Pakistan Oral & Dental Journal

EDITORIAL

Ahmad Iqbal — 2025-01-10

GENDER-WISE VARIATIONS OF WIDTH, LENGTH, AND WIDTH-LENGTH RATIO OF RIGHT AND LEFT MAXILLARY CENTRAL INCISORS (MCI)

Ashfaq Azim — 2025-01-10

Objective: Current study aimed compare variations of width, length, and width-length ratio of MCIs among patients presenting with replacement of posterior teeth.

Materials and Methods: A total of 120 participants male and female subjects with age between 18 to 40 years, having angle class I occlusion and anterior permanent teeth present, presence of anatomically whole MCI, from which good diagnostic cast can be obtained, and no restorations in MCI. Measurements of all these parameters were performed with digital vernier caliper. The clinical crowns of MCI were calculated, the maximum length of the crown and mesio-distal (MD) breadth between the incisal point of the MCI crown and the apical point of the gingival margin. Sample t-test will be applied to compare the effect of gender on width, length, and width-length ratio in both genders. The level of significance was kept 0.05.

Results: The males were 54(53.3%) and females were 56(46.7%). The mean age was 30.12 ± 7.25 years. The width of central incisors on right and left sides were 7.96 ± 0.53mm and 7.83 ± 0.61mm respectively. The length of right and left central incisors were 8.27 ± 1.15mm and 8.06 ± 1.57 mm. The ratio of width/length on right and left side was 0.98±0.11 and 1.02±0.29 respectively. There was not statistical difference mean width among genders (p = 0.201 right side, p=0.388 left side).

Conclusion: There was no sexual dimorphism for width but width to length ratio was statistically different among gender, higher in females.

CRITICAL APPRAISAL OF A QUALITATIVE REVIEW: A SYSTEMATIC REVIEW

Sadaf Humayoun — 2025-01-10

Objective: This review explores the structure, content, and objectives of most widely used appraisal tools available for qualitative reviews.

Materials and Methods: This literature search utilizes the practice as proposed by Haig and Dozier in BEME guide no. 3; finding the literature through databases, hand searching. grey literature and Preferred reporting items for systematic review and meta-analysis checklist 2020 (PRISMA) was used in the process of filtering articles for literature review. After defining key terms, both clinical and educational databases; MEDLINE/PubMed (2014–2024) and ERIC (2014–2024), were searched in the subjects of education and medicine. Grey literature was searched through Google Scholar. Other search strategies included ancestry searching and forward tracing and seeking expert advice. The inclusion criteria for studies was Tools published between 2014 and 2024 in English language, Reports of appraisal tools along with reports about appraisal tools in health-related discipline, published in a peer-review journal, and tools with clear criteria. Comparative analysis for characteristics of six appraisal tools, which were frequently used in the reports for qualitative appraisal, was performed.

Results: The characteristics of the study showed that each tool has different strengths and limitations which are mentioned in the form of percentages for each of them.

Conclusion: In this study characteristics of six qualitative appraisal tools were reviewed and came up to the conclusion that rationale of the evidence preparation, the researcher’s proficiency, and allocated time along with resources which dictate decision to choose an appraisal tool for QES.

A TECHNIQUE FOR FABRICATION OF CUSTOM-MADE PORCELAIN DENTURE TEETH

Abdulaziz S. Alqahtani — 2025-01-10

Partial or complete dentures are more commonly constructed for the elderly group of the population. Artificial teeth fabricated from acrylic resin or porcelain are widely used in these dentures. The biggest disadvantage of acrylic denture teeth is that wear resistance is not as good as porcelain teeth. The amount of wear depends on how much you grind, how strong is your bite, and if the denture teeth are opposing natural teeth, denture teeth, crowns, bridges or if implants are involved. The advantages of porcelain teeth are that they look better than acrylic teeth. If you have crowns and bridges next to your missing teeth and if you make the adjacent denture teeth with the same material (i.e. porcelain), the teeth will match a lot better. The present case report is about a patient seeking removable prostheses with opposing metal ceramic fixed partial dentures and limited inter-arch space. The patient was treated by fabricating customized porcelain teeth for his/her removable dentures. Selection of this technique improved the patient’s esthetics and avoided the wear of the artificial and opposing fixed partial denture teeth.

EVALUATION OF ARCH WIDTH VARIATIONS AMONG SKELETAL VERTICAL PATTERNS

Lalina Taj — 2025-01-10

Objective: This study aimed to compare arch widths among individuals with different vertical skeletal patterns at Peshawar Dental College, Peshawar.

Materials and Methods: A cross-sectional comparative study was conducted at the Orthodontics department, Peshawar Dental College, from July 2022 to February 2023. Ninety patients were selected using non-probability consecutive sampling, divided into normodivergent, hypodivergent, and hyperdivergent groups. Arch width measurements were taken on plaster dental casts, and facial patterns were classified based on the Frankfort mandibular plane angle.

Results: Mean age was 23.58 ± 6.64 years, and wide lower arches were predominant. Statistically significant differences were found in maxillary total arch length (p=0.03) and mandibular posterior intermolar width (p=0.04). Hyperdivergent individuals exhibited narrower maxillary inter-canine (p<0.001), maxillary inter-molar (p=0.010), and mandibular inter-molar (p<0.001) widths compared to hypodivergent and normodivergent subjects. No significant differences were observed in mandibular inter-canine width.

Conclusion: The vertical skeletal pattern significantly influences arch width in both arches, except for mandibular inter-canine width. Arch widths tend to be narrower in high-angle cases.

AWARENESS ABOUT HOT TOOTH AND ITS MANAGEMENT AMONG DENTAL PRACTITIONERS- A QUESTIONNAIRE BASED SURVEY

Jamal Ahad — 2025-01-10

Objective: To determine the awareness of hot tooth and its management among dental practitioners.

Materials and Methods: This descriptive cross-sectional study was conducted on 131 participants were recruited. Inclusion criteria included qualified dentists with a BDS qualification, trainees in operative dentistry, endodontists, dental professionals in Pakistan, and individuals aged 21 to 60 years. Exclusion criteria included trainees of other dental specialties not currently practicing, dental technicians, quacks, and undergraduate students. Data were collected using a structured online questionnaire shared via WhatsApp and email. Chi-square/Fisher exact test employed to compare awareness levels across different academic qualifications.

Results: The mean age was 35.85±6.12 years and 61 females (46.56%) and 70 males (53.44%). General dental practitioners made up the largest group (62, 47.33%), followed by trainees (52, 39.69%) and endodontists (17, 12.98%). Most participants had 1 to 4 years of experience (96, 73.28%). Awareness of the term "hot tooth" was high, with 112 (85.50%) participants familiar with it. In maxillary anesthesia, infiltration was the predominant technique (83.97%). For mandibular anesthesia, the inferior alveolar nerve block was most common (79.39%). Mandibular molars were identified as the most difficult teeth to anesthetize (81.68%). Non-steroidal anti-inflammatory drugs (NSAIDs) were the preferred medication for managing a hot tooth (90.84%). Significant differences in awareness and management practices were observed across different qualification levels.

Conclusion: Awareness of hot tooth and its management varies significantly among dental practitioners, with higher awareness and specific management techniques more prevalent among endodontists compared to general dental practitioners and trainees

PERCEPTION OF THE MIDLINE DEVIATIONS IN SMILE ESTHETICS BY LAYPERSON

Imtisal Asim — 2025-01-10

Objective: This study aimed to assess laypersons' perception of upper dental midline deviations and explore how viewing adjacent facial structures, including lips, chin, and nose, influences the diagnosis of such deviations.

Materials and Methods: A comparative cross-sectional study involving 100 patients was conducted using a non-probability consecutive sampling technique. Participants meeting inclusion criteria (age 18 years or older, no prior orthodontic treatment, normal or corrected-to-normal vision) provided written informed consent. Patients with craniofacial anomalies, severe dental malocclusions, ongoing orthodontic treatment, psychological disorders affecting self-perception, and personals having professional training in dentistry were excluded from the study. Photographs of a female subject with digitally manipulated upper dental midline deviations (0mm to 5mm) were categorized into two groups. one with adjacent facial structures (LCN) and one with lips only (L). Layperson evaluators assessed aesthetic appeal using a Visual Analog Scale (VAS).

Results: Among 100 participants (mean age 31.41 ± 8.01 years; 40% female), perception scores decreased significantly with increasing midline deviation (p < 0.001). One-way ANOVA revealed a significant association between midline deviation and perception scores (p < 0.001). Perception scores were lower in the LCN group compared to the L group.

Conclusion: Laypersons were able to detect upper dental midline deviations of 1mm or more when viewing adjacent facial structures. However, they required deviations of 2mm or more when focusing solely on lips. Viewing adjacent structures influences laypersons' perception of midline deviations.

PERCEPTIONS AND KNOWLEDGE OF MEDICAL AND DENTAL STUDENTS REGARDING ORAL NICOTINE POUCHES

Ruqayya Sana — 2025-01-10

Objective: To assess the knowledge and perceptions of medical and dental students regarding nicotine pouches. To determine the perceptions of medical and dental students regarding the health risks and benefits of nicotine pouches.

Materials and Methods: A cross-sectional study involving 355 students enrolled in medical and dental colleges of Peshawar was conducted. Data was collected using a self-administered questionnaire that underwent content validation and pilot testing. Participants were recruited through simple convenience sampling. Data analysis was performed using SPSS version 22. Frequency tables and percentages were generated for different categorical variables. To assess association between different variables chi-square test was used and p<0.05 was considered significant.

Results: Around 93.3% were aware of nicotine pouches, but knowledge gaps existed regarding their tobacco-free and addictive nature. Most participants (87.9%) recognized their addictive properties, and 88.2% linked them to oral cancer risk. Peer influence was identified as a major driver of use. While 73.3% felt confident counseling patients, 89.1% supported integrating nicotine-related topics into curricula to address misconceptions and health risks. Male participants demonstrated significantly greater knowledge about nicotine pouches and their addictive nature compared to females. MBBS students were more likely to attribute the popularity of nicotine pouches to peer influence than BDS students.

Conclusion: This study found that medical and dental students in Peshawar were aware of nicotine pouches but had misconceptions about their composition and health risks. To combat this issue, increased education and awareness campaigns are crucial, especially for young adults, who are particularly vulnerable to nicotine addiction.

COMPARATIVE ANALYSIS OF THE EFFECT OF MODELING AGENTS ON THE SURFACE PROPERTIES OF AESTHETIC NANO-HYBRID

Mayyadah Almozainy — 2025-01-10

Objective: Resin-Based Composite is one of the most widely used direct restorations in modern dentistry. However, it has its own drawbacks as its stickiness to the dental instrument upon packing which results in some difficulties when handling, therefore some clinicians resort to the use of some agents to ease the handling of the composite. However, this practice raises the question of how such agents can affect the restoration's physical properties.

Aim: This in vitro study aims to assess the effect of different modeling agents on the Nano-hybrid Resin Composite, specifically the restoration's color change and microhardness.

Materials and Methods: The study involved 45 Nanohybrid Resin-based Composite blocks divided into 3 groups with 15 blocks in each. First group was a control group consisting of only composite, meanwhile the second and third groups were subjected to a Modeling Liquid and a Universal adhesive respectively, then all three groups were light cured, immersed in colored media and kept in a container for 1 week. Color change and Microhardness of the cured blocks were measured before and after there immersion into the colored media.

Results: Results have shown statistically significant difference among the values of color change and microhardness within the three groups.

Conclusion: Modeling agent use might negatively affect the microhardness and color stability of the Nano-hybrid Resin-Based Composite depending on the type of the modeling agent itself.

Clinical implications: Based on our findings, it is advised for the clinicians to be more cautious about the use of different agents on Composite, with extra care to be taken when selecting the type of the modeling agent to be used.

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Ahmad Iqbal — 2025-01-10

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Ahmad Iqbal — 2025-01-10

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Ahmad Iqbal — 2025-01-10

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Ahmad Iqbal — 2025-01-10