Semi-customized Scleral Shell Prosthesis for a Pthisical Eye.

One of the most common causes of eye loss is ocular trauma that overtime results in shrunken, non-functional eye known as a pthisical eye. The prosthetic options for such case include either prefabricated prosthesis or custom-made prothesis. Various materials and techniques are used for the fabrication of the prosthesis. Semi-customized prosthesis uses stock iris while the scleral shell is customized. This prosthesis has the advantages of both stock and custom-made prosthesis providing functionally and esthetically satisfactory result. This case report demonstrates the case of a 32 years old male who reported to the Department of Prosthodontics and Crown-Bridge, College of Dental Surgery, BP Koirala Institute of Health Sciences, Dharan, Nepal for eye prosthesis to mask his pthisical eye. For this case, a semicustomized scleral shell prosthesis was planned and fabricated.

Oral Health Care Practice and Circumstances during Covid-19 among Dental Patients in Tertiary Care Hospital in Nepal.

Background Patients are hesitant to enter a dental hospital because of the significant danger of cross infection and illness transmission due to rapid spread of corona virus. Objective To assess knowledge regarding Covid-19, oral health practices and circumstances on dental treatment during a pandemic. Method Cross sectional study was conducted among patients visiting dental department of Dhulikhel hospital from September to October 2020. Questionnaires were interviewed following safety protocols regarding the pandemic and descriptive analysis was performed. Both verbal and written consent as well as ethical approval was taken before the study. Result A total 411 patients aged 14 to 75 years old from 14 different districts across Nepal participated in the study. All of the patient were free of Covid-19 symptoms and had strong knowledge and awareness about disease transmission. During the crisis 96% of the people maintain good oral hygiene while 25.8% acquire new dental problems where majority experienced oral discomfort and swelling, 93.2% of them did not attend a dental clinic or hospital in the interim owing to fear and inaccessibility. Majority of the participants were impressed by the safety precautions and preparations during treatment and 99.3% strongly suggest or pledge to visit dental department if necessary during the pandemic. Conclusion Dental patient visiting Dhulikhel hospital is highly aware of current health crisis, possible transmission and preventive measures. Proper safe hospital setup can encourage them to seek dental treatment during crisis. Dental pain and swelling in Endodontic department recorded most common dental emergency during this pandemic.

Retention and patient satisfaction with bar-clip, ball and socket and kerator attachments in mandibular implant overdenture treatment: An in vivo study.

AIM: The aim of this in vivo study was to evaluate and compare the retention and patient satisfaction in implant supported mandibular overdenture with three different attachment system. MATERIALS AND METHODS: After evaluation of prosthetic space, fifteen edentulous subjects received two implants in the inter-foramina region of the mandible and were divided into 3 groups with 5 subjects each, delayed loading protocol was followed in all the patients. The retention force and satisfaction level with the attachments at baseline and after 6 months was measured in a standardised way using retentive device and VAS questionnaire. The study was based on evaluation of retention and patient satisfaction. 15 subjects were included in the study. The results obtained were statistically analyzed using one-way ANOVA test, and multiple comparisons were carried out using the Bonferroni tests. RESULTS: At the end of six months, the retention force and satisfaction level was higher in Group 3 (Kerator attachment) as compared to Group 1 (ball and socket attachment) and Group 2 (bar and clip attachment) and patient satisfaction was equal in groups 1, 2 and 3 but the total number of interventions is significantly higher in the attachment bar. Analysis of variance with repeated measures showed significant differences in retention force among the three attachment types. CONCLUSION: (1) Group 3 (kerator attachment) exhibit higher retentive capacities than Group 1 (ball and socket attachment) and Group 2 (bar and clip attachment). (2) patient satisfaction was higher in Group 3 (Kerator attachment) in compare to Group 1 (ball and socket attachment) and Group 2 (bar and clip attachment).

Reactive Oxygen Species Responsive Naturally Occurring Phenolic-Based Polymeric Prodrug.

Reactive Oxygen Species (ROS) play a vital role in the biological system. Exaggerated, ROS have devastating effects on the human body leading to the pathophysiological condition including the transformation of a normal cell into a cancer phenotype. Nature has blessed us with various biomolecules that we use along with our dietary supplements. Using such therapeutic small molecules covalently incorporated into biodegradable polyoxalate polymer backbone with a responsive group forms an efficient drug delivery vehicle. This chapter "Reactive oxygen species responsive naturally occurring phenolic-based polymeric prodrug" will be focusing on redox-responsive polymers incorporated with naturally occurring phenolics and clinical application.

Gender Differences in Dental Anxiety and Medical Fear in Croatian Adolescents.

OBJECTIVES: The aim of this study was to differentiate anxious from nonanxious adolescents and evaluate gender differences in anxiety with respect to previous negative dental and medical experiences. The purpose was also to evaluate a causative relationship between child medical fear and dental anxiety. STUDY DESIGN: This study sampled 113 Croatian adolescents from 15 to18 years of age. Children's Fear Survey Schedule - Dental Subscale (CFSS-DS) was used for the assessment of child dental anxiety regarding visits to the dentist and receiving dental treatment. A modified version of Child Medical Fear Questionnaire (CMFQ-M) was used for evaluation of child medical fear related to medical treatment and doctors in general. RESULTS AND CONCLUSION: The results showed significantly higher dental anxiety (CFSS-DS) and medical fear (CMFQ-M) in adolscent girls (p<0,001) as compared to adolescent boys. A significantly strong correlation between medical fear and dental anxiety in adolescent girls was proved by Pearson's correlation coefficient (p < 0,01). In this study, CMFQ-M and CFSS-DS questionnaires were standardized in the Croatian adolescent population and proved reliable in the estimation of anxious behaviour with respect to specific medical and dental situations.

Community-based education: Experiences of undergraduate dental therapy students at the University of KwaZulu-Natal, South Africa.

BACKGROUND: Community-based education (CBE) is a learning strategy that provides meaningful opportunities for students to apply theory learnt in a larger social and cultural context in various community settings. Although the benefits of CBE to health professional students are well documented, to date, there is little evidence describing dental therapy students' experiences. OBJECTIVES: To describe the experience of CBE by undergraduate dental therapy students in the School of Health Sciences at the University of KwaZulu-Natal. METHODS: This descriptive study, conducted in 2016, gives insight into the experiences of community-based education among dental therapy students using a self-administered questionnaire eliciting qualitative data. Ethical clearance was obtained from the institution. RESULTS: Students reported perceived benefits of improved professional and personal growth, and a deeper understanding of cultural, social and economic influences on oral health care. Some of the perceived challenges included language barrier, limited resources and adapting to new environments. CONCLUSION: The reported experiences of undergraduate dental therapy students involved in community-based clinical training suggest that students gained awareness of the context-specific challenges facing communities and health professionals in different oral health settings.

Radiographic features associated with temporomandibular joint disorders among African, White, Chinese, Hispanic, and Indian racial groups.

CONTEXT: Various radiographic features have been associated with temporomandibular joint disorders (TMDs); however, these characteristics have not been compared among different racial groups. AIMS: To radiographically evaluate and compare craniofacial patterns and condylar findings suggestive of TMD among African, White, Chinese, Hispanic, and Indian racial groups. SETTINGS AND DESIGN: This multicenter retrospective study used data from three private orthodontic practices and a University Orthodontic Clinic. SUBJECTS AND METHODS: Panoramic and lateral cephalometric radiographs were collected from 250 subjects who were equally divided into five racial groups: Africans, Whites, Chinese, Hispanics, and Indians. All radiographs were initial records from patients seeking orthodontic treatment. Linear and angular cephalometric measurements were used to evaluate and compare cephalometric characteristics associated with TMD among groups. Panoramic radiographs were analyzed to compare the presence of condylar abnormalities and antegonial notching among groups. STATISTICAL ANALYSIS USED: One-way analysis of variance, followed by Tukey's test. RESULTS: African and Chinese groups had the smallest mean cranial base measurements, while the Indians had the largest. The mean Y-axis value was significantly larger in the Chinese group compared with the other groups. Increased mandibular plane angles were seen in the Chinese and African patients, compared with subjects from other groups. The mean percentage of condylar anomalies was higher in the Chinese subjects compared with all other groups. CONCLUSIONS: Chinese patients presented with more radiographic features suggestive of TMD, whereas the Indians showed the least, compared with subjects from the White, Black, and Hispanic racial groups.

The effect of increased chewing strokes on the DeMeester score.

Saliva is known to be protective for esophageal mucosa. Increased chewing strokes result in a quantitative and qualitative enhancement of saliva. Reduction in the amount of saliva produced results in an increased incidence of gastroesophageal reflux disease (GERD), which can be objectively measured by the DeMeester score. The impact of increased chewing strokes on the DeMeester score remains largely unknown, thus this study aimed to find out their impact on the value of the DeMeester score and its individual components.The effect of increased chewing strokes on the DeMeester score was investigated in 12 subjects (5 male and 7 female) who were diagnosed with GERD. All subjects underwent a 48-hour pH monitoring using the Bravo® pH capsule. All the patients chewed their food 20 times more on Day 2 as compared to Day 1. The data were analyzed for change in the DeMeester score and its individual components in 2 days.In patients with GERD (DeMeester score > 14.72 on Day 1), the number of long refluxes (>5 minutes) on Day 2 (mean = 3.2, SD = 2.3) was significantly lower than on Day 1 (mean = 6.4, SD = 2.7); Z = -2.032, p = 0.04. Though, the DeMeester score and its other individual parameters decreased on Day 2, they were not statistically significant.In patients with GERD, increased chewing strokes lead to a decrease in the number of long reflux episodes. Though there is a decrease in the DeMeester score and its other individual components, larger randomized controlled studies are required to reach statistical significance.

Can undergraduate student learning in prevention influence oral health self-care practices? - a report from a South African University.

INTRODUCTION: Student attitudes and behaviour towards their own oral health status could reflect their understanding of the importance of oral health promotive activities. OBJECTIVES: This was a qualitative and exploratory study designed to gain a deeper understanding of the extent to which the undergraduate curriculum could act as an enabler for student oral health self-care practices. METHODS: Data collection comprised of document analysis (curriculum review) and in-depth face-to-face interviews with undergraduate dental therapy and oral health students and academic staff at the University of KwaZulu-Natal. Ten students volunteered to participate in the study while five academic staff were purposively selected. A separate interview schedule was developed for students and staff, respectively. The emergent themes from document analysis were compared to the analysed data from the interviews. RESULTS: The curriculum was underpinned by a strong foundation in prevention, and there was consensus among respondents that the curriculum met the needs for undergraduate training in preventive dentistry. The following themes emerged from data analysis: curriculum support for self-care practices; depth and scope of clinical training; role of clinical supervisors and challenges in clinical training. Respondents agreed that the curriculum could influence students' attitudes towards self-care practices such as toothbrushing and flossing but that academic responsibilities and clinical contact time placed constraints on these practices. CONCLUSION: The undergraduate curriculum does provide support for enabling student knowledge acquisition and positive attitudes, but more effort is required to enable oral health behavioural modifications among students.

Salivary metabolomics in the diagnosis of oral cancer and periodontal diseases.

Metabolomics is a systemic study of metabolites, which are small molecules generated by the process of metabolism. The metabolic profile of saliva can provide an early outlook of the changes associated with a wide range of diseases, including oral cancer and periodontal diseases. It is possible to measure levels of disease-specific metabolites using different methods as presented in this study. However, many challenges exist including incomplete understanding of the complicated metabolic pathways of different oral diseases. The review concludes with the discussion on future perspectives of salivary metabolomics from a clinician point of view. Salivary metabolomics may afford a new research avenue to identify local and systemic disorders but also to aid in the design and modification of therapies. A MEDLINE search using keywords "salivary metabolomics" returned 23 results in total, of which seven were omitted for being reviews or letters to the editor. The rest of the articles were used for preparation of the review, 13 of these were published in the last 5 years.

Anatomical and Morphological Characterization of the Nasopalatine Canal: A Cone-Beam Computed Tomography Study.

The anterior maxilla, also called pre-maxilla, is an area frequently requiring surgical interventions. Rehabilitation of this area remains a complex restorative challenge. The most prominent anatomical structure within the anterior maxilla is the Nasopalatine Canal. Thorough knowledge about this anatomical structure plays an important role in the successful outcomes of surgical procedures. This retrospective study was done to evaluate the anatomy and morphology of the Nasopalatine Canal using cone-beam computed tomography (CBCT). The study included 125 subjects aged between 15 and 78 years who were divided into the following 5 groups: i) 15-30 years, ii) 30-45 years, iii) 45-60 years, iv) 60-75 years, v) ≥75 years in the Department of Oral Medicine & Radiology, Sri Aurobindo College of Dentistry, Indore, Madhya Pradesh, India from January 2012 to January 2015. Cone-beam computed tomography (CBCT) was performed using a standard exposure and patient positioning protocol. The data of the CBCT images were sliced in three dimensions. Image planes on the three axes (X, Y, and Z) were sequentially analyzed for the location, morphology and dimensions of the Nasopalatine Canal. The correlation of age and gender with all the variables were evaluated. ANOVA and Z-test was used. P value <0.05 was considered statistically significant. Males and females showed significant differences in the length of the canal and anterior bone width in the sagittal sections. Inverted L was identified as a new dimension to the morphological shape of Nasopalatine Canal in central Madhya Pradesh population. The present study highlighted important variability observed in the anatomy and morphology of the Nasopalatine Canal.

The professional role of a dental hygienist in Finland - educators' views.

OBJECTIVES: To assess the role and envisioned professional identity of the dental hygienist in the eyes of their educators at the Finnish training institutes and to determine the need for any changes and improvements. METHODS: A cross-sectional explorative study used as its main method interviews conducted in 2012-2013 among educators of dental hygienists in Finland. Leading representatives of dental hygienist training at all vocational health institutes, dental schools and centres of health education were asked to participate in the study. The interviews consisted of two parts: a self-administered questionnaire and a semi-structured interview. The qualitative data were analysed with thematic analysis. The inductive theoretical approach served to categorize the data based on emergent themes and patterns. RESULTS: The educators held a general respect and appreciation for the dental hygienist profession. They felt that dental hygienists' skills ought to see more use in orthodontics and in preventive care than is customary today, including in tobacco prevention and smoking cessation as well as in dietary instruction among adults. The traditional role of the dental hygienist and the evolving scope of dental practice seemed mismatched. Concern about the lack of clarity regarding the division of labour in clinical practice was expressed. The respondents were convinced of that the division of labour in the public sector differs from that in the private sector. CONCLUSION: The educators thought that the role of the dental hygienist and the evolving scope of dental practice were partly mismatched. A reassessment of stakeholder involvement in the development of training curricula is urgently needed.

Analysis of Post Earthquake Disease Pattern in a Camp at Gyampesal Gorkha.

Background A major earthquake occurred in Nepal on 25th April 2015 with magnitude of 7.8 causing mass panic amongst people. Objective To analyze scenario, experience and disease pattern of Post Earthquake camp at Gyampesal, Gorkha. Method A prospective observational study done on 13th and 14th June 2015 in a population who attended the health camp at health post, Gyampesal Gorkha. Analysis was done for age, sex, and disease pattern. Medicines for their health problems was provided by Manipal Teaching Hospital, Pokhara, Nepal Pediatric Society and Children Welfare in Nepal, Kathmandu. Result Total 159 patients [80.5% children and 19.5% adults] had attended the health camp. The mean age of children was 6.18±4.27 SD with maximum between 2-5 years (39%) and mean age of adults was 37.87±14.07 SD. Among the children males were more (50.8%) than females but in adult group females (83.9%) were more. Most common complaints were earthquake related fear (Children- 60.23% / adults -71%), insect bite [children -25.8% /adults -35.5%], pain abdomen (children- 64.1% / adult -38.7%) and decreased appetite (children- 83.6% / adults - 16.1%). Pain abdomen and decreased appetite was significantly high in children with p < 0.009 and 0.001 respectively. The common disease patterns noted in children were recurrent abdominal pain (25%), acute gastroenteritis (19.5%), upper respiratory tract infections (15.6%), Impetigo (15.6%), Dental caries(10%), Pityriasis alba (10%). In adults Acid peptic disease (51.6%), Headache (32.5%), hypertension, Upper respiratory infections, scabies and Urinary tract infection (16%), Acute gastroenteritis (13%) was common. Conclusion Earthquake related fear, insect bite and Communicable diseases both airborne and water borne were the commonest findings observed. Therefore basic needs and services like safe water and sanitation, adequate shelter, primary healthcare services and vector-control campaigns are crucial and essential for these displaced populations.

Biodegradation of pyrene and phenanthrene by bacterial consortium and evaluation of role of surfactant.

High molecular weight poly aromatic hydrocarbons (HMW PAHs) are well known for their hydrophobicity and they get strongly adsorbed onto the soil particles. Generally, surfactants facilitate the biodegradation of PAH by enhancing their solubility and desorption of hydrophobic compounds from soil particles. To investigate the role of synthetic surfactant in biodegradation of PAHs, two bacterial strains BP10 and P2 were incubated in soil spiked with pyrene and phenantherene (100 µg g-1of soil each) in isolation and in combination with/without Tween 80. After 14 days of incubation, pyrene and phenantherene were degraded by a combination of BP10 and P2 to the extent of 98% and 99%, respectively. Addition of tween 80 reduced the degradation of pyrene and phenantherene by 35 and 10%, respectively. Biosurfactant produced by selected strains i.e. BP10 and P2 could enhance desorption of pyrene (100 µg g-1of soil) by about 27% and 12%, respectively. However, desorption activity was relatively higher (32 and 29%, respectively) in case of phenanthrene (100 µg g-1of soil) from the spiked soil. Present study showed that in spite of additional chemical surfactant, bioaugmentation of highly petroleum hydrocarbon degrading bacterial combination was very effective in boosting the bioremediation of PAHs- contaminated sites.

Screening of ecologically diverse fungi for their potential to pretreat lignocellulosic bioenergy feedstock.

A widespread and hitherto by far underexploited potential among ecologically diverse fungi to pretreat wheat straw and digestate from maize silage in the future perspective of using such lignocellulosic feedstock for fermentative bioenergy production was inferred from a screening of nine freshwater ascomycetes, 76 isolates from constructed wetlands, nine peatland isolates and ten basidiomycetes. Wheat straw pretreatment was most efficient with three ascomycetes belonging to the genera Acephala (peatland isolate) and Stachybotrys (constructed wetland isolates) and two white-rot fungi (Hypholoma fasciculare and Stropharia rugosoannulata) as it increased the amounts of water-extractable total sugars by more than 50 % and sometimes up to 150 % above the untreated control. The ascomycetes delignified wheat straw at rates (lignin losses between about 31 and 40 % of the initial content) coming close to those observed with white-rot fungi (about 40 to 57 % lignin removal). Overall, fungal delignification was indicated as a major process facilitating the digestibility of wheat straw. Digestate was generally more resistant to fungal decomposition than wheat straw. Nevertheless, certain ascomycetes delignified this substrate to extents sometimes even exceeding delignification by basidiomycetes. Total sugar amounts of about 20 to 60 % above the control value were obtained with the most efficient fungi (one ascomycete of the genus Phoma, the unspecific wood-rot basidiomycete Agrocybe aegerita and one unidentified constructed wetland isolate). This was accompanied by lignin losses of about 47 to 56 % of the initial content. Overall, digestate delignification was implied to be less decisive for high yields of fermentable sugars than wheat straw delignification.

Secretome analysis of the thermophilic xylanase hyper-producer Thermomyces lanuginosus SSBP cultivated on corn cobs.

Thermomyces lanuginosus is a thermophilic fungus known for its ability to produce industrially important enzymes including large amounts of xylanase, the key enzyme in hemicellulose hydrolysis. The secretome of T. lanuginosus SSBP was profiled by shotgun proteomics to elucidate important enzymes involved in hemicellulose saccharification and to characterise the presence of other industrially interesting enzymes. This study reproducibly identified a total of 74 proteins in the supernatant following growth on corn cobs. An analysis of proteins revealed nine glycoside hydrolase (GH) enzymes including xylanase GH11, ß-xylosidase GH43, ß-glucosidase GH3, α-galactosidase GH36 and trehalose hydrolase GH65. Two commercially produced Thermomyces enzymes, lipase and amylase, were also identified. In addition, other industrially relevant enzymes not currently explored in Thermomyces were identified including glutaminase, fructose-bisphosphate aldolase and cyanate hydratase. Overall, these data provide insight into the novel ability of a cellulase-free fungus to utilise lignocellulosic material, ultimately producing a number of enzymes important to various industrial processes.

Physico-chemical characterization and biological response of Labeo rohita-derived hydroxyapatite scaffold.

The chemically treated Labeo rohita scale is used for synthesizing hydroxyapatite (HAp) biomaterials. Thermogravimetric and differential thermal analyses of fish scale materials reveal the different phase changes with temperature and find out the suitable calcination temperatures. The composition and structures of wet ball-milled calcined HAp powders are characterized by Fourier transform infrared spectroscopy, X-ray diffraction, field emission scanning electron microscopy, transmission electron microscopy, energy dispersive X-ray analysis (EDX). The EDX as well as chemical analysis of fish scale-derived apatite materials confirms that the Ca/P ratio is 1.71. The compressive stress, hardness and porosity have been evaluated on sintered HAp biomaterials. The cell attachment on HAp surfaces, cytotoxicity evaluation and MTT assay, which are carried out in RAW macrophage-like cell line media demonstrate good biocompatibility. The histological analysis also supports the bioaffinity of processed HAp biomaterials in Wistar rat model for investigating the contact reaction and stability at the artificial or natural prosthesis interface.

Artificial intelligence in age and sex determination using maxillofacial radiographs: A systematic review.

In the past few years, there has been an enormous increase in the application of artificial intelligence and its adoption in multiple fields, including healthcare. Forensic medicine and forensic odontology have tremendous scope for development using AI. In cases of severe burns, complete loss of tissue, complete or partial loss of bony structure, decayed bodies, mass disaster victim identification, etc., there is a need for prompt identification of the bony remains. The mandible, is the strongest bone of the facial region, is highly resistant to undue mechanical, chemical or physical impacts and has been widely used in many studies to determine age and sexual dimorphism. Radiographic estimation of the jaw bone for age and sex is more workable since it is simple and can be applied equally to both dead and living cases to aid in the identification process. Hence, this systematic review is focused on various AI tools for age and sex determination in maxillofacial radiographs. The data was obtained through searching for the articles across various search engines, published from January 2013 to March 2023. QUADAS 2 was used for qualitative synthesis, followed by a Cochrane diagnostic test accuracy review for the risk of bias analysis of the included studies. The results of the studies are highly optimistic. The accuracy and precision obtained are comparable to those of a human examiner. These models, when designed with the right kind of data, can be of tremendous use in medico legal scenarios and disaster victim identification.

Scurvy masquerading as IgA vasculitis.

BACKGROUND: Vitamin C deficiency, or scurvy, is rare but poses risks for children with poor diets, limited resources, or malabsorption issues. It may also be common in children with restrictive or selective dietary habits in children with global developmental delay, autism spectrum disorder, and physical disabilities. Symptoms include fatigue, irritability, joint and muscle pain, joint swellings, edema, swollen gums, easy bruising, and delayed wound healing. Early recognition and prompt intervention are essential to prevent the progression of symptomatic vitamin C deficiency in children. CASE PRESENTATION: We present a case of a 13-year-old boy with developmental delay secondary to Lennox Gastaut syndrome referred for suspected recurrent, severe, and atypical IgA vasculitis. He presented with irritability, loss of appetite, petechial and ecchymotic lower limb lesions, unilateral gum swelling, severe arthritis, peripheral oedema, severe weight loss, anaemia, and raised inflammatory markers. Multiple investigations were performed before the diagnosis of scurvy was made. A surgical finding of friable gingival tissue with multiple loose teeth, a skin biopsy with follicular hyperkeratosis and extravasated perifollicular red blood cells, and a typical X-ray finding led to the diagnosis of scurvy. CONCLUSION: Scurvy should be given careful consideration as a differential diagnosis in patients presenting with musculoskeletal issues, mucocutaneous complaints, and constitutional symptoms such as malaise, asthenia, irritability, and loss of appetite. A focused and detailed dietary history looking for a lack of good sources of vitamin C can be an easy indicator of this differential. Imaging studies revealing the typical features can also help make the diagnosis. Pathology of the skin revealing pathognomonic features can add to the certainty of the diagnosis. In the absence of all else, the rapid response to treatment with an appropriate dose of vitamin C has a diagnostic and therapeutic role.