Objective: To evaluatethe post-operative morbidity associated with harvesting of iliac crest bone graft. Materials and Methods: This study was conducted in the Department of Oral and Maxillofacial Surgery, King Edward Medical University/Mayo Hospital, Lahore, from March 2010 to March2012; and at the Department of Oral & Maxillofacial Surgery, Fatima Memorial Hospital Lahore, from June 2012 to June 2017. After approval of the study was obtained from Institutional Review Board (IRB), informed consent of the patients was taken on customized proforma.A total of 36 patients were subjected to reconstruction of maxillofacial bony defects with 36 bone grafts harvested from anterior iliac crest; 20(55.56%) were male and 16 (44.44%) were female patients with mean age of 23 ± 10.31years (range 11-52 years). Results: At 3 months postoperatively, the pain score was noted as: 02 patients (5.5%) had score 1 and 34 patients (94.44%) had score 0. Only one patient (2.77%) had abnormality in gait. The donor site scars were assessed according to the patients’ satisfactory score whereby 24 patients (66.66%) had a score of 2; 04 patients (11.11%) had score 3 and 08 patients (22.22%) had score 1. While scar hypertrophy was seen in 2 patients (11.11%), wound dehiscence was seen in 1 patient (5.55%) only. Conclusion: Harvesting of bone graft from the anterior iliac crest is a safe and predictable surgical procedure for reconstruction of defects of oral and maxillofacial region with high patient tolerance, low morbidity and fewer complications.

Background: Indian sub-continent (India, Pakistan, and Bangladesh) is one of the high-risk populations for oral cancer cases. Intraoral screening is critical to diagnosis and treating oral cancer at an early stage for a better prognosis. Among the diagnostic adjuncts, toluidine blue staining is considered a simplistic, cost-effective, and highly sensitive method. The objective of the current study was to find out the diagnostic accuracy of toluidine blue in the early detection of oral squamous cell carcinoma. Patients and methods: This prospective observational study was undertaken at the Department of Oral and Maxillofacial Surgery, Institute of Dentistry, CMH Lahore Medical College from15-09-2019 to 15-03-2020 after getting approval from IRB.  Based on inclusion criteria, a sample size of 100 was calculated and enrolled in the study. Non-probability convenient sampling technique was utilized. Oral staining of 100 patients was done with 1% toluidine blue on an OPD basis, and incisional biopsies were then performed. Staining pattern and histopathology reports of patients were evaluated to assess the diagnostic accuracy Results: The study results revealed the sensitivity of Toluidine Blue as 89.87%, and specificity of toluidine blue was found as 76.19%. Positive and negative predictive values of Toluidine Blue remained 93.42% and 66.67%, respectively. Conclusion: Toluidine blue has good diagnostic accuracy for early detection of oral squamous cell carcinoma (SCC).

Objective: To evaluate the success rate of Buccal advancement Flap (BAF) in closure of Oroantral communication (OAC) and Fistula. Materials and Methods: In this case-series study, buccal advancement flap (BAF) was used in 45 consecutive patients at Oral and Maxillofacial Surgery Department of Fatima Memorial Hospital Lahore for period of one year (May 2018-May2019). Male to female ratio was 2:1 and mean age=26 years. Right maxillary OAF of first and second molars presented more than left side (n=35, 77%). All defects were not more than 5mm. After application of flap, patients were evaluated for sign and symptoms of infection, wound dehiscence, loss of flap whether partial or complete and recurrence of oroantral fistula (OAF). Data was analyzed using SPSS version 20, INC, Chicago USA with descriptive analysis to derive percentages and frequencies for all variables. Results: Thirty nine patients (86%) had successful healing of flap. Partial loss occurred in one patient (2.25%). Wound dehiscence was seen in two patients (4.45%). Complete loss of flap was also noted in two patients (4.45%). Recurrent OAF has occurred in one patient (2.25%). Conclusion: BAF is a flap of choice for immediate closure of OAC and OAF of ≤5mm in the region of maxillary first and second molar. The technique is simple and vascular supply ensures the proper healing of flap. More work needs to be done to evaluate the causes for the partial or complete loss of the flap.

No abstract

Background: Odontogenic infections are one of the main causes of patients visit to a dental office. Antibiotics are magical drugs that have revolutionized the 20th Century in their ability to treat infectious diseases, increasing the life expectancy of individuals. Antibiotics prescription is a common practice among dental professionals and according to an estimate by Centre for Disease Control (CDC) and American Dental Association (ADA), over prescription of antibiotics is seen in 30-50% of the cases. Aim: To assess and compare (no comparison) the antibiotic prescription pattern among general dentists and specialty dentists in Lahore, Pakistan. Methodology: A cross sectional survey was conducted amongst dentists working in the teaching institutions and in the private clinics of Lahore. A pre-piloted questionnaire survey adopted from Jagan et al with slight modifications was used. In this descriptive study 300 practicing dentists were selected using consecutive sampling with a 5% level of significance and margin of error Results: Total 300 filled questionnaires were collected. Almost 84% of the dentists were less than 30 years old while 13% were between 31-40 years old. Of the participants 65.3% were females and 34.7 percent were males. Dental infections associated with gross swelling or associated with closure of the eye were the most common reasons for prescription of antibiotics. Almost 62% of the dentists would give antibiotic if any delay in treatment is anticipated. Almost 50% of the dentists would prescribe antibiotics for periapical abscess and cellulitis. Conclusion: There is a trend towards over prescription of antibiotics by dentists without following the standard guidelines. Emphasis on the correct prescription strategies of antibiotics at the undergraduate level and more awareness should be created as continuing dental education programs for practicing dentists. Keywords: Antibiotics, Dentists, Prescription Pattern.