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   Table of Contents - Current issue
May-August 2021
Volume 8 | Issue 2
Page Nos. 57-119

Online since Saturday, August 21, 2021

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Expanding structured dual-degree program of BDS or DMD/MD to dental specialties other than that of oral and maxillofacial surgery p. 57
Hezekiah A Mosadomi
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Therapeutic use of alpha lipoic acid in burning mouth syndrome: A meta-analysis p. 59
Shubhabrata Roy, Deepa Raj, Jayanta Bhattacharyya, Samiran Das, Preeti Goel
Introduction: Primary burning mouth syndrome (BMS) is a chronic pain disorder of the oral cavity without any apparent local or systemic etiologic factor. There is no specific therapy for primary BMS and treatment is basically supportive or symptomatic. There are many pharmacological and nonpharmacological approaches reported by different studies to alleviate pain in primary BMS. Alpha lipoic acid (ALA) has also been used as a therapeutic agent in BMS by many clinicians and researchers. Aims: The aim of this review and meta-analysis was to evaluate the double-blinded placebo controlled randomized clinical trials of ALA to determine its efficacy and potential as therapeutic agent in primary BMS. Six studies were selected for the systematic review after a thorough manual and electronic searching of the databases. Methods: Five out of the 6 selected studies were used for quantitative data synthesis. Results and discussion: The ALA therapy for 2 months provided symptomatic relief to more people in the study groups than in the placebo groups (risk ratio 2.34, 95% confidence interval [CI]: 1.71–3.19). The mean visual analog scale (VAS) scores of the test groups improved (decreased) after 2 months of ALA therapy (standardised mean difference [SMD] 0.72, 95% CI 0.20–1.24). When compared with placebo therapy, mean VAS scores improved (decreased) more with placebo than with ALA after 2 months of treatment (SMD −0.23, 95% CI: −0.70–0.24). The positive responders in the ALA groups presented less incidence of deterioration than the positive responders in placebo groups during the follow-up period. Conclusion: It was concluded from this meta-analysis that ALA could be used as a potential therapeutic agent in primary BMS. It should be administered in proper therapeutic doses and for sufficient time to elicit positive outcome. ALA can be used for a long time without any severe side effect and very few recipients complained about worsening of the situation. It certainly improves pain symptoms in a considerable number of patients when compared with placebo therapy.
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Patient awareness of oral health and periodontal disease before and after comprehensive periodontal treatment p. 66
Fatimah I Patel, Khadija A Khan, Mohamed R Abdelrasoul, Maha A Bahammam
Introduction: Periodontal disease (PD), a major health problem, reportedly affects a large percentage of the adult population with multifactorial etiology including awareness and practices from family and/or their treating physician. Aim: The aim of the study was to assess the patient's oral health as well as PD awareness before and after comprehensive periodontal treatment registered at the Outpatient Department of Batterjee Medical College. Materials and Methods: The present cohort study was conducted on 120 adult patients, selectively undergoing comprehensive clinical care by the dental students of the final 2 clinical years (D4 and D5, respectively) and interns (D6) with a self-answered questionnaire. Results and Discussion: Among the majority (92%, n = 113), the usage of toothbrush and toothpaste was common before treatment like the previous studies. In addition, there was an increase in the knowledge of the word dental plaque and calculus, where the majority believed calculus to be the causative factor of PD. It was noticed that there was very little difference in the knowledge being given regarding systemic association to their oral health. Postoperatively, 70% of the patients believed that they should visit the dentist annually or biannually, but a larger percentage across all groups (them) believed that dental visits are need based. Moreover, awareness increased postoperatively in patients. As a result, the majority of them acknowledged the deleterious effects of smoking. Conclusion: A change in the patient's attitude and behavior toward oral health is achieved in a coalition with the practitioner's professionalism, empathy, and delivery of oral hygiene advice.
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Prevalence, sociodemographics, and indications for extraction of impacted mandibular third molar in Najran, a Southern Saudi Arabian city p. 75
Ramat Oyebunmi Braimah, Dawood Ali-Alsuliman, Hakeem Olatunde Agbaje, Yahyah Alsalah, Harit Kanwar Sharma, Nahal Mamdouh Alsawas
Introduction: Third molar impaction is a common condition associated with a high standard of living. Aim: The main objective of the study was to document the prevalence of mandibular third molar impactions among the Najran populace. Materials and Methods: This is a retrospective study reviewing computerized medical records and panoramic radiographs of patients presenting for the extraction of mandibular third molars. Ethical approval was granted from the General Directorate of Health Affairs, Ministry of Health, Najran region. Data such as demographics, indications for third molar removal, position, and pattern of third molar impaction were collected. Data were stored and analyzed using IBM SPSS software version 25 for IOS (Armonk, NY: IBM Corp). Results and Discussion: Amongst 6205 extractions, 1024 mandibular third molar extractions were carried out with a prevalence rate of 16.5%. There were 609 (59.5%) female and 415 (40.5%) male (F:M = 1.5:1). The age ranged from 17 to 69 years (mean ± standard deviation, 31.4 ± 9.6 years), with the majority (52.1%) in the age group of 21–30 years. One hundred and ninety-one (18.6%) of the pericoronitis cases were associated with vertical impaction, while the majority of the caries were associated with mesioangular impaction (323 [31.5%]). Mesio-angular impactions (40.8%) and Level A depth (477 [46.6%]) were the most common. Class I ramus relationship had the highest distribution (561 [54.8%]). Conclusion: We have reported a prevalence rate of 16.5% of impacted mandibular third molar in mostly 21–30 years of age with female preponderance. Pericoronitis was the main indication for surgical extraction.
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Effects of the outbreak of COVID-19 on oral health-care workers (HCWs) at the regional dental center in Qassim, Saudi Arabia p. 81
Wesam Talal Alsalman, Saad Mulhi Alharbi, Abeer Hani Albattah, Khalid Almas
Introduction: Since the emergence of the 2019 novel coronavirus (COVID-19), the pandemic has rapidly spread all over the globe, affecting millions of people and resulted in over 1,900,000 deaths. During the outbreak of COVID-19 situation, health-care workers in general and dental team specifically are at risk of developing psychological distress and other mental health symptoms. Aim: The study was conducted to investigate the effects of outbreak of coronavirus (COVID-19) on oral health-care workers (HCWs) at the Regional Dental Center in Qassim and how it affects their practice and daily life in terms of psychological, mental, behavioral manner, and social well-being. Materials and Methods: This is a cross-sectional, single dental care facility-based study. A bilingual questionnaire was distributed to a convenience sample of 150 HCWs. The questionnaire contained 26 questions covering the following domains: (a) demographic data, (b) knowledge testing and sources of information, (c) personal precautions and infection control measures, and (d) behavioral and psychological aspects. The questionnaire was distributed through the social media platform. Data were analyzed using SPSS version 22. Descriptive statistics were used for data summarization and presentation. Results and discussion: The response rate was 72% , with the age range from 18 to 54 years, with female 60% to male 40% distribution. A very high level of awareness about the COVID-19 ranging from 60% to 100% was found among participants. The main sources of information regarding coronavirus were Ministry of Health (MoH), social media, followed by the World Health Organization website. Almost 90% started regular hand hygiene and paying attention to the proper use of personal protective equipment. Almost 70% agreed to stop treating patients due to their perception of the risk of contamination. Almost 90% of them felt afraid of transferring the infection to their families. Majority of them spent their time on social media, while nearly 50% on reading and sleeping. Almost two-third of the participants do highly trust the precautions which have been taken by the MoH and the Regional Dental Center in Qassim. Conclusions: It is concluded that the HCWs had good knowledge and awareness about COVID-19. They are concerned about their safety and possibility of spread of infection to their families and considered to stop regular dental treatment. Their satisfaction is moderate about the safety measures provided by MoH and the center. Future research should be carried out at multicenter, primary, secondary, and tertiary care centers to generalize the findings.
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Assessment of knowledge, practice, and level of preparedness of dentists practicing in Nigeria toward COVID-19 pandemic p. 90
Titus Ayodeji Oyedele, Adeola M Ladeji, Yewande I Adeyemo, Aderonke A Abah, Modupe O Coker
Introduction: The coronavirus disease pandemic (COVID-19) had a global impact on health sectors including dentistry. As dental services have to be performed and cannot be withheld for a prolonged period, dentists should prepare themselves to understand the disease process and to face future treatment challenges in affected patients to fully resume dental services. There was a need to evaluate the knowledge of dentists on Covid-19 disease process, and readiness in practicing dentistry in this situation. Aim: This study aimed at assessing the knowledge, practice, and level of preparedness of dentists in Nigeria towards the COVID-19 pandemic. Materials and Methods: An online cross-sectional survey involving dentists practicing in Nigeria was carried out using the SurveyMonkey™ platform. The link for the questionnaire from the platform was forwarded to dentists individually and on platforms of various oral health-care providers. The questionnaires tested for knowledge, practice, and preparedness of the respondents to the COVID-19 pandemic. Their biodata and practice experiences were also collected. Data were electronically retrieved from the SurveyMonkey platform in Excel spreadsheet and analysis was done; statistical significance was established at P ≤ 0.05. Results and discussion: A total of 209 dentists participated in the online survey; there were more respondents from the age group of 25 to 34 years. Majority of the participants practiced in the tertiary setting. Over 97% of the respondents first learned about the novel coronavirus through the media; 97.1% agreed that the main mode of spread of severe acute respiratory syndrome coronavirus-2 is through respiratory droplets on close contact, and 91.4% agreed on spread through respiratory droplets on surfaces. Over 35% had no previous training on infection and prevention control (IPC) and 50% of the centers where the respondents practice had no IPC committee. Ninety-nine percent of the respondents have heard about personal protective equipment (PPE), but only 51.5% had PPE in their clinic, while 33.7% of these have had training on the use of PPE. Over 80% of respondents exhibited fear; junior residents were the most fearful, and 67% of respondents from tertiary institutions have limited their procedures during this pandemic. Conclusion: This study showed that COVID-19 pandemic poses a new threat to dental practices worldwide and Nigeria in particular. Therefore, the practice of dentistry must evolve in the presence of COVID-19.
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Knowledge and perception regarding personal protection equipment and infection control measures against COVID-19 among dental practitioners of Saudi Arabia p. 98
Saeed Ali Alqahtani, Mashael Obaid Alshahrani, Mona Oweidh Alnefaie, Abdullah Mana Almofrej, Fahad Hassan Aldaghsh, Nasser Saad Alamri, Sultan Saleh Alshamrani
Introduction: The lack of interest and knowledge related to personal protection equipment (PPE) and infection control measures might have a detrimental effect on dental occupational workers. Aim: The purpose of this study was to evaluate the knowledge and perception of dental practitioners about PPE to limit the spread of coronavirus disease 2019 (COVID-19). Materials and Methods: This cross-sectional descriptive study was conducted between May and June 2020 among the dental practitioners working in public and private sectors of Saudi Arabia. An online questionnaire was distributed among dental practitioners across Saudi Arabia using E-mails or WhatsApp software. The questionnaire consisted of two parts: (1) basic demographic characteristics (gender, professional status, type of dental setup, and working experience) and (2) knowledge and attitude regarding the use of a face mask, gloves, gowns, and personal hygiene. Descriptive statistics were performed to summarize frequencies and percentages. Results and Discussion: The total number of the responses received was 535 (68.8% – male and 31.2% – female). Only 17.8% knew that surgical masks are made of nonwoven fabric and that the middle layer acts as a barrier (39.8%). Regarding gloves, 57.4% of the participants agreed that latex/nitrile gloves are more reliable and durable. On the contrary, satisfactory knowledge regarding face shield, gown, hand hygiene, and infection control measures was observed. Conclusions: This study showed a low level of certain PPE knowledge among dental practitioners. However, knowledge and perception about biosafety, face shield, gown, hand hygiene, and infection control measures were found to be higher and adequate among the participants.
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Prevalence of burnout and practice-related risk factors among dentists in Saudi Arabia p. 104
Ammar Talal Abdelrahman Asali, Fawaz Pullishery, Nada Mohammed Ibrahim, Wasmah Waheeb Tobji
Introduction: Dentists are exposed to a high level of stress at the workplace and are at higher risk of experience burnout. Burnout has profound consequences on quality of life, patient care, and also on the health-care system. Aim: The present study aimed to assess the prevalence of burnout among dentists and identify its relationship with the work-setting factors in Saudi Arabia. Materials and Methods: A cross-sectional online survey was conducted using a pretested and structured questionnaire. A mixture of convenience and snowball sampling was used to collect the responses from dentists using two versions of the 22-item Maslach Burnout Inventory Scale that had three domains: emotional exhaustion (EE), depersonalization (DP), and feeling of decreased accomplishment. Dentists with scores on EE ≥ or DP ≥10 were considered to have the manifestation of burnout. Results and Discussion: The prevalence of burnout in dentists was found to be 33.4% and Saudi dentists experienced more burnout than non-Saudi dentist (P < 0.05). Among different dental specialties, prosthodontists and endodontists showed more prevalence than any other specialties (P < 0.05). Dentists who worked in clinical settings and also who worked more than 40 h/week experienced more burnout than others (P < 0.05). Conclusion: The prevalence of burnout among dentists working in Saudi Arabia was found to be 33.45%, and it was significantly more among Saudi dentists than expatriate dentists. Occupational burnout among dentists is a serious problem and should be dealt with appropriate interventions such as stress management training, coping up skills, organizational or structural change to reduce workload, and effective use of leisure time activities.
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A technique for mandibular distraction to reduce medially dislocated condylar fracture : Technical report of a case p. 111
Himanshu Thukral, Anson Jose, Indranil Deb Roy, PK Chattopadhyay, Shakil Ahmed Nagori
The treatment of condylar fractures in oral and maxillofacial trauma, where an open reduction and internal fixation has to be done, is still a controversial note. However, when taken a decision by the surgeon to operate, there are many difficulties on the operation theatre table, reducing the proximal condylar stump and applying mini fixtures. The techniques to reduce the condylar stump are endorsed in the medical literature. We report a different technique with the use of simple armamentarium, a 24G intravenous catheter, which facilitates better visualization of the proximal segment by distracting the distal segment for open reduction and internal fixation of condylar fractures.
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Central giant cell granuloma in a child: Surgical intervention by maintaining tooth germ : A case report p. 114
Nisha Kumari, Heena Sarangal, Disha Beniwal, Ritu Namdev
An intraosseous lesion of jaws called central giant cell granuloma (CGCG), is significantly found in children and young adults and most of the cases are nonaggressive, asymptomatic, and slow growing. Approximately 30% of cases show an aggressive and progressively devastating nature with tendency to recur. We present a case of slow growing CGCG in mandible in a 10-year-old male managed by curettage along with preservation of tooth germ.
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Coronavirus disease 2019 and oral health: Changing paradigms and the public health perspective p. 118
Saurabh RamBihariLal Shrivastava, Prateek Saurabh Shrivastava
The coronavirus disease-2019 (COVID-19) pandemic has impacted all the areas of health care, including interruptions in the delivery of essential health care services in varied settings. In the oral settings, the virus transmission can happen either through direct transmission via inhalation of droplets produced during coughing or sneezing, or direct transmission via mucous membranes, or indirect transmission through contaminated surfaces or fomites. It is quite obvious that most of the aerosol-generating procedures are being done in the oral settings and thus the potential risk of transmission of infection cannot be ruled out. There is a specific need to strengthen infection prevention and control measures in the oral health care settings. In conclusion, the oral health care services need to be rigourosly strengthened in the current pandemic as there is a potential risk for the spread of the COVID-19 infection. The need of the hour is to continue the delivery of emergency services and at the same time delay the routine procedures to ensure safety of the patients as well as the health care personnel.
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