Journal of Rehman College of Dentistry

Frequency of Natal Teeth and Their Association with Maternal and Neonatal Factors

Faiza Malik — 2025-10-03

Background: Natal teeth are those teeth which are present at the time of birth. Teeth which erupt within one month after birth are called neonatal teeth.

Objective: To determine the frequency of natal teeth and their association with maternal and neonatal factors.

Materials and Methods: This study was conducted at Orthodontics & Paediatrics Department, Sharif Medical City Hospital (SMCH), Lahore fromSeptember 2023 to August 2024 (1 year). After taking permission from Sharif Medical Research Centre (SMRC) and the Ethics Committee of Sharif Medical and Dental College, Lahore, this study was conducted by the Orthodontics Department in association with the Paediatrics Department of SMCH. A predesigned proforma was filled out for every newborn at SMCH by the primary researcher after taking written informed consent from their parent(s). The proforma included questions about neonatal and maternal factors.

Results: A total of 623 newborns were examined during the study period of 1 year, out of which 7 (1.1%) newborns had natal teeth. Mean maternal age was found to be 25.9±1.9 years. Natal teeth were more commonly found in females (85.7%) as compared to males (14.2%). They were mostly found in the mandibular anterior region. Natal teeth had grade II mobility, and with respect to Helbing’s classification, the third category was most commonly found. There was no significant difference in tooth morphology and colour. With respect to maternal factors, there was a significant association with cousin marriage but an insignificant association with parity.

Conclusion: Natal teeth are very rare. Newborns should be examined by a dental specialist soon after birth, and parental counselling should be done regarding the management of natal teeth.

The Impact of Early Childhood Caries on the Quality of Life of 3-6 year Old Children and Their Parents Visiting Teacher Dental Hospital in Peshawar

Kanwal Nazir Arbab — 2025-10-03

Background: Dental caries is a worldwide challenge to the public health, predominantly effecting young children. Early childhood caries (ECC) can begin soon after tooth eruption starting on the smooth surface, progressing rapidly and require filling or leading to extraction of the involved tooth. Children experiencing caries in the earliest ages of their lives are at a greater risk of developing caries in permanent dentition as well. It can have a drastic impact on the permanent dentition and hence adds up to the increasing burden of oral diseases. Unlike other infectious diseases, dental caries is not self-limiting, and untreated early childhood caries will affect both oral and general health as well as quality of life.

Aims & Objectives: The objectives were to assess the impact on quality of life of early childhood caries (ECC) on the quality of life of children at teaching dental hospital in Peshawar and to determine the impact of ECC on quality of life of their parents. Using the claimed methods for the assessment of the severity of the dmft-index and the severity of their impact on QoL through the use of ECOHIS questionnaire.

Method: The study comprises of 400 children (3 to 6year) attending tertiary care dental hospitals in Peshawar. A consecutive non-probability sampling technique was used. Data related to the severity of ECC and the QoL of the child and parent were collected through clinical examinations and ECOHIS questionnaires (Pahel et al. 2007). ECC and its severity of each child was recorded as nil, mild, moderate and severe using dmft index. Urdu version of the ECOHIS was derived though a forward-backward translation without modifications. Primary caregivers completed an Urdu version of the ECOHIS. Data analysis was done using SPSS version 22.0. The impact levels for QoL of the child and the parent were recorded as weak/mild, moderate, high.

Result: The mean age of the children was 2.58 ± 1.13 with a male to female ratio of 1:0.8. More than half of the families in the study (64%) had a low socioeconomic status. About 41.5% children included in the study had high dmft scores indicative of severe ECC (S-ECC). The ECOHIS scores and children’s caries experience (dmft) were related to each other (r =0.59, P < 0.01). In addition, the variations in ECOHIS scores were apparent with respect to caries severity (P < 0.001), supporting the ability to distinguish between patient groups. About 38.5% of the children showed greater total ECOHIS scores (range 36 to 52) suggesting high impact on QoL. In the CIS 55% of the children reported high impact (range 25 to 36), whereas in the FIS majority of the parents (40.2%) showed weak impact levels. In the child section the functional domain was the most reported item (73.2%), whereas the financial impact item (54.4%) was the frequently reported in the parent section. Cronbach’s alpha values (internal consistency) for total ECOHIS score were 0.86, and 0.78 and 0.82 for both the child and family impact sections respectively.

Conclusions: Severe ECC in children adversely affected their quality of life. The use of an oral health specific instrument such as the ECOHIS proved useful in assessing the impact of dental caries on functional and psychosocial well-being of children. And it is also able to evaluate the functional and financial impact on QoL of parents of children having ECC.

Keywords: oral health, preschool children, Quality of lifeearly, childhood caries.

Comparative Effectiveness of Topical Triamcinolone in Orabase in Treating Recurrent Aphthous Stomatitis: A Comparative Study Between Diabetic and Non-Diabetic Patients

Mansoor Ahmad Miani — 2025-10-03

Objective: The aim of this study was to measure the effectiveness of triamcinolone in orabase for recurrent aphthous stomatitis in diabetic and healthy patients

Material & Methods: This was a case control study. Convenience sampling was carried out and a total of 130 patients were selected. The study included male and female with aged 18-50 years with equal number of patients in case (diabetic patients) and control (non-diabetic individuals). Recurrent aphthous stomatitis less than 48 hours, minor and major aphthae was included in this. The data were analyzed using SPSS 23.0. Independent t-tests and chi-square tests were used to compare continuous and categorical variables. p≤0.05 was kept as statistically significant.

Results: Females were predominant that males in the study with the mean age presentation 36.7 ± 9.7 years. Although both groups showed an improvement but diabetic patients at day 7 exhibit higher pain score (1.4 vs 0.6 p<0.001) significant slower reduction in ulcer size (0.9 vs 0.4 p=0.001) and greater recurrence at 3 months (42% vs 20% p=0.01). The adverse effects were minimal.

Conclusion: This study concluded that Triamcinolone was effective in the treatment of recurrent aphthous stomatitis in diabetic as well healthy patients.

Key words: Recurrent aphthous stomatitis (RAS), Triamcinolone in orabase, Treatment, Pain, Diabetes mellitus.

Evaluating Dental Students’ Knowledge, Attitude and Practice of Needle Stick Injuries

Fatima Arif — 2025-10-03

Background/Objectives: This study aims to evaluate the knowledge, attitudes, and practices (KAP) regarding NSIs among dental students at KMU Institute of Dental Sciences, Kohat.

Methods: A descriptive cross-sectional study was carried out among 130 undergraduate dental students, house officers and post graduate residents. Data were collected using a structured and pre-validated questionnaire⁽⁶⁾that assessed students' awareness of NSI-associated risks, their attitudes towards safety measures, and their adherence to standard practices. Statistical analysis was performed using SPSS 25, with Chi-square tests applied to determine associations between variables.

Results: The findings revealed a high level of awareness regarding NSI-related infections such as HIV, Hepatitis B (HBV), and Hepatitis C (HCV). Most students demonstrated knowledge of universal precautions (69.2%) and post-exposure prophylaxis protocols (82.3%). Preventive practices such as single-handed needle recapping and appropriate disposal methods were widely reported. Despite this, 20% of the participants reported experiencing an NSI within the past year. A concerning trend of underreporting was observed, particularly for injuries involving sterile needles, indicating gaps in the reporting culture and perceived seriousness of such incidents.

Conclusions: While the general knowledge and attitudes of dental students towards NSIs are good, critical gaps remain in reporting behavior and consistent implementation of safety practices.

Knowledge And Attitude of Artificial Intelligence Among Medical And Dental Students of a Public Sector University of Karachi: A Cross-Sectional Study

Tooba Adil — 2025-11-12

Background: Artificial Intelligence (AI) is transforming healthcare, revolutionizing treatment, diagnosis and patient care. It has the potential to not only predict clinical events but also provide prognosis and aid drug discovery. As AI advances, it is crucial to train medical experts for an AI-enhanced healthcare system. This can be achieved by educating future medical and dental students. The first step in doing so is to assess the baseline knowledge at which they currently stand as well as exploring their insights on the famous stigma of AI replacing their future career choices and the current status of AI use in their country. Additionally, exploring ways through which students prefer AI to be incorporated; either curricular or extra-curricular.

Methods: A questionnaire-based survey was conducted from August-November 2023, following IRB approval (Reference No: JSMU/IRB/2023/752) from the Institutional Review Board of JSMU, which was granted on June 24, 2023. The questionnaire, adapted from a similar Canadian study, was distributed via social media to medical and dental students over 18 years old at JSMU. A convenience sampling technique collected 324 completed and consented responses via forms. Statistical analysis was performed with SPSS version 20, using Chi-square test to compare factor variables (gender and year of study) with outcome variable (knowledge about AI).

Results: Most students (74.38%) obtained information about AI from social media.Majority (79.9%) reported being somewhat familiar with AI, but only 22.53% chose accurate definition. Students' program and year of study impacted their knowledge of AI (P < 0.05), while gender did not (P > 0.05). Over half (56.17%) of the population believed students need to learn AI basics, and 53.09% agreed AI will revolutionize healthcare. Top benefits selected were early accurate diagnosis, improved accessibility, and automation of routine tasks. Most students (48.15%) favored integrating AI into their curriculum. A majority of MBBS (47.7%) and BDS (41.33%) students believed AI might replace their careers in the future. Notably, 60.19% of students believed AI will improve patient care, while 45.68% thought it would raise healthcare costs.

Conclusion: Students acknowledge AI’s potential, but lack the necessary knowledge. Recognition of this gap highlights the need for robust educational planning either curricular or extracurricular with the learning objectives as highlighted by the preferences chosen by the students. This study helped address students’ notion about AI replacing careers and identifies the need to educate students about the potential of AI and how it can efficiently supplement but not replace healthcare. We believe that these findings offer valuable guidance for education and health policymakers to plan curricula and integrate modulations for future advancements. The limitations include the study being limited to a single university and two departments, and the use of convenience sampling, which may have affected the generalizability of the findings.

Evaluating the Diagnostic Accuracy of Artificial Intelligence in Periapical Radiographs

Adeel Haidar — 2025-10-03

Background: Over the past few years, significant development has been made in the field of oral and dental diagnostics. A conservative treatment strategy with a favorable prognosis could be implemented by the clinician with an early diagnosis. It has been reported that examiners with greater expertise exhibit more effective diagnostic accuracy than those with less experience. AI is frequently thought of as a useful tool to assist clinicians and dentists in minimizing their workloads.

Objectives: The purpose of this study was to evaluate the diagnostic accuracy of artificial intelligence in identifying common dental problems on periapical radiographs compared with experienced dentists.

Methods: A total of 283 periapical radiographs were randomly selected from the database of the University Dental Hospital. Two general dentists with more than 10 years of clinical experience manually assessed the periapical radiographs, which was ground truth. The same periapical radiographs were then uploaded into AI dental software.

Results: The obtained Cohen’s Kappa values (0.61-0.8) indicated substantial agreement between the two investigators. Good agreement is noted in several parameters; F1 scores of apical radiolucency, obturation, and tooth detection were 0.7, 0.9, and 0.8, respectively. For Caries, the model had poor reliability with an accuracy of 61%.

Conclusion: AI can help detect dental issues on periapical radiographs but still needs improvement before it can fully aid clinical decision making.

Extraction Trends in Orthodontics: Association with Malocclusion and Treatment Planning

Tahira Hussain — 2025-10-03

Objective: To analyze the frequency of orthodontic dental extractions and provide justification for the decisions made, highlighting the connection between extraction patterns and malocclusion types.

Material and methods: Records of 222 patients from the Orthodontics and Dentofacial Orthopaedics Department at Bacha Khan College of Dentistry, Mardan, were retrospectively analyzed over a one-year period. Complete records with thorough treatment plans and extraction choices (except from third molars) were necessary for inclusion. Demographics, extraction patterns, Angle's malocclusion classifications, and the timing of treatment commencement were among the variables evaluated. Associations were assessed using chi-square testing; significance was reached at p < 0.05.

Results: The distribution of malocclusions among 222 patients (mean age 18.60 ± 4.57 years; 65.3% female) was Class I (43.7%), Class II (45.0%), and Class III (11.3%). With a maximum of four teeth extracted and an average of 1.43 extracted per patient, extractions were recommended in 45.5% of instances. First premolar extraction was the most prevalent pattern (22.5%). Class II cases had the highest extraction rate (64.0%), and there was a significant correlation (p < 0.001) between the kind of malocclusion and the need for extraction.

Conclusion: The study reveals a significant rate of extractions in orthodontic practice, particularly among patients with Class II malocclusion. These findings highlight the necessity of personalized treatment planning and early intervention in orthodontic treatments to improve outcomes and potentially reduce the need for extractions.

KEYWORDS: Frequency, Class II malocclusions, Extractions, orthodontic therapy

Frequency of Inadequate Dimensions of Rest Seat Prepared on Molar Abutment Teeth for Cast Removable Partial Denture

Sadaf Khan — 2025-10-03

Background: Properly prepared occlusal rest seats are essential for the stability, support, and longevity of cobalt-chromium removable partial dentures. Inadequate rest seat dimensions can compromise load distribution, leading to prosthesis failure. However, deficiencies in clinical preparation remain common in dental practice.

Objectives: To evaluate the frequency and pattern of inadequate occlusal rest seat preparations on principal molar abutments in patients receiving cobalt-chromium removable partial dentures at the Department of Prosthodontics, Rehman College of Dentistry, Peshawar.

Materials and Methods: A descriptive cross-sectional study was conducted on 96 patients aged 18–74 years. Rest seats were assessed for adequacy based on outline form, mesio-distal width, bucco-lingual width, depth, and over-all preparation. Data were analyzed using SPSS version 23.0. Frequencies and percentages were calculated, and the Chi-square test was applied to determine associations with age and gender.

Result: The highest frequency of inadequacy was observed in the mesio-distal dimension (66.7%), followed by the outline form (56.3%). Statistically significant associations were found between age group and inadequacies in out-line form (p = 0.038) and mesio-distal width (p = 0.041). No significant association was noted with gender.

Conclusions: A substantial proportion of occlusal rest seats were inadequately prepared, particularly in mesio-distal width and outline form, with greater deficiencies noted among middle-aged patients. These findings under-score the need for enhanced clinical supervision, improved training, and stricter adherence to biomechanical de-sign principles in prosthodontic education

Perception of Vapor Products & its Impact on General Health among Healthcare and Non-healthcare Students

Maham Azeem — 2025-10-03

Introduction: Global health concerns have been raised by the increasing prevalence of vapor products, such as vapes, e-cigarettes and sheesha. Despite claims of reduced harm, these products pose significant risks to general health, including lung injury, cardiovascular disease, and oral health issues. This study investigated the perceptions of vapor products and their perceived health impacts among healthcare and non-healthcare students.

Methods: After taking ethical approval and informed consent from all participants, a cross-sectional, comparative study was conducted among healthcare and non-healthcare students to assess perception of vapor products and their perceived impact on health. A convenience sample of 635 participants was obtained. Data was collected using a pre-validated structured questionnaire with content reliability score of 0.762 encompassing demographics, vapor product use, perceptions of health risks, and knowledge sources.The data was analyzed using SPSS version 20.

Results: A total of 635 participants were included (195 males, 440 females), aged 18–35 years (mean = 21.48). Most were undergraduate students (91%), with only 9% pursuing postgraduate education. Vaping was significantly more common among non-healthcare students (n = 119) than healthcare students (n = 69) (p < 0.01). Perceptions of harm varied: healthcare students predominantly viewed e-cigarettes as equally harmful to regular cigarettes, whereas non-healthcare students considered them more harmful. The difference in perceived addictiveness of e-cig over regular cigarettes was statistically significant (p = 0.01). Overall, 80% believed that accessing cigarettes or vapes was easy for youth. The most common reasons for initiating vape use were stress or depression (n = 213), smoking cessation (n = 194), and peer pressure (n = 106). Most users reported no change in physical health; however, sore or dry mouth/throat was the most frequent adverse effect (p < 0.01).

Conclusion: While familiarity with vapor products was widespread, a significant knowledge gap and negative perceptions prevailed among the study population. Healthcare students demonstrated a better understanding of the potential harms compared to their non-healthcare counterparts.

Management of Dens Invaginatus with Fractured Ni-Ti Instrument: A Case Report

Sumbal Khan — 2025-10-03

Background: Dens invaginatus, is an uncommon condition where there is an infolding of a part of dental tissues, leaving a complex shape of the tooth, which is not a self-cleansable area and can lead to caries. This forms a portal of entry of bacteria to the root canal, causing the tooth to suffer from pulp necrosis.

Methods: This case report is about how a 19-year-old male patient with chronic apical abscess and a fractured S2 nickel-titanium (Ni-Ti) rotary instrument, during treatment in a maxiallary left lateral incisor with dens invaginatus, was treated conservatively. Treatment plan was made in accordance to the AAE guidelines and the instrument was bypassed and root canal treatment was completed instead of any surgical procedure to remove the fractured instrument. CBCT images taken 13 months apart revealed gradual improvement at the root apex, while the patient did not experience any pain. Conservative approach and reliance on advanced images are highlighted in this case as keys to a positive outcome (1–3).

Role of Nanoparticles as a Diagnostic and Therapeutic Tool in Oral Cancer: A Systematic Review

Mah Rukh — 2025-10-03

Objective: Cancer has become a life-threatening disease worldwide, with oral cavity and lip cancers becoming the 16th most common malignancy. Over 400,000 new cases are diagnosed annually. Early diagnosis is crucial. Today, nanoparticles play an important part in imaging, diagnosis, and delivering drugs, offering new hope in the fight against cancer. The purpose of this study is to achieve a comprehensive evaluation of the role of nanoparticles as a tool that can help in the diagnosis as well as treatment of oral cancer.

Methodology: For this systematic review, three databases were used (PubMed Central, Google Scholar, and Cochrane). Articles containing combinations such as Nanoparticles [Oral Cancer], Nanoparticles [Drug Therapy], Oral Carcinoma [Nanotechnology], Oral Tumors [Nanomedicine], published in English and the last seven years were selected. 15 original articles were selected and studied thoroughly after using the inclusion and exclusion criteria.

Result: Nanoparticles show promising roles in the early identification and diagnosis of cancers related to the oral cavity and prove to be effective drug carriers targeting cancerous cells.

Conclusion: Nanoparticles offer an innovative approach to cancer treatment, enabling precise diagnosis and early detection of cancerous cells. They allow targeted drug delivery, minimize harm to the healthy cells of the body along with decreasing the harmful effects of conventional treatments. This advancement holds great promise for improving cancer therapy outcomes.

Paradigms Shift of Medical and Dental Students Towards Artificial Intelligence

Nazma Saleem — 2025-10-03