Meisha Gul | Aga Khan University (original) (raw)

Papers by Meisha Gul

PubMed, Dec 1, 2018

Removable complete dentures have been the most costeffective treatment option for edentulous jaws... more Removable complete dentures have been the most costeffective treatment option for edentulous jaws since decades. However, certain problems are encountered by the patients such as stability of the lower dentures resulting in poor masticatory efficiency. Ridge resorption and inadequate bony support are the long-term complications comprising the stability of the denture and patient finding it difficult to control denture movement during speaking and eating reducing patient compliance. Mandibular implant retained over dentures or hybrid dentures have shown to be better alternatives in terms of retention, stability and patient satisfaction. Two implants provide cost-effective, stabilized and comfortable treatment options. The present case report discusses the management of the patient with compromised dentition in which all teeth were extracted followed by conventional upper complete denture and lower two implant supported fixed hybrid dentures with splinted bar attachment.

Journal of Indian Society of Periodontology, 2021

Background: Access to apical root canal system is gained after flap elevation using various incis... more Background: Access to apical root canal system is gained after flap elevation using various incision techniques. Soft-tissue healing after periradicular surgery may include gingival recession, papilla recession, changes in probing depth, and clinical attachment loss. Objective: The objective of this study was to compare the effect of full sulcular flap design versus papilla-sparing flap design on the periodontal parameters in periradicular surgeries. Materials and Methods: It was a systematic review and meta-analysis. Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane, and CINAHL Plus until May 2019. Initial search yielded 2575 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and change in the papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, postoperative pain, bleeding, and discomfort. Random-effects model was employed for computation of effect size, and forest plots were made. Results: Out of the five articles that satisfied the inclusion criteria, three were randomized control trials and two were nonrandom trials. No significant differences were found in the gingival recession (P = 0.79), papilla height (P = 0.55), gingival bleeding, and plaque indices. Statistically significant differences in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004) were observed for the two flap designs in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004). Conclusions: The present systematic review and meta-analysis showed that probing depth and attachment loss are affected by the choice of flap design. On the other hand, gingival recession and papilla height are not influenced by the type of incision. However, finding of the present review may change if more studies on this topic will be included in the future. Therefore, more clinical trials with long-term follow-ups are needed.

Journal of Indian Society of Periodontology, 2019

This is an open access journal, and articles are distributed under the terms of the Creative Comm... more This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work noncommercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Journal of Prosthodontics, Feb 13, 2019

vertical bone gain (mean difference 0.82 [-1.28, 2.91]). Similarly, no significant difference was... more vertical bone gain (mean difference 0.82 [-1.28, 2.91]). Similarly, no significant difference was observed in the 2 techniques for bone resorption (mean difference 0.38 [-0.23, 0.99]). Conclusions: DO was not superior to autogenous block grafting for vertical bone augmentation. Both techniques were associated with a number of complications. There was no difference in the bone resorption observed in the 2 techniques. No conclusive results can be drawn on other techniques on account of limited data.

Evidence-based Dentistry, Dec 2, 2022

Clinical Oral Implants Research, Oct 1, 2020

Background : Peri-radicular surgery has made significant advancement lately. Access to apical roo... more Background : Peri-radicular surgery has made significant advancement lately. Access to apical root canal system is gained after flap elevation using various incision techniques. Soft tissue healing after surgery may include gingival recession, papilla recession, changes in probing depth and clinical attachment loss. Aim/Hypothesis : The aim of the present study was to compare the effects of intrasulcular incision to papilla based incision on periodontal parameters in peri radicular surgery. Materials and Methods : Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane and Cinahl Plus until May 2019. Initial search yielded 2575 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, post-operative pain, bleeding and discomfort. Results : Out of the five articles that fit the inclusion criteria, three were RCTs and two were NRCTs. Out of 3 studies, 2 reported significant change in papilla height postoperatively with 75 percent of data significantly affected by type of incision. No significant differences were found in gingival recession, probing depth, gingival, bleeding and plaque indices. Meta-analysis depicted significant difference in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004) between the incision techniques. Whereas, no significant difference was found in gingival recession (P = 0.79) and papilla height (P = 0.55). Conclusions and Clinical Implications : The use of papilla based technique is recommended to prevent loss in probing depth and clinical attachment. The present systematic review demonstrated that gingival recession and papilla height parameters are equally effected by intrasulcular and papilla based incision. However, more clinical trials are needed to generate a strong conclusion.

International Orthodontics, Mar 1, 2020

Background > Demineralized white spot lesions (DWSLs) are one of the unfavourable effects of orth... more Background > Demineralized white spot lesions (DWSLs) are one of the unfavourable effects of orthodontic treatment. Resin modified glass ionomer cement (RMGIC) was introduced to reduce its occurrence. Objective > The study aimed to determine the incidence of DWSLs as primary objective and bond failure rate in brackets bonded with RMGIC versus conventional composite (CC) as secondary objective. Material and methods > A thorough literature search was done until April 2019 on various databases including Scopus, Web of Science, PubMed, Cochrane database, CINHAL, Dental and Oral Science, and manual search. Only human clinical trials and published in English language were included. We considered the experimental group of orthodontic patients with brackets bonded with RMGIC and the control group with brackets bonded with CC. Blind and induplicate study selection, data extraction, and risk of bias assessment were undertaken. RevMan software was used for data analysis. Odds ratio with 95% confidence intervals (CIs) was used to express the effect estimate of frequency of bracket failure bonded using RMGIC and CC. The risk of bias was assessed using Cochrane risk of bias tool for RCTs and ROBINS-I tool for N-RCTs. Sensitivity analyses and subgroup analysis were performed as well. Results > Out of 2285 articles, nine met the inclusion criteria. Five were RCTs and four were N-RCTs. Out of nine, seven studies were included in the meta-analysis. A random effect model was used. No significant difference was found in the bond failure rate (odds ratio: 1.48; 95% CI: 0.57-3.87; P 0.42). No difference was found in the occurrence of DWSLs between the two groups. Conclusions > Due to the limited number of studies and studies with high risk of bias, no strong conclusion can be drawn. More studies need to be done to reasonably conclude that RMGIC is beneficial in reducing the occurrence of DWSLs and have comparable bond failure rate. The protocol was registered on PROSPERO (CRD42019125386) prior to the commencement of the systematic review. To cite this article: Khan AR, et al. Decalcification and bond failure rate in resin modified glass ionomer cement versus conventional composite for orthodontic bonding: A systematic review & meta-analysis. International Orthodontics (2019),

Journal of Pakistan Medical Association, 2019

Immature necrotic permanent tooth presents a distinctive challenge for the endodontist. Various t... more Immature necrotic permanent tooth presents a distinctive challenge for the endodontist. Various treatment modalities have been employed to create hard tissue barrier at the apex, which includes non-vital pulp therapy with calcium hydroxide, apexification with mineral trioxide aggregate, pulp revascularisation and regeneration. Regenerative endodontics is a novel modality which involves physiological replacement of the damaged structures of tooth like dentin, root and cells of the pulp-dentin complex. Numerous published case reports have revealed increased dentinal wall thickness, continued root development and apical closure, but there is still lack of sound scientific evidence regarding histological nature of the type of tissue. The current literature review was planned to summarise the evidence regarding the treatment of immature necrotic permanent teeth by regenerative endodontic procedures.

International Journal of Prosthodontics, 2022

Purpose: To determine and compare the frequency of contamination on different sites of healing ab... more Purpose: To determine and compare the frequency of contamination on different sites of healing abutments after sterilization with Phloxine B dye on unused and used healing abutments after sterilization. Materials & Methods: A total of 60 healing abutments were divided into two test groups: (1) used and sterilized and (2) a control group (unused). The test This peer-reviewed, accepted manuscript will undergo final editing and production prior to publication in IJP.

Evidence-based Dentistry, Dec 2, 2022

Pakistan Journal of Medical and Health Sciences

Aim: To determine caries activity among school going children using an uncomplicated oral rinse t... more Aim: To determine caries activity among school going children using an uncomplicated oral rinse test (Oratest) Method: A Cross-sectional study was conducted in the Paediatrics Dentistry department of Bahria University Dental College Karachi, Pakistan from July 2019 to October 2019. Out of total 300 children visiting paediatrics dental clinic of private dental college, Karachi, Pakistan between July 2019-Oct 2019, 200 children were excluded who did not meet the inclusion criteria. Out of remaining 100 children, randomly selected 25 children were allocated to test group and separate 25 healthy children without caries were allocated to control group. On the basis of number of decayed teeth, the test group was divided into three subgroups: Group-I had 1-2 carious teeth, individuals with 3-5 carious lesions were included in Group-II, while 7-9 were included in Group-III. Microbial status was evaluated using Oratest. The time observed for the change colour represents the microbial activit...

The International Journal of Prosthodontics

Purpose: To determine and compare the frequency of contamination on different sites of healing ab... more Purpose: To determine and compare the frequency of contamination on different sites of healing abutments after sterilization with Phloxine B dye on unused and used healing abutments after sterilization. Materials & Methods: A total of 60 healing abutments were divided into two test groups: (1) used and sterilized and (2) a control group (unused). The test This peer-reviewed, accepted manuscript will undergo final editing and production prior to publication in IJP.

The journal of Bahria University Medical and Dental College, Apr 1, 2022

Primary concern of majority of young patients visiting dental OPD is compromised dental esthetics... more Primary concern of majority of young patients visiting dental OPD is compromised dental esthetics or dental pain. Discolorations have significant social and esthetic effects. Fluorosis is one of the most common cause. It is prevalent in different areas of Pakistan. Microabrasion was selected for treatment of discoloration in this case report. Microabrasion was performed using slurry made by combining 37% phosphoric acid and pumice. This slurry was applied on the labial tooth surface and mechanically rubbed with a prophylaxis brush in a slow hand piece for a minute, with gentle pressure. The cycle was performed thrice followed by fluoride application. The results of this conservative treatment were satisfactory and patient was satisfied with the esthetic outcome.

Journal of Bahria University Medical and Dental College, Dec 3, 2015

Journal of Ayub Medical College, 2018

Different studies have been conducted in which defects of Ni-Ti files were reported after multipl... more Different studies have been conducted in which defects of Ni-Ti files were reported after multiple usages but limited data is available regarding the defects in the rotary Ni-Ti files subjected to single clinical use. The objective of this study was to determine the frequency of surface defects caused by fatigue in the rotary ProTaper files after single clinical use assessed with visual and microscopic examination methods. A cross-sectional study was conducted in the dental clinics of The Aga Khan University Hospital, Karachi, Pakistan. A total of 189 ProTaper Ni-Ti files (after single clinical use in multi-rooted molars) were analysed visually and then under stereomicroscope at 10Χ magnification for surface defects (straightening, denting, bending, twisting, pitting and change in length). Chi Square test was used to determine association between type of file and type of defect. Spearman's correlation test was used for determination of correlation between visual and microscopic ...

JOURNAL OF PAKISTAN MEDICAL ASSOCIATION, 2018

To determine the effectiveness of different pre-cleaning methods by determining frequency and sit... more To determine the effectiveness of different pre-cleaning methods by determining frequency and site of contamination on the sterilised dental burs using Phloxine B dye. The in-vitro experimental study was conducted from June to August 2017 at dental clinics of Aga Khan University Hospital Karachi. Diamond dental burs were selected and divided into two control and four test groups. The two control groups were classified as Negative (new burs) and Positive (used contaminated). The four test groups were classified as Manual (Group-1), Ultrasonic (Group-2), Manual + Enzyme (Group-3) and Manual + Ultrasonic (Group-4). Phloxine B dye was used to determine the contamination. The images of the burs were taken and enlarged at 15X before subjected to visual assessment. Association between contamination and pre-cleaning methods were determined. Data was analysed using SPSS version 22. A total of 210 burs were selected for the study which were divided in 6 groups of 35(16.66%) each. One (2.8%) b...

IJS Short Reports, 2018

Head and neck cancer is among the leading causes of death globally. Its treatment includes surgic... more Head and neck cancer is among the leading causes of death globally. Its treatment includes surgical resection, radiotherapy, chemotherapy, or the combination of these therapies depending on the extent of disease. Radiotherapy and chemotherapy have a pivotal role in minimizing the morbidity and mortality; however, they also bring about many adverse effects. Both hard and soft tissues of the oral cavity are affected by these therapies ranging from oral mucositis to osteoradionecrosis of jaw thus affecting the quality of life of patients. Prevention and timely management of these complications are essential for better treatment outcomes. The present literature review, therefore, focuses on the prevention and management of hard- and soft-tissue complications associated with patients undergoing radiotherapy and chemotherapy. Comprehensive oral and dental examination of the patient should be performed and all the potential sources of infection should be electively treated appropriately before initiation of the radiotherapy and chemotherapy to reduce the risk of complications associated with the cancer treatment. Management of complication that arises during radiation and chemotherapy is also essential which requires thorough knowledge and skills. Mutual participation of oncology team and dental surgeon is the key to reduce these complications.

Journal of Indian Society of Periodontology, 2021

Background: Access to apical root canal system is gained after flap elevation using various incis... more Background: Access to apical root canal system is gained after flap elevation using various incision techniques. Soft-tissue healing after periradicular surgery may include gingival recession, papilla recession, changes in probing depth, and clinical attachment loss. Objective: The objective of this study was to compare the effect of full sulcular flap design versus papilla-sparing flap design on the periodontal parameters in periradicular surgeries. Materials and Methods: It was a systematic review and meta-analysis. Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane, and CINAHL Plus until May 2019. Initial search yielded 2575 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and change in the papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, postoperative pain, bleeding, and discomfort. Random-effects model was employed for computation of effect size, and forest plots were made. Results: Out of the five articles that satisfied the inclusion criteria, three were randomized control trials and two were nonrandom trials. No significant differences were found in the gingival recession (P = 0.79), papilla height (P = 0.55), gingival bleeding, and plaque indices. Statistically significant differences in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004) were observed for the two flap designs in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004). Conclusions: The present systematic review and meta-analysis showed that probing depth and attachment loss are affected by the choice of flap design. On the other hand, gingival recession and papilla height are not influenced by the type of incision. However, finding of the present review may change if more studies on this topic will be included in the future. Therefore, more clinical trials with long-term follow-ups are needed.

The goal of root perforation management is the regeneration of healthy supporting periodontal tis... more The goal of root perforation management is the regeneration of healthy supporting periodontal tissues without persistent inflammation or loss of periodontal attachment. In case of periodontal attachment breakdown, then the aim is to re-establish tissue attachment. Therefore, a successful perforation repair is mainly dependent on the ability to seal the perforation defect and re-establish the supporting periodontal attachment.So, the selection of sealing material is considered as an important factor that affects the outcome of treatment. This book presents a substantial work on the sealing ability of conventional and contemporary materials.

PubMed, Dec 1, 2018

Removable complete dentures have been the most costeffective treatment option for edentulous jaws... more Removable complete dentures have been the most costeffective treatment option for edentulous jaws since decades. However, certain problems are encountered by the patients such as stability of the lower dentures resulting in poor masticatory efficiency. Ridge resorption and inadequate bony support are the long-term complications comprising the stability of the denture and patient finding it difficult to control denture movement during speaking and eating reducing patient compliance. Mandibular implant retained over dentures or hybrid dentures have shown to be better alternatives in terms of retention, stability and patient satisfaction. Two implants provide cost-effective, stabilized and comfortable treatment options. The present case report discusses the management of the patient with compromised dentition in which all teeth were extracted followed by conventional upper complete denture and lower two implant supported fixed hybrid dentures with splinted bar attachment.

Journal of Indian Society of Periodontology, 2021

Background: Access to apical root canal system is gained after flap elevation using various incis... more Background: Access to apical root canal system is gained after flap elevation using various incision techniques. Soft-tissue healing after periradicular surgery may include gingival recession, papilla recession, changes in probing depth, and clinical attachment loss. Objective: The objective of this study was to compare the effect of full sulcular flap design versus papilla-sparing flap design on the periodontal parameters in periradicular surgeries. Materials and Methods: It was a systematic review and meta-analysis. Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane, and CINAHL Plus until May 2019. Initial search yielded 2575 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and change in the papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, postoperative pain, bleeding, and discomfort. Random-effects model was employed for computation of effect size, and forest plots were made. Results: Out of the five articles that satisfied the inclusion criteria, three were randomized control trials and two were nonrandom trials. No significant differences were found in the gingival recession (P = 0.79), papilla height (P = 0.55), gingival bleeding, and plaque indices. Statistically significant differences in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004) were observed for the two flap designs in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004). Conclusions: The present systematic review and meta-analysis showed that probing depth and attachment loss are affected by the choice of flap design. On the other hand, gingival recession and papilla height are not influenced by the type of incision. However, finding of the present review may change if more studies on this topic will be included in the future. Therefore, more clinical trials with long-term follow-ups are needed.

Journal of Indian Society of Periodontology, 2019

This is an open access journal, and articles are distributed under the terms of the Creative Comm... more This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work noncommercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.

Journal of Prosthodontics, Feb 13, 2019

vertical bone gain (mean difference 0.82 [-1.28, 2.91]). Similarly, no significant difference was... more vertical bone gain (mean difference 0.82 [-1.28, 2.91]). Similarly, no significant difference was observed in the 2 techniques for bone resorption (mean difference 0.38 [-0.23, 0.99]). Conclusions: DO was not superior to autogenous block grafting for vertical bone augmentation. Both techniques were associated with a number of complications. There was no difference in the bone resorption observed in the 2 techniques. No conclusive results can be drawn on other techniques on account of limited data.

Evidence-based Dentistry, Dec 2, 2022

Clinical Oral Implants Research, Oct 1, 2020

Background : Peri-radicular surgery has made significant advancement lately. Access to apical roo... more Background : Peri-radicular surgery has made significant advancement lately. Access to apical root canal system is gained after flap elevation using various incision techniques. Soft tissue healing after surgery may include gingival recession, papilla recession, changes in probing depth and clinical attachment loss. Aim/Hypothesis : The aim of the present study was to compare the effects of intrasulcular incision to papilla based incision on periodontal parameters in peri radicular surgery. Materials and Methods : Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane and Cinahl Plus until May 2019. Initial search yielded 2575 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, post-operative pain, bleeding and discomfort. Results : Out of the five articles that fit the inclusion criteria, three were RCTs and two were NRCTs. Out of 3 studies, 2 reported significant change in papilla height postoperatively with 75 percent of data significantly affected by type of incision. No significant differences were found in gingival recession, probing depth, gingival, bleeding and plaque indices. Meta-analysis depicted significant difference in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004) between the incision techniques. Whereas, no significant difference was found in gingival recession (P = 0.79) and papilla height (P = 0.55). Conclusions and Clinical Implications : The use of papilla based technique is recommended to prevent loss in probing depth and clinical attachment. The present systematic review demonstrated that gingival recession and papilla height parameters are equally effected by intrasulcular and papilla based incision. However, more clinical trials are needed to generate a strong conclusion.

International Orthodontics, Mar 1, 2020

Background > Demineralized white spot lesions (DWSLs) are one of the unfavourable effects of orth... more Background > Demineralized white spot lesions (DWSLs) are one of the unfavourable effects of orthodontic treatment. Resin modified glass ionomer cement (RMGIC) was introduced to reduce its occurrence. Objective > The study aimed to determine the incidence of DWSLs as primary objective and bond failure rate in brackets bonded with RMGIC versus conventional composite (CC) as secondary objective. Material and methods > A thorough literature search was done until April 2019 on various databases including Scopus, Web of Science, PubMed, Cochrane database, CINHAL, Dental and Oral Science, and manual search. Only human clinical trials and published in English language were included. We considered the experimental group of orthodontic patients with brackets bonded with RMGIC and the control group with brackets bonded with CC. Blind and induplicate study selection, data extraction, and risk of bias assessment were undertaken. RevMan software was used for data analysis. Odds ratio with 95% confidence intervals (CIs) was used to express the effect estimate of frequency of bracket failure bonded using RMGIC and CC. The risk of bias was assessed using Cochrane risk of bias tool for RCTs and ROBINS-I tool for N-RCTs. Sensitivity analyses and subgroup analysis were performed as well. Results > Out of 2285 articles, nine met the inclusion criteria. Five were RCTs and four were N-RCTs. Out of nine, seven studies were included in the meta-analysis. A random effect model was used. No significant difference was found in the bond failure rate (odds ratio: 1.48; 95% CI: 0.57-3.87; P 0.42). No difference was found in the occurrence of DWSLs between the two groups. Conclusions > Due to the limited number of studies and studies with high risk of bias, no strong conclusion can be drawn. More studies need to be done to reasonably conclude that RMGIC is beneficial in reducing the occurrence of DWSLs and have comparable bond failure rate. The protocol was registered on PROSPERO (CRD42019125386) prior to the commencement of the systematic review. To cite this article: Khan AR, et al. Decalcification and bond failure rate in resin modified glass ionomer cement versus conventional composite for orthodontic bonding: A systematic review & meta-analysis. International Orthodontics (2019),

Journal of Pakistan Medical Association, 2019

Immature necrotic permanent tooth presents a distinctive challenge for the endodontist. Various t... more Immature necrotic permanent tooth presents a distinctive challenge for the endodontist. Various treatment modalities have been employed to create hard tissue barrier at the apex, which includes non-vital pulp therapy with calcium hydroxide, apexification with mineral trioxide aggregate, pulp revascularisation and regeneration. Regenerative endodontics is a novel modality which involves physiological replacement of the damaged structures of tooth like dentin, root and cells of the pulp-dentin complex. Numerous published case reports have revealed increased dentinal wall thickness, continued root development and apical closure, but there is still lack of sound scientific evidence regarding histological nature of the type of tissue. The current literature review was planned to summarise the evidence regarding the treatment of immature necrotic permanent teeth by regenerative endodontic procedures.

International Journal of Prosthodontics, 2022

Purpose: To determine and compare the frequency of contamination on different sites of healing ab... more Purpose: To determine and compare the frequency of contamination on different sites of healing abutments after sterilization with Phloxine B dye on unused and used healing abutments after sterilization. Materials & Methods: A total of 60 healing abutments were divided into two test groups: (1) used and sterilized and (2) a control group (unused). The test This peer-reviewed, accepted manuscript will undergo final editing and production prior to publication in IJP.

Evidence-based Dentistry, Dec 2, 2022

Pakistan Journal of Medical and Health Sciences

Aim: To determine caries activity among school going children using an uncomplicated oral rinse t... more Aim: To determine caries activity among school going children using an uncomplicated oral rinse test (Oratest) Method: A Cross-sectional study was conducted in the Paediatrics Dentistry department of Bahria University Dental College Karachi, Pakistan from July 2019 to October 2019. Out of total 300 children visiting paediatrics dental clinic of private dental college, Karachi, Pakistan between July 2019-Oct 2019, 200 children were excluded who did not meet the inclusion criteria. Out of remaining 100 children, randomly selected 25 children were allocated to test group and separate 25 healthy children without caries were allocated to control group. On the basis of number of decayed teeth, the test group was divided into three subgroups: Group-I had 1-2 carious teeth, individuals with 3-5 carious lesions were included in Group-II, while 7-9 were included in Group-III. Microbial status was evaluated using Oratest. The time observed for the change colour represents the microbial activit...

The International Journal of Prosthodontics

Purpose: To determine and compare the frequency of contamination on different sites of healing ab... more Purpose: To determine and compare the frequency of contamination on different sites of healing abutments after sterilization with Phloxine B dye on unused and used healing abutments after sterilization. Materials & Methods: A total of 60 healing abutments were divided into two test groups: (1) used and sterilized and (2) a control group (unused). The test This peer-reviewed, accepted manuscript will undergo final editing and production prior to publication in IJP.

The journal of Bahria University Medical and Dental College, Apr 1, 2022

Primary concern of majority of young patients visiting dental OPD is compromised dental esthetics... more Primary concern of majority of young patients visiting dental OPD is compromised dental esthetics or dental pain. Discolorations have significant social and esthetic effects. Fluorosis is one of the most common cause. It is prevalent in different areas of Pakistan. Microabrasion was selected for treatment of discoloration in this case report. Microabrasion was performed using slurry made by combining 37% phosphoric acid and pumice. This slurry was applied on the labial tooth surface and mechanically rubbed with a prophylaxis brush in a slow hand piece for a minute, with gentle pressure. The cycle was performed thrice followed by fluoride application. The results of this conservative treatment were satisfactory and patient was satisfied with the esthetic outcome.

Journal of Bahria University Medical and Dental College, Dec 3, 2015

Journal of Ayub Medical College, 2018

Different studies have been conducted in which defects of Ni-Ti files were reported after multipl... more Different studies have been conducted in which defects of Ni-Ti files were reported after multiple usages but limited data is available regarding the defects in the rotary Ni-Ti files subjected to single clinical use. The objective of this study was to determine the frequency of surface defects caused by fatigue in the rotary ProTaper files after single clinical use assessed with visual and microscopic examination methods. A cross-sectional study was conducted in the dental clinics of The Aga Khan University Hospital, Karachi, Pakistan. A total of 189 ProTaper Ni-Ti files (after single clinical use in multi-rooted molars) were analysed visually and then under stereomicroscope at 10Χ magnification for surface defects (straightening, denting, bending, twisting, pitting and change in length). Chi Square test was used to determine association between type of file and type of defect. Spearman's correlation test was used for determination of correlation between visual and microscopic ...

JOURNAL OF PAKISTAN MEDICAL ASSOCIATION, 2018

To determine the effectiveness of different pre-cleaning methods by determining frequency and sit... more To determine the effectiveness of different pre-cleaning methods by determining frequency and site of contamination on the sterilised dental burs using Phloxine B dye. The in-vitro experimental study was conducted from June to August 2017 at dental clinics of Aga Khan University Hospital Karachi. Diamond dental burs were selected and divided into two control and four test groups. The two control groups were classified as Negative (new burs) and Positive (used contaminated). The four test groups were classified as Manual (Group-1), Ultrasonic (Group-2), Manual + Enzyme (Group-3) and Manual + Ultrasonic (Group-4). Phloxine B dye was used to determine the contamination. The images of the burs were taken and enlarged at 15X before subjected to visual assessment. Association between contamination and pre-cleaning methods were determined. Data was analysed using SPSS version 22. A total of 210 burs were selected for the study which were divided in 6 groups of 35(16.66%) each. One (2.8%) b...

IJS Short Reports, 2018

Head and neck cancer is among the leading causes of death globally. Its treatment includes surgic... more Head and neck cancer is among the leading causes of death globally. Its treatment includes surgical resection, radiotherapy, chemotherapy, or the combination of these therapies depending on the extent of disease. Radiotherapy and chemotherapy have a pivotal role in minimizing the morbidity and mortality; however, they also bring about many adverse effects. Both hard and soft tissues of the oral cavity are affected by these therapies ranging from oral mucositis to osteoradionecrosis of jaw thus affecting the quality of life of patients. Prevention and timely management of these complications are essential for better treatment outcomes. The present literature review, therefore, focuses on the prevention and management of hard- and soft-tissue complications associated with patients undergoing radiotherapy and chemotherapy. Comprehensive oral and dental examination of the patient should be performed and all the potential sources of infection should be electively treated appropriately before initiation of the radiotherapy and chemotherapy to reduce the risk of complications associated with the cancer treatment. Management of complication that arises during radiation and chemotherapy is also essential which requires thorough knowledge and skills. Mutual participation of oncology team and dental surgeon is the key to reduce these complications.

Journal of Indian Society of Periodontology, 2021

Background: Access to apical root canal system is gained after flap elevation using various incis... more Background: Access to apical root canal system is gained after flap elevation using various incision techniques. Soft-tissue healing after periradicular surgery may include gingival recession, papilla recession, changes in probing depth, and clinical attachment loss. Objective: The objective of this study was to compare the effect of full sulcular flap design versus papilla-sparing flap design on the periodontal parameters in periradicular surgeries. Materials and Methods: It was a systematic review and meta-analysis. Electronic and manual searches were conducted in multiple databases including PubMed, Dental and Oral Sciences, Cochrane, and CINAHL Plus until May 2019. Initial search yielded 2575 studies with 5 articles meeting the inclusion criteria. The primary outcomes assessed were gingival recession and change in the papilla height. The secondary outcomes evaluated were probing depth, clinical attachment loss, postoperative pain, bleeding, and discomfort. Random-effects model was employed for computation of effect size, and forest plots were made. Results: Out of the five articles that satisfied the inclusion criteria, three were randomized control trials and two were nonrandom trials. No significant differences were found in the gingival recession (P = 0.79), papilla height (P = 0.55), gingival bleeding, and plaque indices. Statistically significant differences in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004) were observed for the two flap designs in probing depth (P = 0.006) and clinical attachment loss (P = 0.0004). Conclusions: The present systematic review and meta-analysis showed that probing depth and attachment loss are affected by the choice of flap design. On the other hand, gingival recession and papilla height are not influenced by the type of incision. However, finding of the present review may change if more studies on this topic will be included in the future. Therefore, more clinical trials with long-term follow-ups are needed.

The goal of root perforation management is the regeneration of healthy supporting periodontal tis... more The goal of root perforation management is the regeneration of healthy supporting periodontal tissues without persistent inflammation or loss of periodontal attachment. In case of periodontal attachment breakdown, then the aim is to re-establish tissue attachment. Therefore, a successful perforation repair is mainly dependent on the ability to seal the perforation defect and re-establish the supporting periodontal attachment.So, the selection of sealing material is considered as an important factor that affects the outcome of treatment. This book presents a substantial work on the sealing ability of conventional and contemporary materials.