Gorlin-Goltz Syndrome - A Concatenation of Six Case Reports.

Rationale: Gorlin-Goltz syndrome (GGS) has a wide range of expressivity, with a majority of cases being first diagnosed from the oral findings. Early intervention can reduce its severity. Patient Concerns: The primary complaints of all the patients were pain and swelling. Clinical examination with radiological and histopathological evaluation confirmed the diagnosis. Diagnosis: This series presents the six cases of GGS treated over a time frame of five years (2018-2022). Treatment: The treatments range from enucleation, chemical cauterisation and peripheral ostectomy to aggressive modalities such as resection and reconstruction. Outcomes: This series comprises of six patients with ages ranging from 12 to 42 years, four of which were female and two were male presenting minimal expression to highly aggressive forms and its unpredictable frequent manifestation. Take-Away Lessons: This emphasises the significance of long-term periodic follow-up and genetic screening for early detection, thereby reducing the intensity and aggressiveness of the disease.

A Clinical Study for Removal of Impacted Mandibular Third Molar under Local Anaesthesia, with and without Ketamine - A Split Mouth Comparative Study.

Introduction: Disimpaction is one of the most common operations done by oral and maxillofacial surgeons around the world. Ketamine is a well-known general anaesthetic and short-acting intraoperative analgesic. The aim of this study was to measure the efficacy of anaesthesia using combined treatment with local anaesthetic plus a subanaesthetic dose of ketamine and local anaesthetic alone in bilaterally impacted mandibular third molar surgery. Methods and Materials: A total of 24 patients who consented were taken up for a split-mouth study. In the control group, surgical extraction of the impacted lower third molar was done using local anaesthesia (lignocaine 2% with 1:80,000 adrenaline) only, and in the study group, local anaesthesia with ketamine extraction was done using ketamine (0.2 mg/kg) along with local anaesthesia (LA). The time of onset and the duration of anaesthesia intraoperatively were recorded using a digital stopwatch. The depth of anaesthesia was noted on the 10th, 30th and 60th min. After extraction, the post-operative pain on the first, fourth, eighth and 12th hour was evaluated using a Visual Analogue Scale (VAS) score rating of 1-10. The pulse was also noted and compared for any differences in either of the groups. Results: A statistically significant (P < 0.005) difference in result was obtained for the onset, duration, depth and pain score after surgical extraction in both the evaluated groups. The pain index score by the ketamine group was significantly low as compared to the local anaesthesia-only group. Intraoperative onset, duration and depth of anaesthesia obtained had a significant difference. Discussion: Ketamine can be used as a viable option for surgical third molar extractions with reduced discomfort and post-operative pain.

Impact of Scleral Lens Front Surface Eccentricity on Visual Acuity, Contrast Sensitivity, and Higher-Order Aberrations in Eyes With Keratoconus.

PURPOSE: To investigate the effect of front surface eccentricity (FSE) of scleral lenses (SLs) on corrected distance visual acuity (CDVA), contrast sensitivity (CS), and higher-order aberrations (HOAs) in keratoconic eyes. METHODS: Fifteen keratoconic eyes fitted with BostonSight SCLERAL lenses of different eccentricity values (FSE0=0, FSE1=0.30, and FSE2=0.60). CDVA, CS, and HOAs were measured at baseline and after 30 min of SL wear. CDVA and CS were measured with the Early Treatment Diabetic Retinopathy Study and Pelli-Robson chart, respectively, and iTrace aberrometer was used to evaluate the HOAs. RESULTS: Baseline CDVA was 0.30±0.29, which significantly improved to 0.10±0.11, 0.05±0.06, and 0.05±0.08 logMAR with FSE0, FSE1, and FSE2, respectively ( P <0.05). The post hoc showed no significant difference between eccentricities. Baseline CS was 1.19±0.47, which improved to 1.54±0.12, 1.59±0.10, and 1.60±0.11 with FSE0, FSE1, and FSE2, respectively ( P <0.01), but post hoc showed no significant difference between eccentricities. A statistically significant reduction was found in HOAs when compared with baseline ( P <0.01). Comparison between eccentricities showed a significant difference only between FSE0 and FSE1 for RMS coma ( P =0.01) and RMS spherical aberrations ( P =0.004) where FSE1 showed better performance in reducing HOAs compared with FSE0. HO-RMS, RMS secondary astigmatism, and RMS trefoil showed no significant difference between eccentricities, but FSE1 and FSE2 performed superior to FSE0. CONCLUSION: BostonSight SCLERAL lenses with varying eccentricities corrected a significant amount of HOAs and improved CDVA and CS in keratoconus patients. Practitioners should be aware of this distinct feature of SLs and use it as needed to improve visual performance.

Evaluation of Efficacy of Low-Intensity Pulsed Ultrasound on Comorbidities Following Mandibular Impacted Third Molar Surgery: A Prospective Study.

Introduction: Despite several in vitro and in vivo applications of low-intensity pulsed ultrasound (LIPUS), it remains an under-studied feature of the oral and maxillofacial region. The goal of this in vivo study was to objectively investigate the efficacy of low-intensity pulsed ultrasound on wound healing and related morbidities following surgical removal of an impacted third molar. Materials and Methods: The following in vivo prospective, comparative, randomised controlled clinical study was carried out amongst 56 patients who reported to the Department of Oral and Maxillofacial Surgery fulfilling the inclusion criteria. Group A received sham ultrasound, whereas Group B received LIPUS therapy. Based on the group allocated LIPUS 1 MHz, pulsed 20% and dose 1.0 watts/square centimetre (W/cm2)/sham, ultrasound therapy was given on 1st, 2nd and 3rd post-operative days. The assessment of post-operative pain, oedema, trismus and wound healing on preoperative, first, third and seventh postoperative days. Results: The quantitative variables of the study were assessed using independent sample t-test, and qualitative variables were assessed using the Chi-square test. The P < 0.05 on third and seventh post-op days for pain, trismus and wound healing in the LIPUS group compared to control group making it statistically significant. There was no statistically significant difference in the reduction of oedema amongst the two groups. Discussion: Post-LIPUS application in the patients, postoperative pain was significantly reduced, trismus was noticeably improved and wound healing was satisfactory and can be employed as a complementary technique.

Ameloblastic fibroma in a young adult.

Ameloblastic fibroma is a rare mixed odontogenic tumor of the jaw comprising 2.5% of all odontogenic tumors. It is most commonly seen in young adults as a gradually increasing swelling in the jaw. Treatment considered is meticulous enucleation and curettage of surrounding bone. This study presents a case of ameloblastic fibroma in a 15-year-old female patient with a swelling on the right side of the mandible which was managed by enucleation and curettage.

Congenital epulis of the newborn.

Congenital epulis, a benign tumor of the oral cavity, is an extremely rare condition in newborn. It may lead to mechanical obstruction, therefore resulting in respiratory distress and difficulty in feeding. Addressing the problem may need a multidisciplinary team approach at the time of birth. Antenatal ultrasonography and perinatal magnetic resonance imaging are an adjunct to treatment planning. Prenatal diagnosis remains difficult as the findings are nonspecific due to the late development of the tumor. Surgical excision is, therefore, the treatment of choice. Our report discusses this condition and the treatment thereafter on a newborn, with an epulis originating from the upper alveolar ridge discovered at birth. Histological examination confirmed the diagnosis of large polygonal granular cells. The mass was excised under general anesthesia, and the outcome was good after surgery allowing regular feeds on the second postoperative day.

Structure and stability of (NG)nCN3Be3(+) clusters and comparison with (NG)BeY(0/+).

The noble gas binding ability of CN3Be3(+) clusters was assessed both by ab intio and density functional studies. The global minimum structure of the CN3Be3(+) cluster binds with four noble-gas (NG) atoms, in which the Be atoms are acting as active centers. The electron transfer from the noble gas to the Be atom plays a key role in binding. The dissociation energy of the Be-NG bond gradually increases from He to Rn, maintaining the periodic trend. The HOMO-LUMO gap, an indicator for stability, gives additional insight into these NG-bound clusters. The temperature at which the NG-binding process is thermodynamically feasible was identified. In addition, we investigated the stability of two new neutral NG compounds, (NG)BeSe and (NG)BeTe, and found them to be suitable candidates to be detected experimentally such as (NG)BeO and (NG)BeS. The dissociation energies of the Be-NG bond in monocationic analogues of (NG)BeY (Y=O, S, Se, Te) were found to be larger than in the corresponding neutral counter-parts. Finally, the higher the positive charge on the Be atoms, the higher the dissociation energy for the Be-NG bond becomes.

Studies on the encapsulation of F- in single walled nanotubes of different chiralities using density functional theory calculations and Car-Parrinello molecular dynamics simulations.

In this study, the encapsulation of F(-) in different nanotubes (NTs) has been investigated using electronic structure calculations and Car-Parrinello molecular dynamics simulations. The carbon atoms in the single walled carbon nanotube (CNT) are systematically doped with B and N atoms. The effect of the encapsulation of F(-) in the boron nitride nanotube (BNNT) has also been investigated. Electronic structure calculations show that the (7,0) chirality nanotube forms a more stable endohedral complex (with F(-)) than the other nanotubes. Evidence obtained from the band structure of CNT calculations reveals that the band gap of the CNT is marginally affected by the encapsulation. However, the same encapsulation significantly changes the band gap of the BNNT. The density of states (DOS) derived from the calculations shows significant changes near the Fermi level. The snapshots obtained from the CPMD simulation highlight the fluctuation of the anion inside the tube and there is more fluctuation in BNNT than in CNT.

On the perturbation of the H-bonding interaction in ethylene glycol clusters upon hydration.

Ab initio and density functional methods have been employed to study the structure, stability, and spectral properties of various ethylene glycol (EG(m)) and ethylene glycol-water (EG(m)W(n)) (m = 1-3, n = 1-4) clusters. The effective fragment potential (EFP) approach was used to explore various possible EG(m)W(n) clusters. Calculated interaction energies of EG(m)W(n) clusters confirm that the hydrogen-bonding interaction between EG molecules is perturbed by the presence of water molecules and vice versa. Further, energy decomposition analysis shows that both electrostatic and polarization interactions predominantly contribute to the stability of these clusters. It was found from the same analysis that ethylene glycol-water interaction is predominant over the ethylene glycol-ethylene glycol and water-water interactions. Overall, the results clearly illustrate that the presence of water disrupts the ethylene glycol-ethylene glycol hydrogen bonds.

Density functional theory studies on ice nanotubes.

The structure and stability of quasi one-dimensional (1D) ice nanotubes (INTs) have been investigated using Density Functional Theory (DFT) based Becke's three parameter Lee-Yang-Parr exchange and correlation functional (B3LYP) method employing various basis sets. Four different INTs, namely, (4,0)-INT, (5,0)-INT, (6,0)-INT, and (8,0)-INT with different lengths have been considered in this study. The calculated stabilization energies (SEs) illustrate that the stability of INT is proportional to its length and diameter. Further, the encapsulation of various gas molecules (CO(2), N(2)O, CO, N(2), and H(2)) inside the INTs has also been investigated. The calculated SEs of different endohedral complexes reveal that all these gas molecules are stable inside the tubes. The Bader's theory of atoms in molecule (AIM) has been used to characterize intra- and inter-ring H-bonding interactions. The electron density topological parameters derived from AIM theory brings out the difference between the intra- and inter-ring H-bonds of INTs.

Quantum mechanical studies on interaction of carbohydrate with nanomaterials.

The interactions between the fragment of various nanotubes (NTs) and carbohydrate (beta-D-glucose) has been investigated using quantum mechanical methods using different basis sets in gas phase. The most stable isomer of each complex favors multiple CH...pi contacts which arise due to the orientation of the hydrophobic surface of the carbohydrate with reference to the curved or planar aromatic systems. The carbohydrate recognition surface of the aromatic system referred as "three point landing surface" are important in the stabilization of carbohydrate-pi complexes.

Expedient synthesis of coumarin-coupled triazoles via 'click chemistry' leading to the formation of coumarin-triazole-sugar hybrids.

Coumarin-based triazoles were synthesized from 3-azidomethylcoumarin and a terminal acetylenic compound. Uncatalysed thermal conditions result in a mixture of both 1,4- and 1,5-regioisomers or the thermodynamically more stable 1,4-regioisomer, whereas the Cu(I)-catalysed reaction affords only the favourable 1,4-regioisomer. B3LYP/6-31G(d) level of theory has been used to calculate geometry and frequency features of the reactants, transition states (TSs) and products. Computational studies further reveal that 1,4-regioisomeric products are more favourable and also thermodynamically more stable compared to the 1,5-regioisomers.

Carbohydrate-aromatic interactions: the role of curvature on XH...pi interactions.

The interaction between the fragment of carbon nanotube (CNT) and carbohydrates has been investigated using MP2 and M05-2X methods using various basis sets in gas phase. Three carbohydrates, viz., beta-d-glucose, beta-d-galactose, and beta-d-xylose with different degree of hydrophobic nature have been selected for this investigation. With a view to assess the effect of curvature on the interaction between the carbohydrates and CNT, calculations on intermolecular complexes comprising of coronene (COR) and carbohydrates have also been carried out in gas phase. Results obtained from electronic structure calculations combined with the Bader's electron density analysis reveal that CH...pi interaction is the predominant one in the stabilization of the carbohydrate-CNT and carbohydrate-COR complexes. Furthermore, the importance of OH...pi and lone pair...pi (lp...pi) interactions are also evident from the results. The calculated BEs for the various carbohydrate-CNT and carbohydrate-COR complexes at M05-2X with dual basis set [aug-cc-pVTZ for carbohydrate + cc-pVTZ for both CNT and COR] vary from -2.52 to -5.14 and from -4.14 to -8.04 kcal/mol, respectively. The corresponding BEs obtained from MP2/6-311++G(d,p)//M05-2X/6-31+G(d,p) level of calculation range from -4.92 to -9.93 and from -6.75 to -12.53 kcal/mol. Close scrutiny of the energetics of all the complexes elucidate that the electron correlation energy (dispersion energy) significantly contribute to the stability of these complexes. It is found from the analysis of geometrical parameters and BEs that the interplay of orientation of the X-H (X = C and O) bond to the pi-surface is crucial for the recognition and further stabilization. Molecular electrostatic potential (MESP) isosurfaces of curved and planar surfaces have clearly provided the difference between the pi-electron distributions. Evidences form the energy decomposition analysis elicit that the dispersive interaction plays a significant role in the overall stabilization of the complexes. And, it is possible to observe the delicate balance between the electrostatic interaction and the exchange-repulsion energy.