The Knowledge of General Dentists Regarding Trigeminal Neuralgia in Lahore- a Questionnaire Based Study

Objective: To assess and document the knowledge general dentists possess in relation to incidence, diagnosis and management of trigeminal neuralgia and its application in their practice. Methods: This was a cross-sectional survey. The data collection tool was a piloted, self- designed, 14 item structured questionnaire that had questions regarding demographics, factual knowledge and practices of the participants. Hundred general dental practitioners were selected through purposive sampling in Lahore. Only general dentists were included in this survey and all other dental specialties were part of the exclusion criteria. Data was entered and analyzed using IBM SPSS Statistics® (Version 23). Results: Most practitioners responded that they were able to identify a patient with trigeminal neuralgia on the basis of diagnosis of exclusion. Carbamezapine was the drug of choice of pharmacological management or in case pharmacological management did not provide relief the patient was referred to an oral and maxillofacial surgeon. Conclusion: It was concluded that general dentists had adequate knowledge and sound practices on management of Trigeminal Neuralgia. A need for multi-disciplinary approach and continued medical education (CME) was identified. Keywords: Dentists, Disease Management, Facial Pain, Neuralgia, Knowledge, Trigeminal Neuralgia (TN).

Current Trends in the Development and Use of Personalized Implants: Engineering Concepts and Regulation Perspectives for the Contemporary Oral and Maxillofacial Surgeon

The recently adopted Medical Device Regulation (MDR) has finally entered into force on 26 May 2021. As innovation and especially the advent of customized prostheses has deeply modified many surgical procedures in our discipline, it is imperative for the contemporary surgeon to become aware of the impact that the MDR will have on many aspects, including the choice of the manufacturer, the evaluation of the devices, point-of-care 3D printing labs, and medical software. In this paper, the authors tried to identify the cultural gaps in clinical practice that the MDR is supposed to fill. To achieve this purpose, a task force of experts was reunited, including CMF surgeons with direct expertise in medical software and 3D printing, mechanical and material engineers, facing the topic of the MDR from a multidimensional perspective. In this article, surgeons and engineers review many crucial aspects concerning the points of the regulation that mostly affect the field of implantable devices for the cranio-maxillo-facial skeleton. The result of interdisciplinary research is a paper aiming to provide surgeons with the knowledge on the fundamental processes of additive manufacturing, increasing the clinician’s awareness on the evaluation of a customized implant before surgery and on the underlying regulatory framework.

An Approach to Interdisciplinary Orthodontics

Patient seeking orthodontic treatment in the present era comprises of both children and adults, thereby increasing the importance of multidisciplinary approach in orthodontics immensely. The interdisciplinary approach requires active involvement of various specialists like Prosthodontist, Oral and maxillofacial Surgeon, ENT surgeon, Paediatrician, Pedodontist, Endodontist, Periodontist, Audiologist, Physiotherapist etc. A combined interdisciplinary treatment approach will yield a result best suited for the patient as well as clinicians. Orthodontist in such Interdisciplinary treatment approach can play a primary or secondary role. So, the purpose of this article is to briefly summarize interdisciplinary approach for the management of dentofacial problems. Keywords: Interdisciplinary Orthodontics, Orthodontist, multidisciplinary approach in orthodontics

Peter Richard Barton BDS MBBS MA MDS FDSRCS MRCS LRCP (1921–2010) oral and maxillofacial surgeon and artist

Peter Barton enjoyed a rare achievement: distinction in science and the arts. He was an oral and maxillofacial surgeon, a painter, musician and philosopher, with a sharp intellect and questioning mind. A true polymath.

Composite odontoma with 23 denticles in a pediatric patient: A case report

Compound odontoma is an odontogenic tumor of ectomesenchymal origin containing tooth-like structures. Occasionally, this lesion may trigger occlusal, phonetic, and aesthetic disorders. The aim is to report a case of a compound odontoma containing 23 denticles in the anterior region of the maxilla of an infant patient. A 12-year-old male patient was referred for orthodontic treatment at Ribeirão Preto School of Dentistry, University of São Paulo (Ribeirão Preto, Brazil) complaining of a large diastema between the upper central incisors. Panoramic radiograph revealed the presence of a radiopaque lesion with tooth-like structures surrounded by a radiolucent rim in the anterior region of the maxilla, associated with distal displacement of the left central incisor. Surgical approach under general anesthesia revealed and extracted 23 denticles. Post-operative Cone beam computed tomography (CBCT) confirmed removal of all denticles, and further orthodontic treatment could be planned. Multidisciplinary involvement of pediatric dentist, oral and maxillofacial surgeon, and orthodontist was essential to achieve full functional, aesthetic, and psychosocial success.

Comparison of the accuracy of diagnoses of oral potentially malignant disorders with dysplasia by a general dental clinician and a specialist using the Taiwanese Nationwide Oral Mucosal Screening Program

Screening for oral potentially malignant disorders (OPMDs) with dysplasia in high-risk groups is suggested in countries with a high prevalence of the disorders. This study aimed to compare the accuracy of diagnoses of OPMDs with dysplasia made by a primary examiner (general dental clinician) and a specialist (oral and maxillofacial surgeon) using the current Taiwanese Nationwide Oral Mucosal Screening Program (TNOMSP). A total of 134 high-risk participants were enrolled for oral mucosal screening via the TNOMSP. A primary examiner and a specialist examined each participant. Mucosal biopsies were obtained and subjected to histopathological analysis. The OPMD most frequently diagnosed by the primary examiner was thin homogeneous leukoplakia (48/134; 35.8%), and in 39/134 participants (29.1%) the diagnosis was uncertain, but abnormalities were suggested. The OPMDs most frequently diagnosed by the specialist were erythroleukoplakia (23/134; 17.2%) and thin homogeneous leukoplakia (21/134; 15.7%), and 51/134 participants (38.1%) were diagnosed with other diseases. Via histopathology, 70/134 participants (52.3%) were diagnosed with dysplasia, and 58/134 (43.3%) were diagnosed with benign conditions. The specialist’s diagnoses exhibited a higher specificity, positive predictive value, and accuracy than the primary examiners. A specialist using the current TNOMSP for high-risk participants diagnosed OPMDs with dysplasia more accurately than a primary examiner. Early diagnosis of high-risk OPMDs is crucial in countries with a high prevalence of the disorders. Proficient examination via the current TNOMSP by trained clinician is effective for the management of OPMDs with dysplasia.