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Browsing by Author "Lamichhane, S"

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    Assessment of Clinical Outcomes and Patient Response to Gingival Depigmentation Using Gingival Trimming Ceramic Bur and Conventional Scalpel Technique
    (Kathmandu University, 2024) Thapa, S; Humagain, M; Lamichhane, S; Subedi, G; Rijal, AH
    ABSTRACT In this era, role of esthetic in dentistry has been an evolving concern. One of the major concern is the hyperpigmented gingiva in patients with high smile line or excessive gingival display. This varies in different individuals and is assumed to be dependent on cutaneous pigmentation. Therefore, there are various methods of depigmentation. Hereby, is a case report of depigmentation done on upper anterior gingival region and comparing the output and patient response where half of the segment was done by using scalpel and the other half by ceramic bur with a follow up of three months. And this report concludes that ceramic bur has more advantages over scalpel technique. KEY WORDS Depigmentation, Esthetics, Soft tissue trimming ceramic bur
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    Correlation between Femoral Intercondylar Notch Width and Anterior Cruciate and Posterior Cruciate Ligament Widths on MRI of Knee Joint
    (Kathmandu University, 2023) Ghimire, P; Kayastha, P; Suwal, S; Katwal, S; Dhakal, P; Lamichhane, S; Lohani, B
    ABSTRACT Background Anatomic variations have been implicated as one of the intrinsic causes of injuries to the cruciate ligaments which can induce a functional deficiency to the knee. Narrow cruciate ligament widths as well as narrow femoral intercondylar notch widths can increase the risk of these ligaments rupturing. Objective To correlate the width of the femoral intercondylar notch (ICN) with anterior cruciate ligament (ACL) and posterior cruciate ligament (PCL) widths on MRI of the knee joint. Method A total of 46 patients who met the inclusion criteria were evaluated. Intercondylar notch was identified on coronal T1W images while anterior cruciate ligament and posterior cruciate ligament were identified on proton density coronal images. All the widths were measured in the same plane at a mid-coronal level where anterior cruciate ligament and posterior cruciate ligament cross each other. Result Our result showed a significant correlation between the widths of intercondylar notch and anterior cruciate ligament (r = 0.68, p < 0.001) and between intercondylar notch width (INW) and posterior cruciate ligament width (r = 0.65, p < 0.001). Overall, the mean intercondylar notch width measured was 17.5 ±2.5 mm (range 11.8 to 21.8 mm), the mean anterior cruciate ligament width was 5.9 ±1.3 mm (range 3.3 to 8.6 mm), and the mean posterior cruciate ligament width was 8.9 ±1.5 mm (range 5.9 to 11.8 mm). A statistically significant difference was observed between males and females for mean widths of intercondylar notch (p < 0.001) and posterior cruciate ligament (p=0.01). However, no statistically significant difference was seen for anterior cruciate ligament width (p=0.07) between the two genders. Conclusion Measurement of the femoral intercondylar notch width can be used as an indicator of anterior cruciate ligament and posterior cruciate ligament widths which can further assist to identify the individuals who are more susceptible to cruciate ligament injuries. KEY WORDS Anterior cruciate ligament, Cruciate ligament injury, Intercondylar notch width, MRI, posterior cruciate ligament
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    Crown Lengthening Surgery for Enhancing Restorative Treatment in Esthetic Zone
    (Kathmandu University, 2021) Dawadi, A; Humagain, M; Sapkota, B; Subba, M; Neupane, M; Lamichhane, S
    ABSTRACT For obtaining adequate retention for restoring cases like subgingival caries or extensive caries that shortens the tooth, short clinical crown, and fractures, it is usually necessary to disclose more tooth structure. Crown lengthening procedure is done to increase the clinical crown length for restorative or esthetic reasons without breaching the biologic width. These procedures are also utilized to improve the appearance and retention of restorations placed within the esthetic zone. We report a case of crown lengthening surgery with an internal bevel gingivectomy which was done in our department without compromising tooth support and esthetics. KEY WORDS Crown lengthening, Esthetics, Gingivectomy
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    Epidemiological Characteristics of the Spine Tumors in a Single Tertiary Centre of Nepal
    (Kathmandu University, 2025) Kayastha, SR; Pandey, A; Lamichhane, S; Thapa, J; Parajuli, B; Shrestha, D
    ABSTRACT Background Spine tumors can be primary or secondary, depending on their origin. Metastasis compromises the majority of spine tumors. Primary tumors of the spine are rare and mostly asymptomatic; consequently, their real incidence cannot be investigated. Primary malignancies of the spine are even rarer. Most epidemiological data for spine tumors comes from registries in developed countries. Objective To provide epidemiological data on spine tumors in a single tertiary hospital in Nepal. Method This is a descriptive cross-sectional study done at the department of orthopaedics at Dhulikhel Hospital. The study was done using retrospective hospital records from January 2010 to December 2024. The data related to all the spine tumors admitted under the department of orthopedics during the study’s duration were included. Records without complete, relevant information were excluded. We took data from 135 patients admitted for spine tumors. The information related to the demography, site of tumors, types of tumors, and histological diagnosis was entered in Google Sheets and exported for descriptive analysis in Statistical Package for Social Sciences (SPSS) version 20. Result Among the 135 patients, the most common site of spine tumor was thoracic (42.22%). Primary benign neoplasms were the most common (n=68), and among the 61 malignancies, 36 were secondary and 25 were primary malignancies. Schwannomas were the most common benign tumors in the spine (n=23). The most common site for secondaries in the spine was the lungs (n=11). Conclusion This study’s results represent data on the epidemiology of spinal tumors from a single institute. Although this data is far too small to represent the whole country, in the absence of registries or other large multicentric databases, it can shed some light on the less studied spine tumors in Nepal. KEY WORDS Epidemiology, Metastasis, Spine tumors
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    Radiographic Evaluation of Crestal Bone Loss in Pre-loading and Post-loading States of Endosteal Implants in Maxilla and Mandible- A prospective study
    (Kathmandu University, 2023) Lamichhane, S; Humagain, M; Bhusal, S; Rijal, AH; Rupakhety, P
    ABSTRACT Background Peri-implant tissue integrity depends upon healthy peri-implant mucosa and bone. The crestal bone is one of the governing factors for successful implant therapy both functionally and esthetically. There are limited radiographic studies in Nepalese population for determination of crestal bone loss around peri-implant area comparing the bone loss at pre- and post-loading state. Objective To evaluate the bone loss in mesial and distal, maxilla and mandible before and after the implant supported prosthesis delivery. Method A 6-months prospective study was planned and conducted in 26 endosteal implants (13 maxillary and 13 mandibular) which were placed in 20 patients fulfilling the inclusion criteria. The crestal bone loss was measured and compared using digital radiography images using the designated software. The differences among the crestal bone loss in mesial and distal, maxilla and mandible in pre- (3 months of implant placement) and post-loading states (3 months of prosthesis delivery) were evaluated using the appropriate statistical tests. Result The crestal bone loss was more pronounced in the pre-loading stage (1.12 mm) compared to post-loading (0.48 mm). Initially, the bone remodelling was higher in the distal aspect whereas there was no significant difference between mesial and distal aspect in post-loading phase. Comparing maxilla with mandible, there were no significant differences in bone loss in both phases. Conclusion Within the limitations of this study, the crestal bone loss was found upto the physiological limit of bone remodelling provided the implants placed in strict, aseptic condition with proper case selection and planning. KEY WORDS Crestal bone loss, Dental implants, Implant supported dental prosthesis, Osseointegration
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    Sagittal Root Position of Maxillary Anterior Teeth in Nepalese Population Using Cone Beam Computed Tomography
    (Kathmandu University, 2022) Lamichhane, S; Humagain, M; Dawadi, A; Koju, S
    ABSTRACT Background There are no radiographic studies in Nepalese population for determination of sagittal root positioning in maxillary anterior teeth. The sagittal root positioning and root angulation plays a vital role for case selection in immediate implant placement. Objective To evaluate, classify and compare sagittal root position between different maxillary anterior teeth. Method A 2-year retrospective study was conducted on 100 patients (53 males and 47 females) who fulfilled the inclusion criteria using cone beam computed tomographic images. The relationship of root of tooth to its alveolar housing were recorded as Class I to IV. In addition, the root angulation relative to the alveolar process was also measured. Result The sagittal root position (SRP) calculated on six maxillary anterior teeth on average was found to be 87.83% for Class I, 6.67% for Class II, 0.67% for Class III and 5.17% for Class IV respectively. The mean root angulation was found to be higher with canines on both side whereas lateral incisors had lesser mean root angulation. Root angulation of maximum teeth were between 10-20 degrees where immediate implant placement is possible. Conclusion Within the limitations of this study, the sagittal root positioning and root angulation in Nepalese population showed a favorable result for immediate implant placement. Maximum teeth were found to be close to the alveolar process with the exception of few teeth. KEY WORDS Immediate implant, Root angulation, Sagittal root positioning
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    Soft Tissue Ridge Augmentation for Pontic Site Preparation: A Perio-Prostho Synergy
    (Kathmandu University, 2025) Marattha, P; Humagain, M; Lamichhane, S; Rijal, AH; Shrestha, A; Timilsina, S
    ABSTRACT The reconstruction of a lost alveolar housing is important to achieve a harmonious balance between biology, function, and aesthetics for a prosthesis’s successful outcome. Soft tissue ridge augmentation is a periodontal surgical procedure designed to correct mild to moderate horizontal alveolar ridge deformities alongside fixed partial prosthesis, mostly preferred for their aesthetic benefits and less invasive nature as compare to hard tissue augmentation. Moreover, the increase in keratinized tissue and the improved soft tissue profile reduces the risk of future complications and is essential for hygiene maintainance. The purpose of this case report was to present the successful periodontics-prosthodontics synergistic approach to treat a seibert class I moderate type ridge defect with additional vestibular depth and keratinized tissue insufficiency issues in an edentulous molar pontic site using a free gingival onlay graft. KEY WORDS Alveolar ridge augmentation, Autograft, Esthetics, Pontic site preparation
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    Specialist Periodontal Referral Knowledge, Attitude and Practice by General Dental Practitioner in Nepal
    (Kathmandu University, 2024) Rijal, AH; Humagain, M; Lamichhane, S; Ghimire, P
    ABSTRACT Background To enhance the referral process, it is essential for the patient, referring practitioner, and specialist to establish effective communication and ensure they are well- informed and educated about each other’s requirements. Objective To assess the knowledge and attitude of general dental practitioners towards specialist periodontal referral. Method This cross-sectional study was carried out for 6 months from October 2022 to April 2023 using a self-administered questionnaire by general dental practitioners registered in Nepal Medical Council. Knowledge and attitude about periodontics, various diseases and referral to specialist for special treatment were analyzed. Result Total of 238 General Dental Practitioners (GDPs) participated in this web-based questionnaire survey. Majority of general dental practitioners (GDPs) reported that they always performed full-mouth and subgingival scaling (193, 81.09%), providing advice on proper brushing techniques (205, 86.13%), advising patients to stop harmful habits (212, 89.07%), and offering diet counseling (122, 51.26%) for patients displaying signs of gingival or periodontal diseases. Majority of GDPs also indicated that they occasionally consult a periodontist for specific periodontal problems, such as the presence of periodontal pockets (143, 60.084%), mobile teeth (150, 63.025%), gingival enlargement (145, 60.924%), periodontal abscess (146, 61.344%), and gingival recession (149, 62.605%). Conclusion General dental practitioners play a crucial role as the primary point of contact for patients seeking dental treatment. The periodontal health of the general population largely depends on the knowledge, attitude, and practice of GDPs. KEY WORDS General dental practitioner, Periodontal referral, Periodontist

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