Squamous cell carcinoma is the most common oral malignancy. Betel quid, betel quid with tobacco, smoking, alcohol consumption, mechanical irritation, genetic are the most important risk factors for Oral Squamous Cell Carcinoma (OSCC). The aim of the study was to determine the role of habitual risk factors inOral Squamous Cell Carcinoma. Materials and Methods: This is a cross-sectional study for the determination of the risk factors of OSCC over 2 years period of January 2011 to December 2012. Department of Oral & Maxillofacial Surgery, Bangabandhu Sheikh Mujib Medical University, Dhaka, Department of Oral & Maxillofacial Surgery, Dhaka Dental College Hospital, Dhaka,National Institute of Cancer Research & Hospital (NICRH), Mohakhali, Dhaka and Health and Hope Hospital, Dhaka from January 2011 to December 2012 Results:250 patients, comprising 44% male and 56% female were included in the study. Overall mean age was 55.94±10.93 years. The patients of OSCChavemost common habit of betel quid with tobacco 124(49.6%), then betel quid with tobacco and smoking 49(19.6%), betel quid with tobacco and Gul 19(7.6%), only smoking 13(5.2%), Betel quid without tobacco and smoking 13(5.2%), betel quid without tobacco 12(5.2%), betel quid with tobacco and catechu (Khoir) 4(1.6%), betel quid with tobac- co, smoking and gul 3(1.2%), betel quid without tobacco,smoking and alcohol 2(0.8%), betel quid without tobacco and gul 2(0.8%), betel quid without tobacco, smoking and gul 1(0.4%), betel nut chewing 1(0.4%), mechanical irritation but no habit 5(2.0%) and no habitual history 2(0.8%). Conclusion: According to this study betel quid, betel quid with tobacco, gul, smoking are the important risk factors in OSCC.

It is an editorial, To read click full text

Purpose:The Pediatric Out-patient-department (POPD) of a dental hospital deals with children with different tooth related complaints. Dental treatment of a child patient requires three way interactions between the child, the parent and the dental surgeon. Though health of the patient remains the top priority for caregivers, satisfaction with the delivery system is vital for long lasting doctor-patient relationship. Thepurpose of the study was to evaluate the performance of Pediatric OPD by the accompanying parents of children receiving treatment at the OPD of a private dental college hospital. Methods: A cross sectional study was carried out at the POPD of Sapporo Dental College Hospital, Uttara Model Town of Dhaka city during May-July 2017. Sampling was done by simple random sam- pling method .Data were collected from the parents of 122 children aged between 1-12 years by using a self-administrated questionnaire. Results: Majority of the participating parents were residents of Uttara Model Town or areas in the vicinity and were employed, educated and are middle are middle socioeconomic class. More than sixty percent (62.3 %) of the respondents were parents of children between 4-7 years of age. More than 90% of the patients had waiting time at the department between 0-30 minutes. Treatment cost was described as ‘low or ‘reasonable’ by 87% of the parents. Only 8.2% mentioned ‘unsatisfactory’ regarding the cleanliness of Pediatric OPD. More than 95% of the respond- ents expressed ‘Satisfactory’ and ‘good’ level of satisfaction with general performance of OPD and the treatment provided by the dental team. Conclusion: Parents expressed general satisfaction with the performance of Pediatric Department of Sapporo Dental College Hospital.

The retrospective cross sectional study was undertaken to determine the pattern and different meth- ods of treatment of mandible fractures. Four hundred and thirty five patients with mandibular fractures were treated during the year 2014-2015. Among the patients attended with facial trauma during men- tioned period at casualty department of Dhaka Dental College hospital with the mandible fracture not associated with others facial bone fracture who were managed in this department and whose clinical record file are available in our record book were included in this study. A review of patients’ records and radiographs was conducted. Data regarding age, gender, cause of fracture, anatomic site and treatment modalities were reviewed. Data were presented by table and diagram. Age, location of fracture in table form, gender distribution, treatment in pie chart, etiology of fracture by histogram. There was higher prevalence in male (3.9:1), with occurrence peak between 21-30 years. The princi- pal causes of fracture in this study were RTA (Road Traffic Accidents) representing 54.02 %( n=235), followed by physical assault 17.24% (n=75), Fall, Sports injury, Blow by heavy objects, Tube well injury & others. The most injured sites were in decreasing order parasymphysis (26.31%) followed by angle of mandible 17.89% then symphysis, condyle, body of mandible dentoalveolar, ramus, coronoid process of mandible. Most patients of mandibular fractures were treated by closed reduction (arch bar, arch bars with intermaxillary fixation IMF,eyelet wiring& lateral compression plate). Rest of the patients were treated with open reduction ( miniplates fixation. 3D plate fixation) .Only 8.05% patients were managed by conservative approach. This study reflects patterns of mandibular fracture within the community and discuuss various methods of mandible fracture management in the department of Maxillofacial casualty in Dhaka Dental college hospital. It is hoped that assessment presented here will be valuable to government agencies and health care professionals involved in planning future programs of prevention & treatment of mandible fracture.

Background: Lichen planus is a chronic mucocutaneous disease with primary or secondary involve- ment of the oral mucosa. In particular in case of erosive lichen planus most of the patients experience no long term symptoms relief of conventional topical treatment such as corticosteroid ointment. Topical tacrolimus applications to mucosal lesions seem to be an alternative treatment approach. Objective: The aim of this study was to compare the efficacy of topical tacrolimus ointment with that of triamcinolone acetonide ointment on patients suffering from oral lichen planus. Study design: This was a clinical trial. Study setting and period: This study was conducted in outpatient department of Oral and Maxillofacial Surgery, Dhaka Dental College in the period between June 2013 to May 2014. Subjects: A total of sixty patients were enrolled. Out of sixty patients thirty patients used topical tacroli- mus 0.03% (Group A) and another thirty patients used topical triamcinolone acetonide( Group B) for the treatment of oral lichen planus. Methods: A total of sixty patients were asked to answer a questionnaire regarding the degree of pain and burning sensation in every two weeks according to visual analogue scale (VAS). In every two weeks change of colour and size and also any side effects of these drugs were assessed. Data were analyzed using Statistical Package for Social Science (SPSS), version 15.0 for windows. Results: At the end of 12th week follow up periods complete relief of pain and burning sensation in group A patients were 100% and in group B it was 30%. There was no side effect in two study group patients.

Background:Skin act as a protective barrier to prevent the contamination from environment and dehy- dration of tissue. After any surgery to the oral cavity, wound closure or reconstruction is mandatory which is done by skin graft and skin substitute like amniotic membrane by the process of epithelializa- tion and tissue regeneration. Amniotic membrane is use as skin substitute in burn, eye and oral cavity as biologic wound dressing. Objective:To evaluate the epithelialization after use of amniotic membrane in mucosal defect of oral cavity as a biologic dressing. Methods:This was a prospective study which included 26 with premalignant lesion in buccal mucosa who under went excision of the lesion from intraoral buccal mucosa between January 14-june 15 and post operative follow up for 4-6 month after the surgical procedure. We used amniotic membrane(am) for dressing of the defects in buccal mucosa of oral cavity under local anesthesia. Efficacy of this procedure was assessed by granulation tissue formation with surface epithelialization on the graft site. Results:The epithelialization evaluated in postoperative period. According to sex 40 males 70% and 30 females age 22-72 years with means age 45.0±10.5 years. After excision of lesion from buccal mucosa amniotic membrane was grafted on the defect. Completeadherence of amniotic membrane in most of the cases.Wound covered by epithelialization was entire wound coverage in 85% and Nearly entire wound coverage in 15% when use amniotic membrane use as a biologic dressing in oral cavity. No allergic reaction occurs in any patients. Conclusion: Amniotic membrane can be useas a skin substitute in buccal mucosa of the oral cavity.

Background: This paper reviews the types, prevalence and demographic distribution of maxillofacial tumors, cysts and tumor-like lesions in a Bangladeshiteaching Hospital.An observational descriptive study (January’ 2014 to December’ 2016) was performed at Oral and Maxillofacial Surgery depart- ment, Dental Unit,TMSS Medical College and Hospital. This study presents 55 cases of maxillofacial tumour & tumour like lesions collected over 3 years at a tertiary oral care centre in Bogra, Bangla- desh. Objectives:To find out the distribution & pattern of maxillofacial tumours and to find out the age, sex, site, clinical presentation and thehistological types of these tumors Method: A cross sectional descriptive study where the Histopathological types of the maxillofacial tumours were analyzed to indicate the numbers that occurred and also the pattern of occurrence according to age, gender, site and clinical presentation. Result: There were 55 maxillofacial tumour & tumour like lesions of which 44 (80.01%) were Benign tumours & 11 (19.81%) were malignant tumours. Among Eighteen histo- pathologic types were found of which Squamous cell carcinoma (18.18%), Ameloblastoma (16.36%), Odontogenic keratocystic tumour (10.90%), Dentigerous cyst (7.27%)& Radicular cyst (7.27%) were predominant. The male to female ratio was 1.29:1. Patients were between 10 years and 72 years with most patients (27.27%) in 51 to 60 years of life. Case presented with symptoms such as swelling (41.96%), pain (28.82%) and loosetooth (17.12%). Conclusion: Both malignant and benign tumours are seen. In the present study, SCC and ameloblastoma were the commonest malignant and benign odontogenic tumours seen respectively; the two representing more than 34.54% of all tumors.Tumour & tumour like lesions of the oral & maxillofacial region with late presentation still remains the main challenging factor in the early detection & management. Surgery was the main modality used for treat- ment while some patients had no treatment due to self discharge and late presentation.

Aim: This prospective observational study was conducted to find out “delay of starting adequate treat- ment” as a prognosis predictor of head and neck space infections. Material and method:50 patients were selected purposively with inclusion criteria of presence of head and neck space infections. The exclusion criteria was presence of any other co-morbid diseases. After proper evaluation and diagnosis, adequate treatment was provided. Structured questioner method was used to collect data related to delay of starting of treatment and outcome of disease. Result: In this prospective observational study, caries was the most frequent cause of space infection. Time elapsed in between starting of symptoms and initiation of adequate treatment (timing of starting treatment) was 8.52(±6.689) days. This delay of starting treatment causing increased recovery time significantly (P= < 0.001 level). However, there was no correlation in between delay of starting treat- ment and number of involved space infection but later has impact on recovery time. Conclusion: Information about delay of starting treatment and number of involved spaces can be used as a prognosis predictor in HNSI.

Introduction: Patient satisfaction is one of the important factors to determine the success of health care facility. The real challenge is not getting ready with mere requirements, but also delivers services ensuring good quality. Thus, there is a need to assess the health care systems regarding patient satisfaction as often as possible. The aim of this study was to determine the patient satisfaction with health care services in out-patient department (OPD) of a dental college hospital in Pakistan. Materials and Methods: A descriptive cross-sectional pilot study was undertaken during the month of May 2015 in the OPD of Bibi Asifa Dental College and Hospital, Larkana, Pakistan. A randomly selected 100 patients were interviewed by using pre-structured questionnaires. The questionnaires had semi-structured, open-ended and closed questions. While analyzing, they were grouped into categories like availability of services, clinical care, waiting time and cost. Results: The overall opinions about the satisfaction level of patients for availability of health services in the hospital were good. As location of the hospital and timings of the OPD were convenient to the most of the patients 86% and 93% respectively. Availability of the doctors was also found adequate. However, regarding seating arrangements one fourth of the total patients were found to be unsatisfied. Efficiency of the doctor was found satisfactory by 83%, while majority of the patients did not faced any kind of language problem. Conclusion: According to patient’s opinion, the study revealed that the degree of satisfaction was satisfactory with respect to waiting time and availability of the doctors in the hospital, which need to be further explored and corrected.

Fibro osseous lesions area diverse group of disorders characterized by replacement of normal archi- tecture of bone by a benign connective tissue matrix that displays various amount ofmineralizationin the form of woven bone or cementum. It includes developmental, reactive and neoplastic lesions. The different type of fibro-osseous lesions express a common clinical and radiological features. Soad- equate knowledge and clinical observationare necessary for proper interpretation and appropriate diagnosis of these lesions.becausemanagement of patients with fibro-osseous lesions are case specificandindividualized.The aim of this study was to analyse the clinical, radiological and histo- pathological characteristics of fibro osseous lesions andprovide a proper management system affect- ed by this type of lesions. Materials and methods:The retrospective study was performed in the Department of Oral & Maxillofacial surgery, Dhaka Dental College and Hospital, Dhaka, Bangladesh from a period of January 2015 to January 2018. Patients were selected for this study based on clinical, radiological and histopathological confirmation of fibro-osseous lesion. The management of each case were plannedand follow-up data were also documented. Results: A total number of 30 patients were selected for this study.The most common fibro-osseous lesionsin this study were fibrous dyspla- sia 10 (33%) and ossifying fibroma 20 (67%).The mean age offibrous dysplasia were 17.4 years with an age range 12 to 33 years and at ossifying fibroma the mean age were 30.35 years with an age range 12 to 57 years. Female17 (57%) represented the majority of the affected patients. Fibrous dysplasia were more common in maxilla(70%) and ossifying fibroma were more common in the man- dible(60%).Surgical recontouring and clinical observation were treatment of choice infibrous dysplasia and surgical resection, enucleation and curettage were treatment of choice in ossifying fibroma. Conclusion:The most common fibro-osseous lesion in our clinical study was fibrous dysplasia and ossifying fibroma which presents painless bony swelling and deformity in maxilla and mandible. Fibrous dysplasia presents as a homogenous, radioopacity,ill defined border and ossifying fibroma presents a mixed radioopacity and radiolucent lesion that is well demarcated from normal bone. Surgi- cal recontouring and clinical observation was done in treatment of fibrous dysplasiaand ossifying fibroma wastreated enucleation and curettage, segmental resection completelyenucleatefromsur- rounding bone.