A comparative study of conventional and Hall techniques of crown placement using finite element stress analysis

BACKGROUND

Hall technique of crown placement causes the changes in vertical occlusal dimension; the mode of settlement of which needs to be explored.

AIM

To assess and compare the changing patterns of stress distribution following placement of stainless steel crowns on primary teeth by Hall and conventional techniques using a finite element model analysis.

MATERIALS AND METHODS

The clinical crown heights of primary molars restored with Hall and conventional techniques and opposing teeth in contact, vertical dimension changes in the primary canine area were measured using intraoral digital scan. T-scan was used to measure the changes in bite force while the finite element analysis was used to assess deformative changes on the 2^nd, 5^th, 10^th, and 15^th days.

RESULTS

The Hall technique of crown placement caused more stress distribution in the tooth supporting tissues that settled in 2 weeks as compared with conventional technique of crown placement in which settlement occurred in 2 days.

CONCLUSION

The settling of vertical occlusal dimension as well as stress distribution in Hall technique probably takes place by intrusion of crowned tooth and opposing teeth in contact.

Retropharyngeal lymph node metastasis in oral cancer. Systematic review and survival analysis

INTRODUCTION

Metastasis to retropharyngeal lymph nodes (RPLN) from oral squamous cell carcinoma is rare and associated with poor outcomes. The poor prognosis of RPLN is multifactorial and includes the clinicopathological aggressiveness of the primary disease and the late presentation. The aim of this systematic review is to assess the evidence on RPLN in patients diagnosed with oral squamous cell carcinoma (OSCC), the quality of the diagnostic modalities and the available treatment options. We aimed to analyse the overall survival of these patients diagnosed with RPLN.

METHODS

A systematic review was undertaken according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guidelines. The initial literature search generated 289 articles. A total of 11 papers satisfied our criteria. Eight papers provided enough data to perform survival analysis and 3 papers compared the diagnostic modalities used in the detection of RPLN.

RESULTS

A total of 73 OSCC patients diagnosed with RPLN metastasis were identified. The most common primary tumour subsites included the tongue (20), buccal mucosa (15) and gingiva (11). The cumulative 5-year OS rate was 17.8% while the 2-year overall survival was 35.9%.

CONCLUSION

The presence of nodal metastasis is an independent prognostic factor in head and neck cancer. In this study, RPLN metastasis had a poorer prognosis (5 years overall survival is 17.8%) when compared to the survival rate of oral cancer without RPLN metastasis (5 years overall survival is 40%). There was no statistically significant difference between the overall survival in primary RPLN metastasis and recurrent RPLN disease.

An assessment of the effectiveness of oral health education on oral health-related knowledge and attitudes of caregivers of children with hearing impairment

AIM

To assess the effectiveness of oral health education on oral health-related knowledge and attitudes of caregivers of children with hearing impairment and its impact on the oral health status of their children.

MATERIALS

Study design: Non randomised pre- and post-comparison study. Fifty-six pairs of caregiver-child with sensory impairment were chosen and divided into study and control groups. Health education was provided to the caregivers of the study group for 1, 3, 6 and 12-month period and periodic assessment of their knowledge, attitudes and practices (KAP) was performed. The caregivers of the control group did not receive any oral health education during the study period. The oral health status of these children was evaluated using the WHO assessment form (2013) and modified OHI-S (oral hygiene index- simplified) at baseline, 6 month and 12-month period. The effectiveness of KAP of caregivers and the oral health status of their children was correlated at the end of the study.

STATISTICAL ANALYSIS

The mean KAP scores between caregivers' of study and control group at different time intervals was compared using repeated measures of ANOVA test. Chi square test was used to compare the presence of bleeding gums and Mann Whitney U Test was used to compare the mean DMFT, deft and OHIs scores at different time intervals between study and control groups. Pearson correlation test was used to assess the relationship between KAP scores and clinical parameters at different time intervals in study and control group of both the populations.

CONCLUSION

The oral health education given to the caregivers has shown a positive impact on the oral health status of their children. Periodic reinforcement of the oral health-related measures among caregivers of children with hearing impairment is recommended.

A clinical and radiographic comparative evaluation of custom-made zirconia crowns using CAD-CAM and stainless steel crowns in primary molars

BACKGROUND AND AIM OF STUDY

Early childhood caries is a multifactorial disease process affecting children below 71 months of age and continues to be a global health problem. Stainless steel crowns (SSCs) are widely used and are very popular in pediatric dentistry due to its superiority and durability when compared with multisurface amalgam restorations. However, one of the major disadvantages with these crowns is the poor esthetics. Parents often request for a more esthetic alternative to the SSC. Zirconia crowns are one of the tooth-colored full crown restorations currently available for use in primary teeth. These are available as both preformed and custom-made crowns and show excellent esthetics. However, these require extensive tooth preparation with a subgingival finish lines, which would cause gingival trauma and bleeding during the preparation. The present study uses intraoral scanners for making the custom-made zirconia crowns, which will avoid the conventional impressions. Currently, there are no studies available in pediatric dentistry regarding CAD-CAM crowns. Hence, there is a need for the study.

AIM

The aim of this study is to clinically evaluate the performance of preformed SSCs and custom-made zirconia crowns in primary molars. To elicit parental and patient satisfaction with respect to preformed SSCs and custom made zirconia crowns and to radiographically compare the interproximal bone height for 1 year.

METHODS

The patients were selected with purposive sampling. The tooth of interest was prepared according to the crown it would receive. The upper and the lower arch of the tooth receiving custom-made zirconia crown was scanned using an intraoral scanner. The crowns were cemented using Type 1 glass ionomer cement (GIC) (SSC) and resin modified GIC (custom-made zirconia crown). After the crown placement, the patient and the parent's satisfaction was scaled regarding the time taken, comfort, cost of crown, appearance of crown, etc., using a 5-point Likert scale. A baseline radiograph was taken after crown placement. The patient was recalled every 3 months till 1 year for evaluation (loss of retention, loss of proximal contact, gingival inflammation, opposing tooth wear, and marginal integrity). At the end of 1 year, radiographs were taken to check the interproximal bone.

RESULTS

After 1 year evaluation of custom-made zirconia crowns and preformed SSCs in primary molars, it was shown that both SSC and zirconia crowns showed good gingival scores but zirconia crown was better than SSC in improving the gingival health. SSCs showed better results with respect to the opposing tooth wear and marginal adaptability. Parents as well as patients preferred a tooth-colored crown as a treatment option.

CONCLUSION

Custom-made zirconia crowns are comparable to the preformed SSCs and they show better gingival scores and excellent color match.

Unforeseen rupture of pseudoaneurysm of common carotid artery: An arduous anesthetic challenge

Pseudoaneurysm of the common carotid artery (CCA) is exceptionally unstable and unpredictable; it mandates quick medical attention in order to circumvent neurologic sequelae or hemorrhage. Unanticipated rupture is extremely lethal and a potential provocation for the anesthesia caregiver. It is an arduous challenge for an anesthetist to establish emergency airway when a huge bleeding pseudoaneurysm is compressing and deviating the trachea, securing invasive lines in collapsing vessels, volume and vasopressor resuscitation in deteriorating hemodynamics in order to maintain cerebral perfusion without compromising other vital organs, arranging huge amount of blood and blood products in a short span of time, and transferring an exsanguinating patient for the rapid institution of cardiopulmonary bypass. Not only preoperatively it also necessitates appropriate neuromonitoring and neuroprotection during and after surgery. The association of unforeseen rupture of common carotid artery pseudoaneurysm secondary to the tubercular spine and lifesaving management by the rapid institution of cardiopulmonary bypass (CPB) is a rare occasion. To the best of the authors' knowledge, there is not any similar case in the peer-reviewed literature. Therefore, the authors enumerate the clinical experience of an unexpected rupture of CCA pseudoaneurysm requiring lifesaving CPB and emphasize the “Timely Teamed Effort Approach” that can sustain a life in such an inevitable situation.

1537 Squamous Cell Carcinoma Arising in A Maxillary Odontogenic Keratocyst in Gorlin Goltz Syndrome - A Rare Case Report

Introduction

Gorlin Goltz syndrome (GGS) is a rare, hereditary, AD condition with multiple BCCs, odontogenic keratocysts (Jaw cysts), calcification of falx cerebri, skeletal anomalies & a predisposition to neoplasms like medulloblastomas, fibromas and rhabdomyosarcomas.

Aim

We present a rare case of a Squamous cell carcinoma (SCC) developing in a Maxillary odontogenic keratocyst in a 32-year male with GGS.

Discussion

This patient was referred to the OMFS unit with a non-healing UL3 extraction socket and exophytic growth. Initial biopsies suggested an atypical squamo-proliferative lesion, however a repeat biopsy demonstrated an invasive SCC arising from a background odontogenic keratocyst of the maxilla. He was initially reluctant to undergo a staging CT scan to avoid risks of developing further BCCs due to IR exposure. This was eventually performed as per H&N MDT recommendation & showed a T4aN0M0 SCC of the left maxilla and bilateral multiple mandibular odontogenic keratocysts. He underwent a left maxillectomy, left neck dissection & reconstruction with a DCIA free flap, but did not want his mandibular keratocysts treated at the same time. Complete tumour clearance was achieved with no involved neck nodes & he remains disease-free at 4 months postoperatively. Although for a T4 tumour he would have needed postoperative radiotherapy, in view of the GGS, no adjuvant treatment was indicated.

Conclusions

SCC developing in a maxillary OKC is exceedingly rare with only two previous cases reported in GG syndrome. This is the first reported case of a GGS patient with oral SCC undergoing a complex free flap reconstruction.

A comparative evaluation of pain perception following topical application of benzocaine gel, clove-papaya based anesthetic gel and precooling of the injection site before intraoral injections in children

BACKGROUND AND AIM OF THE STUDY

The topical anesthetic property of clove remains unexplored even though it has been widely used in dentistry since ages. Hence, the aim of the study was to compare the topical anesthetic efficiency of precooling with ice, clove-papaya based topical gel and benzocaine gel in pediatric patients.

METHODOLOGY

Sixty healthy children aged 9-10 years who required local anesthetic injections for dental procedures were selected and divided into three groups with 20 patients each. In the first visit, written consent and intraoral screening of the patients were performed. In the second visit, the topical anesthetic agents were applied in the respective groups for 1 min and later local anesthetic injections were administered. Pain perception was evaluated using Sound, Eye, Motor Scale (SEM scale) and Wong Baker Faces Pain Rating Scale (WBFPRS), tabulated, and statistically analyzed. A.

RESULTS

The test results demonstrated that benzocaine group has the highest mean WBFPRS score followed by clove-papaya group and then ice cone group. The ice group showed the least mean SEM scale score, followed by the benzocaine group and then clove-papaya group. However, the mean WBFPRS score and the mean SEM scale score did not show any statistically significant difference.

INTERPRETATION AND CONCLUSION

All the three topical anesthetic agents provided similar surface anesthesia in children. The newly introduced clove-papaya based topical anesthetic gel showed encouraging results, hence can be used as a potent topical anesthetic agent.

Splitting fracture in bovine bone using a porosity-based spring network model

We examine the specific role of the structure of the network of pores in plexiform bone in its fracture behaviour under compression. Computed tomography scan images of the sample pre- and post-compressive failure show the existence of weak planes formed by aligned thin long pores extending through the length. We show that the physics of the fracture process is captured by a two-dimensional random spring network model that reproduces well the macroscopic response and qualitative features of fracture paths obtained experimentally, as well as avalanche statistics seen in recent experiments on porcine bone.

Caudal Epidural Analgesia in Pediatric Patients: Comparison of 0.25% Levobupivacaine and 0.25% Ropivacaine in Terms of Motor Blockade and Postoperative Analgesia

CONTEXT

Ropivacaine and Levo-Bupivacaine have been safely used for caudal anaesthesia in children, but there are limited studies comparing the efficacy of 0.25% Ropivacaine and 0.25% Levo-Bupivacaine for caudal anaesthesia in infraumbilical surgeries.

AIMS

The aim of this study was to compare the incidence of motor blockade and postoperative analgesia with 0.25% ropivacaine and 0.25% levobupivacaine for the caudal block in children receiving infraumbilical surgery.

SETTINGS AND DESIGN

This was a randomized double-blinded study.

SUBJECTS AND METHODS

Sixty patients of either sex, between 1 and 10 years posted for elective infraumbilical surgeries, to receive caudal block with either (Group R) ropivacaine 0.25% or (Group L) levobupivacaine 0.25% of volume 1 ml/kg were included in the study. Motor blockade was assessed using motor power scale, and pain was assessed every 1 h for first 6 h, then 2nd hourly for following 18 h using modified Hannallah objective pain scale. If pain score is ≥4, the patients were given paracetamol suppositories 20 mg/kg as rescue analgesia.

STATISTICAL ANALYSIS USED

All analyses were performed using Chi-square test, Student's independent t-test, Kruskal-Wallis test, Mann-Whitney U-test.

RESULTS

The time for full motor recovery was similar in both groups; in Group R, ropivacaine: 180.50 ± 14.68 min, and in Group L, levobupivacaine: 184.50 ± 18.02 min, with P = 0.163. The duration of postoperative pain relief between the groups was 330.50 ± 9.54 min in Group L (levobupivacaine) and 312.67 ± 5.56 min in Group R (ropivacaine) with P = 0.165 not statistically significant.

CONCLUSIONS

Both ropivacaine 0.25% and levobupivacaine 0.25% have similar recovery from motor blockade and postoperative analgesia.

Two particle tracking and detection in a single Gaussian beam optical trap

We have studied in detail the situation wherein two microbeads are trapped axially in a single-beam Gaussian intensity profile optical trap. We find that the corner frequency extracted from a power spectral density analysis of intensity fluctuations recorded on a quadrant photodetector (QPD) is dependent on the detection scheme. Using forward- and backscattering detection schemes with single and two laser wavelengths along with computer simulations, we conclude that fluctuations detected in backscattering bear true position information of the bead encountered first in the beam propagation direction. Forward scattering, on the other hand, carries position information of both beads with substantial contribution from the bead encountered first along the beam propagation direction. Mie scattering analysis further reveals that the interference term from the scattering of the two beads contributes significantly to the signal, precluding the ability to resolve the positions of the individual beads in forward scattering. In QPD-based detection schemes, detection through backscattering, thereby, is imperative to track the true displacements of axially trapped microbeads for possible studies on light-mediated interbead interactions.

L-Methionine based phenolic compound mediates unusual assembly of AgNPs and exerts efficient anti-biofilm effect

A methionine based phenolic chelating ligand together with PSS, PVA, PVP and SDS capping agents produced an unusual self-assembly of AgNPs and strong anti-biofilm effect.

Electrochemical Performance of Electrophoretically Deposited Nanostructured LiMnPO4-Sucrose Derived Carbon Composite Electrodes for Lithium Ion Batteries

The present study reports an approach by which thin films of sucrose added olivine type LiMnPO4-Ccomposite and pristine LiMnPO4 is made by a technique of electrophoretic co-deposition in which pristine and composite samples were synthesized by a sol-gel route. These thin films with enhanced surface area is used to fabricate cathodes for rechargeable Li ion batteries. XRD confirms phase pure single crystalline orthorhombic structure. Transmission Electron Microscopy (TEM) images shows the carbon coating over LiMnPO4 and the particle size restricted in the nano regime. The presence of sp2 hybridized carbon on LiMnPO4 particles is confirmed by X-ray Photon spectroscopy (XPS). To explore the electrochemical behavior, cyclic voltammetry (CV) and cycling studies were performed. The specific capacity for LiMnPO4-C is found to be increased by 43% in comparison to the pristine LiMnPO4. It also exhibited 86% retention in capacity compared to the pristine LiMnPO4 (52%). The result indicates that a proper carbon coating can significantly improve the electronic conductivity and hence the specific capacity.

Electrochemical Performance of PbO2 and PbO2-CNT Composite Electrodes for Energy Storage Devices

In this work we report the electrochemical performance comparison of two new hybrid supercapacitors one based on graphene as negative electrode and lead dioxide thin film as positive electrode and the other with graphene as negative electrode and lead dioxide-carbon nanotube composite as positive electrode in 0.1 M KOH electrolyte. In the present work, PbO2 was synthesized using sol-gel method which is one of the promising materials for hybrid supercapacitors. The XRD confirmed the single phase of the PbO2 and the grain size is 39 nm which has been determined using Scherrer's formula. Thin films of PbO2, PbO2-CNT composite and graphene were coated on the titanium substrate by electrophoretic deposition. Further material characterisation has been carried out using SEM, TEM, XPS and electrochemical characterisation using CV, charge/discharge and electrochemical impedance spectroscopy (EIS) for obtaining energy density and power density, cyclic stability and internal resistance respectively. The present results revealed that PbO2-CNT composite/graphene asymmetric hybrid supercapacitor exhibits large specific capacitance and energy density over PbO2/graphene based system. The PbO2-CNT composite/graphene asymmetric hybrid supercapacitor exhibited maximum power density and energy density of 1200 W/Kg and 65 Wh/Kg respectively at a current density of 2 A/g. The PbO2-CNT composite/graphene asymmetric hybrid system exhibited excellent cycling stability with the capacitance retained 85% of its maximum value up to 3000 cycles.

Preparation, structural and morphological studies of Ni doped titania nanoparticles

TiO2 nanoparticles doped with different weight percentages (4%, 8%, 12% and 16%) of nickel contents were prepared by a modified sol-gel method using Titanium tetra iso propoxide and nickel nitrate as precursors and 2-propanol as a solvent. X-ray diffraction studies show that the as prepared and annealed products show anatase structure with average particle sizes running between of 8 and 16 nm. FTIR results demonstrate the presence of strong chemical bonding at the interface of TiO2 nanoparticles. The optical properties of bare and doped samples were carried out using UV-DRS and photoluminescence measurements. The surface morphology and the element constitution of the nickel doped TiO2 nanoparticles were studied by scanning electron microscope attached with energy dispersive X-ray spectrometer arrangement. The non linear optical properties of the products were confirmed by Kurtz second harmonic generation (SHG) test and the output power generated by the nanoparticle was compared with that of potassium di hydrogen phosphate (KDP).

Linear and nonlinear optical studies of bare and copper doped TiO2 nanoparticles via sol gel technique

In general, the nanoparticles of TiO2 may exist in the phases of anatase, rutile and brookite. In the present work, we used titanium terta iso propoxide and 2-propanol as a common starting material to prepare the precursors of bare and copper doped nanosized TiO2. Then the synthesized products were calcinated at 500°C and after calcination the pure TiO2 nanoparticles in anatase phase were harvested. The crystallite sizes of bare and copper doped TiO2 nanoparticles were calculated from X-ray diffraction analysis. The existence of functional groups of the samples was identified by Fourier transform infrared spectroscopy. The optical properties of bare and doped samples were carried out using UV-DRS and photoluminescence measurements. The surface morphology and the element constitution of the copper doped TiO2 nanoparticles were studied by scanning electron microscope fitted with energy dispersive X-ray spectrometer arrangement. The nonlinear optical properties of the products were confirmed by Kurtz second harmonic generation (SHG) test and the output power generated by the nanoparticle was compared with that of potassium di hydrogen phosphate (KDP).

Structural, optical and morphological analyses of pristine titanium di-oxide nanoparticles--synthesized via sol-gel route

Pure titanium di-oxide nanoparticles (TiO2) were synthesized by sol-gel technique at room temperature with appropriate reactants. The synthesis of anatase phase TiO2 nanoparticles was achieved by tetraisopropyl orthotitanate and 2-propanol as common starting materials and the product was annealed at 450 °C for 4 h. The synthesized product was characterized by X-ray diffraction analysis (XRD), Fourier transform infrared spectroscopy (FTIR), UV-VIS-Diffuse reflectance spectroscopy (DRS), Photoluminescence (PL) spectroscopy and Scanning electron microscopy (SEM) with Energy dispersive X-ray (EDX) analysis. XRD pattern confirmed the crystalline nature and tetragonal structure of synthesized composition. Average grain size was determined from X-ray line broadening, using the Debye-Scherrer relation. The functional groups present in the sample were identified by FTIR spectroscopy. Diffuse reflectance measurement indicated an absorption band edge on UV-region. The allowed direct and indirect band gap energies, as well as the crystallite size of pure TiO2 nanoparticles are calculated from DRS analysis. The microstructure and elemental identification were done by SEM with EDX analysis.

Sol-gel synthesis and characterization of pure and manganese doped TiO2 nanoparticles--a new NLO active material

Pure and Manganese (4%, 8%, 12% and 16%) doped titanium di-oxide (Mn-TiO2) nanoparticles were synthesized by sol-gel technique. The preparation of pure and Mn doped TiO2 nanoparticles were achieved by tetra-isopropyl orthotitanate and 2-propanol as common starting materials and the products were annealed at 450°C and 750°C to get anatase and rutile phases, respectively. The prepared materials were characterized by X-ray diffraction analysis (XRD), Fourier transform infra-red spectroscopy (FT-IR), UV-VIS-Diffuse reflectance spectroscopy (DRS), Photoluminescence (PL) spectroscopy, Scanning electron microscopy (SEM) with Energy dispersive X-ray analysis (EDX) and Kurtz powder second harmonic generation (SHG) test. XRD patterns confirmed the crystalline nature and tetragonal structure of synthesized materials. The functional groups present in the samples were identified by FTIR study. The allowed direct and indirect band gap energies, as well as the crystallite sizes of obtained nanoparticles were calculated from DRS analysis. Microstructures and elemental identification were done by SEM with EDX analysis. The existence of SHG signals was observed using Nd: YAG laser with fundamental wavelength of 1064 nm. The products were found to be transparent in the entire visible region with cut-off wavelengths within the UV region confirms its suitability for device fabrications.

Thin film rechargeable electrodes based on conductive blends of nanostructured olivine LiFePO4 and sucrose derived nanocarbons for lithium ion batteries

The present study provides the first reports of a novel approach of electrophoretic co-deposition technique by which titanium foils are coated with LiFePO4-carbon nanocomposites synthesized by sol gel route and processed into high-surface area cathodes for lithium ion batteries. The study elucidates how sucrose additions as carbon source can affect the surface morphology and the redox reaction behaviors underlying these cathodes and thereby enhance the battery performance. The phase and morphological analysis were done using XRD and XPS where the LiFePO4 formed was confirmed to be a high purity orthorhombic system. From the analysis of the relevant electrochemical parameters using cyclic voltammetry and electrochemical impedance spectroscopy, a 20% increment and 90% decrement in capacity and impedance values were observed respectively. The composite electrodes also exhibited a specific capacity of 130 mA h/g. It has been shown that cathodes based on such composite systems can allow significant room for improvement in the cycling performance at the electrode/electrolyte interface.

Assessment of the effect of probiotic curd consumption on salivary pH and streptococcus mutans counts

BACKGROUND

Antimicrobial methods of controlling dental caries that include probiotic agents can play a valuable role in establishing caries control in children at moderate to high risk for developing dental caries. Several studies have demonstrated the beneficial effects of use of various Probiotic products including curd. The objective of this study was to compare the effect of short-term consumption of probiotic curd containing Lactobacillus acidophilus and normal curd on salivary Streptococcus Mutans counts, as well as salivary pH.

MATERIALS AND METHODS

Forty, caries-free, 10-12 years old children were selected and randomly allocated to two groups. Test Group consisted of 20 children who consumed 200ml of probiotic curd daily for 30 days. Control Group consisted of 20 children who were given 200ml of regular curd for 30 days. Salivary pH and salivary Streptococcus Mutans counts were recorded at baseline and after 30 days and statistically compared using the Student's t-test.

RESULTS

Consumption of probiotic curd resulted in a statistically significant reduction in S. Mutans colony counts (P<0.001) as compared to regular curd. However, there was a slight reduction in pH (P>0.05) in both the groups.

CONCLUSION

Short-term consumption of probiotic curds can reduce oral S. Mutans counts. However, this caused a slight reduction in salivary pH.

Accidental ingestion of foreign object: Systematic review, recommendations and report of a case

One of the serious complications during a routine endodontic procedure is accidental ingestion/aspiration of the endodontic instruments, which can happen when proper isolation is not done. There are at present no clear guidelines whether foreign body ingestion in the gastrointestinal tract should be managed conservatively, endoscopically or surgically. A 5 year old boy reported to the Department of Pediatric and Preventive Dentistry, D.A. Pandu Memorial R.V. Dental College, Bangalore, India, with a complaint of pain and swelling in the lower right back teeth region. Endodontic therapy was planned for the affected tooth. During the course of treatment the child accidentally swallowed a 21 mm 15 size K file. Endoscopy was performed immediately but the instrument could not be retrieved. The instrument passed out uneventfully along with the stools 48 h after ingestion. Careful evaluation of the patient immediately after the accident helps in managing the patient effectively along with following the recommended guidelines.

Comparison of digital radiography and apex locator with the conventional method in root length determination of primary teeth

AIM

The purpose of this study was to compare the Working length in primary teeth endodontics using intra oral digital radiovisiography and apex locator with conventional method for accuracy.

MATERIALS AND METHODS

This in vivo study was conducted on 30 primary teeth which were indicated for pulpectomy in the patients of the age group of 5-11 years All experimental teeth had adequate remaining tooth structure for rubber dam isolation and radiographicaly visible canals. Endodontic treatment was required due to irreversible pulpitis or pulp necrosis. A standardized intraoral periapical radiograph of the tooth was taken using conventional method by paralleling technique. The distance between the source and the tooth, tooth and the films were standardized using X-ray positioning device. During the pulpectomy procedure, the working length was determined by digital radiograph and apex locator. The measurements were then compared with the conventional method of root canal measurement technique for accuracy.

RESULT

From the results obtained we can conclude that Working length determined in primary molars using digital radiography and Apex locator did not show any significant difference in the mean working length measurements when compared with the conventional radiographic method.

CONCLUSIONS

Apex locator is comparable to conventional radiograph in determining the working length without radiation in the primary teeth. Intraoral digital radiography is the safest method in determining the working length with significant reduction in radiation exposure.Hence, both the techniques can be safely used as alternatives to conventional radiographic methods in determining working length in primary teeth.

Study of arsenic content in mine groundwater commonly used for human consumption in Utah

Of the various sources of arsenic released in to the environment, the presence of arsenic in water probably poses the greatest threat to human health. Arsenic is released in to the environment through water by dissolution of minerals and ores. Natural release is slow, but in some areas the concentration of arsenic in groundwater (commonly referred to as Acid Mine Drainage (or AMD)) is accelerated by mining activity. In fact the presence of arsenic may last a long time even after the mining activity has ceased. Hence it is imperative to study the quality of water (especially for those areas in the vicinity of mines) used for different purposes to identify an appropriate remediation technique for effective pollution control. In this paper, contents of arsenic and other metals in the water were quantified from three different sources: (1) groundwater from the mining tunnel (Judge tunnel), (2) drinking water, and (3) water used in the hydrant-flushed distribution system (Park City) in Utah (USA). The results showed the content of arsenic from the mining tunnel, after chlorination, and in tap water were below 10 microgl(-1). However, significant amounts of arsenic, lead, zinc, iron, manganese and antimony have been found in water samples taken from the distribution systems. In the consideration of the further use of mine groundwater for drinking purposes and the distribution system, Park City should regularly be maintained by a flushing program in the distribution system.

Secondary prevention of osteoporosis: Calcium, Vitamin D and bisphosphonate prescribing following distal radial fracture

Over 200,000 osteoporotic fractures occur in the UK annually. Patients with fragility fractures are at highest risk of further fracture, though preventative treatment has been shown to reduce subsequent fracture incidence. We reviewed the pre- and post-fracture medication (via the PCTs and in-patient discharge letters) of all patients over 55 years who suffered a distal radial fracture between April 2003 and November 2004. Complete data was available for 175 patients (170 female): 95 were in-patients, 80 out-patients. Following distal radial fracture, calcium and Vitamin D was prescribed for 39 patients (22%), bisphosphonates to 16 patients (9%) and only 15 patients (8.5%) were referred for DEXA scanning. Higher rates of prescribing were seen in hospital, with over half of all in-patients started on fracture prevention treatment; however, less than a half of these patients continued to receive this medication in primary care. We believe, the results demonstrate a lack of health promotion opportunities to prevent future fracture, which is a common finding across healthcare systems nationally. Although there is clear focus and impetus for developing falls prevention services nationwide, this enthusiasm has not been translated across to bone health, despite the potential savings in terms of morbidity, mortality and healthcare costs. Important deficiencies in local services have been identified, particularly with respect to communication between secondary and primary care. This study has added weight to secure funding for a fracture liaison nurse in our institution; we suggest others follow suit and employ similarly dedicated personnel to ensure assessment and treatment for the prevention of further fractures.