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To determine and compare the frequency of contamination on different sites of healing abutments after sterilization with Phloxine B dye on unused and used healing abutments after sterilization.A total of 60 healing abutments were divided into two test groups: (1) used and sterilized and (2) a control group (unused). The test group was evaluated for contamination after sterilization; the control group did not undergo any procedure. Data were analyzed using SPSS version 22. Descriptive statistics were used to determine the frequency of contamination in the different groups and at the different healing abutment sites. Chi-square test was used to evaluate the association of frequency of contamination with the site and design of the healing abutment. The level of significance was kept at P ≤ .01.The test group showed more contamination compared to the control. The most contaminated sites were the screw thread and the screwdriver engagement location.Reuse of healing abutments is cost-effective, but cleaning and sterilization was not effective for these components; thus, healing abutments need to be reused with caution as they were heavily contaminated when compared to new healing abutments. Among the different sites, the screw thread and screwdriver engagement sites were more prone to contamination. Healing abutment type did not influence the frequency of contamination.

OBJECTIVE: The objective of this study is to assess infection control measures in dental practices during COVID-19 outbreak in Pakistan. METHODOLOGY: It was a cross-sectional web based survey conducted during COVID-19 outbreak from the period of June 2020 to August 2020. The study participants were the dental surgeons who were either working in hospital setup or running their own private practice or working in private dental setup. The survey consisted of sets of questions to assess whether dental practitioners have implemented strategies to combat novel corona virus infection in their practice. It also consists of questions that assess aerosol generating procedures are commencing with or without out any COVID-19 symptoms. RESULTS: About 39.1% participants reported that 75% of the number of patients in their clinic had been reduced and 52.2% of the participants reported that >50% of the patients came for endodontic procedures with pain. Eighty one percent of the participants were maintaining hand hygiene before touching all patients, 71.7% before any cleaning, 78.3% before any aseptic procedure, 81% after exposure to patient’s fluid and 80.4% after touching. There was low compliance regarding the use of personal protective equipment and almost 62.6% were using eye wear for all patients, 58.7% were disinfecting whole clinical room before new patient and 43.9% were using single use (disposable) examination set during COVID-19 outbreak. CONCLUSION: Majority of dentist in Pakistan were following the recommendations and guidelines of infection control practices related to COVID-19 pandemic. KEYWORDS: COVID-19, coronavirus, infection control measures, practices, dentistry

The purpose of the present review was to examine success, survival and failure following intentional replantation of endodontically treated teeth with existing periapical pathosis and to determine the factors that might affect the outcome of replantation. Clinical trials, longitudinal studies, case series with10 cases and at least 1-year follow-up were included. The average rate of success following intentional replantation was 77.23%. Meta-analysis revealed the mean weighted survival to be 85.9% (95% CI: 79.6-91.2) Common complications include inflammatory root resorption (0%-27%) and ankylosis (0%-25%). Variables influencing successful outcome include extra alveolar dry time15 min; root-end resection (2-3 mm) and cavity preparation (3 mm); manipulation of the tooth using the crown only; and use of an appropriate storage media. The review concludes that intentional replantation is a viable treatment option with acceptable survival rates for endodontically treated teeth with periapical pathosis.

Tooth wear is a common problem seen in population and poses restorative challenge to a dentist as well. Extensive dental procedures are usually required for the treatment of tooth wear associated with loss of occlusal vertical dimension. An overlay removable partial denture provides conservative treatment option for patients with moderate to severe worn down dentition and partial edentulism. It is designed in such a way that some part of denture component also covers the occlusal surface of remaining teeth and replace the remaining teeth to achieve a functionally stable occlusion. This case report is about a patient who was given cast metal overlay upper and lower denture for a correction of lost vertical dimension of occlusion, replacement of few missing teeth and for the prevention from further tooth wear. KEYWORDS: Tooth wear, vertical dimension, overlay denture HOW TO CITE: Aziz S, Nazeer MR, Zafar K, Ghafoor R. A Permanent solution to restore occlusal vertical dimension and partial edentulism – Overlay removable partial denture. J Pak Dent Assoc 2021;30(1):66-69.

Bibliometric analysis of a particular specialty published in single journal allows the identification of publication trends, areas of focus and potential domains for future research that could be publishable within the scope of that journal. This study aimed to analyse the characteristics of dental literature published in JCPSP in order to determine the trend of publication of dentistry-related papers in this journal.An electronic and hand search was conducted of all JCPSP issues from 1991 till June 2018. The selected articles were analysed for year of publication, field of study, type of article, the names of first author, their gender and affiliation (institute, country), number of authors in each publication and citation count. Data was statistically analysed using SPSS version 20.0.Out of approximately 5,400 published articles, 253 were included for analysis. Articles related to Oral and Maxillofacial surgery were in majority (n=54), followed by Operative Dentistry and Endodontics (n=38). Most (n=103) were original research articles. Pakistani authors contributed the majority of articles (n=184). The greatest number of dental articles were published in the year 2014 and 2017 (n=30). The institutions with the highest number of dental papers were Aga Khan University, Karachi and NIMS Dental College, Jaipur, India. The majority of articles were by Manas Bajpai as first author (n=22 articles). The highest citation count was found to be 55.Overall, the proportion of dentistry related articles published in JCPSP is low (4.6%). Researchers working in dental specialties where few publications were observed could be invited to submit relevant publications to JCPSP to broaden the scope of the journal. Foreign authorship should be encouraged to further elevate the standing of this journal. A separate journal for dental research in light of the continually increasing number of dental specialists and researchers is the need of the hour.

To analyse characteristics of literature related to dental research and education published in a single medical journal, The Journal of Pakistan Medical Association.The bibliometric study was conducted at the Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University from March till May 2020, and comprised electronic and hand search of scientific literature relevant to dentistry published in the Journal of Pakistan Medical Association from the first issue published in 1953 till March 2020. The selected articles were analysed for year of publication, field of study, type of article, institute and country of first author, number of authors and citation count. Keyword mapping was also carried out. Data was analysed using SPSS 19.Of the 159 articles identified, 117(73.6%) were contributed from Pakistan. The most common specialties were Oral and Maxillofacial Surgery and Epidemiology with 20(12.6%) articles each, followed by Operative Dentistry and Endodontics 19(11.9%). Majority of articles were Original / Research 87(54.7%). The highest number of articles were published in 2019 26(16.35%). The Aga Khan University, contributed the most publications 30(18.9%), followed by Dow University of Health Sciences, 11(6.9%). Majority of the articles were contributed by three authors 48(38.4%). The top cited article was found to have 113 citations, followed by articles with 103 and 91 citations.The contribution of scientific papers related to dentistry and dental education in the Journal of Pakistan Medical Association was significant. With growth of dentistry as a discipline along with a parallel increase in the publication of dental research papers, it is imperative that a dedicated indexed journal for dental research be commenced.

To compare the effect of ProTaper Next and One Shape rotary files on canal transportation and centering abilities in resin block with simulated curved canal.An in-vitro experimental study was carried out in Dental clinics. Sixty resin blocks (30 per group) having simulated curved canals prepared with ProTaper Next and One Shape and then filled with red and blue Indian ink, respectively. Photographs of resin blocks obtained using standardized manner were then transferred to the Adobe Photoshop 7.0. Centering abilities and amount of transportation were then calculated at coronal, middle and apical portion of canal for both the groups. Independent sample t-test was used to compare the transportation and centering ability of both file systems. Level of significance was kept at p-value ≤0.01.One Shape file resulted in more canal transportation at all the levels (apical, middle and coronal part) as compared to ProTaper Next file, however, difference was not statistically significant (p-value0.01). Statistically significant difference was noted at the apical third between these two rotary files with One Shape file showing more centered preparation as opposed to ProTaper Next file (p-value0.01).One Shape file system had more centered canal preparations specifically at the apical region as compared to ProTaper Next. One Shape also lead to more canal transportation in comparison to ProTaper Next, however the difference was not statistically significant.

Highlights • Gingivitis is one of the most prevalent diseases that affects 82% of adult population. • This current protocol is effective at reducing the gingival inflammation. • The use of alternate gel application of Chlorhexidine and Metronidazole showed improvement in the treatment of gingivitis. • Need further implementation of the protocol followed by re-assessment., Introduction Dental plaque has been established as an etiological factor in the development of gingivitis and periodontitis. Several antimicrobials including Chlorhexidine and Metronidazole have been used as an adjuvant to mechanical plaque removal. Objective To compare 0.8% Metronidazole gel, 0.2% Chlorhexidine gel and alternate application of the two gels in reducing gingival inflammation when used for 14 days as an adjuvant with home based oral hygiene instructions. Methods The bleeding sites, probing depth and the gingival index score will be calculated. (Group A standard 0.2% Chlorhexidine gel applied on the marginal gingiva; Group B subjects will be instructed to apply 0.8% Metronidazole gel; Group C subjects 0.2% Chlorhexidine gel on the marginal gingiva after morning tooth brushing and 0.8% Metronidazole gel after evening tooth brushing). After 2 weeks second clinical examination will be carried out for bleeding sites, probing depth and the gingival index score. Scaling & polishing of teeth in all three groups and oral hygiene instructions will be reinforced. Subjects will be recalled at 6 weeks for evaluation of gingival and oral hygiene indices. Descriptive statistics for variables such as age, baseline clinical parameters including probing depth, bleeding sites, gingival index, and oral hygiene index will be computed. Generalized estimation equation (GEE) will be run to account for the correlated data for the comparison of study arms. Friedman test will be used to assess the bleeding sites among three study groups at the baseline and endpoint. Similarly, gingival index and oral hygiene index in the three groups at baseline, after 2 weeks and 4 weeks will be compared. The level of significance will be kept at 0.05.

During the ongoing COVID‐19 pandemic, healthcare professionals are at the forefront of managing the highly infectious coronavirus. As the most common route of transmission is via aerosols and droplet inhalation, it is critical for healthcare workers to have the correct personal protective equipment (PPE) including gowns, masks and goggles. Surgical masks are not effective in preventing the influenza and SARS, so they are unlikely to be able to resist contaminated aerosols from entering the respiratory system. Therefore, it is vital to use respirators which have been proven to offer better protection against droplets, aerosols and fluid penetration and which form a tight seal around the mouth and nose. Various types of respirators are used in healthcare settings, such as half‐mask filtering facepiece respirators (FFRs) and powered air‐purifying respirators (PAPRs). The most commonly used FFR is the N95 disposable respirator, which is tight fitting and has a 95% or above particle filtering efficiency for a median particle size of 0.3 µm. This review discusses respirators, their purpose, types, clinical efficiency and proper donning and doffing techniques.

Recent advances in the field of endodontics have greatly improved the outcome and success rate of dental materials. For last three decades, there has been great interest in the development of bioactive dental material with the ability to interact and induce surrounding dental tissues to promote regeneration of pulpal and periradicular tissues. As these bioactive materials are mainly based on calcium silicates, they are also referred to as Calcium Silicate materials. The first material introduced was Mineral Tri-oxide Aggregate, which, due to its favourable biological properties, gained importance initially. However, later, due to its drawbacks, liked is colouration, long setting time and difficult manipulation, several modifications were done and newer bioactive materials, such as Biodentine, BioAggregate, Endosequence, Calcium-Enriched Mixture etc., were developed. The main applications of these materials are for pulp capping (direc t/indirec t), pulpotomy, perforation repair, resorption defects, apexogenesis and as retrograde filling materials, apexification and endodontic sealers. This review discusses the various types of bioactive materials, their composition, setting mechanism, and literature evidence for current applications.

The management of Amelogenesis imperfecta often poses a challenge for the dentists. It not only includes aesthetic and functional rehabilitation of the patient, but also requires a positive rapport building with the patient due to psychosocial issues. The treatment plan is driven by patient demands, age, cost-affordability, severity of the disease and the presenting condition. The present case report elucidates step by step management of a 20 year-old female who presented with generalized hypersensitivity, intermittent pain associated with multiple decayed posterior teeth, poor dental aesthetics and anterior deep bite. The management consisted of endodontic treatments in all teeth, crown lengthening to gain ferrule in some teeth, provision of provisional bridges at an increased vertical dimension for six weeks followed by full mouth all ceramic crowns on all teeth. The prosthetic management aimed at reorganized occlusal scheme. There was a significant improvement in the aesthetics, deep bite, and along with correction of the vertical dimension of occlusion. Key words:Amelogenesis imperfecta, hypoplastic enamel, mouth rehabilitation, dental esthetics.

Ever since their introduction, nickel–titanium (NiTi) alloys have continued to revolutionize the field of endodontics. They have considerable advantages over the conventional stainless steel file in terms of mechanical properties. However, despite of their superior mechanical properties, NiTi alloys still pose some risk of fracture. Consequently, there has been considerable research conducted to investigate the mechanisms behind the occurrence of these procedural errors. Since the last decade, different proprietary processing procedures have been introduced to further improve the mechanical properties of NiTi alloys. These treatments include thermal, mechanical, electropolishing, and recently introduced electric discharge machining. The main purpose of these treatments is to impart a more martensitic phase into the files at normal body temperature, so that the maximum advantage of flexibility can be obtained. These heat-treated instruments also possess improved cyclic fatigue resistance when compared to conventional NiTi alloys. NiTi alloys can be subclassified as the instruments mainly containing austenitic phase (conventional NiTi, M-wire, R-phase), and those containing martensitic phase (controlled memory wire, ProTaper Gold, and Vortex Blue). Instruments based on austenitic alloys possess superelastic properties due to the stress-induced martensitic transformation. Contrary to this, martensitic alloys can easily be deformed due to phase transformation, and they can demonstrate the shape memory effect when heated. This review discusses the different phase transformations and heat treatments that the NiTi instruments undergo.

The objective of the present systematic review is to evaluate the success of pulpotomy in mature permanent teeth presented with irreversible pulpitis. The following databases were searched: PubMed, Oral and Dentistry Database, Cochrane, and CINAHL plus. We included studies published in the English language only. However, narrative reviews and case reports/series were excluded. The first electronic and hand search yielded a total of 2851 articles. After going through extensive screening and eligibility process, only six articles were finally selected for the review. The follow-up period ranged from 1 to 10 years. Randomized controlled trial compared pulpotomy with the root canal treatment and reported comparable and even better success of the pulpotomy (78% success). All the other studies have also shown better clinical and radiographic success of pulpotomy (68%-100%). Pulpotomy can be considered an alternative option for mature permanent teeth with irreversible pulpitis.

Objective To determine the frequency of complications in crowns cemented over a 5-year period in a tertiary care hospital and also to report the survival of these crowns. Methods The retrospective cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from March 2017 to March 2018 and comprised porcelain fused-to-metal crowns placed on the anterior or posterior teeth that were fabricated at the institutional laboratory and were placed in institutional dental clinics in the preceding 5 years. Porcelain-fused to-metal The crowns were clinically and radio-graphically evaluated in a duration of two months for presence/absence of complications. Factors associated with the failure of the crowns, their survival and the impact of covariates, like gender, flossing and bruxism, on the survival time were determined. Data was analysed using SPSS 22. Results There were 150 crowns related to 107 patients who had a mean age of 45.0±11.4 years. The most common complication observed was open proximal contacts 9(6%) followed by de-cementation 8(5.3%), porcelain chipping 9(6%) and abutment fracture 2(1.3%). The 5-year survival rate of the crowns was 127(84.7%). The mean follow-up time was 57.2±1.0 months. Overall, year-wise survival of PFM crowns for one year till five years was 147 (98%), 144 (96%), 135 (90%), 130 (86%) and 119 (79%) respectively. Conclusions The porcelain-fused-to-metal crowns had a high 5-year survival rate. Open proximal contacts represented the most common complication.

To assess the knowledge of practising dentists regarding immediate management of dental avulsion.The cross-sectional analytical study was conducted in various dental colleges and teaching hospitals of Karachi, Pakistan, in October-November 2016, and comprised dentists working in academic institutions / departments or as general dental practitioners for at least 1 year. The subjects were asked to fill out a self-administered questionnaire. Questions related to knowledge and practice regarding immediate management of dental avulsion was asked and then responses were categorised as good knowledge, moderate and poor knowledge. SPSS 22 was used for data analysis..Of the 282 subjects, 179 (63.5%) were females and 103(36.5%) were males. The overall mean age was 28. 33±4.7 years, and 194 (68.8%) had clinical experience of less than 5 years. Of the total, 30(11%) dentists had good knowledge while 130(46%) had moderate and 122(43%) had poor knowledge. Statistically significant association of knowledge regarding tooth avulsion was observed with the specialty (p= 0.006) and qualification (p=0.001).The knowledge of dentists regarding immediate management of avulsion injuries was inadequate. Knowledge was significantly associated with specialty and qualification of the dentist.

The incidence of head and neck cancer is increasing and it is regarded as one of the leading causes of morbidity and mortality. The treatment of head and neck carcinoma is very challenging and depends on the stage of the disease. Radiotherapy is largely employed as primary therapy, adjuvant to surgery, or in combination with chemotherapy for the treatment of head and neck carcinomas. Patients undergoing radiotherapy are prone to a range of short- and long-term complications which adversely affects their health and quality of life. Management of these complications is complex and based on early detection, prevention, and oral care before, during, and after the treatment, to establish the best oral care pathway for these patients. Dental management of these patients is especially important to maintain oral hygiene, overall health, and nutrition status. Management involves multidisciplinary team approach which includes dental practitioners and the oncology team not only in the primary treatment but also in the long-term care and maintenance. It is, therefore, essential for clinicians involved in cancer treatment and cancer survivors to be aware of prevention and management these complications. The aim of this review is to highlight importance of postoperative complications associated with radiotherapy and to draw attention of multidisciplinary teams involved in cancer management toward dental needs of patients treated with radiation therapy, to ensure good quality care and better quality of life in irradiated head and neck cancer patients.