A Case of Generalized Tooth Wear caused by Bruxism and its Rehabilitation

Bruxism may lead to dental problem such as tooth wear, fracture, crack of tooth, muscles of mastication discomfort, temporomandibular joint (TMJ) dysfunction syndrome and periodontal signs such as gingival recession and tooth mobility. This article presents a case report in which bruxism caused severe tooth wear that lead to great muscular discomfort with TMJ pain. The initial treatment approach was the installation of an inter-occlusal acrylic device in centric relation of occlusion for re-establishment of the occlusal stability. Vertical dimension of occlusion, anterior guides and return of normal muscle activity were observed within 3 months. After subsiding primary symptoms, oral rehabilitation therapy was approached by means of metal bond ceramic restoration and new inter-occlusal device was provided for protection of restoration. Satisfactory aesthetics, improved function, occlusal stability were obtained after oral rehabilitation therapy. No specific trouble occurred during 1 year follow up period. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13747 City Dent. Coll. J Volume-10, Number-1, January-2013

Correlation between Degenerative Changes and Osteoporosis in Lumbar Spine of Elderly Women in Dhaka city, Bangladesh

Aims: Degenerative joint diseases and decreased bone mass i.e. osteoporosis are two common age related skeletal disorders responsible for pain and disability. Bangladesh has a high incidence of osteoporosis and the incidence particularly in women, occurs among a relatively younger age group than in the developed world. However little is known about the correlation between degenerative changes and osteoporosis in lumbar spine of elderly women. The purpose of this study was to clarify this relationship in elderly women of Dhaka, Bangladesh. Methods: A cross-sectional study was conducted at the department of radiology and imaging of Bangladesh institute of research and rehabilitation in diabetes, endocrine and metabolic disorders (BIRDEM), Dhaka during the period of 1st January, 2009 to 31st December, 2010. DEXA scan of spine and BMD measurement were done at a renowned private hospital of Dhaka. Total 63 elderly female aged between 50-75 years were randomly selected for this study. Results: An inverse relationship between osteoporosis and spondylosis in postmenopausal women as evaluated by bone mineral density and semiquantitative scoring of spinal degeneration was observed. A significant negative correlation (r=-0.53:p<0.05) was found between T-score and grade. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13740 City Dent. Coll. J Volume-10, Number-1, January-2013

Preventive Practice on Hepatitis B Virus Infection among Dentists in Selected Hospitals at Dhaka City, Bangladesh

Aims: The study was carried out among 120 dentists working in the selected hospitals of Dhaka city to find out the preventive practice on hepatitis B virus (HBV) infection. Methods: A descriptive type of cross-sectional study was carried out involving 120 dentists working in the selected hospitals of Dhaka city from December 2011 to March 2012 to quantify the preventive practice on HBV infection through a pretested semi-structured questionnaire. Results were analyzed by using the software SPSS 16.0 version (Chicago). Then analyzed data were presented according to the variables of the study showing percentage relationship between variables using appropriate statistical method.Results: Mean age of the dentists was 26.43±6.29 (range, 25-45) years where 74.17% were male and 25.83% were female. Among 120 respondents, 20.83% obtained BDS degree along with a postgraduate training (PGT) in any of the respective fields of dentistry. Others obtained MS in dentistry (21.67%), MPH in dentistry (10.83%), PhD in dentistry (9.17%), DDS in dental surgery (10%) and FCPS in dentistry (6.67%). Academic positions of the respondents were 33.33%, assistant professors, 26.67% associate professors, 19.17% medical officers, and 17.5% were lecturers. Majority (93.3%) dentists knew about HBV transmission, prevention, symptoms, risks, and concurrences. Out of them, 87.5% reported having been tested for HBV which was associated with their designations (p=0.013) and more than 75% reported having been vaccinated against HBV. Conclusions: A high level of knowledge and attitude towards practice in the prevention of HBV was found to be very good among the dentists of Dhaka city though seemed it was not always possible to take precaution for handling emergency patients. Further broad scale studies would be needed to have decisive results. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13831 City Dent. Coll. J Volume-10, Number-1, January-2013

Practice and Knowledge of Health Personnel on Impact of Medical Wastes in Upazilla Health Complexes under Dhaka Division in Bangladesh

A cross-sectional study was conducted among 42 health personnel and people without a medical background but concerned with the waste management. They were interviewed through pretested semistructured questionnaires at their working places of the upazilla health complexes at Sreepur, Kapasia, Kaligonj, Shivaloya, Saturia, Savar and Dhamrai under Dhaka division of Bangladesh. A total of 6 respondents (2 doctors, 2 nurses and 2 support staff) from each of the upazillas were recruited. Upazilla health complexes were running with average bed occupancy of ?10/day and where ?10 health personnel were working. The objective of this study was to assess the practice and knowledge on impact of the medical wastes of the health personnel working in the health complexes. The distribution of the respondents by their responses regarding environmental impact of medical wastes were recorded, analyzed and tabulated. Hundred percent (100.0%) respondents said about pollution of air, 89.7% said about pollution of surface water, 69.0% said about pollution of ground water, 58.6% said about open dump with infectious agents, soil pollution, 48.3% said about enhance spread of infectious diseases by rodent, 34.5% said about litter and leachate, 20.7% said about production of methane and greenhouse gases and 10.3% said about raised environmental temperature due to the increase of greenhouse gases. Regarding the knowledge of environmental impact of medical wastes, doctors and nurses were found to be more knowledgeable than the support staff. The difference was found to be statistically significant. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13830 City Dent. Coll. J Volume-10, Number-1, January-2013

An Endodontic Enigma: A Case Report of External Inflammatory Root Resorption-2 years Follow up

In dentistry,root resorption is the breakdown or destruction and subsequent loss of the root structure of a tooth caused by living body cells attacking part of the tooth. When the damage extends to the whole tooth is called tooth resorption. Severe root resorption is very difficult to treat and often requires the extraction of teeth. Root canal therapy has been shown to be a verysuccessful means of treating inflammatory resorption. It has been recommended to include a calcium hydroxide paste in the root canal therapy to enhance the success of the treatment out come. Calcitonin has also been suggested as an interim root canal medicament to assist in the inhibition of osteoclastic bone and dentin resorption. Calcitonin penetrates the dentinal tubules in the out word direction, thus exerting a direct effect DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13833 City Dent. Coll. J Volume-10, Number-1, January-2013

Common Malocclusion Problems and their Management: A Hospital based study

Aims: Orthodontics is the branch of dentistry concerned with the prevention, interception and correction of malocclusion. The present study aimed at the common malocclusion problems and their management in Bangladeshi population. It was also aimed to align for aesthetics reason, functional efficiency and structural balance. Methods: A cross-sectional study was carried out among 120 respondents having malocclusions. Students, especially young women and urban residents were selected as the main respondents of our series which reflected its aesthetic value against malocclusion Results: Mean age of the respondents was 22.22±9.07 years with a male and female ratio of 1:3.1. Among the respondents, 37.5% were within the 11 to 20 years age group with a past (21.0%) and present (7.5%) history of finger sucking habit and abnormal over jet (71.7%) and over bite (55.8%). Mean over jet and overbite were 4.4 ±3.47 (range, -2 to 12) mm and 3.47±1.98 (range, 0 to 7) mm, respectively. Angle’s classification revealed type 1, type 2 (division 1), type 2 (division 2) and type 3 were 55.0%, 28.3%, 3.3% and 13.3%, respectively, and based on skeletal relationships, type 1, type 2 and type 3 were 64.2%, 25.0% and 10.8%, respectively. Of all patients, 66.7% had convex, 22.5% straight and 10.8% had concave face profiles. They also had 44.2% competent, 36.7% incompetent and 19.2% habitual competent anterior lip seals. Conclusions: Smile is a global language though many of our patients are deprived of both socially and economically, especially young women from this language. With growing importance imposed on preventive orthodontic treatment and proper oral health education, incidence of malocclusion can be reduced. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13827 City Dent. Coll. J Volume-10, Number-1, January-2013

Oral Health Status of the Arsenic Exposed and Non-Exposed Children in Bangladesh

Aims: This cross-sectional study was conducted in rural areas of Bangladesh to assess and compare the state of oral health among the arsenic exposed population affected through drinking water with the non-exposed group. Materials and Methods: A total of 400 respondents were interviewed and examined through a structured questionnaire and a checklist. Exposed group was included with or without the signs of arsenicosis.Results: Among them, 200(50%) were found exposed to arsenic and the rest 200(50%) were in non-exposed group. Study showed that 6% respondents were suffering from sensitivity of teeth, and 24.5% and 20% developed pigmentation on gingival and tongue surfaces, respectively, who used to take arsenic contaminated water, in comparison to non-exposed group, 10.9%, 5%, 0.5%, respectively. Arsenic exposed group had tooth abrasion 24%, while it was 4.5% in non-exposed group. Less caries (18.5%) was found among the arsenic exposed group than the non-exposed group (25.9%). Conclusion: Arsenic might have influence on enamel hypoplasia and this low tendency of occurring carries. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13834 City Dent. Coll. J Volume-10, Number-1, January-2013

Palatal Drop Augmentation and Tongue Prostheses: A Case Report

Background: After a total glossectomy, one lost the ability to speak and swallow due to the loss of tongue mobility and the increase of space between the palate and tongue remnants. To improve swallowing by creating negative pressure, tongue and palatal drop prostheses can be utilized. This prosthesis does not restore other tongue functions such as mastication, speech articulation and resonance because the prosthesis cannot reproduce natural tongue movements. Purpose: To rehabilitate the tongue deformity due to the gun shot wound. Methods and Materials: The case report revealed the total lost of tongue of a Bangladeshi patient who cannot be able to swallow and speak. The remaining teeth still fully intact but the palatal drop and tongue prosthesis was fabricated with the silicone prosthesis. Results: Both palatal drop prosthesis and tongue prosthesis allowed the patient to increase the capacity to swallow and reduce the remaining odondus space. The speech appeared to be more intelligiable but cannot fully restore. Conclusion: The quality of life of a patient after post operative follow-up appeared to be better; however, the physiologic function of the missing organ cannot fully restored.DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13828City Dent. Coll. J Volume-10, Number-1, January-2013 Retracted: Due to complain

Prevalence of Periodontal Diseases among Patients Attending the Outpatient Department at the College of Dentistry, King Khalid University, Abha, Saudi Arabia

Aims: A retrospective study was performed involving 2739 patients who were attending the College of Dentistry outpatient clinic department of King Khalid University (KKU), Abha, Kingdom of Saudi Arabia (KSA) during the period of 1st January to 31st December, 2009. Methods: Random data were collected from the patients record files ofthe College of Dentistry who attended from 1st January to 30th December, 2009. Results: Among 2739 patients mean age 32±13 (range 11~82) years, males 86.5% and females 13.5%, were found sufferers of different types of periodontal diseases i.e., gingivitis and periodontitis. Gingivitis cases were found 1722(63.2%), in which mild gingivitis was 49.8%, moderate gingivitis 45.8%, severe gingivitis 1.97%, acute gingivitis 0.52% and puberty gingivitis 1.80%. Total number of patients affected with various forms of periodontitis was 1009 (36.8%), in which mild periodontitis was 57.4%, moderate periodontitis 36.6%, severe periodontitis 4.95% and aggressive periodontitis 0.89%. The prevalence and severity of gingivitis was found increased with age to a peak in the 21~30 years age group, whereas, periodontitis increased significantly (p<0.001) in subjects above the age of 40 years. Conclusion: Using the research results, a greater effort can be made in providing periodontal health to the population of at or around the city of Abha, KSA. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13835 City Dent. Coll. J Volume-10, Number-1, January-2013

Periodontitis and Cardiovasculardisease: Association and Risk

Periodontitis has been associated with an increased risk of cardiovascular events.Two internet databases were selected in search of appropriate papers for the study purpose: i)the National Library of Medicine,Washington DC,USA (MEDLINE-PubMed) and ii) HINARI Access to Research in Health Program,World Health Organization,Geneva,Switzerland.Both databases were searched from 1985 to 2009.In the past decades, there has been renewed interest in the old hypothesis that infections increase the risk of developing cardiovascular disease.Atherosclerosis has a major inflammatory component and the main underlying pathological pathway for cardiovascular disease (CVD). Periodontal pathogens may be involved in the initiation and progression of atherosclerosis and subsequent coronary heart disease.Periodontal pathogenPorphyromonasgingivalis caused atherosclerosis in experimental animals and have been found in human atherosclerotic lesions.The nature of association is unclear because both periodontitis and CVD share a host of risk factors.Epidemiological studies, mainly observational studies (case-control,cross-sectional and prospective cohort studies) are usually the first to generate association data between exposure and adverse health outcomes. Clinical trials with statistically significant positive outcomes are easy to interpret and indicate that the tested intervention is effective in favorably altering the adverse health outcomes.Available evidences suggest that having periodontitis contributes to the total infection and inflammation burden and may contribute to cardiovascular events in susceptible subjects.The impact of periodontal therapy must be further investigated. DOI: http://dx.doi.org/10.3329/cdcj.v10i1.13829 City Dent. Coll. J Volume-10, Number-1, January-2013