Unusual problems in renal hypertension.

Ten cases of renal hypertension with uncommon causes were presented and unusual problems in their diagnosis and surgical management were discussed. These causes included segmental stenosis involving aberrant renal artery, renal artery stenosis in association with renal arteriovenous fistula, postoperative renal hypertension and hypertension secondary to renal tuberculosis. A high index of clinical suspicion and increasing awareness will help in diagnosing such rare and unusual cases of renal hypertension.

Anterior maxillary osteotomy: A technical note for superior repositioning: A bird wing segment.

AIM: The aim of this study is to evaluate the efficacy of a single piece bird wing osteotectomy segment during anterior maxillary osteotomy (AMO) markedly reduces the duration of the surgery by nearly one-half of the time during bone removal with the conventional method thereby reducing the kinking effect to the palatal pedicle and gives good perfusion to the anterior segment. MATERIALS AND METHODS: This study was conducted at Karpaga Vinayaga Institute of Dental Sciences composing of 20 patients in which male: female ratio was 8:12, with a mean age of 25-30 years. This bird wing segment technique is performed following presurgical orthodontics under the guidance of clinical assessment of the gummy smile with an incisal show when the lip is at repose (vertical maxillary excess), especially for the calculated amount of superior repositioning. It is calculated by subtracting 2 mm from the total amount of an incisor show when the lip is at repose. The normal incisal show when the lip is at repose is 2 mm. After conventional primary AMO cut was performed, the precise calculated. RESULTS: All our cases were tested positive for pulp vitality, no relapse, and minimal edema and with no changes in the bite or dentoalveolar relation followed until 1 year postoperatively indicating a good perfusion to the anterior segment and all the patients were satisfied esthetically and free of complaints. CONCLUSION: This simple technique allows the precise amount of calculated bone removal in a single piece from the nasal floor markedly reduces the duration of the surgery by nearly one-half of the time during bone removal with the conventional method there by reducing the kinking effect to the palatal pedicle and maintains good perfusion.

A new atraumatic method of removing fractured palatal root using endodontic H-files luted with resin modified glass ionomercement: A pilot study.

PURPOSE: The purpose of this study is to evaluate the efficacy of using endodontic H-files luted with Resin modified glass ionomer cement (RMGIC) in removing fractured palatal root. MATERIALS AND METHODS: This study consists of 30 patients, of which 16 were males and 14 were females with a mean age of 36 years. In which, 19 were maxillary first molar and 11 were maxillary second molar. In that, 18 were fractured at the level of apical 1/3(rd) and 12 were at the level of apical 2/3(rd). All cases were first tried with endodontic H-files, within few attempts, it was wedged tightly in the remaining pulp chamber with one or two clockwise direction and using sudden jerk with a downward pull the remnant part was removed. The cases, which fail to deliver after several attempts were taken up for study. After sufficient isolation with a rubber dam and the socket was dried using sterile gauze, under good lighting and vision again the same file was introduced, which was now luted with RMGIC, after 5 min of setting time, the same attempt using sudden jerk with a downward pull was given. RESULTS: In those 30 cases, 20 cases were removed in the first few attempts using endodontic H-files. The 10 cases (7 cases were apical 2/3(rd) and 3 cases were of apical 1/3(rd)), which fails to come out were tried using endodontic H-files luted with RMGIC, in which 9 cases were successfully removed (90%) and 1 case of apical 1/3(rd) was again failed to come out. CONCLUSION: Even though, the number of cases were too small to come to a definitive conclusion, the encouraging result (90%) and technically easy, this is a novel method of removing fractured palatal root atraumatically and devoid of any complication.