JOURNAL OF KHYBER COLLEGE OF DENTISTRY

ASSESSMENT OF MAXILLARY DENTAL MIDLINE DEVIATION FROM FACIAL MIDLINE IN DENTATE PATIENTS: A LOCAL STUDY AT BACHA KHAN DENTAL COLLEGE

2026-02-11T17:29:00+00:00

Objectives: To evaluate the frequency of non-coincidence between the maxillary dental midline and the facial midline in dentate patients.

Materials and Methods: The study comprised 329 dentate individuals, male and female, aged 18 to 45 years. A comprehensive patient history was gathered, and the facial midline was identified by measuring essential features from the nasion to the pogonion, including the center of the philtrum, with a scale or dental floss. Any variation between the dental midline and the face midline was assessed, with negative values suggesting a leftward shift and positive values indicating a rightward shift.

Results: With a range of 18 to 45 years, the participants' mean age was 32.39 ±5.71 years; their average BMI was 26.21±1.28 kg/m2, their average blood count was 4.81±0.30 million cells/mcL, and their average duration of illness was 4.25 ±1.82 weeks. Of the participants, 36.2% had misaligned facial and dental midlines (non-coincidence).

Conclusion: According to the study's findings, approximately one-third of the participants had a misalignment between their axillary dental and facial midlines, highlighting how common this misalignment is in the general population.

ASSESS THE KNOLEDGE, ATTITUDES, AND CLINICAL PRACTICES OF DENTAL GRADUATES FROM DIFFERENT DENTAL SCHOOLS ACROSS PAKISTAN REGARDING THE IDENTIFICATION, MANAGEMENT AND REPORTING OF CHILD ABUSE

2026-03-10T13:54:43+00:00

Objectives: This study aims to assess the knowledge, attitude and practice of the dental graduates of different universities of Pakistan, regarding the identiﬁcation, management, and reporting of child abuse.

Materials and Methods: A cross-sectional study was conducted on dental graduates from different colleges of Pakistan through an online questionnaire which was shared through focal persons nominated from their institutions. A total 204 participants ﬁlled the proforma, which was previously used in an internationally published study, containing different sections of knowledge, attitude and practices, that how they examine, diagnose, document, and report the child abuse cases during their clinical practices. ach section was marked and assessed by the individuals on their marks achieved. The data analysis was performed on R and R studio and Pearson's Chi-squared test/Fisher exact were applied.

Results: According to our study the knowledge level of participants regarding child abuse was generally low i.e. 80%, although dentists working in dental teaching hospitals had better knowledge as compared to dentists working in other settings. On the other hand, the attitude towards neglect and abuse among participants of the study was generally positive (91%). Reporting and documentation to the law enforcement agencies and concerned authorities was overall poor (94%). Our study also found no statistical signiﬁcance between age/ experience with knowledge regarding neglect and abuse (P-value >0.9).

Conclusion: Dentist's knowledge was very low regarding child abuse identiﬁcation, documentation and reporting to the concerned authorities. Dentists often don't report abuse and neglect cases.

COMPARISON OF INTER-PROIMAL CONTACT BETWEEN ALL-METAL CROWN VS PORCELAIN FUSED TO METAL CROWN IN POSTERIOR TEETH. A COMPARATIVE CROSS-SECTIONAL STUDY

2026-03-27T09:35:19+00:00

Objectives: The objective of this study was to evaluate the frequency of loose Inter-Proximal Contacts (PC) in All-Metal and PFM crowns and to determine association of loose PC with age, gender, dental arch, surface of crown, duration of crown and type of crown.

Materials and Methods: This comparative cross-sectional study was conducted in Prosthodontic department of Khyber College of Dentistry, Peshawar, Pakistan. Files records of patients for the last 11 years, who received single crown or as retainer for ﬁxed partial denture for posterior teeth and had follow up visit for the evaluation of inter-proximal contact (PC) between crown and adjacent tooth/teeth were included. Type of crown was divided into two groups; All-metal and Porcelain fused to metal (PFM) crown. Outcome measure that is, type of PC was labeled as Acceptable and loose. Frequencies, chi-square and logistic regression analysis was used to determine prevalence, association and strength of association of PCs with age, gender, arch, surface, duration and type of crown.

Results: There were 150 crowns related to 100 patients. The mean age of patients was 45.1±12.1 years. Out of 150 crowns, 9 (65.3) were PFM and 52 (34.6) were All-metal crowns, leading to the assessment of 29 PCs on proximal surfaces. Among 29 PCs, 194 (69.5) were acceptable and 5 (30.5) were loose. Among PFM crowns, 36.6 of PCs were loose comparing to 20.2 in metal crowns. There was statistically signiﬁcant association of type of PC with type of crown (chi =0.004, O= 2.52, 95 C 1.44.6, p=0.002), dental arch (chi=0.025, O=0.52 95 C 0.29-0.915, p=0.023), and surface of crown (chi= 0.04, O= 1., 95 C 1.004-2.91, p=0.04). No signiﬁcant association of type of PC was found with gender and age.

Conclusion: In comparison with Metal crowns, PFM crowns manifested three times more loose PC.

ASSESSMENT OF THE PROPERTIES (SENSITIVITY AND SPECIFICITY) OF CYFRA 21-1 IN THE DIAGNOSIS OF ORAL SQUAMOUS CELL CARCINOMA

2026-04-09T16:02:18+00:00

Objectives: To evaluate the sensitivity and specifi city of the salivary CYFRA 21-1, to be applied in a defined clinical context.

Materials and Methods: A case-control design was employed, conducted in Sardar Begum Dental College, and the data was collected from Khyber College of Dentistry, with a total of 101 diagnosed but untreated individuals of Oral squamous cell carcinoma (cases) with biopsy reports and 101 controls, non-disease (matched for age and gender) were selected for the research. Saliva samples were taken from both groups and followed by, testing CYFRA 21-1 using a commercially available ELISA kit to determine its concentration and its sensitivity and specificity.

Results: The findings demonstrated that CYFRA 21-1 exhibits strong diagnostic performance for Oral squamous cell carcinoma, with a sensitivity of 93.6%, Specifi city of 93%, a positive predictive value of 92.5%, and a negative predictive value of 93.75%.

Conclusion: The results highlight the validity of CYFRA 21-1, as a promising biomarker of the saliva for the very initial identification of Oral Squamous Cell Carcinoma.

THE ASSOCIATION BETWEEN SOCIOECONOMIC STATUS AND KNOWLEDGE, ATTITUDES, AND PRACTICE OF ORAL HEALTHCARE IN ABBOTTABAD, PAKISTAN.

2026-04-09T16:02:01+00:00

Objectives: This cross-sectional study aimed to assess the association between socioeconomic status (SES) and the knowledge, attitude, and practice (KAP) of oral healthcare among patients in Abbottabad, Pakistan.

Materials and Methods: A cross-sectional study was conducted at the Frontier Medical and Dental College, Abbottabad, from December 2024 to February 2025. A convenience sample of 250 participants was recruited. While this method was pragmatic, it limits the generalizability of the findings. Data were collected using a validated questionnaire adapted from Selvaraj et al. (2021). One-way ANOVA was used to assess associations, with post-hoc Bonferroni correction and eff ect size (η²) calculation.

Results: Education (F=5.10, df=3, 246, p=0.002, η²=0.059) and income (F=3.30, df=3, 246, p=0.019, η²=0.039) were significantly associated with knowledge scores. However, no significant associations were found between any SES variable and attitude or practice scores (p>0.05 for all).

Conclusion: While higher education and income were linked to better knowledge, this did not translate into better attitudes or practices. This disconnect highlights the need for public health interventions that target behavioral change directly, moving beyond knowledge dissemination to address the specifi c barriers in this population.

DISTAL CERVICAL CARIES IN MANDIBULAR SECOND MOLARS: A CONSEQUENCE OF IMPACTED THIRD MOLARS

2026-04-09T16:01:11+00:00

Objectives: To determine the frequency, predisposing patterns of impaction, and subsequent treatment outcomes for distal cervical caries (DCC) in mandibular second molars (M2) associated with impacted mandibular third molars (M3).

Materials and Methods: This prospective observational study was conducted at Oral Surgery Department of Frontier Medical and Dental College, Abbottabad, during May-Oct. 2025. A convenience sample of 200 patients with impacted M3s was enrolled after applying inclusion and exclusion criteria; no refusals were reported. Clinical and radiographic assessments were performed to classify M3 angulation, depth, and ramus relationship (Pell & Gregory/Winter) and diagnose DCC. Data were analyzed using descriptive statistics, Chi-square tests, and binary logistic regression to identify independent predictors. Adjusted odds ratios (aOR) with 95% confidence intervals (CI) are reported.

Results: The overall prevalence of DCC was 46.5% (n=93). Univariate analysis revealed significant associations between DCC and mesioangular impaction, Depth A, Class I ramus relationship, and contact at the cervical line (all p<0.001). Binary logistic regression identified mesioangular impaction (Adjusted Odds Ratio, aOR=14.2, 95% CI: 7.1–28.4, p<0.001) and contact at the cervical line (aOR=9.1, 95% CI: 4.5–18.4, p<0.001) as the only independent predictors of DCC. Of the affected M2s, 57.0% required restoration, 26.9% required root canal treatment, and 16.1% required extraction.

Conclusion: Mesioangular impaction and contact at the cervical line are the strongest independent risk factors for DCC. In appropriately selected patients, shared decision-making regarding prophylactic removal of M3s exhibiting this high-risk pattern may be considered to preserve the second molar and prevent complex dental treatments.

GENDER-DEPENDENT CAREER CHALLENGES AND THEIR IMPACT ON PERCEIVED WORK-LIFE BALANCE IN FEMALE DENTAL SURGEONS OF A PUBLIC SECTOR UNIVERSITY HOSPITAL, KARACHI, PAKISTAN.

2026-04-09T16:00:54+00:00

Objectives: To determine the gender-dependent career development challenges faced by female dental house officers/interns and residents of Sindh Institute of Oral Health Sciences, Jinnah Sindh Medical University, Karachi and the association between these career development challenges and perceived work-life balance.

Materials and Methods: A cross sectional study was carried out at Jinnah Sindh Medical University, where a non-probability convenience sampling technique was used to survey the female dental surgeon. A sample size of 81 female dentists was computed to acquire a Confi dence Interval (C.I) of 95% & a margin of error of 5%, using the online calculator OpenEpi. A modified, structured pre-tested questionnaire was used for data collection. Descriptive analysis aided in the calculation of frequencies, percentages, mean and median of categorical variables. The association between the independent and dependent variables was determined by using binary logistic regression.

Results: Our study revealed that environmental challenges were signifi cantly related to work–profession balance (Odds ratio=2.018). Cultural challenges were associated with both work–profession (Odds ratio=1.171) and work–personal leisure balance (Odds ratio =1.230). Interpersonal challenges significantly influenced work–family (Odds ratio = 3.416) and work–personal leisure balance (Odds ratio=1.446).

Conclusion: In our society, female dentists do not face major barriers to career development. However, family responsibilities, pregnancy, childcare, and long working hours can still negatively affect their progress. Our study indicates that familial responsibilities and childcare infl uence career-related decisions among female dentists.

2026-04-09T07:57:15+00:00

A PANORAMIC STUDY OF THE MANDIBULAR CONDYLE MORPHOLOGY

2025-09-04T09:18:42+00:00

Objectives: The study aims to evaluate mandibular condyle morphology, gender peculiarities, population predominant shape, and symmetry between condyles in Peshawar district, Khyber Pakhtunkhwa, through visual inspection.

Materials and Methods: A Descriptive cross-sectional study was conducted at Rehman College of Dentistry in Peshawar from February to April 2019. The study included 380 individuals aged 15-35, with 760 condyles. The participants had fully erupted, periodontally healthy teeth and sound temporomandibular joints. The study classified mandibular condyle morphology into four types: oval, bird beak, diamond, and crooked finger.

Results: The study found that the majority of condyles (52.4%) were round/oval, followed by bird beak (24.5%), diamond (24.6%) and crooked finger (12.6%). Females had no significant difference in condyle symmetry, with 188 condyle pairs symmetric.

Conclusion: OPG, a low-dose imaging prescription, provides valuable insights into condyles, particularly oval-shaped ones in both sexes. Expanding sample sizes could increase population-specifi c information and forensics interest.

FROM PHENOTYPE TO GENOTYPE: MOLECULAR PATHOLOGY OF CRANIOFACIAL DISORDERS IN PAKISTAN.

2026-01-13T04:58:16+00:00

The global shift toward precision medicine, driven by advances in genomic technologies such as next-generation sequencing (NGS), whole-exome sequencing (WES), and whole-genome sequencing (WGS), has transformed the diagnosis and management of rare genetic diseases. While these tools are now embedded in routine clinical care in many countries, Pakistan remains largely excluded from this genomic revolution despite bearing a disproportionately high burden of inherited disorders.

This gap is particularly troubling given Pakistan’s high prevalence of consanguineous marriages, exceeding 60% in some regions, which significantly increases the incidence of autosomal recessive diseases. Yet, most rare genetic conditions remain undiagnosed or are managed symptomatically without molecular confirmation. Patients and families often endure prolonged diagnostic odysseys, receiving fragmented care that targets individual manifestations rather than the underlying genetic cause.

A substantial proportion of rare genetic disorders manifest early within the dental and craniofacial complex. Conditions such as amelogenesis imperfecta, dentinogenesis imperfecta, hypodontia, ectodermal dysplasias, cleidocranial dysplasia, and syndromic short stature commonly present with distinctive dental, facial, and skeletal anomalies. In many cases, these features are the earliest or only clinically apparent signs of an underlying multisystem disorder. Despite this, dental anomalies in Pakistan are routinely treated in isolation, with limited recognition of their syndromic or genetic significance.

Failure to utilize dental and craniofacial findings as entry points for genetic evaluation leads to missed or delayed diagnosis of associated systemic involvement, including hearing impairment, skeletal dysplasia, cardiac anomalies, and neurodevelopmental disorders. This compartmentalized approach compromises diagnostic accuracy, delays preventive care and surveillance, and deprives families of timely genetic counseling.

Limited access to genomic diagnostics remains a major barrier. While targeted gene panels, WES, WGS, chromosomal microarray analysis (CMA), and copy number variation (CNV) testing are standard internationally, availability in Pakistan is extremely restricted. Comprehensive NGS platforms, including Illumina- and Oxford Nanopore–based systems, are rarely available for routine clinical use, and molecular testing is frequently outsourced abroad, placing it beyond the financial reach of most families. The absence of national rare disease registries, biobanks, and population-specific genomic databases further hampers variant interpretation, particularly in consanguineous populations.

Compounding these limitations is a lack of awareness and a severe shortage of genetic counseling services, leaving families uninformed about recurrence risks, carrier status, and reproductive options. As precision medicine reshapes global healthcare, Pakistan remains ill-prepared to engage meaningfully. Dental and craniofacial services represent an underutilized strategic asset and could serve as frontline screening points for rare genetic diseases. Without a coordinated national genomic strategy integrating early phenotypic recognition, molecular diagnostics, and clinical genetics, Pakistan risks remaining on the periphery of the precision medicine era.