Background and Aims: Dental anxiety often causes psychological problems including the fear that have a negative impact on dental treatment. Periodontal health and dental deteriorating might be caused by the patient’s interference with dental fear. The current study aims to evaluate dental anxiety, smoking and snuff use in dental patients. Methods:One hundred eighty consecutive dental patients with meanage ±SD 31.45±13.75 were investigated for dental anxiety, smoking, and snuff use.The evaluation of dental anxiety was measured with the specific question “Do youfeel any type of anxiety while visiting the dentist?” and their answers were givenas follows: “Absolutely not”, “Somehow” and “Extreme fear”. Tobacco use wasinvestigated with the question “Do you smoke or take snuff?” with the alternatereplies “Absolutely not”, “regularly on a daily basis” and “occasionally. Chi-squaretest and multiple regression analysis were carried out in statistical analysisusing SPSS version 20. Results:Among one hundred eighty dental patients, higher dental anxiety was reported in 32 (17.8%) being common among women (71.9%) than men (28.1%). General mood and social situation was reported negative in 9 and 36 patients respectively. It was observed that tobacco use on routine a basis was more common among men (8.5%) than women (1.5%). Age played key a role in dental fears among patients. Patients of young age feel more anxious than mature or older aged patients. Higher dental anxiety and fear was observed in those dental patients who used snuff on a regular basis compared to occasional and no users at all while controlling for age, social status, and general mood. It was observed that chain smokers feel more anxious compared to occasional or no smoking at all, when smoking was added to the model and asked the participants about their visits to the dentists. Conclusion: Our study findings were common vulnerability factors among dental patients related to dental anxiety or fear, smoking, and snuff use. The reason for patients' anxiety was found to be the fear of pain which was more common among women compared to men. Also, Regular tobacco users felt more anxious than occasional or no users at all. Hence, dentists should focus on anxiety alleviation among patients while treatment and follow-up call for maintenance. Keywords: Dental anxiety, Tobacco use, Dental fear
Background: Head and neck carcinoma is the malignant lesions which develops on lips, oral cavity, nasal mucosa, paranasal sinuses, inside or outside the throat or parotid glands. Magnetic resonance imaging can be a good alternative to invasive procedures for detection of metastatic disease in cases of head and neck tumors. Objective: To evaluate diagnostic accuracy of magnetic resonance imaging in detecting metastasis in neck nodes of oral squamous cell carcinoma with reference to postoperative neck histopathology. Study Design: Cross sectional study Place and Duration of Study: Department of Oral and Maxillofacial Surgery, Mayo Hospital Lahore from 1st January 2014 to 30th June 2014. Methodology: Eighty seven patients with biopsy proven squamous cell carcinoma of orofacial origin were enrolled who had single malignant tumor at the time of diagnosis. Results: The mean age of the patients was 50.44±12.44 years. There were 58 (66.67%) males and 29 (33.33%) females. In terms of sensitivity, specificity, and diagnostic accuracy, magnetic resonance imaging was 94.12%, 61.11%, and 80.46% respectively taking histopathology as gold standard. Conclusion: For the detection of cervical nodal metastases in oral squamous cell carcinoma, MRI is a useful and trustworthy method with a high sensitivity and specificity, especially when compared to postoperative neck histopathology. Keywords: Histopathology, Carcinoma, Magnetic resonance imaging (MRI),Metastasis
Aim: To estimate the frequency of cervical lymph node extracapsular spread in oral squamous cell carcinoma patients. Methodology: This prospective study was conducted in the Department of Oral and Maxillofacial Surgery, The University of Lahore from 1st December 2021 to 30th November 2022 and 50 diagnosed cases of oral squamous cell carcinoma were enrolled. Computed tomography scan was conducted for the diagnosis in addition to the histopathology of the samples. The CT scan images were used for identification of lymph node size, shape, and central necrosis. The frequency of the extracapsular extension of lymph nodes with the central necrosis was correlated with histopathology. Results: The mean age of the patients was 60.5± 11.1 years with 60% of the cases were males and 40% of the cases were females. 36% of those patients were having a history of smoking, 22% were having a history of taking pan, 14% supari & chalia, 8% alcoholics and 6% consuming gutka. The primary tumor site identified through clinical and diagnostic imaging was anterior 2/3rd of tongue in 38% followed by posterior 1/3rd of tongue in 20%, buccal mucosa 14%, mandible and lip each as 10%, maxilla 4%, floor of mouth and retromolar trigone region each as 2%. It was observed that T3 and T4 cases had more ECS than T1 and T2 with a percentage of 20% and 30% respectively. Practical implication: Knowledge of frequency and burden of this disease in Pakistan will assist in generating more efficient management and treatment protocols with early detection strategies of oral squamous cell carcinoma through association analysis and biomarker role of cervical lymph node extracapsular spread. Conclusion: Extracapsular spread is observed more in patients having advanced stage tumor or having advanced grade of oral squamous cell carcinoma. Key words: Extracapsular spread, Oral squamous cell carcinoma, Recurrence, Histopathological examination
Objectives: Surgical treatment of patients with multiple mandibular fractures involving condylar segments may be a difficult proposition for a maxillofacial surgeon. These fractures can be double or triple fractures of the lower mandible and can also be associated with other fractures of the face. While many authors have suggested that the conventional approach to reducing and stabilizing a mandibular symphysis / para-symphysis fracture is appropriate before addressing a fractured condyle, there is another school of thought that suggests that the condylar segment should be reduced and repaired first. This article aims to review the results of operations where the reduction and fixation of a fractured condyle is performed prior to other associated mandible fractures, and to explore the effectiveness of various surgical methods including preauricular and retromandibular proposed in this case. Place and Duration: In the Oral and Maxillofacial surgery department of Faryal Dental College, Lahore for two-years duration from Jan 2018 to Jan 2020. Material and methods: The study included 60 surgically treated patients with multiple mandible fractures (double / triple), including the condyle component. For treatment of the fractured condylar segments, the preauricular and retromandibular (anterior parotid-transmasseteric) approach was used. Results: Condyle fracture was the first segment to be managed during sequencing of surgical treatment, regardless of the method used. First, good reduction and stabilization have been achieved with limited complications in treating a condyle fracture. Conclusion: While it is the surgeon's prerogative to sort multiple mandible fractures, addressing the condylar segment first provides the operator with a viable alternative to the conventional technique. Key words: condylar fractures, multiple mandibular fractures, preauricular approach, retromandibular approach
Aim: To estimate indications and frequency of plate removal in patient treated for maxillofacial fractures. Method; In this retrospective study, records were reviewed from March 2015 to March 2018, over a period of 3 years. 139 Maxillofacial trauma patients treated with Open reduction and Internal Fixation with 202 plate, Result; In 139 patients, 202 plates were implanted for bone fractures. In total, 128(92%) were male and 11(8%) were female, 32(23.02%) had revisited with complaint and subsequently 47(23.26%) plates were removed. Mandible was commonest location where majority of the plates32(68.08%) were removed. Most common reason for plates removal was infection 20(42%). Minimum time for plate in situ was 3 months. Conclusion; the reason for plate removal is multifactorial. Establishing measures to minimize plate related complication and avoid patients from further invasive procedures. Keywords: Facial Bone Fracture, Osteosynthesis Plate, Plate Removal Trauma.
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