Optimal sites for mini-implant insertion in the lingual or palatal alveolar cortical bone as assessed by cone beam computed tomography in South Indian population.

OBJECTIVES: To determine the optimal sites of mini-implant placement in the palatal alveolar cortical bone by using cone beam computed tomography (CBCT). SUBJECTS AND METHODS: Cone beam computed tomography records of 60 patients were divided into two groups of equal sizes, based on age and sex. The images were analysed using Planmeca Romexis Software (Version 4.1.2). The measurements were made in axial sections of the maxilla and mandible, at 2, 4 and 6 mm from the CEJ. The optimal sites were defined in terms of (a) Palatal or lingual alveolar cortical bone thickness and (b) Mesiodistal palatal or lingual inter-radicular width. RESULTS: The optimal site for mini-implant insertion, anteriorly, was the canine-lateral incisor embrasure in both the jaws. Posteriorly, the inter-molar embrasure in the mandible and the molar-premolar embrasure in the maxilla were optimal sites. Females demonstrated significantly lesser bone widths in all areas of the maxilla (P < .05) but greater bone thickness in the mandibular regions, as compared to males. The adolescent age group demonstrated a significantly lesser bone thickness but greater mesiodistal widths than the adult population in both the jaws (P < .05). CONCLUSION: The optimal sites for mini-implant insertion were the anterior canine-lateral incisor and posterior buccal inter-radicular embrasures, in both the jaws. Significant differences existed between age and gender groups, which need to be kept in mind while choosing the locations for placing mini-implants.

Knowledge, attitude and practice on exposure to Bisphenol A among dental surgeons in Southern India.

BACKGROUND: Bisphenol A (BPA) is a product in the manufacture of Bis-GMA, which is commonly used in dentistry, and is known to have a number of adverse effects. OBJECTIVES: The aim of this study is to evaluate to assess the knowledge, attitude and practice based on exposure and handling of BPA containing materials among dental surgeons for better understanding about the level of care rendered to the patients. MATERIAL AND METHODS: A questionnaire survey was conducted on 400 dental surgeons in Southern India. The questionnaire consisted of 20 objective type questions out of which ten questions assessed knowledge and five questions assessed the attitude and five questions to understand the practice related measures taken by the dentist. The data collected were analysed using SPSS version 23. RESULTS: A total of 402 responses were collected for this online questionnaire survey over a period of 2 months. It was found that females showed higher knowledge and attitude towards exposure to BPA which was statistically significant when compared to males. It showed that dentists with more than 20 years of practice had a higher level of knowledge. Though most of the groups agreed fairly on safety practice to be undertaken related to BPA exposure in their clinics, the ones with experience more than 20 years displayed the least positive attitude and dentists with 6-10 years of practice had the least positive behaviour among all. CONCLUSIONS: In spite of having a good knowledge regarding the harmful effects of BPA, dental surgeons are not very cautious while using materials containing them on a regular basis. Therefore, there is a need to enhance the awareness with the help of Continuing Dental Education programs or proper instructions on the packaging.

Radiographic and histochemical assessment of root resorption during canine retraction through piezocision site.

Introduction: The number of adult patients seeking orthodontics treatment has increased drastically. There is increased need for faster tooth movement and good esthetics. Piezocision is one of the methods used for accelerating the rate of tooth movement. Aims and Objectives: To assess the amount of root resorption after retraction of canine through piezocision site and compare it with that of recently extracted site using cone-beam computed tomography (CBCT) and assessment of dentin sialoprotein (DSP) levels in gingival crevicular fluid (GCF). Materials and Methods: A split mouth design was used in 15 patients who were undergoing first orthodontic treatment with premolar extractions. Randomly one of the sides was chosen as control (Group I) and the other side underwent piezocision procedure (Group II). 0.022 × 0.028'' MBT system was used with 0.017 × 0.025 SS wire for canine retraction using 150 grams of force. GCF samples were collected from mesio-buccal and disto-buccal of the canine with micropipette at baseline (TO) and day 90(T1) to detect the levels of DSP and the root resorption was measured using CBCT. Results: Statistically significant amount of root resorption was observed after retraction in both the groups. DSP levels were increased in both the groups, though little higher in Group II when compared to group I. Conclusion: DSP level was increased on the piezocision side but it was statistically insignificant which suggests the amount of root resorption on both the sides is similar.

Assessment of dentofacial widths in adults with anterior open bite.

CONTEXT: Anterior open bite is a complex condition involving a combination of various dental and skeletal components in three dimensions. The data on the differences and changes in the transverse relation in individuals with anterior open bite are limited. AIMS: To assess the dental arch widths in individuals with anterior open bite using study casts and facial widths using frontal cephalogram and to compare these widths with that of individuals without anterior open bite. MATERIALS AND METHODS: Eighty adults [40 with and 40 without anterior open bite, mean (standard deviation) age = 20.68 years] were selected. The study group was divided into skeletal (n = 19) and dental (n = 21) open bite groups according to Jarabak's ratio. Posteroanterior cephalograms and study casts were analyzed. RESULTS: The mean width of zygomatic arch (112.18 mm) and condylar region (100.55 mm) in the control group was significantly higher (P < 0.05). The mean gonial width in the skeletal open bite group (81.143 mm) was significantly (P < 0.05) lesser than the dental open bite group (84.842). The maxillary intercanine width for the skeletal open bite group (36.48 mm) was significantly (P < 0.01) higher than that of the dental open bite group (34.26 mm). CONCLUSION: A transverse deficiency was seen in in the zygomatic and condylar regions in adults with anterior open bite. Individuals with a skeletal open bite showed a narrow gonial and wider maxillary intercanine width compared with individuals with dental open bite.

A proposed classification for orthodontic practice in India.

AIM AND BACKGROUND: Dental practice is blooming in India with many conventional and advanced setups providing orthodontic services. Orthodontics as a specialty has come to the forefront, as awareness of orthodontic therapy has increased. It is important to classify any health practice to understand, compare, and research the implications of various organizational setups in the country. It should possess the ability to chart the similarities and distinctions between different setups for ease of communication and patient awareness. Presently, there is no defined system that classifies the type of orthodontic practice in the country. Lack of any classification of the organizational setups makes it impossible to categorize or compare the various setups for research purpose, recognition of the dental personnel and facilities provided. This article aims to propose a simple 3-stage classification to orthodontic practices in India. TECHNIQUE: Three-stage classification of orthodontic practice in group, type, and subtype gives a comprehensive coverage to all types of orthodontic setups in India. The group explains the center in three levels based on the armamentarium and services provided. The type explains the center in five levels based on ownership and scope of providing care. Finally, the subtype explains the availability and qualification of the operating personnel. CONCLUSION AND SIGNIFICANCE: This classification aims to provide a tool for communication and recording the levels of orthodontic care possible at any given center. It also facilitates continued study of its impact on practice efficacy and patient awareness.

Investigations into the cellular immune responses in latex allergy.

Latex allergy is a hypersensitivity response to allergens in the natural latex products. Skin prick tests, which do not correlate very well with latex-specific immunoglobulin E (IgE), are yet the only reliable diagnostic tools for clinically determining hypersensitivity to latex. In this study, patients who were skin test (SPT) positive with (STP+/ANA+) or without (SPT+/ANA-) history of anaphylaxis formed the test groups. Healthy volunteers (SPT-/ANA-) served as controls. Lymphocyte proliferation in response to crude and purified latex antigens, serum immunoglobulin E-total, and latex-specific and in vitro immunoglobulin E (IgE) production in response to crude latex antigens were studied. Results indicate that both patient groups showed enhanced response to latex antigen by lymphoproliferation. In patient groups this response to the different antigens tested, or to crude versus purified antigens, was not statistically different. Serum total IgE (ng/ml) was elevated in patients (range, SPT+/ANA-, 40 to 1250; SPT+/ANA+, 40 to 4550) when compared with controls (40 to 450). Low levels (1 to 3 ng/ml) of IgE were detected in the peripheral blood mononuclear cell culture supernatants from the patient groups. These levels were < or = 1 ng/ml in the control group. Significant levels of IgE (log titer, mean +/- SD) specific to MFL1 and glove antigens were measured in serum from both SPT+/ANA- (MFL1, 1.85 +/- 0.23, p < 0.001; glove, 1.81 +/- 0.23, p < 0.001) and SPT+/ANA- (MFL1, 1.92 +/- 0.39, p < 0.007; glove 1.85 +/- 0.4, p < 0.006) and compared with results from the control group (MFL1, 1.50 +/- 0.1; glove, 1.38 +/- 0.19).(ABSTRACT TRUNCATED AT 250 WORDS)

Characterization of a major latex allergen associated with hypersensitivity in spina bifida patients.

Hypersensitivity to latex proteins present in health care products, particularly in latex gloves, has emerged as an important public health problem in recent years. Most of these latex allergens have not been purified or characterized. Here we report the purification and characterization of a 23-kDa latex polypeptide from nonammoniated natural rubber latex. This purified 23-kDa polypeptide reacted with IgE from 13 of 17 (76%) latex-allergic spina bifida patients, but from only 1 of 5 health care workers with latex allergy. Furthermore, all the sera of patients with anaphylaxis to latex showed reactivity with the 23-kDa polypeptide. This allergen also induced significant lymphocyte proliferation by PBMC from spina bifida patients, but not from health care workers. The 90 amino acid residues sequenced from the 23-kDa polypeptide showed a 45.6% homology with a previously reported latex protein, rubber elongation factor. By using a mAb LAM-1, produced against the 23-kDa allergen, we could also detect this allergen or its epitope in ammoniated latex and natural rubber latex products used in health care management, but not in non-latex extracts studied.

Latex antigens induce IgE and eosinophils in mice.

Hypersensitivity to latex proteins has been reported with increasing frequency in recent years. Elevated levels of latex specific IgE have been detected in the majority of these patients. Severe anaphylaxis and death resulting from latex exposure has also been reported. Nevertheless, the immune mechanism of latex allergy is not fully understood. In this report, we describe a model of latex allergy developed in mice exposed to latex proteins. Animals exposed to latex proteins demonstrated enhanced levels of total IgE, peripheral blood and lung eosinophilia, and elevated levels of serum IL-4 and IL-5. mRNA transcripts of IL-4 and IL-5, but not IFN-gamma, could be demonstrated in spleen lymphocytes. Antibodies to latex belonging to all IgG subclasses were detected in the sera of mice exposed to latex antigens. The histology of the lung showed non-necrotizing granulomas and extensive interstitial chronic inflammatory infiltrates, particularly around bronchioles and small blood vessels. Although this model of latex allergy demonstrates a heterogeneous immunological response, the CD4-positive Th2 cell-mediated response predominated.