Background: Maxillofacial injuries are on the rise and the etiology of maxillofacial injuries varies from one country to another because of social, cultural and environmental factors. Road traffic accidents (RTAs) are still the most common cause of maxillofacial injuries. Nerve injury following fracture may involve traction, pressure, ischemia, inflammation and physical damage; therefore fractures of Zygomaticomaxillary complex (ZMC) are characterized by sensory neuropathy in the area of innervation of infra-orbital nerve both as presenting symptom and as a postop complication. The objectives of the study were to investigate the frequency of infra-orbital nerve paresthesia following ZMC fractures and determine the frequency of functional nerve recovery in patients with paresthesia treated with open reduction and internal fixation.Methods: Patients (n = 75) qualifying our inclusion criteria were selected, examined, reduced by surgery and followed up.Results: A total of 75 patients were included in the study with male: female ratio of 5:3. Mean age was 37.43±3.78 years, with majority of patients (72 %) presenting with RTAs. Infra-orbital nerve paraesthesia was found to be positive in 70.67% (n = 53) patients with 62.26% (n = 33) patients with functional nerve recovery after 3 months.Conclusions: Prognosis of infra-orbital nerve recovery after a Zygomaticomaxillary complex fracture can be enhanced by open reduction and internal fixation.

Background Oro-facial clefts (OFCs) are formed due to a combination of genetic factors and environmental factors. Treatment is usually extensive and lasts till adult age. The treatment also includes a large portion of dental rehabilitation. Objective This study aims to look at the different dental anomalies associated with OFCs. Methods A total of 100 participants with OFCs were randomly selected from Clap centre Lahore. They were categorized into cleft lip (CL), cleft palate (CP), and both. Dental anomalies were recorded clinically and family history for OFCs was also recorded. Results Out of the 100 participants, 15 had CL only, 37 had a CP, and 48 had both CL and CP. Missing teeth and hypodontia were significantly associated with all OFCs (p-value > 0.05). Supernumerary teeth were only significantly associated with CP (p-value: 0.04). Other dental anomalies were not significant for OFCs. Conclusion OFCs in all its three forms are associated with dental irregularities. They can either be missing teeth or extra teeth. There is a strong need for dentists to be a part of the treatment planning of OFCs and to treat dental anomalies alongside the clefts.

Background: Periapical radiographs play a pivotal role in dentistry, offering invaluable insights essential for various dental procedures. Objective: This study aims to systematically assess the quality of intraoral periapical (IOPA) radiographs evaluating adherence to the recent guidelines established by the Faculty of General Dental Practice (FGDP). Methods: A cross-sectional study was conducted at the University College of Dentistry (UCD), employing a non-probability consecutive sampling technique to acquire a calculated sample of 300 IOPA radiographs from the operative, oral surgery, and oral radiology departments. Two senior faculty members evaluated the radiographs according to the recent two-tier grading system outlined in the FGDP guidelines. Results: The study revealed that 197 (65.67%) of the assessed radiographs were diagnostically acceptable, while 103 (34.33%) were deemed diagnostically unacceptable. Contrast problems emerged as the most prevalent issue, accounting for 85 (28.3%) of the cases. Other common problems included incorrect film positioning in 66 (22%), incorrect vertical cone angulation in 37 (12.3%), incorrect horizontal cone angulation in 11 (3.7%), and incorrect processing in 15 (5%) of the IOPA radiographs. Conclusion: This study revealed that approximately two-thirds of the IOPA radiographs were deemed diagnostically acceptable. However, contrast issues emerged as the predominant concern affecting image quality. These findings highlight the critical importance of continuous quality improvement initiatives in radiographic practices to enhance diagnostic precision and ensure optimal patient care.

This brief note addresses the comparison between conventional ELISA and a slightly newer, equally sensitive, specific, less time consuming and cost effective version of its "Paper based ELISA," which have a few major benefits on the conventional ELISA.

Background: Accurately locating the mandibular foramen is crucial for oral and maxillofacial surgeons due to its variability and difficulty in conventional clinical palpation, necessitating advanced imaging techniques such as cone-beam computed tomography (CBCT). Objective: This study aims to utilize CBCT to accurately ascertain the precise location of the mandibular foramen and investigate potential variations across different age groups and genders in our population. These insights can improve surgical precision and patient care in oral and maxillofacial procedures. Methods: A retrospective comprehensive radio-anatomical investigation analyzed CBCT images of 103 patients collected over 21 months using convenient sampling. The distances between the mandibular foramen (MF) and key mandibular landmarks (anterior and posterior ramus borders, deepest sigmoid notch point, lowest mandibular notch point, and mandibular occlusal plane) were measured. Ratios for MF's horizontal and vertical locations were assessed. Statistical analysis was performed using Student's t-test and one-way ANOVA. Results: The average distance between the MF and the occlusal plane was 5.38 mm. The MF was centrally positioned along the anteroposterior axis and shifted anteriorly and superiorly with age. No significant difference in MF location was found between the right and left sides, except for the distance to the posterior ramus border (13.89 ± 2 mm on the right vs. 14.46 ± 1.99 mm on the left, p = 0.041). Males had greater distances to landmarks compared to females, but the overall MF position was similar across genders. Conclusion: Understanding MF variations, demonstrating that while gender differences exist in mandible dimensions, the MF's position remains consistent. These findings emphasize the need for tailored approaches in local anesthesia administration and surgical planning, particularly in the context of demographic-specific anatomical variations.

Dental practitioners frequently encounter medical emergencies due to the nature of their work and the inherent stress within a dental office. Adequate preparation and confidence in handling such emergencies are very important for patient safety. Objectives: To assess the knowledge, skills and perceived competency of house officers and general dentists in managing medical emergencies in dental practice. Methods: A cross-sectional survey was conducted in Lahore among house officers and general practitioners. The survey included a pre-valid questionnaire on medical history documentation, attendance at medical emergency workshops, confidence in performing cardiopulmonary resuscitation, administering intravenous drugs, and managing common emergencies like syncope and hypoglycemia. Statistical analysis was performed with Chi-square and Fisher’s exact tests applied to assess associations. Results: The majority of participants demonstrated adequate knowledge of medical emergency protocols, with 68% aware of the need to record medical history and 73% familiar with universal precautions. However, 45% reported being trained in administering cardiopulmonary resuscitation and 29% in administering intravenous drugs. Confidence in handling emergencies such as syncope (0.004) and unconscious hypoglycemic patients (p-=0.03) was significantly higher among dentists with more experience. Conclusions: It was concluded that while dental practitioners generally possess knowledge about medical emergency protocols, there is a gap in training and confidence particularly in administering lifesaving procedures. More experienced dentists demonstrated higher confidence compared to house officers.