Antibiotic Resistance - Knowledge, Attitude And Practice Based Survey Amongst Dental Health Care Providers In An Institution​

Introduction: Antibiotic resistance is definitely one of the most dreaded outcomes of injudicious use of antibiotics in a developing country like India. The prevalence of Over the counter (OTC) availability of antibiotics has also contributed to this bane and burden of antibiotic resistance in our country. Aim: The aim of this survey based study was to examine the knowledge on antibiotic usage, resistance, attitudes, perceptions and practices among dental health care providers using an online survey. Methods and Methodology: An Eighteen point online close ended questionnaire based survey was conducted amongst 100 randomly selected postgraduate stu- dents in various dental specialities from our institution, whereby their Knowledge, attitude and Practice regard- ing antibiotic resistance and usage was assessed. The questionnaire was designed to include demographic information of the participants along with questions based on frequency of antibiotic usage, resistance and interest of participants to attend educational seminars as a part of continuing education. Results: 76.47% participants agreed that antibiotic resis- tance is a major public health burden in India and glob- ally. Participants who had never attended seminars on antibiotic resistance were 82.35% and 89.41% were willing to attend seminars. Conclusions: Our survey showed few mis-prescriptions of antibiotics in cases of resistance to penicillin groups of drugs and use of broad versus narrow spectrum antibiotics. However, the overall awareness and prescription protocols were appropriate, thereby concluding that post graduates had a good knowledge of antibiotics, their use and risks involved.

Surgical procedures in patients on aspirin. Literature Review

Aspirin is referred to as the original of the common non-steroid anti-inflammatory drugs and is used as a comparison measure to new ones. Aspirin, whose active ingredient is acetylsalicylic acid, combines strong antipyretic, analgesic, anti-inflammatory and anti-coagulant action. For the latter, aspirin is administered on an ongoing basis to patients for the prevention of cardiovascular events or recurrence of cerebral throm- bosis and therapeutically to patients with a history of heart attack or ischemic stroke. Taking aspirin as an anticoagulant chronic medication concerns dentists es- pecially when it comes to surgical procedures as it is likely to cause increased bleeding perioperatively. The management of the patient on aspirin varies depending on the reason aspirin is administered and its dosage, the co-administration of other antiplatelet or anticoagulant drugs and the severity of the surgical procedure itself. An interruption of antiplatelet medication is decided after assessing the above-mentioned criteria and con- sulting the patient’s physician. Additionally, in cases of increased bleeding risk like complex extractions, pre- prosthetic surgery, periodontal surgery, the procedure needs to be performed as atraumatically as possible and be accompanied by local haemostatic measures.

A comparative study of the effects of the anterior disc displacement with reduction and without reduction on the components of the temporomandibular joint by using magnetic resonance imaging – A Retrospective study

Background: Internal derangement of the temporomandibular joint (TMJ) results in anterior disc displacement with reduction (ADDR), the disc is ante- riorly displaced in the closed position whereas in the opened position the disc returns to its normal location. In anterior disc displacement without reduction (AD- DWR), the disc is anteriorly displaced in the closed po- sition but does not return to its original location in the opened position. Here we studied and compared the effects of the ADDR and the ADDWR on the components of the TMJ by using the magnetic resonance imaging technique (MRI). Methods and materials: From the archival MRI records, 214 joints from 107 patients were included. The selec- tion criteria for the patients complaints as TMJ pain, clicking, limited mouth opening, headache, jaw tenderness and difficulty in eating. MRI records with sequences Proton Density (PD), PD FAT SAT and T2* gradient in the closed position and T2* gradient echo in the opened position. Data analysis and frequency distribution of explanatory variables by disc position in the open state was performed using chi-square test Results: Statistically significant differences were observed between the variables such as the joint space (closed position), disc morphology (closed position) and range of movement (opened position) among the ADDR and the ADDWR. In ADDWR, 20.3% demonstrated narrowed joint space and 1.6% with widened joint space, while in ADDR, 2.5% of joints had narrowed joint space and 0% widened joint space. Same was observed with abnormal disc morphology and rang of movement. Conclusion: The disc deformity is more in ADDWR compared to ADDR which can be seen as an alteration in the signal intensity. The malaligned disc could lead to the narrowing of the joint space and decreased range of movement in the ADDWR affected individuals.

A clinical-statistical study of patients with disabilities’ oral health problems, treated under general anesthesia, at the dental department of «Agios Dimitrios» General Hospital of Thessaloniki, Greece, from 01/01/2008 to 31/12/2009.

General anesthesia has proved to be an ef- fective mean for treating patients in need of restorative and surgical treatment, when other methods have failed. Aim: The aim of this retrospective clinical-statistical study was to assess the characteristics, oral health management of special needs patients attending for DGA treatment at Agios Dimitrios General Hospital of Thessaloniki,. Patients and method: Medical files retrieved from 169 male and 129 female patients, from 5 to 63 years of age and 36,2% of them were children and adoles- cence.257 patients during a twelve year old period, from 01/01/2008 to 31/12/2019. Demographic, quantitative and qualitative data were obtained from patients’ files (e.g place of residence, gender, age, type of disability, comorbidity, amount and type of treatments provided and were analyzed by means of descriptive and comparative statistics.Results: 298 DGA treatments were performed to 169 males and 129 female patients, from 5 to 63 years of age and 63,8% of them were over 18 years old. 68,5% of the patients were mentally retarded, 17,8% were au- tistic, 7% had cerebral palsy, 3,5% suffered from vari- ous syndromes and 3,2% were patients with systemic diseases and other health issues. A total of 2787 treat- ments were provided, with higher prevalence of 49,8% for restorative treatments. Conclusions: In many patients with severe disability, DGA is the only treatment option. The number and the geographic distribution of dental departments of Greek NHS that provide DGA, does not guarantee the equal and unimpeded access of special needs patients. Therefore, implementation of organized oral preventive programs is necessary, along with investment on the appropriate infrastructure, that would allow the creation of additional dental departments providing DGA treatments within the NHS.

Computer-assisted resection of mandibular cancer and repair with fibula free flap. Case report

Oral cancer is a disease, in the treatment of which the surgical resection of the lesion plays a lead- ing role. Oncological resections in the maxillofacial area create large deficits that affect the functionality and aesthetics of the patient to a large extent, while many times make oncological resection impossible due to their inability to restore. The mandibular deficits are particularly difficult, with the free osteocutaneous fibular flap being the gold standard in repairing large mandibular deficits. In recent years, technology has offered significant as- sistance in the successful restoration of functional and aesthetic disorders through the virtual planning of the operation. In this paper we present a case of oral cancer whose resection and reconstruction with fibula free flap were done after digital design and under the guidance of special cutting guides. To our knowledge, this case of computer-guided reconstruction with FFF represents the first description of such a technique for mandibular reconstruction in the available greek medico-dental literature.

Expect the unexpected – A rare case of Orthokeratinized Odontogenic Cyst and its surgical management

Orthokeratinized Odontogenic Cyst (OOC) is a rare, developmental odontogenic cyst of the dental lamina. It was initially defined as the uncommon orthokeratinized variant of the Odontogenic Keratocyst (OKC), until the World Health Organization’s (WHO’s) classification in 2005 and 2017, where it was separated from the Keratocystic Odontogenic Tumor (KCOT) and has been included as a separate entity from the category of developmental odontogenic cysts respectively. It presents as a unilocular radiolucent lesion involving the posterior mandible and is frequently related to impacted teeth, often similar to other odontogenic cysts. Due to low local aggressiveness and less proliferative activity, it has to be differentiated from the other cysts in terms of surgical management. Here we report a rare case of OOC involving the maxilla along with an impacted canine and discuss the surgical management and why a secondary surgical intervention is unnecessary.

Bullous pemphigoid: Case report and review of literature​

Bullous pemphigoid (BP) is an autoimmune bullous disease characterized by subepithelial blistering mostly affecting elderly but may be seen in all ages. A 52-year-old female patient came with a chief complaint of itching, redness and ulcer in the hands and oral cavity for the past 2 weeks. The examination revealed ulcer- ated lesions in palate and buccal mucosa. Erythematous lesions were also seen in upper limb. Incisional biopsy was done and histological examination revealed bullous pemphigoid. The patient was immediately started with systemic and topical steroids and was continued for 3 weeks. The extra-oral lesions were healed and intraoral ulcerations subsided after 3 weeks.

Canalicular adenoma of minor salivary gland: Report of a case and a brief review of the literature

We refer a case of a canalicular adenoma of minor salivary gland, located at the submucosal region of the upper lip. The patient’s clinical state was thoroughly studied, along with the histopathological findings. Numerous histogenesis theories and the appropriate tumor treatment are mentioned, being always in accordance with the relative literature. Canalicular adenoma of minor salivary gland is a rare oral mucosa lesion. The differential diagnosis among many oral swellings is interesting. The surgical excision is the treatment of choice. The histological examination confirms the clinical diagnosis.

Mucormycosis. Case report and literature review

Mucormycosis the life-threatening opportunistic fungal infection affects primarily immuno-compromised patients in an aggressive manner. Mucormycosis in the oral cavity is not common. The case we report presented with infra orbital swelling and pain with radiographic appearance of small area of bone destruction in maxillary anterior region. The patient also had uncontrolled type 2 diabetes. The patient underwent extraction of his anterior teeth 10 days back before he developed the swelling and pain. The primary diagnosis was osteomyelitis. After the histopathology diagnosis of mucormycosis the patient was immediately started with Amphotericin-b and surgical debridement of the involved site was done. The combination of medical and surgical treatment of mucormycosis will have good prognosis.

Congenital giant lower eyelid hidrocystoma in a patient with possible orofacial digital syndrome: case report and literature review

Hidrocystomas are benign cystic lesions which arise from the secretory part of sweat glands. Hidrocystomas can be either eccrine or apocrine and are often found in the head and neck region. In this paper we present a case of a large congenital hidrocystoma of the lower eyelid in a patient with possible orofacial digital syndrome (ODS). A special feature in our case was the presentation of bone remodeling of the anterior surface of the maxilla. The basic clinical and histological features of hidrocystomas are also reviewed.