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Objective: To measure the intensity of post-operative pain after using two techniques for root canal treatment. Study Design: Quasi-experimental study. Place of Study and Duration: Operative Dentistry Department, Fatima Jinnah Dental College, Karachi Pakistan, from May to Oct 2019. Methodology: The study was conducted on 60 patients referred to the Department of Endodontic, Fatima Jinnah Dental College. Enrolled patients were randomly divided into two groups (A and B) using the sealed envelope technique. Two different root canal file systems were used to assess the post-operative pain intensity in both groups. Results: The post-operative pain intensity considerably decreased in both groups. The difference between the rotational and reciprocal techniques was found to be statistically insignificant (p=0.86) in the 6 hours (p=0.73) and 24 hours' periods (p=0.147) between the instrumentation techniques. However, pain experienced in the 48 hours was statistically different between the two groups (p=0.03). Conclusion: Post-operative pain is a consequence of both instrumentation techniques, which should be thoroughly investigated and assessed. [ABSTRACT FROM AUTHOR]

OBJECTIVE: This study is to compare the dentin bridge thickness achieved using calcium hydroxide and MTA using radiographs. METHODOLOGY: Single blinded randomized controlled trial conducted in the Operative Dentistry department at Fatima Jinnah Dental College and Hospital, Karachi. A total of 100 premolar and molar teeth with class I and II cavities were included in this study. The study participants were assigned into two groups, A and B of 50 participants each. Under local anesthesia, Group A was indirectly pulp capped with Calcium hydroxide (Dycal) and Group B received Mineral Trioxide Aggregate as an indirect pulp capping material. Both groups were then restored with Glass Ionomer Cement. Radiographic follow up was carried out at three and six months to determine mean dentin thickness of reparative dentin bridge. RESULTS: Statistical analysis was performed using SPSS v 23. Independent Sample t-test was applied to evaluate the formation of dentin bridge formation using Ca(OH)2 and MTA at 3 months & 6 months, the outcomes were highly significant (p-value<0.001). Paired sample t-test was applied to evaluate the difference in dentin bridge formation at three months and 6 months, the results were highly significant (p-value <0.001). CONCLUSION: Statistically significant difference was observed in the dentin thickness of reparative dentin bridge amongst the two groups after three months and six months. A greater success rate was noted in the MTA group as compared to the Ca(OH)2 group after 6 months. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The aim of this study was to assess the knowledge of Endodontic Postgraduate trainees regarding clinically relevant situations where an antibiotic cover is needed and is focused on the prescription patterns of various antibiotics depending on the clinical evaluation of the patients. METHODOLOGY: A cross sectional study was performed in which data was collected from five different dental institutes offering post-graduate residency in endodontics all over Karachi, Pakistan. Preferred antibiotic for odontogenic infections and the duration for the antibiotic coverage were evaluated amongst postgraduate clinicians. A total of 100 questionnaires were distributed out of which only 82 questionnaires came back with responses. The study was conducted for a period of one month from August 2018-September 2018. The data collected was analyzed by SPSS version 21. RESULTS: A combination of amoxicillin with Clavulanic acid was the first choice of antibiotic in patients with no known allergies to penicillin (40.6%), whereas erythromycin was the first choice of antibiotic in patients having allergic reactions to penicillin (39.3%). The duration of treatment on average was 5 days. In clinical situations of irreversible pulpitis, with or without apical periodontitis, 74.3% and 67% of the respondents prescribed antibiotics. 78 % of respondents have prescribed antibiotics in cases of necrotic pulp with acute apical periodontitis. CONCLUSION: Our study concludes that antibiotic over prescription is very common amongst post graduate trainees and is contributing towards a larger issue of antibiotic resistance. Proper protocols of prescription should be followed by professionals and further refinement is required focusing on need, duration and choice of the antibiotic being used. [ABSTRACT FROM AUTHOR]

Background: The massive corona virus (COVID-19) outbreak started in China in 2019 and spread around the globe with significant increase in number of cases. The educational institutes have been forced to shut down temporarily and pushed them to adapt a new ways for spending their daily routine. The least highlighted is longterm impact on medical education, where students are concerned about their role, serving the humanity and protection of the society from such catastrophe situations. Objective: The objective of the study was to investigate the impact on the lifestyle of Medical Student's dwelling during quarantine lockdown, induced by COVID-19. Study type, settings & duration: An online cross-sectional survey was carried by group of undergraduate medical students of Shalamar Medical and Dental College, Lahore from June to August 2020. Methodology: After the approval of SMDC-IRB, the data was collected from 255 undergraduate medical students of Shalamar Medical & Dental College, through Google form based self-administered questionnaire. The consent was part of the Google form. The Google forms were transported into excel sheets and data was analyzed, response was recorded as percentage and frequency, for demographics, perception, education and impact. Results: The data collected from 255 respondents, the slight majority 54.1% was of female students. The first source of knowledge was internet, 92.2% felt the situation is challenging. With lock down situation, only 20.4%were satisfied, whereas 28.3% were not satisfied while 25.5% were not sure and 80.8% lost their interest in online class lectures. For co-curricular activities, only 33.7% adapted some activity at home. The emotional status was disturbed, 38.5% were depressed and 70% had mood swings, 57.7% felt insecure with increase in anxiety, this resulted in some i.e. 32.2% loss of sleep and 43.1% felt burnt out. Conclusion: There has been significant ongoing mental disturbance due to challenging situation caused by COVID-19 lockdown. The psychosocial consequences made an impact. The health officials need to emphasize on health and provide awareness on physical activities and its importance on the mental well-beings. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The outcome of endodontic treatment is dependent on many factors, but the success of endodontic treatment depends primarily on the quality of the obturation. The objective of this research was to analyze the standard of obturation and to recognize the iatrogenic errors on periapical radiographs and also to equate between the caliber of endodontic treatment and procedural errors executed by male and female house officers. METHODOLOGY: This was a cross sectional study in which data of 350 treated root canal fillings radiographs along with their proforma showing demographic variables with the name of house officers who treated the patients were assessed. All 350 periapical radiographs were taken from a single institute Fatima Jinnah Dental College Karachi Pakistan from the year 2014-2016. All endodontic treatments were performed by house officers using crown down technique by hand instrumentationand for each tooth, three periapical radiographic images were assessed. Two calibrated investigators assessed the radiographs for quality and procedural errors. The sample size was calculated using the WHO Calculator and the results were evaluated using chi-square test. SPSS version 21 was used to analyze the results. RESULT: Overall 122(35%) of radiographs were up to the acceptable quality as per quality parameters. Gouging and apical perforations were the most common procedural errors found on periapical radiographs. Overall male house officers have performed an acceptable degree of obturation. Chi-square analysis was used to assess the results. CONCLUSION: Gouging and apical perforations were the most common procedural errors found on periapical radiographs. Overall male house officers have performed better quality of root canal filling in anterior, premolar and molar tooth and overall 122(35%) of radiographs were up to the acceptable quality as per quality parameters. [ABSTRACT FROM AUTHOR]

OBJECTIVE: The objective of this study was to determine the difficulties faced by house officers during endodontic procedures and refine the quality of therapy provided to masses. METHODOLOGY: A detailed survey form was given out to a total of 350 dental house officers, collected from seven different dental institutes in Karachi. A total of 60-80 survey forms were given out to each college, depending on the strength of house officers present, out of which 50 forms, on average, were returned and results were tabulated. The supervisor to house officer ratio recorded on average from these institutes was 1:7. WHO Calculator was used on the sample size of 350 entries and SPSS Version 22 was used to analyze the results. RESULT: The current study displays that majority of the house officers faced immense difficulties in the cleaning and shaping task of the endodontic procedure such as in cleaning and shaping and less problems were encountered when access opening and initial instrumentation were concerned. The most common difficulty faced by the house officers was that apical perforation resulted during the procedure (51.4%) followed by loss of estimated WL (51.1%), ledge formation (40.9%), file separation (39.1%), whereas using accessory GP while obturations was recorded as the most frequently encountered problem (56%). CONCLUSION: The current study displays the most commonly faced difficulties by fresh dental graduates during their house job. The major difficulties were faced during cleaning and shaping owing to increased incidence of ledge formation, apical perforation and loss of working length. Majority of the cases revealed gutta purcha extruding or short of the apex. Difficulty in administering IANB was also highly noted. [ABSTRACT FROM AUTHOR]

ABSTRACT Objective: To compare the effectiveness of Intraligamentary Injection with the IANB injection technique for root canal treatment of mandibular molars and premolars in patients with asymptomatic irreversible pulpitis undergoing access opening. Study Design: Quasiexperimental study. Place and Duration of Study: Operative Dentistry Department, Fatima Jinnah Dental College Karachi Pakistan, from Nov 2018 to Apr 2019. Methodology: The study was conducted on 80 patients. Visual analogue scale was used to determine the level of pain. Three groups were made depending on the effectiveness of anaesthesia at 2-sites (Group-A), 4-site (Group-B) and failure of Intraligamentary injection (Group-C). Anaesthesia was successful when the patient revealed no pain symptoms during access opening. Results: A total of 80 cases were evaluated, out of which 47 were males (58.70%), and 33 were females (41.30%). The most common age groups recorded in our study were 18 - 25 years (33.75%) and 36- 45 years (33.75%). According to our results, the Intraligamentary technique was successful in 23(28.75%) cases. The remaining 57(71.25%) cases which received anaesthesia via IANB showed a 100.00% success rate with profound anaesthesia. Conclusion: Inferior alveolar nerve block was more successful compared to Intraligamentary injections for providing profound anaesthesia to mandibular posterior teeth previously diagnosed with asymptomatic irreversible pulpitis and undergoing the procedure of access opening. [ABSTRACT FROM AUTHOR]

OBECTIVE: The purpose of this clinical study was to analyze the etiology, assess the factors associated with non carious cervical lesions and to determine the most commonly involved teeth and their inter/intra arch relations. METHODOLOGY: 100 patients with non carious cervical lesions (NCCL) were clinically examined and a questionnaire of associated factors to help determine the cause of the presence of the lesion was included in the assessment. The obtained data was statistically analyzed using descriptive statistics, frequency, Chi-square test and cross tabs to determine the relationship between the number of NCCL in groups and the associated factors. RESULTS: Sensitivity (P= 0.471), aesthetic concern (P= 0.077), diet concerns (P = 0.557), regurgitation (P= 0.810), medical condition (P= 0.344), nervous habits (P= 0.799), drug use (P= 0.880), Unilateral chewing habits (P= 0.159) were not associated with the presence of NCCL. However, parafunctional habits (P= 0.039), right working side (P= 0.012) were associated with increase in the number of NCCL. First premolars were found to be the most affected teeth and cross tabs suggested that if there was a lesion in the maxillary first premolar, the mandibular first premolar was also involved of the same side. CONCLUSION: Parafunctional habits do have association with NCCL. Premolars are the mostly affected teeth. If a premolar of maxillary arch is affected, it is most likely that the premolar of mandible on the same side will be affected. [ABSTRACT FROM AUTHOR]

Patients experiencing irreversible inflammation of the dental pulp tend to have a less anesthetic effect of the Inferior alveolar nerve block. Aim of this study was to assess the role of preoperative administration of alprazolam along with inferior alveolar nerve block in patients experiencing permanent damage to the dental pulp. This study included one hundred patients experiencing severe inflammation of the dental pulp involving the mandibular molars and was a potentially randomized double blinded study. 45 minutes prior to administration of the inferior alveolar nerve block the patients were either given 0.5mg of alprazolam or a placebo drug. An interval of 15 minutes was given between the IAN block injection and the initiation of access cavity preparation. Lack of sensation in the lip area was noted for all patients. A visual analogue scale recording was used for every patient to record any stimuli to pain during cavity preparation and initial instrumentation. No or mild response to pain was recorded as a successful outcome. The information was examined using t test and chi square test. The patients given preoperative alprazolam had 52% rate of success. The success rate was 44% (the P value = 0.402), in the control group, showing no statistically significant difference. Giving preoperative 0.5mg alprazolam did not improve the effectiveness of the IAN block in patients with permanent deterioration of the dental pulp. [ABSTRACT FROM AUTHOR]

The purpose of the study was to investigate the reasons for the failure of Class I and II amalgam restorations in patients presenting at the Operative Department of Fatima Jinnah Dental College and Hospital. Sample of 100 patients was clinically evaluated to assess the reasons for the failure of amalgam restorations. Information regarding the patients' age, gender, presenting complaints, and reasons for the failure was collected for conducting this study. Results revealed that the most common reason for the failure and replacement of amalgam restorations was secondary caries, followed by inadequate resistance form. It was concluded that the prevailing reason for the failure of restoration is secondary caries which may be as a result of incomplete caries removal and non-retentive cavity preparations. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate the effects of staining of two types lipsticks (one with common fixer other with ultra fixer) on the color stability of resin-based composite restorative material at different time intervals. METHODOLOGY: Ninety disc-shaped specimens (10x2 mm) were prepared from Nanofilled composite. Filtek Supreme XT (3M ESPE, St. Paul, MN, USA). Discs were polished and divided in to 9 groups according to time elapsed after curing (0 hour, 1 hour, and 24 hours) and contact with different lipstick (lipstick with common fixer, lipstick with ultra fixers). Color measurements (L*, a*, b*) of each specimen were taken with a spectrophotometer (Data color; SF 600; Plus-CT; USA) according to the CIELAB color scale. For control group discs did not have any contact with lipsticks. For lipsticks group discs were stained at different time intervals (0 hour, 1 hour and 24 hours). Color analysis was done before and after staining. Discs were stored in artificial saliva at 370c. STATISTICAL ANALYSIS: The color change value ΔE* were calculated. Data were analyzed using a 2-way analysis of variance with repeated measurement at a significance level of 0.05 and Tukey's Honestly Significant Difference (HSD) for multiple comparisons. RESULTS: All specimens displayed color changes after curing, and there was a statistically significant difference between both lipsticks and time periods (P<0.05); however, the change was not visually perceptible (ΔE*<3.3) for control group and group with common fixer. Color change for group with ultra fixer was visually perceptible (ΔE*>3.3). CONCLUSIONS:Groups with ultra fixer caused greater staining than other groups. Therefore, lipstick wearers should be warned to avoid the use of lipsticks with ultra fixer after receiving composite restoration in anterior teeth for at least 24 hours. [ABSTRACT FROM AUTHOR]

This article discusses the significance of root canal disinfectants and comments on how these can be used professionally. The complex root canal system is inhabited with different microbes in periapical periodontitis. There is no particular disinfectant that alone satisfactorily fulfills the entire functions essential for irrigation. Best possible irrigation is found on the combined use of two or more disinfectant, in a particular sequence. Sodium hypochlorite is the most commonly recommended endodontic irrigant, in spite of some adverse reactions. Chlorhexidine, Iodine and Chelators are successful against several bacteria and viruses, mainly in retreatment cases. Newer root canal irrigants like MTAD (Mixture of Tetracycline, Acid and Detergent), Tetraclean, Photo-activated disinfection, Electronically Activated Water, Ozonated water and lasers have potential to maximize root canal disinfection. Currently these newer irrigants could be used as an adjunct to NaOCl, while investigators are continuously looking for the subtle ideal root canal irrigant. [ABSTRACT FROM AUTHOR]

Objective: To assess the success rate of resin bonded bridges., Design: A descriptive cross-sectional study., Place and Duration of Study: Fatima Jinnah Dental College Hospital, Karachi between August 1998 and August 2002., Subjects and Methods: Seventy resin bonded bridges fitted in 60 patients were clinically assessed for debonding. The inclusion criteria included minimal reduction of teeth with minimal occlusal contacts. Patients were excluded if teeth had a large discrepancy of space and heavy occlusion. The retainers were designed self retentive and covered the maximum tooth surface lingually and proximally. Impressions were taken and resin bonded bridges were fabricated and bonded. Information regarding the patient's data, bonding and debonding was collected on a proforma and was analysed using SPSS version 10.0., Results: Seventy resin-bonded bridges had been in place for an average of 33 months. The results showed a 94.3% success rate. Statistically significant results were found between anterior bridges and posterior bridges for bonding status (p< 0.05). Results were not significant where maxillary versus mandibular bridges were compared for bonding status. (p>0.05)., Conclusion: Resin bonded bridges achieved a high level of clinical success in the study.