Objectives. To provide consistent method for assessment of sedation need among patients undergoing dental treatment based on specific risk factors that is dental anxiety, medical status, and treatment complexity of needed dental treatment using IOSN (indication of sedation need) tool for assisting the clinician in decision making process. Methods. A total of 237 patients aged ≥12, ASA I and II were enrolled in the study. A structured questionnaire comprising of three sections was distributed among the participants. Section 1 comprises details about age, gender, literacy level, occupation, monthly income, and previous dental treatment history. Section 2 is based on Modified Dental Anxiety Scale which is a questionnaire comprising of five questions ranging from “not anxious” to “extremely anxious.” The third section was based on using the IOSN tool comprising three components: MDAS (Modified Dental Anxiety Scale) rank score, Systemic Health (ASA status) rank score, and treatment complexity rank scores. The total of three scores was then computed to determine the total rank score which suggested the sedation need. History of past traumatic dental experiences was also inquired from each patient. Results. A total of 237 patients aged ≥12, ASA I and II were enrolled in the study, out of which 56.1% were female. Statistical analysis was conducted by using the IBM SPSS Statistics 23 software. Based on the MDAS score, 47/237 (19.8%) participants were found to be highly anxious related to dental procedures. 34.6% of the participants showed to have a high sedation need while performing a dental procedure. The sedation need was found to be significantly associated with the female gender with a significant p value of p = 0.016 , higher education status p = 0.016 , and history of previous traumatic dental experience p < 0.001 . Conclusion. A simple assessment tool can enable clinicians in their decision making to identify patients in need for dental treatment under sedation based on patient-specific risk factors such as past traumatic dental experiences. Need for sedation can be assessed by information on patient anxiety level towards dental treatment, medical history, and complexity of planned dental treatment. The IOSN tool is a simple and quick assessment tool that can be applied for preprocedural assessment of sedation need for dental treatment.
Objective: To assess the peripheral nerve injury incidence among patients suffering from oral and maxillofacial trauma. Method: This cross-sectional study was conducted in Department of Oral and Maxillofacial Surgery, Ayub Teaching Hospital, Abbottabad. Sample was of 187 patients, and data was collected using non- probability, Consecutive sampling technique. Results: The findings showed that the age range of 10% patients was between 10-20years, age range of 40% patients was between 21-30years, age range of 32% patients was between 31-40years, and age range of 18% patients was >40years. The mean value of age of total sample was 31.21 ± 7.01. Males were 86% and females were 14% of entire sample. Trigeminal nerve injury was found in 35% patients whereas facial nerve injury was found in 16% patients. Conclusion: The study concludes that the peripheral nerve injury incidence was 35% (trigeminal nerve injury) of oral trauma while in maxillofacial trauma (facial nerve injury) 16% in our setup. Keywords: peripheral nerve injury, trigeminal nerve injury, facial nerve injury
Objective: This study was planned to evaluate the techniques of primary wound closure as well as secondary wound closure after removal of mandibular 3rd molar and the difference of both techniques was assessed in term of swelling, pain, and trismus. Methodology: This randomized clinical trial was conducted in the surgery department a tertiary care hospital of Sargodha, Pakistan. Sample size was 60 patients. Both genders were included and the patients’ age was between 19 to 30years, who presented with the complaint of pain and later on, referred for surgical removal of 3rd molar of mandible were the subject of interest of current study. Using lottery method, patients were divided into two groups. Primary closure technique was used on patients of group 1 and secondary closure technique was used for patients of group 2. The collected data was entered in SPSS version 25.0 and analyzed. Independent sample t test was used to explore the difference between two groups. Results: Facial swelling and trismus was found significantly different in both groups on 3rd and 7th day after surgery (p=.001, P=.001). Conclusion: In Conclusion, secondary wound closure technique is better in terms of pain, facial swelling and trismus than primary wound closure technique in surgical removal of impacted 3rd molar of mandible. Keywords: Trismus, Facial Swelling, Primary wound closure, Secondary wound closure
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