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Objective: To assess the techniques used by dental specialists for placement of extensive posterior composite restorations. Methodology: A cross sectional descriptive was conducted in 150 dentists of College of Dentistry, SMDC, Lahore from June 2019 to July 2020 after obtaining ethical approval from Sharif Medical Research Centre (SMRC). Data was collected using a pre validated questionnaire Results: A statistically non-significant association between the specialty of the dentist the technique used for placement of the composite during restoration (p=0.08). The most commonly used techniques for the placement of posterior composite restorations by dentists of all specialties including Periodontology (88%), Prosthodontics (68.4%), Orthodontics (85.7%), Oral Surgery (91.3%), Oral Pathology (71.4%), Oral Biology (33.3%), Dental materials (75%), Community Dentistry (100%), Operative Dentistry (90.9%) and Oral Medicine (75%) is incremental curing. Practical implication: This study will give an insight on the various techniques used by dentists from various specialties for the placement of composite restorations in posterior teeth. This will in turn help them adopt new and revisit old techniques used by them while placing composite restorations. Conclusion: The most commonly used techniques for the placement of posterior composite restorations by dentists of all specialties is incremental curing followed by use of moisture control during the placement of composites both with and without rubber dam isolation. Keywords: Dental Specialists, Composite Restorations, Posterior Dental Restorations, Incremental Curing

Objective: To assess the impact of dialysis on periodontal and general oral health of chronic kidney disease patients. Methodology: A Cross sectional comparative study was conducted in the department of Nephrology and Urology, Sharif Medical and Dental College, Lahore on 32 patients with chronic kidney disease in the time duration of one year. Chronic kidney disease stage 3, 4 and 5 patients with age above 18 years, belonging to both the genders and same socioeconomic status were a part of the study. Data collection was based on the following parameters: Community Periodontal Index of Treatment Needs (CPITN). Results: There was a statistically non-significant association between stage of chronic kidney disease and periodontal health of patients undergoing dialysis (p=0.185) and general oral health (p=0.120). Practical Implication: This study will help dental practitioners understand the impact of renal dialysis on general oral and periodontal health of patients with chronic kidney disease and in turn help them provide effective health care to these patients who have specialized treatment needs. Conclusion: It was seen that stage 3 patients had the highest percentage of bleeding gums while none had periodontal pockets nor calculus deposition. Stage 4 patients had an equal percentage of calculus deposition and periodontal pocket depth of 4-5 mm. Stage 5 patients had a high percentage of Periodontal pocket depths of 4-5mm followed by calculus and then bleeding gums. A higher percentage of stage 3 and 5 patients undergoing dialysis had a high DMFT whereas the percentage of stage 4 patients with high and low DMFT scores was equal. Keywords: Dialysis, Chronic kidney disease, periodontal health, Community periodontal index for treatment needs (CPITN)

Objective: To assess the inter-rater reliability of dentists regarding assessment of depth of impacted third molars on the Orthopantomograms Methods: A cross sectional comparative study was conducted in College of Dentistry, Sharif Medical and Dental College, Lahore in which dentists from four different specialties namely; Oral Pathology, Endodontics, Prosthodontics and Oral and Maxillofacial surgery were included as raters. The study was conducted from December 2020 to February 2021. A total of 21 Orthopantomograms were assigned to each rater for assessing the angle of the impacted third molar. The classification for angle of impaction used was Winter`s classificati1. The raters were provided with the OPGs and a proforma for recording their observations. Results: The level of agreement regarding the depth of impacted third molars observed on the Orthopantomograms between rater 1 with rater 2 (κ=.692, p≤0.001) and rater 1 with rater 3 (κ=.639, p≤0.001) was very strong but was moderate with rater 4 (κ=.538, p=0.001). Conclusion: There was an excellent agreement regarding the depth of impacted third molars of rater 1 (Oral and maxillofacial surgeon) with rater 2 (oral pathologist) and rater 3 (Prosthodontist) but a moderate agreement with rater 4 (Endodontist). Keywords: Depth of impaction, Third molars, Inter-rater reliability, Orthopantomograms

Objective: To find the inter-rater reliability to the assessment of ramus relationship of mandibular impacted third molar among denitsts. Methodology: A cross sectional comparative study was conducted in College of Dentistry, Sharif Medical and Dental College, Lahore after obtaining ethical clearance from ethical committee of Sharif Medical Research Centre (SMRC) in which dentists from three different specialties namely; Oral Pathology, Endodontics and Prosthodontics were included as raters. The study was conducted from December 2020 to February 2021. A total of 21 Orthopantomograms were assigned to each rater for assessing the ramus relationship of impacted third molar. The classification for angle of impaction used was Winter`s classification. The raters were provided with the OPGs and a proforma for recording their observations. Results: The level of agreement regarding the ramus relationship of impacted third molars observed on the Orthopantomograms between rater 1 and rater 2 was fair (κ=0.366 ,p=0.022). The agreement was also fair between rater 1 and rater 3 (κ=0.300, p=0.094). Conclusion: There was a fair agreement in assessment of ramus relation of the impacted mandibular molars of rater 1 with rater 2 and 3 where majority of the class 2 and class 3 relations were rated similarly by both the raters as Keywords: Inter-rater reliability, Cohen Kappa, Impacted third molar, Orthopantomogram, Ramus relationship

Objective: To assess the periodontal treatment needs of patients in different stages of chronic kidney disease Methodology: A Cross sectional comparative study was conducted in the department of Nephrology and Urology, Sharif Medical and Dental College, Lahore on 32 patients with chronic kidney disease in the time duration of one year. Data was collected after taking an informed consent from the patients. The demographic data along with a list of variables associated with chronic kidney disease was recorded using a structured questionnaire. Data collection was based on the following parameters: Community Periodontal Index of Treatment Needs (CPITN). Results: The highest percentage (10%) of patients who required no treatment (TN0) were stage 3 patients. Majority of the stage 5 (93.1%) patients required scaling, prophylaxis and oral hygiene instruction (TN2) followed by stage 4 (90.9%) and stage 3 (40%) respectively. None of the patients required complex treatment, scaling, prophylaxis and oral hygiene instructions (TN3) Conclusion: The highest percentage of patients with healthy periodontium were stage 3 patients. Periodontal pocket depths 4-5 mm were found to be in stage 4 patients the most followed by stage 5 and then stage 3. None of the patients had pocket depths of 6mm or more. Majority of the stage 5 patients required scaling, prophylaxis and oral hygiene instruction (TN2) followed by stage 4 and stage 3 respectively. None of the patients required complex treatment, scaling, prophylaxis and oral hygiene instructions (TN3). Keywords: Chronic kidney disease, periodontal treatment needs, oral hygiene instructions, oral prophylaxis, complex treatment

Objective: To assess pregnant women's periodontal and gingival health compared to non-pregnant women. Study Design: Cross-sectional comparative study. Place and Duration of the Study: Department of Gynecology, Sharif Medical and Dental College, and Raiwind Polyclinic Lahore (Outreach program of the Sharif Medical and Dental College, from Mar 2019 to Aug 2019. Methodology: The periodontal and gingival health of 44 pregnant and 52 non-pregnant females was evaluated using the community periodontal index of treatment needs and gingival index. Results: A total of 44 pregnant and 52 non-pregnant were evaluated. The periodontal health and pregnancy status were significantly associated (p=0.008). The periodontal health and the trimester of pregnancy were not significantly associated (p=0.787). There was no significant association between the gingival health of the females with the status of pregnancy (p=0.773). Maximum calculus deposition in the oral cavity of pregnant women was during the third trimester (36.4%). Conclusion: The pregnant females had a higher percentage of bleeding gums, while calculus deposition was higher in non-pregnant females. Pregnant females had more periodontal pockets of 4-5 mm, while pocket depths of 6mm or more were seen in non-pregnant females only.

Objective: To determine the barriers to the maintenance of COVID 19 cross infection control protocols among medical and dental practitioners Methodology: A cross sectional study was conducted in College of Dentistry, Sharif Medical and Dental College, Lahore from July 2021 to July 2022 on medical and dental practitioners. The sampling technique employed was convenient sampling. Medical and dental practitioners irrespective of their age, gender and specialty of practice were included in the study. Data was collected using a pre-validated questionnaire with a Cronbach alpha value of 0.7. Results: There was s statistically significant difference in the scores of barriers to maintenance of COVID 19 cross infection control protocols of overcrowding in the hospital (p= ≤0.001), limitation of infection control material (p=≤0.001), insufficient training in infection control (p=0.05), lack of handwashing (p=0.022), not wearing a mask while examining the patient (p=≤0.001) and lack of knowledge about mode of transmission of COVID 19 (P=0.036) Conclusion: The barriers faced to maintenance of cross infection control protocols pertaining to the hospital administration were reported to be higher for medical practitioners in comparison to the dental practitioners. The barriers faced to maintenance of cross infection control protocols pertaining to the attitude and practices of health care workers were also higher for medical practitioners in comparison to the dental practitioners. Keywords: Cross infection control, COVID 19 pandemic, medical practitioners, dental practitioners

Objective: To find the inter-rater reliability of dentists from various specialties regarding the observation and interpretation of angle of impacted third molars on the OPG. Methodology: A cross sectional comparative study was conducted in College of Dentistry, Sharif Medical and Dental College, Lahore after obtaining ethical clearance from ethical committee of Sharif Medical Research Centre (SMRC) in which dentists from four different specialties namely; Oral Pathology, Endodontics, Prosthodontics and Oral and Maxillofacial surgery were included as raters. The study was conducted from December 2020 to February 2021. A total of 21 Orthopantomograms were assigned to each rater for assessing the angle of the impacted third molar. The classification for angle of impaction used was Winter`s classification Results: The level of agreement regarding the angle of impacted third molars observed on the Orthopantomograms between rater 1 and rater 2 was very strong (κ=0.791,p≤0.001) but was moderate between rater 2 and rater 3 (κ=0.438, p≤0.001) and rater 2 and rater 4 (κ=0.577, p≤0.001) . Conclusion: The level of agreement regarding the angle of impacted third molars observed on the Orthopantomograms between rater 1 (oral pathologist) was very strong with rater 2 (Oral and Maxillofacial surgeon) while that of rater 2 with rater 3 (endodontist) and rater 4 (Prosthodontist) was moderate. Keywords: Inter-rater reliability, Orthopantomograms (OPG), impacted third molars, mesioangular, distoangular, vertical, horizontal

Objective: To assess the knowledge, attitude and practices of medical and dental practitioners regarding COVID-19. Methodology: A cross sectional study was conducted in College of Dentistry, Sharif Medical and Dental College, Lahore from July 2021 to July 2022 on medical and dental practitioners. Medical and dental practitioners irrespective of their age, gender and specialty of practice were included in the study. Participants who refused to give consent to be included in the study were excluded. Informed consent was taken from the participants before data collection. Data was collected using a pre-validated questionnaire Results: There was a statistically significant difference in the scores of attitude (p=≤0.001) and practices (p=≤0.001) while the non-significant difference in the scores of knowledge (p=0.200) across medical and dental practitioners regarding COVID-19 pandemic. Conclusion: The level of knowledge, attitude and practices of dental practitioners was higher in comparison to the medical practitioners. Keywords: COVID 19 pandemic, Dental practitioners, medical practitioners, knowledge, attitude, practice

Objective: To assess the general oral and periodontal health status of chronic kidney disease patients in various stages and compare it to healthy controls. Methodology: A Cross-sectional comparative study was conducted in Sharif Medical and Dental College, Lahore on 50 patients with chronic kidney disease and 58 controls for the time duration of one year. Data collection was based on the Community Periodontal Index of Treatment Needs and Decayed Missing and Filled index. Results: There was a significant association between stage of kidney disease and periodontal health (p= ≤0.001) and general oral health as determined by the DMFT index (≤0.001). There was a significant difference in the scores of decayed teeth between the controls and stage 3 (0.042), stage 5 (≤0.001) and stage 4 (p= 0.001). The difference in the scores of missing teeth was significant between controls and stage 5 (p=≤0.001) and stage 4 (p=0.001). Similar was the case for decayed missing and filled teeth index scores for controls and stage 3 (p=0.013), stage 5 (≤0.001) and stage 4 (≤0.001). Conclusion: Bleeding gums were most common in stage 3 while pocket depths of 4-5mm were highest in stage 4 and 5 patients. Pocket depth of 4 to 5mm was the most prevalent periodontal problem in controls. In the controls, more individuals had a high DMFT score in comparison to low scores. The scores of decayed teeth and decayed missing filled index were significantly different among the controls and stages 3, 5 and 4 while for missing teeth score, the difference was significant between controls and stages 4 and 5. Keywords: Periodontal health, Community periodontal index for treatment needs (CPITN), Decayed missing and filled teeth (DMFT) index, chronic kidney disease.

Objective: To assess the impact of socio-demographic factors on different personality types in individual. Methodology: A Cross-sectional descriptive study was conducted in College of Dentistry, Sharif Medical and Dental College, Lahore over a period of 5 months from July to November 2021. Data was collected using a ten-item personality inventory scale (TIPI). The sociodemographic variables included age, gender, marital status, occupation and educational level. All individuals irrespective of their age and gender were included in the study. Individuals with a history of psychiatric illness were excluded from the study. Results: There was a statistically significant difference in conscientiousness personality traits among age groups (p=0.006). Similarly, the difference in the personality trait of agreeableness (p≤0.001), conscientiousness (=0.016), and emotional stability (p=0.007) across gender was statistically significant. There was also a statistically significant difference in the scores of agreeableness among the employed and unemployed individuals (p=0.044). Conclusion: The conscientiousness personality trait score among age groups was the highest for the age group 50 to 59. The personality trait scores of agreeableness, conscientiousness, emotional stability across gender were higher in females in comparison to males. The contrary was true for emotional stability. The score of agreeableness was higher for unemployed individuals in comparison to employed individuals. Keywords: extraversion, agreeableness, conscientiousness, emotional stability, openness to experience, sociodemographic factors.

employed to minimize their failure. METHODOLOGY: A cross sectional descriptive was conducted in 150 dentists of Sharif College of Dentistry, SMDC, Lahore from June 2019 to July 2020 after obtaining ethical approval from Sharif Medical Research Centre (SMRC). Data was collected using a pre-validated questionnaire. Data was analyzed using SPSS 23. RESULTS: There was no significant association between years of clinical experience and case selection (p=0.436). The association between reason for selection of composites as posterior restorations and clinical experience of dentists was also non-significant (p=0.105). Similar was the case with concerns regarding using composites and clinical experience (p=0.950). The association between years of clinical experience and techniques to minimize failure of composite restorations was also non-significant (p=0.936). CONCLUSION: Majority of dentists with a clinical experience of less than 5 years as well as more than 5 years selected composites as posterior restorations only for small defects while the least chose them only when centric contacts were not involved. The major concern for dentists with clinical experience less than 5 years as well as more than 5 years was polymerization shrinkage of composites while the least were worried about wearing off of the restoration and difficulty in establishing contact points. In order to tackle these concerns the dentists reported in our study that they mostly used the techniques of incremental curing and moisture control procedures.

Objective: To find the association of sociodemographic factors with oral parafunctional habits. Methodology: A Cross-sectional descriptive study was conducted in College of Dentistry, Sharif Medical and Dental College, Lahore over a period of 5 months from July to November 2021. Data was collected using medical questionnaire and ten item personality inventory scale (TIPI). Results: The association of nail biting with gender (p=0.315), marital status (p=0.653), occupation (p=0.137) and education level (p=0.081) was not significant. Similar was the case for teeth grinding and gender (p=0.223), marital status (p=0.927), occupation (p=0.711) and education level (p=0.197). The association of teeth clenching habit with gender (p=0.174), marital status (p=1.000), occupation (p=0.349) and education level (p=0.362) was not significant. The association of the parafunctional habits of biting hard objects and chewing gum with sociodemographic factors was also not significant. Conclusion: It was seen that the majority of females, unmarried, unemployed individuals and those with tertiary level of education reported to have the habit of nail biting, teeth grinding and teeth clenching, biting on hard objects and chewing gum. Keywords: sociodemographic factors, nail biting, teeth clenching, teeth grinding, lip biting

When it comes to dental fluorosis, the severity of the condition determines which treatment method is the best. Considering the good aesthetics, wear resistance, biocompatibility, and ease of manipulation of direct composite veneers, they are considered the treatment for mild to moderate cases of fluorosis. In this case study, a 20-year-old female underwent a step-by-step rehabilitation of fluorosis teeth with resin composite as direct veneers. The patient presented in the department of operative and restorative dentistry at the College of Dentistry, Sharif medical and dental college with tooth discoloration.

This study aimed to determine the effectiveness of aromatherapy and music therapy in managing dental anxiety and pain among restorative dental patients in Peshawar, Pakistan. Sixty dental patients were selected after strictly following the inclusion and exclusion criteria. Informed consent was taken from the patients and instructed on the study protocols. Two groups were formed. One group had aromatherapy during the dental procedure, and the other had music therapy. The dental anxiety scale revised, present pain intensity and pain severity were used as the measuring tools in the study. SPSS 23 was used for statistical analysis. Chi-square and Mann-Whitney U tests were used for the analysis of the results. The association between pain intensity of dental patients with aromatherapy and music therapy was not significant. The percentage of discomforting pain in patients after aromatherapy was higher than in music therapy, while a higher percentage of patients were completely pain-free after music therapy. The mean rank score of pain severity was higher in a patient who received aromatherapy than music therapy. The difference in the pain severity scores across the therapy groups was statistically significant. The mean rank score of dental anxiety was also statistically significantly different across the therapy groups. The mean rank score of dental anxiety was higher for the patients who received aromatherapy than music therapy. It was concluded that distraction therapy works better to reduce the dental anxiety and pain intensity of dental patients. Furthermore, studies should be conducted to closely evaluate the difference and association of non-pharmacological treatments in this area.

To analyze the student`s perception of the effectiveness of online versus campus-based teaching. A descriptive cross-sectional study was conducted on students of Bachelor of Dental Surgery from College of Dentistry, Sharif Medical and Dental College Lahore. Dental students from all four years were included in the study irrespective of their academic records. Students who did not attend the online classes or refused to give consent were excluded from the study sample. A pre-validated questionnaire with a Cronbach alpha of 0.94 was used. The difference in the mean rank score across different student perceptions of the effectiveness of online in comparison to campus-based teaching was significant for motivational problems and time interruptions (p≤0.001) while non-significant for instructor and personal problems (p=0.437), lack of support services (p=0.942), lack of pre-requisite skills (p=0.218), technical problems (p=0.238) and lack of social interaction (p=0.187). The difference in the motivational problems and time interruptions across the different student perceptions was significant with the highest mean rank score for students who cannot learn well in online classes as in traditional classes. Keywords: Online learning, campus-based learning, student perception, effectiveness

Objective: To assess the presence and coexistence of multiple oral parafunctional habits in individuals with extravert personality type Methodology: A Cross-sectional descriptive study was conducted at the College of Dentistry, Sharif Medical and Dental College, Lahore, over 5 months, from July to November 2021. Data was collected using medical questionnaire and ten item personality inventory scale (TIPI). Results: There was significant association in the coexistence of parafunctional habit of nail biting with tooth clenching (p≤0.001), tooth grinding(p≤0.001), biting hard objects (p≤0.001) and chewing gum (p=0.027). Practical Implication: This study will help dental practitioners use personality assessment as an effective and important tool to find the propensity of an individual for development of oral parafunctional habits. In this way they will be able to provide timely treatment and counselling to the individuals before their dental health deteriorates due the development of oral parafunctional habits. Conclusion: The oral parafunctional habits found to coexist the most with nail biting habit was tooth grinding followed by biting hard objects, chewing gum and tooth clenching. Keywords: Extraverts, Oral parafunctional habits, Ten Item Inventory Scale, Nail Biting

Pyogenic granuloma is a type of inflammatory hyperplasia of the oral mucosa and skin that occurs commonly. Histopathologically, it mimics an angiomatous lesion instead of granulomatous disease. These lesions generally appear as a sessile papule or solitary nodule and may have a smooth or lobulated surface clinically. These granulomas present in a variety of sizes, ranging from a few millimeters to several centimeters. About 75% of the pyogenic granulomas of the oral cavity are associated with the gingiva. In this case report a 31 years old female presented in the department of oral and maxillofacial surgery with the complaint of abnormal growth of gingiva in maxillary anterior region. The patient was diagnosed with the pyogenic granuloma (pregnancy tumor), which had developed in the second trimester of her pregnancy. Surgical excision was done to remove the lesion.

Objective: To find the association between oral parafunctional habits and personality traits in individuals. Methodology: A Cross-sectional descriptive study was conducted at the College of Dentistry, Sharif Medical and Dental College, Lahore, over 5 months, from July to November 2021. All individuals, irrespective of their age and gender and those who reported having oral parafunctional habits, were included. Individuals with a history of smoking and those with any systemic illness were excluded. Data was collected using a medical questionnaire and a ten-item personality inventory scale (TIPI). Results: The association between personality traits and oral parafunctional habits was not statistically significant. The association between extraversion personality trait and nail-biting (p=0.267), teeth grinding (p=00754), teeth clenching (p=0.450) and biting hard objects (p=0.582) was not significant. The association between agreeableness and nail-biting (p=0.112), teeth grinding (p=0.612), teeth clenching (p=0.430), biting hard objects (p=0.639) and chewing gum (p=1.000) was not significant. The association between conscientiousness and nail-biting (p=0.588), teeth grinding (p=0.588), teeth clenching (p=0.325), biting hard objects(p=1.000) and chewing gum (p=1.000) was non-significant. Similarly, the association between personality traits of emotional stability and openness to experience with nail-biting (p=0.138, p=0.594 respectively), Teeth grinding (p=0.586,0.594 respectively), teeth clenching (p=0.813, p=1.000 respectively), biting hard objects (p=0.075, p= 0.347 respectively) and chewing gum (p=0.585, p=0.556 respectively) was non-significant. Conclusion: The majority of individuals from all personality types had a habit of teeth clenching followed by biting on hard objects. The least prevalent parafunctional habit reported by them was the parafunctional habit of chewing gum. Keywords: Extraversion, Agreeableness, Conscientiousness, Openness to experience, Emotional stability, Oral parafunctional habits

Objective: To assess the relationship of oral pathologies associated with second molars to the patterns of adjacent impacted third molar. Methodology: A cross sectional descriptive study was conducted on 385 Orthopantomograms (OPG) of patients. The study was conducted in the Institute of Dentistry, CMH Lahore Medical College, Lahore, Sharif Medical and Dental College (SMDC) and Services Institute of Medical Sciences (SIMS) over a period of three months from December 2020 to February 2021. The Pell and Gregory classification was used for depth of third molar impaction and ramus relationship of mandibular third molars. Winter`s classification was used for classifying the angle of impaction. Results: The association between presence of caries (p=≤0.001) and external resorption (p=≤0.001) in second mandibular molar with depth of impaction of adjacent an impacted third molar, ramus relationship of third molar with presence of external root resorption in second molar (p=≤0.001) and presence of caries (p=0.005), periapical radiolucencies (p=0.009) and external root resorption (p=≤0.001) in second molar with the angle of impacted third molar were significant. The association of presence of caries, pericoronal, periapical radiolucencies and external root resorption in the maxillary second molars with the depth and angle of adjacent impacted third molars was not significant. Conclusion: The carious lesions were the highest where the third molar had class A depth of impaction while the maximum external resorption was seen where the third molar had class C depth of impaction. Second mandibular molars adjacent to impacted third molars in class 2 ramus relationship had the most external root resorption. It was seen that second molars adjacent to the impacted third molars with mesioangular impactions had the highest percentage of caries and periapical radiolucencies while those adjacent to third molars with horizontal angle of impaction showed the maximum external root resorption. Keywords: Second molars, impacted third molars, pericoronal radiolucency, periapical radiolucency, external root resorption, caries

Objective: To find the difference in the periodontal treatment needs of females across different trimesters of pregnancy. Methodology: A cross sectional comparative study was conducted among 44 pregnant visiting the gynecology department of Sharif Medical and Dental College and Raiwind Polyclinic, Lahore (community outreach program of the institute). Data was collected using the Community Periodontal Index of Treatment Needs (CPITN) Results: The highest percentage of females (24%) requiring no treatment (TN0) were in their third trimester. The majority of females in their second trimester (85.7%) required oral hygiene instructions and had periodontal treatment needs (TN1) and those in their first trimester (83.3%) required Scaling and prophylaxis and Oral hygiene instructions (TN 2). Conclusion: The highest percentage of females with healthy periodontium were in their third trimester. Periodontal pocket depth of 4-5 mm were seen the most on the clinical examination of women in their second trimester but least in third trimester. The highest percentage of females requiring no treatment (TN0) were in their third trimester. The majority of females in their second trimester required oral hygiene instructions and had periodontal treatment needs (TN1) and those in their first trimester required Scaling and prophylaxis and Oral hygiene instructions (TN 2). Keywords: Periodontal treatment needs, first trimester, second trimester, third trimester, Community periodontal index for treatment needs (CPITN)

Objective: To assess the periodontal treatment needs of smokers in comparison to non-smokers. Methodology: A Cross sectional comparative study was carried out on 100 patients, 50 smokers and 50 non-smokers, visiting Sharif Medical and Dental College, Lahore from June 2019 to July 2020. Intra-oral examination was done using the Community Periodontal Index of Treatment Needs (CPITN). Recorded data was coded, entered and analyzed using SPSS statistical Package version 23. Results: Majority of the smokers and non-smokers (100%) required oral hygiene instructions and had periodontal treatment needs (TN1). It was seen that a higher percentage of smokers (92%) required Scaling and prophylaxis and Oral hygiene instructions (TN 2) in comparison to non-smokers (36%). It was seen that 26 % smokers and none of the non-smokers required required complex treatment, scaling, prophylaxis and oral hygiene instructions (TN3). Conclusion: Majority of the smokers and non-smoke required oral hygiene instructions and had periodontal treatment needs (TN1). A higher percentage of smokers required Scaling and prophylaxis and Oral hygiene instructions (TN 2) as well as complex treatment, scaling, prophylaxis and oral hygiene instructions (TN3) in comparison to non-smokers Keywords: Periodontal treatment needs, smokers, non-smokers, Community periodontal index of treatment needs (CPITN).

Delay in wound healing is a diabetes mellites resulting disorder causing persistent microbial infections, pain, and poor quality of life. This disorder is treated by several strategies using natural biomaterials, growth factors and stem cells molded into various scaffolds which possess the potential to accelerate the closure of impaired diabetic wounds. In this study, we developed a hydrogel patch using chitosan (CS) and polyethylene glycol (PEG) with laden bone marrow-derived mesenchymal stem cells (BMSCs) that were pretreated with fibroblast growth factor 21 (FGF21). The developed hydrogel patches were characterized by scanning electron microscopy and fourier transform infrared (FTIR) spectroscopy. After studying the swelling behavior, growth factor (FGF21) was used to modulate BMSC in the hyperglycemic environment. Later, FGF21 treated BMSC were embedded in CS/PEG hydrogel patch and their wound closure effect was assessed in diabetic rats. The results showed that CS/PEG hydrogel patches have good biocompatibility and possess efficient BMSC recruiting properties. The application of CS/PEG hydrogel patches accelerated wound closure in diabetic rats as compared to the control groups. However, the use of FGF21 pretreated BMSCs laded CS/PEG hydrogel patches further increased the therapeutic efficacy of wound closure in diabetic rats. This study demonstrated that the application of a hydrogel patch of CS/PEG with FGF21 pretreated BMSCs improves diabetic wound healing, but further studies are needed on larger animals before the use of these dressings in clinical trials.

Hydrogels have been the material of choice for regenerative medicine applications due to their biocompatibility that can facilitate cellular attachment and proliferation. The present study aimed at constructing a porous hydrogel composite scaffold (chitosan, sodium alginate and elastin) for the repair of chronic skin wounds. Chitosan-based hydrogel incorporating varying concentrations of zinc oxide nanoparticles i.e. ZnO-NPs (0, 0.001, 0.01, 0.1 and 1 % w/w) as the antimicrobial agent tested against Escherichia coli (E.coli) and Staphylococcus aureus (S. aureus) exhibited good antibacterial activities. ZnO-NPs were characterized by UV visible spectroscopy, Scanning electron microscopy (SEM) analysis, Fourier transform infrared spectroscopy (FTIR) and X-ray diffraction (XRD) analysis. Fabricated gels were characterized by SEM analysis, FTIR, XRD, swelling ratio, degradation behavior and controlled release kinetics of ZnO-NPs. In vitro cytocompatibility of the composite was investigated using human adipose stem cells (ADSCs) by MTT and lactate dehydrogenase (LDH) assay, further assessed by SEM analysis and PKH26 staining. The SEM and XRD analysis confirmed the successful loading of ZnO-NPs into these scaffolds. Fluorescence PKH26 stained images and SEM analysis of ADSCs seeded scaffolds revealed biocompatible nature. The findings suggested that the developed composite gels have potential clinically for tissue engineering and chronic wound treatment. The authors acknowledge Dr. Muhammad Ali, The Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA, for checking the manuscript for English language, grammar, style and syntax. The authors acknowledge Higher Education Commission Pakistan for providing funding for conduct of this work from TDF 02-163 (Dr. Azra Mehmood) and HEC NRPU Project number 8762 (Dr. Muhammad Yar). Scopus

OBJECTIVES: To compare the impact of traditional classroom-based teaching versus online teaching on the academics and attendance of male as compared to female students METHODOLOGY: A study was conducted on 51 third year BDS students, College of Dentistry, Sharif Medical and Dental College, Lahore. An aggregate of the scores based on weightage assigned to each test for all the assessments conducted in the regular session and online session was formulated. The attendance record of the months taught in both the sessions was also taken as percentages. Fisher Exact test was used to find the statistical association between the level of academic performance as well as attendance in the regular session and online session with gender of the students. Man Whitney U test was used to find the statistical difference in the scores of assessments in the regular as well as online session of male and female students. RESULTS: There was a significant association between gender and academic performance in the online session (p=0.002). Gender and academic performance of students during the traditional classroom-based teaching session had a significant association (p=0.001). The attendance of male and female students was found to be significantly associated with the online teaching system (p=0.009). CONCLUSION: It was observed that females had an overall better academic performance in the online teaching as well as traditional classroom-based teaching system. A similar trend was observed in attendance also, where the females had better attendance record in online and traditional classroom-based teaching set up.

Introduction: Diabetic wounds are challenging to treat due to a wide range of pathophysiological changes. Hypoxia is one of the predominant contributing factors of poor vascularization and chronicity in diabetic wounds. This study was designed to develop polycaprolactone (PCL)-based oxygen-releasing electrospun wound dressings and evaluate their efficacy for improved full thickness wound healing in diabetic rats. Methods: PCL-based oxygen releasing wound dressings were made using electrospinning technology. The developed dressings were characterized in terms of physical as well as biological properties both in vitro and in vivo. E-spun nanofibrous dressings were physically characterized with scanning electron microscopy, Fourier-transform infrared spectroscopy, and Energy-dispersive X-ray spectroscopy. To study the likely impact of the fabricated wound dressings in hypoxic conditions, HIF-1α expression analysis was carried out both at gene and protein levels. Wound dressings were further evaluated for their healing potential for extensive wounds in diabetic rat models. Results: The experimental results showed that the developed dressings were capable of continuously generating oxygen for up to 10 days. Cell studies further confirmed pronounced expression of HIF-1α at gene and protein levels in cells seeded on PCL-sodium percarbonate (SPC) and PCL scaffolds compared with the cells cultured on a tissue culture plate. Chorioallantoic membrane assay revealed the supportive role of oxygen releasing dressings on angiogenesis compared to the control group. Histological assessment of the regenerated skin tissues proved that full thickness wounds covered with SPC loaded PCL dressings had a comparatively better vascularized and compact extracellular matrix with completely covered thick epithelium. Discussion: The developed oxygen generating polymeric nanofibrous wound dressings could potentially be used as an envisioned approach for the efficient recovery of chronic diabetic wounds. © 2020 Zehra et al.

Objective: To find the prevalence of diastasis recti abdominis in females with respect to their stage and status of pregnancy Methodology: A cross sectional study was conducted in Lahore General Hospital from September 2018 to January 2019.Child bearing female in the age group of 20-40 years. Child bearing females not willing to participate, menopausal females, females with any gynecological disorders and those who suffered from ectopic pregnancy were excluded from the study. The questionnaire distributed as hand-outs in selected hospitals. Data was collected in person/ through representatives appointed in every hospital. Results: There was no statistically significant association between previous pregnancy and presence of Diathesis Recti (P=0.566). A statistically significant association between status of pregnancy and presence of Diathesis Recti was present (p≤0.001). Conclusion The prevalence of Diathesis Recti was higher in the females who did not have a history of previous pregnancy.The presence of Diathesis Recti was the highest in females in their third trimester while those in the first and second trimester did not suffer from this condition. It was also seen that the non-pregnant females suffered more from the condition in comparison to the pregnant women. Keywords: Diathesis Recti, Pregnant females, Non-pregnant females, trimester.

BackgroundFollowing recent findings from our group that curcumin preconditioning augments the therapeutic efficacy of adipose-derived stem cells in the healing of diabetic wounds in rats, we aimed to investigate the regenerative effects of curcumin preconditioned adipose-derived mesenchymal stem cells (ASCs) for better recovery of acid inflicted burns in this study.MethodsASCs were preconditioned with 5 μM curcumin for 24 hours and assessed for proliferation, migration, paracrine release potential and gene expression comparative to naïve ASCs. Subsequently, the healing capacity of curcumin preconditioned ASCs (Cur-ASCs) versus naïve ASCs was examined using acidic wounds in rats. For this, acid inflicted burns of 20 mm in diameter were made on the back of male Wistar rats. Then, 2 × 106 cells of Cur-ASCs and naïve ASCs were intradermally injected in the wound periphery (n = 6) for comparison with an untreated saline control. Post-transplantation, wounds were macroscopically analysed and photographed to evaluate the percentage of wound closure and period of re-epithelization. Healed wound biopsies were excised and used for histological evaluation and expression analysis of wound healing markers at molecular level by quantitative PCR and western blotting.ResultsWe found that Cur-ASCs exhibited greater proliferation, migration and paracrine potential in vitro. Further, Cur-ASCs showed more effective recovery than naïve ASCs as exhibited by gross morphology, faster wound closure and earlier re-epithelialization. Masson’s trichrome and hematoxylin and eosin staining demonstrated the improved architecture of the healing burns, as evidenced by reduced infiltration of inflammatory cells, compact collagen and marked granulation in Cur-ASC treated rats. Corroborating these findings, molecular assessment showed significantly reduced expressions of pro-inflammatory factors (interleukin-1 beta, interleukin-6, tumor necrosis factor alpha) a with striking upsurge of an oxidative marker (superoxide dismutase 1), pro-angiogenic factors (vascular endothelial growth factor, hepatocyte growth factor, hypoxia-inducible factor-1 alpha) and collagen markers (transforming growth factor beta 1, fibroblast growth factor-2, collagen type 1 alpha 1), verifying that Cur-ASCs modulate the regulation of pro-inflammatory and healing markers at burn sites.ConclusionsTreatment with Cur-ASCs resulted in faster re-epithelization of acid inflicted burns compared to the treatment with naïve ASCs. Based on observed findings, we suggest the transplantation of Cur-ASCs is a valuable therapy for the potent clinical management of acidic burns.

Objectives: To evaluate the detrimental impact of smoking on oral health.Methodology: A Cross sectional comparative study was carried out on 100 patients, 50 smokers and 50 non-smokers, visitingSharif Medical and Dental College, Lahore from June 2019 to July 2020. Intra-oral examination was done using the CommunityPeriodontal Index of Treatment Needs (CPITN). Recorded data was coded, entered and analyzed using SPSS statistical Packageversion 23.ResultsThe periodontal health was significantly associated with status of smoking (p=0.001). The most prevalent periodontal problemsof smokers were periodontal pockets of 4 to 5 mm (19%) while the least (4%) had bleeding on probing. Majority of the nonsmokers(32%) had bleeding on probing. The number of cigarettes smoked in a day and periodontal health status weresignificantly associated (p=0.004). Light smokers (1 to 10 cigarettes/day) had periodontal pockets of 4 to 5mm as their biggestperiodontal problems (38%) while the least (8%) had bleeding on probing. The periodontal problem that intermittent smokers(11 to 15 cigarettes/day) predominantly had was periodontal pockets of 6 mm or more (8%) and same was the case with heavysmokers (2%).Conclusion: The main periodontal problem of smokers was periodontal pockets of 4 to 5 mm while the least was bleeding onprobing. Most of the non-smokers had bleeding on probing while none of the non-smokers had periodontal pockets. Lightsmokers (1 to 10 cigarettes/day) mainly had periodontal pockets of 4 to 5mm as their main concern. The periodontal problemthat intermittent and heavy smokers mainly had were periodontal pockets of 6 mm or more.

OBJECTIVES: The aim of this study was to identify the stress factors among dental postgraduate residents of Lahore, Pakistan. METHODOLOGY: A cross-sectional study was conducted using non-probability convenient sampling techniques. Total 150 dental postgraduate residents were enrolled in this study. Questionnaire was composed of questions regarding stress factors and the influence of stressors on individuals. The data was analyzed; Chi-square test was used to find the statistical association of level of stress with the demographic factors (gender, marital status, and accommodation), professional characteristics (working hours and practice) and impact on the individuals (mood change, weight change and headache). The level of significance was set at P≤0.05. RESULTS: Total 150 individuals responded with a mean age of 29 years (SD +/-2.96). Male to female ratio was 1:2.5. The most prevalent factors that contributed to stress were post-graduate examination (81%), clinical case presentations (80%), competition for higher performance (61%), inconsistency of feedback by supervisors (59%), research program (55%) and fear of failure to treat patients (53%). More than half of the respondents (69%) suffered from mood swings and (65%) from tension headaches followed by clenching and bruxism in nearly half of the residents (50%), musculoskeletal problems (49%) and weight changes (48%) with p-value