Degenerative Temporomandibular Disorders: An Assessment of Bone Trabecular Structure Using Fractal Analysis in Digital Panoramic Radiographs.

Introduction Fractal analysis has proved to be a salient tool to quantitatively assess the qualitative changes in the bone trabeculae of patients with hyperparathyroidism, osteoporosis, and various temporomandibular disorders, including osteoarthritis (OA) and rheumatoid arthritis of temporomandibular joint (TMJ), in several previous studies. The purpose of this study was to use fractal analysis to assess alterations in the trabecular pattern of the mandibular condyle in patients with degenerative temporomandibular disorders. Materials and methods This study comprised 98 subjects with 49 subjects in the study group and 49 subjects in the control group, aged 18-50 years. Age and sex in the control group were matched to those in the case group. The subjects were assessed clinically with the Diagnostic Criteria for Temporomandibular Disorders. Digital panoramic X-ray equipment with set parameters of 70 kvp, 8 mA, and 16-second exposure duration was used to take panoramic radiographs. Fractal analysis was done and the calculated fractal dimension value was obtained using ImageJ version 1.48 software (National Institutes of Health, Bethesda, MD). The same observer used Muir and Goss's method to rate the total degenerative changes in the condylar surfaces, which were substantiated by the calculated fractal dimension value. The data were statistically analyzed. Results The results revealed a significant difference (p-value = 0.041) between the mean fractal value in the case group's (1.35) and the control group's (1.38) left sides whereas the differences in the mean fractal values between the case and control groups on the right side was not significant (p-value = 0.49). Conclusion It is recommended to use the fractal dimension value and the total degenerative severity score together to quantify degenerative changes in the TMJ OA rather than exclusively relying on fractal value.

Frontier Breakthroughs: A Comprehensive Review of Diathermy in Dentistry With a Focus on Oral Medicine.

Diathermy is a therapeutic technique utilizing electromagnetic waves that is widely used in the medical field, especially for orthopedic injuries such as musculoskeletal disorders. Shortwave diathermy (SWD), microwave diathermy (MWD), sonic therapy or ultrasound (US), and long-wave diathermy are the various types, out of which shortwave diathermy is most commonly used in medical fields. However, diathermy has not been explored much in dentistry. This literature review aims to discuss the various applications of diathermy and its potential use in dentistry with the existing scarce literature and further emphasize its role as a recommendation in the management of orofacial pain in dental practice.

Anti-inflammatory and Antioxidant Activity of Cucumis sativus and Citrus macroptera Herbal Formulation: An In-Vitro Study.

Background The interest in natural remedies is increasing rapidly as they can serve as alternatives to synthetic drugs and reduce their potential side effects. Current research is focused on examining the antioxidant and anti-inflammatory characteristics of a combination of Cucumis sativus and Citrus macroptera extract in an in-vitro context. The combination of citrus, cucumber, and glycerol extract could serve as an effective alternative to synthetic antioxidants and anti-inflammatory drugs and lower the side effects of the available synthetic drugs. This extract can be used to treat potentially malignant oral disorders like oral leukoplakia, oral submucous fibrosis, and oral lichen planus, which are attributed to its antioxidant properties. Aim To evaluate the anti-inflammatory and antioxidant activity of formulation of C. sativus, C. macroptera, and glycerol extract. Materials and methods The cucumber and citrus fruits were separated, cleaned, and dried. The cucumber was then peeled, its seeds cleaned, and the pulp cut into pieces. Using a laboratory mortar and pestle, a 5 ml extract was prepared. The citrus fruit was cut in half, its seeds were removed, and a 5 ml extract was prepared from their pulp only. These two extracts were combined to form a 10 ml extract solution with 8 ml of glycerol. The extracts were combined, shaken for 24 hours, filtered, and stored at 4°C. Assays like the 2,2-diphenyl-1-picrylhydrazyl (DPPH) radical scavenging assay, Hydrogen Peroxide (H2O2) assay, Bovine serum albumin (BSA) assay, and Egg albumin (EA) denaturation assay were performed to assess their anti-inflammatory and antioxidant properties. Results The antioxidant and anti-inflammatory properties of the extract showed comparable activity (percentage of inhibition: 76% in BSA and EA assays; 90% in DPPH and H2O2 assays) to that of the standard values (percentage of inhibition: 78% in BSA and EA assays; 92% in DPPH and H2O2 assays) at concentrations 30, 40, and 50 µl in the BSA assay, EA assay, DPPH, and H2O2 assay. The maximum concentration at which the antioxidant and anti-inflammatory effects were appreciable was 50 µl in all assays.  Conclusion This study concluded that the combination of cucumber, citrus, and glycerol extract could serve as an effective alternative to synthetic antioxidants and anti-inflammatory drugs currently available. These extracts can provide a promising solution in the field of drug development for treating lesions caused by free radicals and oxidative stress in the oral cavity.

Image Quality Assessment of Digital Radiographs Captured by Hand-Held Devices Versus Wall-Mounted Devices: A Retrospective Comparative Study.

Background In diagnostic radiology, the image quality of radiographs is paramount for impeccable diagnosis as it is essential for efficient treatment planning and patient care. In comparison to their well-established wall-mounted equivalents, the growing use of handheld devices raises concerns regarding their diagnostic effectiveness by questioning their image quality. Hence, to fully comprehend the clinical importance of handheld X-ray equipment, it is important to look into their image quality for better diagnostic performance. Aim The study aimed to determine the image quality of handheld X-ray units and compare them with wall-mounted X-ray units in routine dental practice based on objectifiable image quality parameters. Materials and Methods For the study, 200 digital radiographic images (102 taken using handheld and 98 using wall-mounted X-ray units) were collected randomly from archives, including radiographs with cone-cut and positional errors. Five observers, three faculty members, and two postgraduates, who were all blinded, subjectively judged the image quality using a five-point rating scale for five individual parameters: contrast, sharpness, cone-cut, and error in vertical and horizontal angulations of position indicating device separately. The mean score for all observers was calculated, and statistical analysis was performed using the Mann-Whitney U test. The scoring of one faculty member experienced in oral radiology as baseline data was used to compare interobserver agreement among the other observers. Results There is a significant difference between the two groups in cone-cut and error in horizontal angulation. There is no significant difference between the two groups when parameters such as contrast, sharpness, and error in vertical angulation are considered. The images from handheld devices showed better image quality (p = 0.006) compared to the wall-mounted device. There was 87% interobserver agreement between the five observers. Conclusion The present study demonstrated a significant difference between the handheld device and the wall-mounted device when all the five parameters including errors are considered to assess the image quality. Hence, handheld devices can be used for regular clinical practice as an alternative to wall-mounted devices. Nevertheless, stringent radiation safety precautions are essential.

Clinical Dilemma and the Role of Cone-Beam Computed Tomography in the Diagnosis of an Unusual Presentation of Central Odontogenic Tumor-A Case Report.

Cone beam computed tomography (CBCT) provides a detailed analysis of the dentition and of cortical and medullary bone free of superimposition inherent in radiographs, which are effortlessly plausible, easily available, and relatively inexpensive when compared with other cross-sectional imaging modalities such as computed tomography (CT) and magnetic resonance imaging (MRI). This article presents a case report of a 23-year-old male patient with a complaint of a mass in the right side lower back tooth region for the past 2 and a half months, which had the unusual presentation of prominent exophytic growth masking the central odontogenic tumor, wherein the diagnostic performances of CBCT in unveiling the diagnostic challenge that led to the clinical dilemma is emphasized. Routine radiographs such as orthopantomogram, mandibular occlusal view were taken along with CBCT, which accentuated the precise diagnosis in this case. The lesion was surgically enucleated with curettage and extraction of the involved teeth. CBCT unveiled the classic multilocularity of ameloblastoma, which routine imaging failed to display. CBCT played a pivotal role in counteracting the diagnostic challenges faced and also in distinguishing it from a cystic lesion that was initially deceived by routine two-dimensional radiographs.