Background: Although the removal of impacted mandibular third molars is a common minor oral surgical procedure, the extraction of these teeth can present with certain post-operative complications. Koerner KR proposed a Diffi culty Index Scale for removal of these teeth on the basis of local anatomy and radiographs, which were helpful in predicting the diffi culty that would be encountered intra-operatively, as well as the post-operative complications. Objective: To study the different post-operative complications in the removal of impacted mandibular third molars calculating their diffi culty index value. Method: A total of 119 patients, 79 females and 40 males who underwent extraction of their impacted third molars were selected over a one year period. Data were collected prospectively, according to the angulation, depth and position of the impacted mandibular third molars and their diffi culty index calculated. This was further correlated with the postoperative complications encountered. Results: Mesio-angular impaction (43.7%), with level A (66.4%) and Class I (70.6%) impaction were the major type of impaction seen. The diffi culty index showed that majority were in the moderately diffi cult category (51.2%), with swelling and trismus seen to increase as the diffi culty index value increased. Females were affected more than males, with swelling (Odds ratio 2.206) and trismus (Odds ratio 2.570) seen to be signifi cantly more. Conclusion: Surgical removal of impacted mandibular third molars causes post-operative complications and special care is required in their removal, especially in females. The Diffi culty Index, as described by Koerner KR can be used as a tool for predicting the frequency of the post-operative complications, especially swelling and trismus.

Gorlin-Goltz syndrome or Nevoid basal cell carcinoma syndrome is an autosomal dominant disorder with a predisposition to cancer. Features like basal cell carcinoma, odontogenic keratocysts, calcifi cation of falx cerebri, bifi d ribs, pits on palms and soles and hypertelorism are evident. A case of this rare disease seen on a 13 year old female patient is presented here, where multiple odontogenic keratocysts were causing disfi gurement of the lower jaw as well as displacement and malocclusion of the lower teeth.

Background: Empathy is a behavioural aspect of understanding and communicating with a desire to help. Empathy in medical personnel with patient is one of the basic ingredients of good physician/dentist –patient relationships. Objectives: To assess empathy level among dental undergraduate students, interns and dental postgraduate students of Nepal and to investigate the differences in empathy scores based on gender and year of dental training. Methodology: A cross-sectional questionnaire study was carried out among 240 dental students of different dental colleges in Nepal. Eighty students were included in each group of third to final-year undergraduate dental students, interns and postgraduate students. Data was collected using a standard-validated, self-administered Jefferson Scale of Empathy-Health Care Provider Student Version (JSE-HPS). This questionnaire included 20 items with a seven-point Likert scale. This scale has relevant content that allows assessing empathy between students and their patients. The collected data was entered in Microsoft Excel and statistical analysis was done in Statistical Package for the Social Sciences version 20. Results: Out of 240 dental students, 74 (30.8%) were males and 166 (69.2%) were females with the mean age of 25.35 ±3.203. The mean empathy score was 79.59 ± 6.492.There was no significant difference in mean empathy level score by gender. The interns were the most empathetic (80.80 ± 6.147). The mean empathy score was found to be highest for the students with less than one year of experience of treating patient (81.85 ± 7.841). Conclusion: Empathy should be given importance to in dental curriculum to improve dentist-patient relationship, thereby improving the treatment outcomes.

Background Coronavirus disease 2019 (COVID-19) is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and Nepal is a part of this worldwide corona virus disease. In this critical situation, the patients have a sense of insecurity visiting dental hospital. Objective To assess the pattern of dental problems in patients visiting a dental college during COVID-19. Method A descriptive cross-sectional study was conducted in Dental Hospital of Kathmandu Medical College and Teaching Hospital from May to August 2020. The patients visiting the Dental hospital were assessed for dental problems. Data were analyzed in Statistical Package of Social Sciences version 20. Frequency and percentage for pattern of dental problems were calculated. Result Most of the patients of age group of 14 to 31 years 530 (36.53%) had dental problems during the survey period. Out of total patients having dental emergency, 739 (50.93%) were males and 712 (49.07%) were females. Majority 545 (37.56%) visited the dental hospital for endodontic consultation followed by emergency consultation for oral surgical procedures 298 (20.54%). Least consulted dental emergency condition was prosthodontic consultation 18 (1.24%). Conclusion The study findings showed that the major dental problems in patients causing emergency visit to dental hospital during COVID-19 pandemic period were dental pain and swelling requiring endodontic consultation and the least need felt is prosthodontic consultation.

Introduction: Survival after sudden cardiac arrest depends upon early intervention, quality of cardiopulmonary resuscitation (CPR) and time of defibrillation. So, it is very important that at least the medical personnel know about Basic Life Support (BLS) as they are frequently facing the life threatening situations. Objective: To assess the level of awareness regarding adult basic life support among graduates in a medical college of Kathmandu. Methods: A descriptive cross-sectional study was conducted after ethical approval in Kathmandu Medical College and Teaching Hospital from April to September 2018 among 150 medical and dental graduates including interns and dental/medical officers. A structured self-administered questionnaire was used to assess their awareness regarding Adult BLS. Data were entered and analysed in Microsoft Excel Sheet. Mean, standard deviation, frequency, and percentage were calculated. Results: Most of the graduates surveyed (122, 81.3%) had heard about Adult BLS and felt the need to know about it (142, 94.7%). They felt the necessity including BLS training as a part of medical curriculum (144, 96%). Some of them (58, 38.7%) had seen BLS being done. However, very few (2, 1.3%) had actually done BLS on a patient. Some (54, 36%) had attended workshop on BLS. Conclusion: The findings of the study concluded that although most of the medical and dental graduates felt the need, very few had attended workshop for BLS. The BLS training should be included in the medical curriculum so that the graduates would be able to effectively manage the life-threatening emergencies.

Introduction: Effectiveness of the learning process can be measured by evaluation of interns’ confidence level in each of the competencies which will be helpful in their future dental practice. This study was conducted to assess self-confidence level of dental interns of a dental college in performing various dental procedures. Methods: A descriptive cross-sectional study was conducted among 65 dental interns selected by census method. Self-administered questionnaire was provided to the study participants for assessment of their confidence level in different dental procedures. Data were analyzed in the Statistical Package of Social Sciences version 20. Mean and standard deviation for quantitative data and frequency/percentage for qualitative data were calculated. Results: Majority of dental interns had good confidence in history taking (53, 83.1%), radiography (53, 81.5%), diagnosis (39, 60%), treatment planning (34, 52.3%), scaling (42, 64.6%), preventive resin restorations (39, 60%), anterior composite restorations (35, 53.8%), posterior composite restorations (55, 84.6%), anterior endodontics (29, 44.6%), premolar endodontics (23, 35.4%), treating pediatric patients (43, 66.2%), indirect pulp capping (41, 63.1%), acrylic partial denture design and construction (33, 50.8%) and simple extractions (33, 50.8%). They had poor/least confidence in metal partial dentures design and construction (58, 89.2), bridge preparation (44, 67.7%), molar endodontics (31, 47.7%), bleaching (57, 87.7%), veneering (61, 93.8%) and surgical extractions (38, 58.5%). Conclusions: The findings of the study concluded that the dental interns were confident in simple dental procedures and had least confidence in complex dental treatments. They need more exposure to the complex procedures during internship to enhance their confidence level.

Introduction: Dental professionals frequently encounter infectious agents. Those not practicing proper infection control measures are at serious risk of infections. This study was conducted to assess knowledge, attitude, practice, and satisfaction of dental professionals regarding infection control guidelines to be followed in Prosthodontics. Materials and Methods: This cross-sectional descriptive study was conducted from August to October 2020 in department of Prosthodontics, Kathmandu Medical College after obtaining ethical clearance and informed consent. Participants comprised of dental surgeons, interns, students, and faculties who were recruited by convenience sampling. The data on the questionnaire were collected via Google forms and analysed with Microsoft Excel. Descriptive statistics have been presented as frequency and percentages. Results: A total of 154 questionnaires filled by 39 (25.32%) males and 115 (74.68%) females of mean age of 25.02±4.85 years were analysed. Of all, 25 (16.23%) had never had a lecture and 118 (76.62%) had never had attended clinical demonstration or hands-on workshop on infection control. Only 129 (83.77%) had received immunisation for hepatitis B. Most (144, 93.51%) preferred mouth rinse before any procedure; 145 (94.16%) agreed that disinfection is required between patients; and only 77 (50%) of the participants washed their hands prior to wearing gloves. Majority (123, 79.97%) were not satisfied with their knowledge and performance. Conclusions: Knowledge and attitude of participants regarding infection control was found adequate and positive, though lacking in practice. It is recommended that the infection control lectures and clinical demonstrations be increased in curriculum so that no future dentists are deprived of essential knowledge.

Background: One of the most important aspects during endodontic treatment is to control pain during and after root canal treatment. Occlusal reduction has been widely used after root canal treatment to     reduce post treatment pain and flare up. The purpose of this study was to evaluate the effect of occlusal reduction on postoperative pain in teeth with irreversible pulpitis and tenderness to percussion. Methods: Forty-eight patients with irreversible pulpitis and mild tenderness to percussion were allocated into two groups; occlusal tooth reduction group and no occlusal tooth reduction group. After root canal instrumentation, patients were recalled after 24 hours, 2nd day, 3rd day, 4th day, 5th day and 6th day to      record their postoperative pain on the Visual Analogue Scale. The final outcome that is mean post        instrumentation pain score was measured till 6 days of post instrumentation. Data was collected and     entered in Microsoft Excel sheet and analysis was done using Statistical Package of Social Sciences     software version 20.  Results: There was no significant difference in postoperative pain between the 2 groups (P > .05) after root canal preparation. Conclusions: Occlusal surface reduction did not provide any further reduction in postoperative pain for teeth with irreversible pulpitis and mild tenderness to percussion compared with no occlusal reduction. Keywords: endodontic preparation; occlusal reduction; postoperative pain; root canal treatment.