Comparative evaluation on wear resistance of metal sleeve, sleeve-free resin, and reinforced sleeve-free resin implant guide: An in vitro study.

BACKGROUND: In-office three-dimensional (3D) printers and metal sleeveless surgical guides are becoming a major trend recently. However, metal sleeve-free designs are reported to be more prone to distortion which might lead to variation in the inner diameter of the drill hole and cause deviation and inaccuracy in the placement of the implant. Carbon fiber nanoparticles are reported to improve the properties of 3D printing resin material in industrial application. AIM: The purpose of the study is to evaluate and compare the wear resistance of 3D-printed implant guides with metal sleeve, sleeve-free, and reinforced sleeve-free resin to the guide drill. MATERIALS AND METHODS: A total of 66 samples with 22 samples in each group. Three groups including 3D-printed surgical guide with metal sleeve (Group A), without metal sleeve (Group B), an carbon fiber reinforced without metal sleeve (Group C) were included in the study. All samples were evaluated before sequential drilling and after sequential drilling using Vision Measuring Machine. The data were tabulated and statistically evaluated. RESULTS: The data obtained were statistically analyzed with one-way analysis of variance and posthoc test. The data obtained for wear observed in the samples showed that the wear was highest in Group B with a mean of 0.5036 ± 0.1118 and the least was observed in Group A with a mean of 0.0228 ± 0.0154 and Group C was almost similar to Group A with mean of 0.0710 ± 0.0381. The results showed there was a significant difference between Group B with Group A and C, respectively (P < 0.05). The results showed that there was no significant difference regarding the wear observed between Groups A and C (P > 0.05). CONCLUSION: The wear observed in the guide with a metal sleeve and carbon fiber reinforced without a metal sleeve was almost similar. The carbon fiber-reinforced guide showed better tolerance to guide drill equivalent to metal sleeve. Thus, carbon fiber nanoparticles reinforced in 3D printing resin have shown improved strength and can be used as a good replacement for a metal sleeve for an accurate placement of the implant.

The Role of Salivary Lactate Levels in assessing the Severity of Septic Shock.

Background: Sepsis is a major worldwide cause of morbidity and mortality. Hence, rapid and reliable diagnosis is essential. Emergency departments use a standard measure of sepsis, based upon an elevated Lactate level in blood. Saliva is more readily available and easier to obtain than blood samples, and is increasingly being studied as a new source of diagnostic information. Aim: This study aimed to evaluate whether analysis of Lactate levels in saliva can substitute for that of Lactate levels in blood. Methods/Materials: We processed saliva samples and serum samples from septic shock and non-septic shock patients. We found out Lactate levels in both the group. We plotted the concentration of Lactate in non-septic and septic patients and compared lactate levels in saliva to its levels in blood.Statistical analysis: Results were statistically analyzed by independent sample t test and A Spearman rho correlation. Results: We found increased serum and salivary Lactate levels in all cases of sepsis compared to the control group. Notably, the increase in Lactate levels was higher in serum as compared to saliva in septic patients, suggesting saliva may not serve as a better indicator of sepsis compared to blood. Salivary lactate was more in septic shock patients compared to non-septic shock patients. Conclusions: To our knowledge, this is the first study to compare lactic acid levels in serum and saliva in cases of sepsis. The increase in serum lactate in patients with sepsis is evident when compared to increase in salivary lactate, so serum lactate level would be easier for physicians to differentiate septic patients from non-septic patients. Salivary lactate may not serve as better indicator in septic shock patients.

Comparative Evaluation of Ion Release in Bonded and Nonbonded Stainless Steel Brackets with Use of Different Mouthwashes: An In vitro Study.

BACKGROUND: Orthodontic treatment is a long-term procedure that involves the usage of brackets and archwires which are mainly metallic in nature. This study evaluated the levels of metal ions release from bonded and nonbonded orthodontic brackets after immersion in distilled deionized water and three different types of mouthwash. MATERIALS AND METHODS: Eighty premolar stainless steel brackets (3M, Unitek) were divided into Group A (bonded brackets) and Group B (nonbonded brackets). Each group was further subdivided into four subgroups to analyze the release of ions from three different types of mouthwash along with the control group. All the samples were incubated at 37°C for 45 days, and immersion solutions were tested in inductively coupled plasma-optical emission spectrometer for the release of free metal ions. RESULTS: Mean ion release in the bonded bracket group was less than that of nonbonded bracket group. Ion release in control subgroup of both groups was 0.18 ± 0.08 µg/dl (A1) and 0.17 ± 0.06 µg/dl (B1); in Phos-Flur mouthwash subgroup was 0.12 ± 0.06 µg/dl (A2) and 0.13 ± 0.05 µg/dl (B2); in chlohex mouthwash subgroup was 0.13 ± 0.06 µg/dl (A3) and 0.14 ± 0.06 µg/dl (B3); in Hiora mouthwash subgroup was 0.10 ± 0.06 µg/dl (A4) and 0.12 ± 0.05 µg/dl (B4). CONCLUSIONS: The mean ion release was the highest in deionized water (control group) followed by chlohex, Phos-Flur, and Hiora in both Group A and Group B. Ion leaching from bonded brackets was less compared to nonbonded brackets in all different mouthwashes except in the control group. However, this difference was statistically insignificant (P > 0.05) between all the groups.

Assessment of fragile histidine triad expression in ameloblastoma, odontogenic keratocyst and dentigerous cyst.

BACKGROUND: FHIT (Fragile histidine triad) a member of tumor suppressor family, has been extensively studied in many solid tumors including head and neck squamous cell carcinoma. Among all head and neck cyst and tumors odontogenic lesions account approximately 3%-9%. The molecular pathogenesis of these lesions is less explored. Defects in cell cycle regulators and tumor suppressor genes could result in the development of odontogenic cyst and tumors. Hence, we aimed to determine the significant role of a tumor suppressor gene FHIT in most commonly occurring odontogenic lesions mainly ameloblastoma, odontogenic keratocyst and dentigerous cyst. SUBJECTS AND METHODS: Immunohistochemical analysis of FHIT was done in ameloblastoma, odontogenic keratocyst, dentigerous cyst and dental follicle. Interpretation of the stained slides were done using standard scoring criteria by two pathologist. The results were subjected for statistical analysis. RESULTS: Expression of FHIT varied among the groups, with highest negative expression in ameloblastoma 44.4% followed by odontogenic keratocyst 14% and 100%positive expression was seen in dentigerous cyst. The expression levels between the groups were statistically insignificant. CONCLUSION: The varied expression or negative expression of FHIT could be considered as an indicator for aggressive behavior and transformation of preneoplastic/cystic epithelium.

Psychiatric comorbidities in acute coronary syndromes: Six-month follow-up study.

INTRODUCTION: Acute coronary syndrome (ACS) caused by coronary atherosclerosis include ST-segment elevation myocardial infarction (STEMI), non-STEMI, and unstable angina. The relation between psychiatric disorders and coronary artery disease is a complex one which includes the effect of the psychosocial factors on heart and vice versa. Point prevalence studies have been reported, but there is paucity of follow-up studies from India. MATERIALS AND METHODS: The study is a follow-up evaluation at discharge of 248 consecutive patients presented with ACS at JSS Hospital, Mysuru, Karnataka, over a period of 6 months to assess the psychiatric comorbidities. The patients were assessed on a structured and validated pro forma before discharge, at 3 months, and at 6 months. Screening of psychiatric disorders was done using Mini International Neuropsychiatric Interview PLUS 5.0.0 and assessment of depression was done using Hamilton Depression Rating Scale. ANOVA, Student's t-test, and SPSS 21 were used for statistical analysis. RESULTS: The most common psychiatric comorbidities include major depressive disorder (44%), it persisted at the end of 3 (P < 0.001) and 6 (P < 0.001) months. A spectrum of anxiety disorders including panic disorder (12.10%), dysthymia (3.60%), agoraphobia (2.40%), social phobia (2%), obsessive-compulsive disorder (1.6%), specific phobia (1.2%), and posttraumatic stress disorder (0.8%) in descending order at the end of 6 months were found. Significant reduction in substance use of nicotine (66.1%) and alcohol (56.0%) was reported on follow-up. CONCLUSION: Depression, anxiety, and substance use occur in patients with ACS which persist on follow-up. Early recognition at discharge and appropriate counseling on follow-up improve the clinical outcomes.

Diagnostic and surgical aspects of central hemangioma of mandible: a surgical approach for the reconstruction of mandible.

Intraosseous vascular lesions are rare lesions, accounting for 0.5-1% of all intraosseous tumors. They were found to be affecting the second decade of life, more frequent in women. The frequency found affecting the vertebral column and skull; the mandible is a quite rare location. At present, according to the World Health Organization, these lesions are now considered as benign vasoformative neoplasms of endothelial origin. However, the origin of the central hemangioma is debatable. Some authors state it as a true neoplasm, few state it is a hamartoma. On examination, the patient may or may not show any symptoms, some present discomfort, blood discharge, bluish discoloration, mobility of the teeth. The radiographic finding is a multilocular radiolucenies with classic honeycombs or soap bubble appearance. Differential diagnosis includes odontogenic lesions like ameloblastoma, cystic lesions such as residual cyst, central giant cell tumor, fibrous dysplasia. The wide surgical excision along with the reconstruction is choice of treatment of hemangioma. We present a case report of a 24-year-old female diagnosed with intraosseous mandibular hemangioma and surgical reconstruction of mandible with rib graft.

Do tobacco stimulate the production of nitric oxide by up regulation of inducible nitric oxide synthesis in cancer: Immunohistochemical determination of inducible nitric oxide synthesis in oral squamous cell carcinoma--a comparative study in tobacco habituers and non-habituers.

BACKGROUND: Oral cancer accounts for 6% of all cancers. The most prevalent form of oral cancer is oral squamous cell carcinoma (OSCC), which accounts for 90% of the oral cancer cases. The major risk factor for development of OSCC is the use of tobacco in various forms. NO has been studied widely over the years due to its role in various physiological and pathophysiological processes, including its complex role in carcinogenesis. MATERIALS AND METHODS: A total of 20 cases of OSCC in tobacco habituers and tobacco non-habituers were retrieved respectively from the archival biopsy specimens. Immunohistochemistry was done to assess the inducible nitric oxide synthase (iNOS) protein. RESULTS: This study was performed to assess the correlation between tobacco and nitric oxide in OSCC in order to know the association of these two in the process of carcinogenesis. The results showed the enhanced expression of iNOS in tobacco habituers in comparison with tobacco non-habituers. Though the increased expression of iNOS is found, significant difference is not obtained with scores, but significant difference was found with intensity of staining. CONCLUSIONS: The results of the present study indicate the enhanced expression in OSCC of tobacco habituers when compared to OSCC of tobacco non-habituers indicating the effect of tobacco on nitric oxide. Carcinogenic chemical compounds in Tobacco induce nitric oxide production by iNOS, by its tumor-promoting effects which may enhance the process of carcinogenesis.

Prevalence of recurrent aphthous ulceration in the Indian Population.

OBJECTIVE: Patients with an oral ulcer may present initially to a general physician or a dental practitioner. Majority of the ulcers are benign and resolve spontaneously but small proportions are malignant. The aim of the present study was to determine the prevalence of recurrent aphthous ulcerations in the Indian population. MATERIAL AND METHODS: 3244 patients attending the Department of Oral Medicine and Radiology during the period from November, 2010 to December, 2012 with various complaints were examined. Of the patients examined 1669 were females and 1575 were males. RESULTS: 705 patients presented with recurrent aphthous ulceration (21.7%). Females (56.3%) were more commonly affected than males (43.7%). Patients in the third and fourth decade were most commonly affected. Stress was the most common factor associated with recurrent aphthous stomatitis (386 patients). 54.5% patients did not take any medications and 72.9% patients opined that the condition needed no dental consultation. CONCLUSION: The results of the present study indicate that recurrent aphthous ulceration is a common mucosal disorder in the Indian population. The early and proper diagnosis of the ulcers will help the dental practitioner in providing information to the patient regarding awareness and management of the condition. Key words:Recurrent aphthous ulcers, prevalence, Indian population.

Cytokeratin 14 and cytokeratin 18 expressions in reduced enamel epithelium and dentigerous cyst: Possible role in oncofetal transformation and histogenesis- of follicular type of adenomatoid odontogenic tumor.

INTRODUCTION: Odontogenic cysts and tumors arise from the structures and remnants associated with tooth development. Cysts and tumors derived from the odontogenic tissues constitute an unusually diverse group of lesions. This diversity reflects the complex development of the dental structures, since all these lesions originate through some alteration from the normal pattern of odontogenesis. Cytokeratin (CK) 14 is the typical intermediary filament of odontogenic epithelium, CK 18 is the major components of the intermediate filaments of simple or single layered epithelial tissue; it is not expressed in stratified squamous epithelium. The present study was undertaken to understand the expression pattern of these cytokeratins in dentigerous cyst, dental follicular tissue, adenomatoid odontogenic tumor (AOT) and unicystic ameloblastoma. MATERIALS AND METHODS: The present study consists of 60 specimens consisting of 20 samples of Dentigerous cyst, 20 samples of Reduced enamel epithelium/dental follicles, 10 samples of Follicular type of AOT, 10 samples of unicystic ameloblastoma. The sections of these specimens were stained for CK 14 and CK 18. The number of cells positive for CK 14 and CK 18 was counted per 100 cells. The cells were counted in four randomly selected high-power fields and the mean was calculated. Scoring of cytokeratin 14 expressions was done using Remmele score. RESULTS: The highest expression of cytokeratin 14 was noted in AOT, least was seen in dental follicle/Reduced enamel epithelium (REE). CK18 was negative in all the cases included in the present study. CONCLUSION: In the present study, the expression of CK14 was noted in AOT, Dentigerous cyst (DC), Unicystic Ameloblastoma (UCA) and Dental follicle/REE. The expressions between these lesions were compared. These expression pattern may provide an insight to the histogenesis of AOT.

Evaluation of the effect of different surface treatments on the retention of posts: a laboratory study.

BACKGROUND AND OBJECTIVES: There are numerous post and core systems variety of materials. Several methods are used to increase the retentive strength.The present study was conducted with the purpose of analysis of the effect of surface treatment with ethyl alcohol, resin primer and air-borne alumina particle abrasion on retention of glass fiber posts, carbon fiber posts and cast metal posts MATERIALS AND METHODS: Surface treatment of glass fiber posts, carbon fiber posts and cast metal posts was done with ethyl alcohol, resin primer and air-borne alumina particle abrasion and cemented with dual cure resin cement into the post spaces prepared in the teeth. For the Retentive force test, a screw driven universal testing machine was used to apply tensile load to the post. The force required to dislodge each post from prepared post space was recorded. STATISTICAL ANALYSIS: Comparison of the mean retentive strength was done using two-way Analysis of Variance (ANOVA) followed by Bonferroni method for multiple comparisons. RESULTS: Significant difference in the retentive strength between air borne alumina particle abrasion and resin primer treated posts was (P < 0.001) noticed. Further, there was no significant difference between ethyl alcohol and resin primer treated posts. CONCLUSION: Air-borne alumina particle abrasion increased the retentive strength of all the type of posts used in this study. Treating the surface of the posts with resin-primer and ethyl alcohol produced no statistically significant difference in the retentive strength.

A Combined Surgical and Prosthetic Approach for the Successful Management of a Mutilated Eye Socket: A case report.

Facial disfigurement through the loss of an eye due to a road traffic accident can be devastating for the patient and may leave few options for an ophthalmologist, especially if the situation demands urgency. In the present case report, the patient had a major accident, which resulted in the severe disruption of the socket. The requirements of the prosthodontist regarding the morphology of the socket guided the ophthalmologist to undertake reconstructive surgery. The prosthesis was then fabricated such that both its longevity and the morphology of the socket were safe guarded.