Browsing by Author "Dahal, Sirjana"
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Publication Anatomical Position of Lower Third Molar in Relation to Mandibular Canal on Cone-Beam Computed Tomography Images in A Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Chaudhary, Bikash; Joshi, Ujjwal; Khanal, Pranaya; Sagtani, Alok; Dahal, Sirjana; Bhattarai, NirojAbstract: Introduction: The positional relationship between the mandibularcanal with impacted mandibular third molar is the main factor of inferior alveolar nerve injury. The purpose of this study wasto classify the anatomical three dimensional relationship between the proximity of impacted mandibular third molars to the inferior alveolar canal. Methods: The descriptive cross-sectional study was conducted inthe Department of Oral and Maxillofacial Surgery of a tertiary care hospital from July 2020 to August 2020 after obtaining ethical approval from the Institutional Review Committee (Reference number 2506202001). Cone-beam computed tomography images of 200 patients’ mandibular third molars were used. A convenient sampling method was used. Data were analyzed using Statistical package for the Social Sciences. Results: Mandibular canal relative to the roots of the mandibular third molar was observed on the apical side in 104 (52.0%) and 173 (86.5%) third molars had direct contact with the mandibular canal. About 36 (97.3%) lingually placed mandibular third molars had contact with the mandibular canal. Conclusions: The findings of the study conclude that most of the mandibular third molars situated lingually had a higher occurrence of mandibular nerve involvement. The anatomic structures of the mandibular third molar and the mandibular canal may be helpful to draw upon the adequate surgical plan to avoidor reduce nerve involvement.Publication Anxiety among Patients Visiting for Periodontal Therapy in a Tertiary Care Dental Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Bhattarai, Bhagabat; Gupta, Sujaya; Dahal, Sirjana; Roy, Deepak Kumar; Pant, Saroj; Karki, Rachana; Thakuri, TanuAbstract: Introduction: The aetiological factors of dental fear include negative information, witnessing or having a bad experience, and negative conditions related to periodontal treatment. Modified Dental Anxiety Scale Nepali version, is one of the tools used in epidemiological studies to measure dental anxiety in adults. The objective was to find out the prevalence of anxiety among dental patients visiting for periodontal therapy in a tertiary care hospital. Methods: This descriptive cross-sectional study was conducted among patients visiting for periodontal therapy from November 2020 to January 2021 at a tertiary care dental hospital. Ethical clearance from Institutional Review Committee (Reference no. 0311202001) was taken before the study. Convenient sampling was done. A standard questionnaire for dental anxiety was used for data collection after receiving informed consent from the participants. Data were entered and analyzed in Microsoft Excel Sheet. Descriptive data are presented as means, standard deviations, frequencies, and percentages. Results: Among a total of 311 participants visiting for periodontal therapy, 297 (95.49%) (92.57-97.42 at 95% Confidence Interval) were having anxiety. Among total patients, 113 (36.33%) were fairly anxious, 111 (35.69%) were slightly anxious, 62 (19.94%) very anxious and 11 (3.54%) were extremely anxious. Majority of males 54 (17.36%) were slightly anxious while most females 67 (21.54%) were fairly anxious. Mean Modified Dental Anxiety Scale-Nepali score of all the participants was 11.59±3.808. Extreme dental anxiety was observed in 11 (3.54%) participants 7 (2.25%) females; 4 (1.29%) males. Conclusions: The prevalence of anxiety among patients visiting for periodontal therapy in this study was found to be higher compared to other studies done in similar settings.Publication Classification of Impacted Third Molars on Conebeam Computed Tomography Images(Nepal Health Research Council, 2025) Niroula, Deepa; Dahal, Sirjana; Poudel, Kalpana; Singh, Ashutosh Kumar; K.C, KrishnaBackground: An important anatomical factor in injuries to the inferior alveolar nerve is the spatial relationship between the mandibular canal and the corresponding third molars. This study was designed to classify the anatomic three-dimensional relationship between mandibular third molars and the mandibular canal on cone-beam computed tomography mages. Methods: A cross-sectional study was conducted by using CBCT images of 100 individuals visiting the Dental Outpatient Department of X hospital from Jan 2022 – Oct 2022. The images were used to classify the threedimensional relationship between the mandibular canal relative to the roots of the mandibular third molar according to Liqun Gu et al 2018 classification. In this classification, four anatomical positions were considered: buccal, lingual, apical and inter-radicular. The second factor considered was the contact and non-contact relationship between the inferior alveolar nerve canal and the mandibular nerve. The data was analyzed via SPSS version 20. Chi square test was performed to determine the contact relationship of the mandibular third molar root with the mandibular canal. Results: Most of the mandibular canals observed via CBCT (45.0%) were located on the buccal side of the mandibular third molar followed by the apical side (26.0%), between the roots (23.0%) and very few (6.0%) on the lingual side. A significant association was found between the position of the mandibular third molar and the mandibular canal (p<0.001) when the position was lingual and interradicular. Conclusions: The findings of this study revealed that the majority of mandibular third molars were located on the buccal side. There was a significant relationship between the position of the mandibular third molar and the mandibular canal. Keywords: Cone-beam computed tomography; impaction; mandibular canal; third molar.Publication Pain and Oral Health Related Quality of LIfe among Patients Undergoing Fixed Orthodontic Treatment: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Poudel, Prakash; Dahal, Sirjana; Thapa, Vivek BikramKeywords: fixed orthodontic treatment, oral health impact profile-14, pain Abstract Introduction: Fixed orthodontic procedures such as separator placement, archwire placement and activations, application of orthopaedic forces, and debonding of brackets produce pain in patients. This study was conducted to assess pain and oral health-related quality of life among patients undergoing orthodontic treatment. Methods: This descriptive cross-sectional study was conducted among 152 orthodontic patients of a teritary care center from January 2019 to October 2019 after receiving ethical approval from the Institutional Review Committee (Ref. no. 2311201813). Convenience sampling method was done to select the participants. Oral health-related quality of life using “Oral Health Impact Profile-14†and pain experienced during the first month of fixed orthodontic treatment were assessed. Data analysis for calculation of frequency and proportion was done in Statistical Package of Social Sciences. Results: Mean pain score of the study participants was 5.05±2.07 and their mean oral health impact was 12.71±7.27. Most of the study participants 86 (56.58%), had experienced moderate pain due to orthodontic treatment. Out of the reported impacts, 134 (88.2%) had painful aching in mouth and 127 (83.6%) had difficulty during eating. Least impact was seen in alteration of taste 35 (23%). Conclusions: The pain intensity experienced by patients was variable. Most participants had moderate pain but few patients perceived no pain at all. The participants had at least one or other oral health impacts due to fixed orthodontic treatment. Orthodontists should counsel the patients regarding possible discomfort so that there is no discontinuation of treatment due to pain.Publication Palatal Rugae as an Indicator of Sexual Dimorphism(Institute of Medicine, 2021) Dahal, Samarika; Baral, Radha; Gupta, Sanjay P; Dahal, Sirjana; Sharma, RinuABSTRACT Introduction: Palatoscopy or palate rugoscopy has been studied over the years to identify its unique characteristics to utilize for the human identification process. The unique anatomical location of the palatal rugae provides stability which along with the uniqueness of the palatal rugae pattern can contribute in human identification. Despite its simplicity and reliability, the palatal rugae is unexplored in the Nepalese population. The objective of the present study is to identify the rugae pattern and assess its sexual dimorphism. Methods: This was a cross-sectional analytical study conducted in Tribhuvan University Dental Teaching Hospital (TUDTH). The characteristics of palatal rugae based upon number, length, shape, and unification were analyzed on 100 dental casts. The rugae patterns were marked with a black color graphite pencil under adequate illumination. The length of the rugae was measured with the help of a digital vernier caliper and brass wire. The independent sample T-test and Mann Whitney U tests were used to assess the sexual dimorphism. Results: The predominant type of rugae according to the size in both males and females was primary rugae. According to the shape of the rugae, the predominant type of rugae was wavy followed by curved, straight, diverging, converging, and circular in both the sexes. However, no significant difference was seen in the rugae pattern in males and females. Conclusion: Based on the findings of the present study, the use of palatal rugae for sex determination is not recommended. Keywords: Human identification, palatal rugae, sexual dimorphismPublication Patient’s Preferences in Selecting Prosthodontist Based on Age and Sex in a Tertiary Hospital in Kathmandu(Institute of Medicine, 2022) Guragain, Manjeev; Dahal, Sirjana; Joshi, Kalit R; Rathi, Ankita; Dahal, Samarika; Poudel, Samikshya S; Pantha, Sandesh; Bhochhibhoya, AmarABSTRACT Introduction: Most of the dental research has focused on dentist’s perceptions of patients based on their demographic profiles, while little is known about patient’s perceptions of their dentists. Further, there is a lack of data regarding patient preferences in selecting prosthodontists based on gender and age in Nepal. This study aims to investigate the influence of various demographic factors on patient preferences in selecting their prosthodontist. Methods: A sample of 358 patients presenting at the Department of Prosthodontics, Tribhuvan University Teaching Hospital, Institute of Medicine for replacement of missing teeth took part in this questionnaire-based study. The questionnaire was designed to assess the influence of sex and age of the prosthodontist on the decision to select a prosthodontist. Statistical analysis was performed by SPSS version 16. Results: Majority (258, 72.1%) preferred treatment by a prosthodontist of age <44 years. There was a significant association seen between participants’ age, sex, and educational status and age preference for prosthodontists. Also, their sex, educational status, and prosthodontist among family and friends were significantly associated with prosthodontist’s sex preference. Conclusion: There was preference for younger prosthodontists by the study participants but they had no gender preference for having their treatment done. Keywords: Age, gender, preference, prosthodontist, treatmentPublication Perception of Online Lectures among Students of a Medical College in Kathmandu: A Descriptive Cross-sectional Study(Nepal Medical Association, 2021) Bhattarai, Bhagabat; Gupta, Sujaya; Dahal, Sirjana; Thapa, Aarzu; Bhandari, PoojaAbstract: Introduction: The COVID-19 global pandemic has affected all aspects of human life, with education no exception. Online lectures have been practiced in different academic institutions around the world. The objective was to know the perception towards online lectures by the undergraduate students of a medical college. Methods: This descriptive cross-sectional study was conducted among the undergraduate students of dentistry, medicine, and nursing at Kathmandu Medical College via self-administered online questionnaire. Data were collected from November to December 2020 after ethical clearance from institutional review committee (Ref. no. 0311202002). Students who had not attended even one hour of online learning per week were excluded. Responses were collected using Google Forms which were analysed in Microsoft Excel. Results: Out of 318 valid questionnaires, 143 (44.97%) students agreed that online lectures were effective but 138 (43.4%) disagreed that online lectures were more useful than traditional lectures. One hundred and forty five (45.60%) found online classes difficult to concentrate and 175 (55.03%) agreed that they preferred a combination of traditional teaching and online tutorials. Only two (0.63%) students strongly agreed on excellent internet during classes and 104 (32.70%) agreed it caused economic burden. Mean age of participants was 20.75±1.538 years; 202 (63.52%) were females; online learning per week was 18.75±9.157 hours; and duration of online learning was 20.28±9.997 weeks. Conclusions: Most of the students had a positive attitude towards e-learning when compared to similar studies. Further multicentric studies with larger sample size would better demonstrate whether online education partly or fully can be effective adjunct to traditional face to face interaction.Publication Post Operative Pain During and After Root Canal Treatment in a Government Hospital Setting in Nepal(Nepal Health Research Council, 2025) Tripathi, Rupam; Dahal, Sirjana; Acharya, Nisha; Nepal, Manisha; Khanduri, Nitin; Lamichhane, SamitaAbstract: Background: Postoperative pain is a most common symptom of endodontic patients after root canal treatments (RCTs). The aim of this study was to evaluate Postoperative pain during and after root canal treatment (RCT) among patients at a government hospital of Nepal. Methods: Maxillary and mandibular teeth with necrotic pulp or irreversibly inflamed pulp, with or without preoperative pain, were included in this study. Subject’s age and gender, as well as pulp status and preoperative pain status, were recorded. Root canal treatment was done using a standard protocol. Visual analog scale (VAS) and facial rating scale were used to record the level of pain felt. Results: A total of 400 patients were enrolled in the study. The VAS score for pain decreased from 6(4-8) recorded before RCT, to 0 (0-4) during and 0 (0-0) after RCT and the difference was statistically significant (P<0.001). Similarly, in Facial rating scale, the scores decreased significantly from 2(2-5) before RCT to 0(0-0) during and 0(0-0) after RCT (P<0.001). There was significant difference in facial rating scores during root canal treatment between males and females (P=0.014). Conclusions: Postoperative pain significantly decreases after the initiation of root canal treatment. No significant difference was found in VAS score between male and female whereas significant difference was found in facial rating scores during root canal treatment between males and females. These findings of facial rating score emphasize that biological and psychosocial factors make females more susceptible to experiencing pain. Keywords: Facial rating scale; necrotic pulp; post-operative pain; RCT; visual analog score.Publication Prevalence of Dental Fear among 6-15 Years Old School Children(Nepal Medical Association, 2020) Dahal, Sirjana; Shrestha, Ashish; Bhagat, TarakantAbstract Introduction: Odontophobia or dental fear is a “unique phobia with special psychosomatic components that impact on the dental health of the odontophobia persons". It is well documented that dental fear has a significant impact on dental care utilization behaviors. The objective of this study was to find out the level of dental fear among school children studying in government schools of Dharan, Nepal. Methods: A descriptive cross-sectional study was conducted from March to August 2017 among 215 school going children of Dharan of age group 6 to 15 years. Ethical approval was obtained. Children studying in six different government schools of Dharan were selected using two stage cluster sampling method. The Children’s Fear Survey Schedule-Dental Subscale was used to measure dental fear among the study group. Data were entered in Microsoft Excel Sheet 2007 and analyzed in Statistical Package of Social Sciences 11.5. Results: This study showed that among the total study population, 96 (44.7%) had high fear, 62 (28.8%) had moderate fear and 57 (26.5%) had low dental fear. Among males, 29 (34.5%) had high fear whereas more than half of the female respondents had high fear. Conclusions: The present study showed that most of the school going children had high fear of dental treatment. So, school health programs should be planned to make the children familiar to dentistry and proper treatment modalities should be provided to make the child comfortable to seek dental care. Keywords: children;dental fear; gender differences; Nepal.Publication Prevalence of Dentinal Hypersensitivity among Dental Patients Visiting Tertiary Care Center: An Observational Study(Nepal Medical Association, 2025) Ghimire, Saru; Ghimire, Sagar; Dahal, Samarika; Dahal, Sirjana; Paudel, Neetika; Paudel, PrayashAbstract Introduction: Dentinal hypersensitivity is a widespread condition characterized by a brief, sharp pain arising from exposed dentin in response to external stimuli, which cannot be linked to any other dental conditions. This study aimed to estimate the prevalence of dentinal hypersensitivity among patients attending a tertiary health care center. Methods: A observational cross-section study was conducted, involving 376 patients aged 10-70 years who visited a tertiary care center. Convenience sampling was employed to select participants, and the prevalence of dentinal hypersensitivity was assessed through a questionnaire. Data were collected from the Department of Oral Medicine and Radiology after obtaining ethical approval Institutional Review Committee (Reference number: 385 (6-11) E2 079/80). The analysis was performed using Microsoft Excel, and descriptive statistics were reported . Results: There were 376 patients in the study and the prevlence of dentin hypersensitivity wasa 236 (62.77%; CI 95%: 57.66%-67.67%). Among those diagnosed, 138 (73.02%) were male, and 98 (52.41%) were female. The age-specific prevalence was found to be 30 (50.85%) in patients aged 10-19 years, 73 (63.48%) in those aged 20-29 years, 42 (53.16%) in patients aged 30-39 years, 23 (51.11%) in those aged 40-49 years. Conclusions: This study identified a high prevalence of dentin hypersensitivity among the patient population, with variations observed across different age and sex groups.Publication Satisfaction Level among Patients Treated with Fixed Dental Prosthesis in a Tertiary Care Hospital: A Descriptive Cross-sectional Study(Nepal Medical Association, 2020) Shrestha, Lajana; Dahal, Sirjana; Pradhan, Dilesh; Lohani, JunuAbstract Introduction: Dental treatment aims at correction of existing disease; prevention of future disease with rehabilitation of patient’s lost functional capacity and aesthetics. Fixed dental prosthesis is any prosthesis that is cemented to a natural tooth or dental implants abutments that cannot be removed by patient. The success of prosthodontic treatment is related to prosthesis survival, with its ability to fulfil biologic and patient-evaluated objectives with patient satisfaction. This study is aimed to find the patient satisfaction with fixed prosthodontic treatment. Methods: This descriptive cross-sectional study was done in a tertiary care hospital among 102 patients rehabilitated with fixed dental prosthesis from August to September 2019 after taking ethical approval from Institutional Review Committee of Kathmandu Medical College. (IRC No. 1207201918). Convenience sampling was done. The questionnaire assessed patient’s satisfaction of fixed prosthesis on the basis of appearance, chewing ability, cleansibility, speech and awareness of oral hygiene measures for cleaning of the prosthesis. Data entry was done in Microsoft excel and analysed using Statistical Package for Social Sciences (SPSS)version 20.0, point estimate at 95% Confidence Interval was calculated along with frequency and proportion for binary data. Results: The majority of the patients 87 (85.3%) were satisfied with their fixed prosthesis, at 95% confidence interval (93.5- 81%). Eighty one (79.4%) were satisfied with their chewing ability; 99 (97.1%) satisfied with their speech, 78 (76.4%) satisfied with appearance of fixed prosthesis. Ninety eight patients (96.1%) were aware of oral hygiene measures, out of which only 66 (67.3%) used interdental aids for cleaning of their fixed prosthesis. Conclusions: Several factors (chewing ability, appearance, speech, cleansibility of fixed prosthesis) had positive impact on overall satisfaction in majority of the patients. Dentists should continue to emphasise on the significance of maintaining good oral hygiene and use of interdental aids for the longevity of fixed prosthesis. Keywords: dental prosthesis; interdental aids; satisfaction.Publication Self-Assessment of Oral Health Status among Adults Residing at Chautara, Sindhupalchowk, Nepal(Nepal Health Research Council, 2025) Dahal, Sirjana; Khapung, Anju; Dahal, Samarika; Poudel, PrakashBackground: Little is known about attitudes and practices regarding oral health of developing countries. This study aimed to determine the self-assessment of oral health status among adults residing at Chautara, Sindhupalchowk, Nepal. Methods: A descriptive cross-sectional study was conducted among 440 adults selected by convenience sampling method. Interview using WHO oral health questionnaire for adults 2013 was taken after receiving informed consent. Data were entered in Microsoft Excel Sheet and analysed in SPSS version 24. Mean, standard deviation, frequency and percentage were calculated. Results: Majority had positive assessment regarding their teeth (366, 83.18%) and gums (384, 87.27%). Many (417, 94.77%) cleaned their teeth ?one times a day. Majority used toothbrush (434, 98.64%) and paste (411, 93.41%) for cleaning their teeth. Some, (184, 41.82%) visited a dentist at least once in their lifetime and the main reason was pain or trouble in teeth/gums/mouth (94, 51.09%). Very often, they faced problems chewing (31, 7.0%) and biting (27, 6.1%) foods. They mostly consumed tea with sugar (132, 30.0%) and biscuits, cakes and cream cakes (59, 13.4%) several times a day. Most of them smoked cigarettes every day (93, 21.1%), followed by tobacco chewing (67, 15.2%). In the past 30 days, 179 (40.7%) drank one or more drinks of alcohol. Conclusions: The study findings showed that most of the adult residents of Chautara, had positive self-assessment of their oral health status. However, they faced many oral health problems which may be due to their unhealthy lifestyle suggesting need for oral health awareness programs. Keywords: Adults; oral health; self-assessment.