teeth are important in enabling the consumption of a varied and healthy diet throughout the life cycle. Tooth loss impairs chewing function and may result in the consumption of a limited diet of poor nutritional quality and may impact on diet-related quality of life. To be able to eat better is one of the main reasons for the provision of dental prostheses, the other reasons being aesthetics and speech. The objective of this study was to compare body mass index (BMI) of the patient before and after provision of complete denture therapy in a six months period. Seventy completely edentulous patients were included in this quasi - experimental study with age ranges between fifty five to sixty five years. Body Mass Index (BMI) was calculated at baseline, three and six month interval after provision of complete denture. Within the limitations of this study, no significant differences were found in BMI, before and after provision of complete denture. [ABSTRACT FROM AUTHOR]

Techniques for bonding denture teeth to acrylic resin denture base remains empirical, with little consensus from the literature, among clinicians or among dental laboratories. Despite of this great variation, the data available regarding effectiveness of various methods used are sparse. The study was carried out to compare the effect of different surface treatments of ridge lap area of acrylic resin denture teeth on bond strength of acrylic resin denture teeth with acrylic resin denture base. 180 Maxillary central incisors were divided into 6 groups of 30 each according to surface preparations. First group served as the control with no surface preparation; other groups included horizontal grooves, vertical grooves, diatorics, sand blasting and roughened surfaces. Compressive shear force was applied to incisal edge of each tooth until fracture occurred, the force recorded and teeth visually inspected to determine adhesive or cohesive failure. Significant increase in failure load ranged for diatoric 274±78N. Significant decrease in failure mode was observed after sand blasting 157±79N. Remaining groups showed non-significant increase in force required for bond failure. [ABSTRACT FROM AUTHOR]

Modern dentistry is facing growing demands for esthetic tooth-colored restorations, whether in composite, porcelain or acrylic systems. This makes shade selection, on the chair-side and its accurate formulation in the laboratory, the key determinant to the overall success of these restorations. The process of shade selection itself is based on scientific, artistic and physiological principles, which should be properly understood to avoid any shade mismatches and consequent remakes. Hence, the aim of this article was to review the basic principles involved in the shade selection process and present them in an easy-to-understand manner. For this, an electronic search was carried out in PubMed and PakMedinet databases and journal websites, supplemented by a hand search of the published literature and standard textbooks of Prosthodontics to gather all relevant information. It is hoped that this article shall provide useful knowledge to the dental community on the science behind the art of successful shade selections. [ABSTRACT FROM AUTHOR]

Aim of this study was to determine of the frequency of occurrence of various patterns of partial edentulism in armed forces personnel seen at the department of Prosthodontics, Armed Forces Institute of Dentistry (AFID). Utilizing convenience sampling 1000 patients were selected. Kennedy's Classification was utilized after applying Applegate's rules to record the patterns of partial edentulism. Partial edentulism in maxillary arch , was found in 32.6% patients, while 36.8% personnel had partial edentulism in mandibular arch. The remaining 30.6% of samples had missing teeth in both arches. Kennedy's Class III was found to be the most prevalent pattern in both maxilla and mandible. Kennedy's Class III modification 1 was the most common modification encountered in both arches. Highest percentage of combination pattern found was maxillary Class III opposing mandibular Class III. A higher frequency of partial edentulism among the younger age groups found in this study was alarming and is suggestive of the need to create awareness among armed forces health care system for timely prevention of diseases causing tooth loss. [ABSTRACT FROM AUTHOR]

This randomized clinical trial was carried out to compare post cementation sensitivity in vital abutments of metal-ceramic fixed partial dentures using glass ionomer luting cement and resin based luting cement. It analyzed the results of 182 patients whose records were completed during study duration of 09 months at Department of Prosthodontics, AFID, Rawalpindi. Cold sensitivity tests were used to compare post cementation sensitivity in vital abutments of fixed partial dentures using resin based luting cement and glass ionomer luting cement. Sensitivity was assessed on a modified visual analogue scale of 0-10; scores of 1-4 signified mild sensitivity, 5-7 moderate sensitivity, 8-10 severe sensitivity and score of 0 signified no response. The sensitivity results were checked at base line, at 1 week, at 1 month, at 3 months. Data of 182 subjects of mean age 26.15±3.15 was evaluated. Chi-sqaure test was used to see the association of type of cement used and the postoperative sensitivity. The p values for the chi square test were insignificant P- values (P>0.05) at all appointments in abutments of fixed partial denture with either resin based or glass ionomer luting cement. The study showed that there is no significant difference between resin based luting cements and glass ionomer luting cements in terms of post cementation sensitivity in vital teeth. [ABSTRACT FROM AUTHOR]

The aim of this cross sectional prospective study was to determine reasons and patterns of permanent 1st molar extraction in patients reporting to oral and maxillofacial surgery department at Armed Forces Institute of Dentistry, Rawalpindi. All patients referred to oral and maxillofacial surgery department for extraction of permanent first molar teeth from 1st of January 2009 till 31st of December 2009 were included in the study irrespective of their age and gender. The primary reason of extraction was recorded along with other relevant information. The pattern of extractions of the permanent first molars was also noted. A total of 470 patients were included in the study. Out of these 291 (61.9%) were males (M: F 1.6:1). Caries was the most common cause with 281 extractions (59.8%) in all age groups in both genders followed by periodontitis, which was responsible for 109 (23.2%) of permanent first molar extractions. Mandibular molars were more frequently extracted (62.7%) as compared to the maxillary molars (37.3%), with the mandibular left molar being the most frequently extracted tooth in the sample population. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the association of the occlusal plane with level of retromolar pad in dentate individuals. A descriptive cross-sectional study was conducted at the department of Prosthodontics, Armed Forces Institute Dentistry (AFID), Rawalpindi over a period of 6 months and included 60 subjects from either gender with intact dentition. Convenience sampling technique was employed. The results from this study showed that greatest number of the study participants had occlusal plane coinciding with either the middle 3rd i.e. 33.3% or the lower 3rd i.e. 35%. Only 11.7% of the patients had retromolar pad at the level of upper 3rd or the junction of upper and middle 3rd of the retromolar pad. No significant difference was found between the male and female gender as far as the location of the occlusal plane and its relationship with the retromolar pad was concerned. Within the limitations of this study, it can be concluded that in most of the individuals the occlusal plane coincides with the lower part of the retromolar pad and this association is irrespective of the gender of the patients. [ABSTRACT FROM AUTHOR]

The objective of this study was to compare the masticatory performance with bilateral balanced occlusion and lingualized occlusion in complete denture patients reporting to Armed Forces Institute of Dentistry Pakistan. A randomized control trial study was carried out on sixty edentulous patients. Subjects were divided into two equal groups, A and B by non-probability consecutive sampling method. Group A patients were provided complete dentures with bilaterally balanced occlusion and group B patients were provided complete dentures with lingualized occlusion. Masticatory performance was determined at the 01-month follow-up appointment using Sieving method. Data were analyzed using SPSS 19.0.Results of the study showed that patients with bilateral balance occlusion dentures had superior masticatory performance as compared to ones' with lingualized occlusion. Conclusion made was that bilateral balance occlusal scheme patients were able to masticate properly with ease and comfort and were more comfortable with their prostheses. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine denture hygiene habits in complete denture patients according to their age and time of dentures reporting at Armed Forces Institute of Dentistry, Rawalpindi. A cross sectional study was carried out on 200 hundred completely edentulous patients between 45 to 65 years wearing complete acrylic dentures. They were further subdivided according to gender 120 males, 80 females) and age groups as 45-55 years (Group I) and 54-65 years (Group II). Data were collected on a standardized data sheet. A Proforma was filled in by every patient and denture hygiene habits of the subjects were documented. Data collected was analyzed using SPPS 17.0.Out of 200 patients, 65% of the subjects cleaned their dentures once daily. Group I patients who had been wearing dentures since 2 years showed more tendency towards denture cleaning. Patients mostly used water only for denture cleansing. Clinicians should provide proper denture hygiene instructions. Noncompliance of the patients is main reason for poor status of complete dentures seen in the elderly population. [ABSTRACT FROM AUTHOR]

To determine the pattern of acquired postsurgical unilateral maxillary defects (Aramany Class I) for Prosthodontics rehabilitation in patients at AFID. A descriptive study was conducted in the Department of Prosthodontics, Armed Forces Institute of Dentistry from August 2014 to March 2015. A total of 65 acquired unilateral postsurgical maxillary defect patients referred from Oral & Maxillofacial surgery department, with an age ranging between 25-70 years. Only Aramany Class I post-surgical defect patients were included in this study. Out of 65 patients 34 were male and 31 were female. The mean age of patients was 41+6.921 SD. Almost all of the patients 98.46% (n=64) belonged to a poor socioeconomic status. 81.5% (n=53) of the unilateral maxillary defect were on the left side where as 18.5% (n=12) were on the right side. Chi square test used to determine the association of gender with pattern of maxillectomy was not significant (p=0.859). Logistic regressions wald test used to determine the association of age with maxillary defect was significant (p=0.000). Within the limitations of this study, the pattern of Aramany Class I post-surgical defect was more prevalent on the left side as compared to the right side and most of the patients belonged to poor socioeconomic status irrespective of the age of patients. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the frequency of complaints in patients wearing removable partial dentures reporting at Armed Forces Institute of Dentistry Pakistan. The study included One hundred patients (60 males and 40 females) wearing removable partial dentures for at least 6 months. Details of age, gender, medical history and denture history were obtained. Patients post insertion complaints were recorded. The collected data was statistically analyzed using SPSS v17. The results were estimated statistically at a significance level of P<.05.It was found that 55% of the subjects had complaint of their dentures being loose; 40% complained of ulceration around or under their appliances; 35% of patients had problem of pain and discomfort; 25% reported that they had low masticatory efficacy. 28% of the patients had problems in speech. 10% patients complained of debonded artificial teeth. Pain and soreness, difficulty in mastication and speech, loss of retention, ulcerations and debonding/ fracture of artificial teeth are the main post insertion complications in RPD patients. Proper RPD design and patient compliance can help overcome these challenges. [ABSTRACT FROM AUTHOR]

The objective of this study was to determine the frequency of different classes of partially dentate patients reporting to Armed Forces Institute of Dentistry Pakistan on the basis of PDI classification. A cross-sectional study was carried out on five hundred thirty four (534) partially dentate patients of age between 35 to 65 years. Data was collected by taking history, clinical and radiographic examination. A Proforma was filled in by the principal investigator and PDI classification of the patient determined. Out of 534 patients, 92 patients (17.2%) were classified in PDI class I. 212 patients (39.7%) were classified in PDI class II.146 patients (27.3%) were grouped in PDI class III while 84 patients (15.7%) were classified in PDI class IV. Inclusion of PDI classification in everyday practice will be helpful in accurate diagnosis and treatment planning of the patients seeking prosthodontic rehabilitation. [ABSTRACT FROM AUTHOR]

Background: To investigate nasal carriage of Methicillin-Resistant Staphylococcus aureus (MRSA) among dental healthcare workers (HCWs), as the carriers could be the potential risk factor for the transmission of nosocomial infection when exposed to hospital setting during clinical posting. Methods: One hundred HCWs including postgraduate trainees, house physicians, staff nurses and technicians participated in the study. Nasal specimens were obtained by using cotton swabs moistened in sterile saline. The nasal specimens collected were processed as per (CLSI, 2008). Specimens were inoculated on blood agar to look for β-hemolysis of Staphylococcus aureus. Nutrient agar was used for the direct colony identification of Staphylococcus aureus. Mannitol salt agar (MSA) and DNAse were used as selective media for the isolation of Staphylococcus aureus and incubated at 35°C for 48 hrs. Resistance to methicillin was detected with cefoxitin(30 μg) through Disk Diffusion Test and interpreted according to (CLSI, 2009). A diameter of ≥22 mm was considered as susceptible and ≤21 mm as resistant as per (CLSI, 2010). Results: Out of 100 nasal swabs collected, 71 nasal swabs were from the dental surgeons and 29 were from the nursing staff, 35 (35%) showed a growth of Staphylococcus aureus. Among those who were positive for Staphylococcus aureus 62.85%were positive for MRSA. Overall 22 (22%) out of a 100 individuals came out to be positive for MRSA. Conclusion: Health care workers (HCWs) were the potential colonizers of methicillin resistant Staphylococcus aureus and may serve as reservoirs or disseminators of MRSA. [ABSTRACT FROM AUTHOR]

Background: After loss of natural teeth, provision of prosthodontic services almost becomes necessity in the present day living. To provide effective mastication teeth have peculiar forms. To make it more efficient both functionally and biologically, they are arranged in particular geometric manner referred to as dental arch. The objective of this study was to compare the distance between mesial edge of the maxillary central incisors and posterior border of the incisive papilla in dentate individuals with different arch forms., Methods: After sample selection, impressions were made for upper and lower arches and the resultant casts were standardised. Arch forms were assessed by their morphological description. Measurements on cast were recorded for incisive papilla (IP) and maxillary central incisor (CI) distance after securing it on cast surveyor., Results: Ovoid arch form was the most frequently observed arch form both in males (57%) and females (68%) while their combination (Ovoid Square and Ovoid tapered) were the least commonly observed arch forms (4% and 5% each). Gender seems to be important in about 1/4th of the dentate individuals, regarding both the type of the arches and CI-IP distance., Conclusion: Ovoid type of arches was the commonest arch form seen in either sex. There is no significant difference between males and females in 3/4th of dentate individuals, regarding the type of dental arch as well as CI-IP distance.