Clinical Trial to Assess Physiology and Activity of Masticatory Muscles of Complete Denture Wearer Following Vitamin D Intervention.

Background and Objectives: Little information is available on the role of Vitamin D as a micro-nutrient deficiency with masticatory muscle efficiency and its effect on the function of removable prosthesis. The aim of this study was to evaluate the role of vitamin D on masticatory muscle activity among completely edentulous patients and its effect on the retention of removable complete dentures (RCDs). Materials and Methods: A non-randomized clinical control trial was conducted on completely edentulous patients (60.53 ± 7.01 years) in the Indian population between 2017 and 2019. Subjects were evaluated for temporomandibular disorders according to the Diagnostic Criteria for Temporomandibular Disorders (DC/TMD). Serum Vitamin D (S Vit D) levels, Ultrasonography (USG), and surface Electromyography (sEMG) readings of the masseter muscle were recorded at enrolment (Level 0), after 3 months of Vitamin D therapy (Level 3), and after consecutive 3 months of maintenance therapy, i.e., after 6 months from baseline (Level 6). The fabrication of new RCDs was done for all after the enrolment, and the retention of RCDs was assessed by asking a question regarding denture retention and asking respondents to mark their satisfaction on a 5-point Likert scale. Data were analysed using ANOVA, Paired'-test and Pearson correlation coefficients. A p-value less than 0.05 indicated a statistically significant association. Results: Between enrolment and a six-month follow-up, S Vit D levels showed an increase from 16.03 ± 5.68 ng/mL to 31.35 ± 9.28 ng/mL, showing an increase of 15.32 ± 9.38 ng/mL (95.57% rise). Statistically significant values were observed for USG and sEMG. Conclusions: Results showed that S Vit D affects masticatory muscle activity by improving its thickness and boosting its tonicity. Healthy muscles assist in the retention of RCDs, consequently aiding in mastication, speech, and phonetics, hence improving patient satisfaction. Clinical implication: Acknowledging the fact that the prevalence of Vitamin D deficiency is worldwide. We suggest Vitamin D therapy as a nutritional intervention among the elderly completely edentulous population, following dietary counselling, and consider Vitamin D therapy to be an adjunct to nutritional counselling for improving masticatory muscle activity and efficiency, which aids in RCD retention and stability. Consequently, improving oral health-related quality of life for individuals.

A Unique Appliance for Median Facial Cleft Management With Sleep Apnea due to Undeveloped Nasal Septum: A Rare Case Report.

The role of a prosthodontist in the management of facial cleft patients is the restoration of feeding, respiration, facial harmony, dental harmony and phonation. This case report presents the fabrication of an appliance for a pediatric patient with congenital median facial cleft who had sleep apnea due to the absence of nasal septum, which is a rare condition, with a unique method that fulfilled the patient's needs and improved quality of life. The patient also had median cleft lip and premaxilla along with hypertelorism.

Dental esthetics and its impact on psycho-social well-being and dental self confidence: a campus based survey of north Indian university students.

To evaluate the subjects perceived satisfaction of their dental appearance and to compare it with a various attitudes and practices which may affect social and psychological behavior and dental self confidence. This was a questionnaire based cross-sectional study done in the campus of Aligarh Muslim University, Aligarh (India). 426 students participated in the study. Questions were pooled in from various components of psychosocial impact of dental esthetics questionnaire (PIDAQ) for various attitudes and practices. Quantitative analysis was done using descriptive analysis and Chi square test using SPSS software. Majority of subjects (57.7 %) was highly satisfied with their smile, more than one-third (37.3 %) were satisfied and there were only 4.9 % subjects who were not satisfied with their smile. Tooth color was the most common (27.9 %) smile component causing dissatisfaction amongst the subjects. More than two-fifth (42.5 %) liked to show their teeth, one-half (49.5 %) liked to see their teeth in mirror, photographs and videos, almost one quarter (23.9 %) subjects used to hide their teeth while smiling. As compared to females, significantly higher proportion of males was conscious of opposite sex while smiling. The proportion of subjects which was highly satisfied with their smile was significantly higher for the item 'like to show their teeth and who liked to see their teeth in mirror, photographs and video' whereas for all the other items the proportion of respondents which was not satisfied with their smile was significantly higher. Self perceived satisfaction of dental esthetics has positive impact on person's social and psychological behavior and dental self confidence.

Comparison of Microleakage in Nanocomposite and Amalgam as a Crown Foundation Material Luted with Different Luting Cements under CAD-CAM Milled Metal Crowns: An In Vitro Microscopic Study.

Microleakage is a persistent problem despite advancement in materials and techniques in fixed prosthodontics. This leads to the importance of sound crown foundation material and luting agents used to maintain the marginal seal. The literature is deficient with studies, comparing microleakage under various crown foundation materials and luting agents, especially with CAD-CAM (computer-aided design and computer-aided manufacturing) metal crowns. This study was aimed to compare microleakage in a nanocomposite/dentinal bonding agent and amalgam/cavity varnish as crown foundation materials luted with two different luting cements: resin-reinforced glass ionomer cement and self-adhesive resin cement, under both dry and contaminated conditions. A hundred intact, caries-free human molars were prepared to receive crown foundation material and extra coronal restorations. Amalgams with cavity varnish and nanocomposites with dentinal bonding agent in both ideal and contaminated conditions were used as crown foundation materials. After restoration, each sample was cemented with a CAD-CAM milled metal crown using two different luting agents-resin-reinforced glass ionomer cement and self-adhesive resin cements both in ideal and contaminated conditions. Cementation was followed by thermocycling of samples, immersion in erythrosine B dye, embedding in clear auto polymerizing acrylic resin and sectioning to evaluate microleakage using stereomicroscope. The mean microleakage between different luting cements on the experimental side of the facial surface was 137.64 µm and 211.01 µm for resin-reinforced GIC and for self-adhesive resin cement was 119.78 µm and 150.42 µm, under ideal and contaminated condition, respectively. There was a significant difference in mean micro-leakage between different crown foundation material and cement groups used in the study. The composites and amalgam, both when used as crown foundation material and luted with use of technically advanced CAD-CAM metal crown with self-adhesive resin cement (in both ideal or contaminated condition), showed less microleakage than in resin-reinforced glass ionomer cement. Overall, the self-adhesive resin cement showed comparatively reduced microleakage in all combinations with different crown foundations. Thus, this combination can be used in daily clinical practice to provide better protection from further decay.

EEG abnormality as a prognostic factor in cirrhotic patients with Grade III-IV hepatic encephalopathy requiring mechanical ventilation: A retrospective analysis.

BACKGROUND AND AIM: Hepatic encephalopathy is a serious complication that entails liver cirrhosis with a high mortality rate. The Child- Turcotte-Pugh class (CTP class) and model for end-stage liver disease (MELD) score are two important prognostic indicators for cirrhosis, while sequential organ failure assessment (SOFA) is a dynamic score for the assessment of critically ill patients. Patients with liver disease with advanced CTP class and higher MELD scores have poor prognosis. The aim of this study was to evaluate the role of electroencephalography (EEG) in cirrhotic patients requiring ventilator support for hepatic encephalopathy Grade III-IV. METHODS: A retrospective study was conducted on patients admitted to the liver intensive care unit (ICU) of a tertiary teaching institute. EEG records of 92 patients with Grade III-IV hepatic encephalopathy who were admitted between April 2015 and May 2017 to the liver ICU were analyzed. The correlation between EEG findings and 28-day mortality, ICU length of stay, and the number of days on mechanical ventilation was determined. RESULTS: Seventy-eight of 92 patients (85%) exhibited bilateral slowing EEG pattern, suggestive of encephalopathy. A triphasic pattern was the most common EEG abnormality in 40% (31 of 78) of the patients. Patients with abnormal EEG had a significantly higher MELD score compared to those with a normal EEG (P=0.02). There were no significant differences in length of mechanical ventilation between both groups, but an increasing trend was observed in those with abnormal EEG (P=0.09). CONCLUSION: EEG findings correlate well with severity of disease in critically ill patients with liver disease. RELEVANCE FOR PATIENTS: EEG has a role in monitoring and prognostication of hepatic encephalopathy in critically ill patients with liver disease.

Recent apprise on coronavirus and its terrible insinuations.

Epidemically increased evidence reveals that the link between the 2019-nCoV and other similar strain of coronaviruses circulating in bats and specifically the Rhinopodous bat sub-species. These sub-species are ample and widely present in Southern China, Middle East Africa and Europe. Recent studies show that more than 500 CoV have been identified in bats in China. The Center for Diseases Control and Prevention and the World Health Organization maintains a website that is updated frequently with new cases of MERS-CoV infection. As per WHO Situation report 16th, 24,554 number of cases confirmed globally out of which 99.22% cases from china. A new coronavirus (2019-nCoV) is causing respiratory syndrome mostly in Hubei Province, China. Corona Virus spread over 24 countries including Japan, India, Korea, and other countries 2019-CoV infection vary from mild, moderate or severe illness; the later includes severe pneumonia, ARDS, sepsis and septic shock. There are two diagnostic tests for coronavirus infection i.e. molecular test and serology test. In this review article there are the various recent cases of the patients that are suffering from the corona virus, the outcome of these studies is that corona virus infection is an epidemic disease which affects Central Nervous System (CNS).