Evaluation of Infantile Brachial Plexopathy Using 3T MRI and High-Resolution Ultrasound: Experience From a Tertiary Care Centre.

BACKGROUND: Currently, clinical assessment is the main tool for the evaluation of brachial plexus injury, complemented by electrophysiologic studies (EPS), and imaging studies whenever available. Imaging plays an important role as it enables the differentiation of pre-ganglionic and postganglionic injuries, and adds objectivity to presurgical evaluation. OBJECTIVES: The primary objective was to evaluate the utility of magnetic resonance imaging (MRI) and high-resolution ultrasonography (USG) in the localization and characterization of brachial plexus injury in infants. MATERIALS AND METHODS: In this prospective study, 34 infants with signs and symptoms of brachial plexus injury were evaluated by clinical examination, EPS, MRI, and USG. Imaging findings were correlated with intraoperative findings in infants who underwent surgical management. The association between EPS and MRI findings, and USG and MRI findings were assessed using Fisher's exact test. Semi-quantitative subjective analysis of various MRI sequences was done as well. RESULTS: The most common findings of preganglionic injury and postganglionic injury, in our study, were pseudomeningocele and nerve thickening, respectively. MRI detection of injuries had a significant association with EPS findings. All MRI-detected injuries had a muscle power of grade 3 or less. muscle. Three-dimensional (3D) short tau inversion recovery (STIR) sequence was found to be superior for detecting postganglionic injuries (P < 0.05). CONCLUSION: Imaging studies enable localization of the site of injury, determining the extent, and nature/morphology of injury. The gamut of findings obtained from MRI is far wider compared to that from USG. USG can be used as the first-line screening investigation.

A Comparative Evaluation of Surface Properties of Cention N and TiO2-Enriched Cention N After Brushing Simulation and Erosive Challenge: An In Vitro Study.

Background This study aimed to evaluate and compare the abrasive and erosive wear resistance of Cention N and titanium dioxide (TiO2) nanoparticle-enriched Cention N after three years of brushing simulation. Methodology A total of 48 freshly extracted mandibular molars were mounted in acrylic blocks and divided into two groups of 24 molars based on the type of restorative material used to restore them. Cavities of a standardized size were prepared. Group A was restored with Cention N, and group B was restored with 5% TiO2-enriched Cention N. Each group was further divided into three subgroups of eight. Subgroup 1 was the control subgroup. Subgroup 2 was the abrasive subgroup, subjected to the abrasive challenge in a brushing stimulator with 30,000 cycles to 10,000 cycles in the linear X-axis and Y-axis each and another 10,000 cycles divided into 5,000 cycles clockwise and 5,000 cycles anticlockwise. The total number of brushing cycles was equal to three years of brushing with a duration of eight to nine hours. Subgroup 3 was the erosive and abrasive subgroup, subjected to an erosive pH cycle consisting of exposure to Coca­Cola for five minutes thrice a day for seven days, and then subjected to brushing simulation as above. After the surface treatment, specimens were subjected to the Vickers microhardness test using a diamond indenter and the surface roughness test using an optical profilometer. The resulting values were subjected to statistical analysis. Results There was a significant decrease in mean surface roughness in group B, where TiO2 nanoparticles were added after erosive challenge and brushing simulation, than in group A. There was an increase in mean microhardness in group B which was not significant. Conclusions With the addition of 5% TiO2 to Cention N, there was a significant reduction in surface roughness. The surface microhardness of Cention N containing 5% TiO2 increased non-significantly compared to the control group.

Abdominal MRI on a Commercial 0.55T System: Initial Evaluation and Comparison to Higher Field Strengths.

RATIONALE AND OBJECTIVES: This study aims to assess the quality of abdominal MR images acquired on a commercial 0.55T scanner and compare these images with those acquired on conventional 1.5T/3T scanners in both healthy subjects and patients. MATERIALS AND METHODS: Fifteen healthy subjects and 52 patients underwent abdominal Magnetic Resonance Imaging at 0.55T. Images were also collected in healthy subjects at 1.5T, and comparison 1.5/3T images identified for 28 of the 52 patients. Image quality was rated by two radiologists on a 4-point Likert scale. Readers were asked whether they could answer the clinical question for patient studies. Wilcoxon signed-rank test was used to test for significant differences in image ratings and acquisition times, and inter-reader reliability was computed. RESULTS: The overall image quality of all sequences at 0.55T were rated as acceptable in healthy subjects. Sequences were modified to improve signal-to-noise ratio and reduce artifacts and deployed for clinical use; 52 patients were enrolled in this study. Radiologists were able to answer the clinical question in 52 (reader 1) and 46 (reader 2) of the patient cases. Average image quality was considered to be diagnostic (>3) for all sequences except arterial phase FS 3D T1w gradient echo (GRE) and 3D magnetic resonance cholangiopancreatography for one reader. In comparison to higher field images, significantly lower scores were given to 0.55T IP 2D GRE and arterial phase FS 3D T1w GRE, and significantly higher scores to diffusion-weighted echo planar imaging at 0.55T; other sequences were equivalent. The average scan time at 0.55T was 54 ± 10 minutes vs 36 ± 11 minutes at higher field strengths (P < .001). CONCLUSION: Diagnostic-quality abdominal MR images can be obtained on a commercial 0.55T scanner at a longer overall acquisition time compared to higher field systems, although some sequences may benefit from additional optimization.

Psychological Stress as a Determinant of Increased Maximum Voluntary Bite Force - A Clinical Observational Study.

Background Psychological stress is a known risk factor and modulator for several oral diseases. It is among the critical etiological factors of bruxism and several other disorders. The quantum of bite force is one of the prime determinants of wear resistance and the clinical performance of restorations. Thus, the present study aims to investigate the relationship between the maximum voluntary bite force (MVBF) and the amount of perceived stress experienced by an individual.  Materials and methods Patients (n=111) fulfilling the exclusion and inclusion criteria were divided into high, medium, and low-stress groups based on their stress scores deduced from the Perceived Stress Scale questionnaire (PSS). Bite force measurement was recorded in Newtons (N) for each subject using a portable customized bite recording FlexiForce sensor (B 201). The data were analyzed using Kruskal-Wallis and independent samples t-test. Results  Among the females, the bite force in the medium and high-stress groups was greater compared to the low-stress level group. On the other hand, there was no difference in bite force between any of the stress level groups among male participants.  Conclusion The results show that higher MVBF is associated with higher perceived stress scores in adult females. Practical Implications Psychological counseling can be included in the dental treatment plan of individuals with a high-stress score to counteract their stress-related higher occlusal forces, parafunctional jaw movements, and risky oral health behaviors, thereby potentially reducing the incidence of adverse outcomes such as temporomandibular joint dysfunction and restoration failure by careful choice of restorative materials.

Comparative Evaluation of Microhardness, Smear Layer Removal Efficacy and Depth of Penetration Using Punica granatum, Emblica officinalis and Sodium Hypochlorite As Endodontic Irrigants: An In Vitro Study.

Introduction Root canal morphology tends to be complicated by nature and dealing with this intricacy can be challenging because it makes it difficult to completely disinfect the root canal space. The success of root canal therapy is also determined by the biomechanical preparation of the canal with the application of instruments and irrigating solutions. Due to the fact that the root dentin surface continues to interact with the irrigating solution during preparation, it's critical to evaluate the mechanical characteristics and smear layer removal. Though sodium hypochlorite (NaOCl) is the most commonly used irrigant due to its tissue-dissolving abilities, it has certain drawbacks which include the inability to remove the smear layer and also affects the mechanical properties of root dentin. To overcome these limitations, a variety of herbal substitutes like Punica granatum and Emblica officinalis which possess anti-bacterial and anti-fungal properties can be used as endodontic irrigants. Several studies on the anti-bacterial properties of natural irrigants of pomegranate and amla were reported. However, the mechanical properties and smear layer removal of Punica granatum and Emblica officinalis have not been explored in the field of endodontics. Aim The main aim of this in vitro study is to compare and evaluate microhardness, smear layer removal efficacy and depth of penetration of herbal and conventional irrigants. Materials and methods Thirty-six palatal roots of maxillary molars were decoronated and instrumented up to F3. These roots were sectioned longitudinally and divided into three test groups: Group 1: 12.5% Punica granatum; Group 2: 6.25% Emblica officinalis; control: Group 3: 2.5% NaOCl. All specimens were irrigated with 5ml of each irrigant for 5 minutes. Microhardness of root dentin was measured using a Vickers diamond intender, smear layer removal using a scanning electron microscope (SEM) and depth of penetration using a stereomicroscope. The data was analyzed using one-way ANOVA and the inter-group comparison using Tukey's post hoc test. Results Statistical analysis was done using one-way analysis of variance (ANOVA) and Tukey's post hoc test using SPSS software version 17.0 (SPSS Inc., Chicago ). The highest microhardness was seen in Group 1 (cervical: 53.8375 ± 1.35956, middle: 53.9875 ± 1.01761, apical: 53.6875 ± 1.63133) while Group 2 (cervical: 43.2750 ± 1.73596, middle: 43.3125 ± 1.17648, apical: 43.8000 ± ​​​​​​​1.32665) and Group 3 (cervical: 42.7250 ±â€‹â€‹â€‹â€‹â€‹â€‹â€‹ 2.93391, middle: 41.9625 ±â€‹â€‹â€‹â€‹â€‹â€‹â€‹ 1.66985, apical: 42.0250 ±â€‹â€‹â€‹â€‹â€‹â€‹â€‹ 2.21085) showed significant reduction in root dentin hardness. Regarding smear layer removal Group 1 (1.3750 ±â€‹â€‹â€‹â€‹â€‹â€‹â€‹ 0.51755), and Group 2 (1.2500 ±â€‹â€‹â€‹â€‹â€‹â€‹â€‹ 0.46291) reveals greater smear removal in the middle third of the root dentin compared with Group 3 (2.3750 ±â€‹â€‹â€‹â€‹â€‹â€‹â€‹ 0.51755), which showed the least smear layer removal. A greater depth of penetration was seen in Group 1 (0.5488 ± 0.05222) and Group 2 (0.5263 ±â€‹â€‹â€‹â€‹â€‹â€‹â€‹ 0.05181) than in Group 3 (0.3087 ±â€‹â€‹â€‹â€‹â€‹â€‹â€‹ 0.05743). Conclusion The present study reveals that the least reduction of microhardness was seen in Punica granatum followed by Emblica officinalis and NaOCl. The smear layer removal efficacy and depth of penetration were greater in Punica granatum and Emblica officinalis than in NaOCl. It was concluded that as these herbal irrigants are biocompatible agents, they can be considered for future use in root canal treatment.

Management Protocols of the Hot Tooth-A KAP Survey among General Dentists and Endodontists.

Aim: Pain management is a cornerstone in the practice of endodontics. However, optimum pain control has been a challenge in cases of symptomatic irreversible pulpitis resulting in a "hot tooth." Thus, the objective of the study is to assess the knowledge and attitude and to determine the clinical protocols of "hot tooth" management followed among general practitioners and specialists. Materials and Methods: The KAP questionnaire contained 05 knowledge, 04 attitudes, and 06 practice-related items. The questionnaire was pretested among 10 randomly selected general dentists and endodontists. Testing-retesting was also performed. The questionnaire was self-administered and the acceptance to answer the questionnaire was considered consent to participate in the study. The sample size was calculated to be 200 with a 95% level of confidence. Descriptive statistics were used. For significance level, P < 0.05 was considered statistically significant. The Chi-square test was used for comparison between the endodontists and the general dentists. Results: The anesthetic techniques that clinicians are most skilled in are infiltration and inferior alveolar nerve block (IANB) - 96.6% and 98.5% respectively. The intraosseous technique (IO) was the least preferred technique (6.8%). The most common supplementary injection used among both the BDS and MDS graduates was intrapulpal anesthesia. In cases of acute pulpitis, 54% of the respondents prescribed NSAIDs as a pre-anesthetic medication. Conclusion: The current study shows that supplemental injections like intraosseous and intraligamental techniques are underutilized. Also, the benefits of preanesthetic medication for hot tooth management are not harnessed among clinicians despite the sufficient body of evidence.

Current Trends in Intentional Replantation Treatment Among Endodontists and Postgraduate Students in India, the United States of America, and the United Kingdom: A Cross-Sectional Study.

Objective This study aimed to investigate the knowledge, attitude, and practices (KAP) of intentional replantation among postgraduate students and endodontists in India, the United States of America, and the United Kingdom. Materials and methods The sample size was estimated using G*Power. Based on the pilot study done before with 60 participants, a sample size of 928 was obtained. The survey consisted of 22 questions, which were finalized after content validation by two endodontic experts. It was circulated through multiple online social platforms such as Instagram, Facebook, WhatsApp, and other online dental communities/channels. The respondents were questioned about the case selection, extraction methods, antibiotic therapy, patient acceptance level, operator preference, prognostic indicator, and various other steps in the intentional replantation treatment modality. The data for this KAP survey were organized in an Excel sheet, and statistical analysis was done using the Chi-squared test. Analysis of descriptive and inferential statistics was conducted using SPSS version 20.0 (IBM Inc., Armonk, New York). A p-value of <0.05 was considered significant. Results A strong statistical difference was found in the KAP of the practitioners in different countries. The vast majority (72.7%) considered intentional replantation as an adjunct treatment modality rather than a last resort. A total of 76.5% of the respondents preferred replantation of the tooth into the socket within 15 minutes, and 86.4% of the participants regarded replantation as the most cost-effective treatment modality. Ultrasonics (76.8%) was most commonly chosen for retrograde preparation, and Biodentine (60.1%; Septodont, Saint-Maur-des-Fossés, France) as root-end filling material. Conclusion It can be concluded that a broad majority of practitioners in different countries view intentional replantation as an adjunct treatment modality rather than a last resort. Thus, intentional replantation seems to be a promising option for preserving the natural dentition of teeth with high survival rates and better outcomes.

Influence of Simulated Wound Exudate on the Antimicrobial Efficacy of Various Intracanal Medicaments Against Enterococcus faecalis: An In Vitro Study.

Aim The aim of this study is to compare and evaluate the antimicrobial efficacy of chlorhexidine, calcium hydroxide, and cetylpyridinium chloride against Enterococcus faecalis in the presence and absence of contamination with simulated periapical exudate at different time intervals. Methods Simulated wound exudate and cetylpyridinium chloride gel were prepared prior to testing. The test groups were divided into groups A and B based on the presence and absence of simulated wound exudate. They were further divided into four subgroups as follows: subgroup 1: calcium hydroxide; subgroup 2: 2% chlorhexidine gel; subgroup 3: 0.5% cetylpyridinium chloride gel; subgroup 4: 0.9% saline as control. E. faecalis was inoculated, and the test groups were evaluated at different time periods of six, 12, and 24 hours. Aliquots were then obtained and subjected to 10-fold serial dilutions. A total of 10 µl of individual samples was spread onto the nutrient agar medium using L-rod. The plates were then assessed for colony-forming units (CFU), and the values obtained were subjected to statistical analysis. Kolmogorov-Smirnov and Shapiro-Wilk normality tests were used to check whether the variables follow a normal distribution. For within-group comparison, the Friedman test and the Kruskal-Wallis test were used. For between-group comparison, the Mann-Whitney U test was used. Results Saline had the highest CFU values, while cetylpyridinium chloride had the lowest CFU values in both contaminated and non-contaminated groups. In all the conditions, the CFU values of cetylpyridinium chloride were significantly lowest compared to the other three groups. CFU values of the calcium hydroxide group were significantly high, followed by the chlorhexidine group when compared to cetylpyridinium chloride in both contaminated and non-contaminated groups. Conclusion Within the limitations of the current study, it can be concluded that cetylpyridinium chloride was the most effective intracanal medicament against E. faecalis than calcium hydroxide and chlorhexidine at varying time intervals, even in the presence of a periapical exudate. Thus, cetylpyridinium chloride can be considered an effective intracanal medicament for root canal disinfection.

Antibiotic Prescription Patterns for Endodontic Procedures in India: A Knowledge, Attitude, and Practices (KAP) Survey.

Objective The purpose of this study is to evaluate the antibiotic prescription patterns of endodontists, general dentists, and other dental specialists for endodontic procedures in India by using the knowledge, attitude, and practices (KAP) survey method. Methods This cross-sectional study was carried out from February 2022 to May 2022 and involved dentists across India. A self-made questionnaire survey was created to judge the knowledge of various dental practitioners, which includes general dentists, endodontists, other dental specialists, and post-graduates with regard to antibiotic usage guidelines for endodontic purposes. A total of about 310 dental practitioners were surveyed across India. The questionnaire was circulated via social platforms such as WhatsApp, Instagram, and Facebook Messenger. Statistical analysis Data for KAP regarding antibiotic prescription patterns among general dentists, endodontists, other dental specialists, and postgraduates were entered into Microsoft Excel and analyzed using IBM SPSS Statistics for Windows, Version 20 (IBM Corp. Released 2011. IBM SPSS Statistics for Windows, Version 20.0. Armonk, NY: IBM Corp.). Descriptive statistics of the study population were examined. The level of statistical significance was determined at p<0.05. Results For the percentage of patients who were prescribed systemic antibiotics every day for endodontic reasons, about 38.6% (119) responded 0-10% and 27.3% (84) responded 10-30%. For the order of antibiotics that they prefer from most to least, about 85.4% (263) responded amoxicillin > metronidazole > doxycycline > azithromycin > clindamycin > ciprofloxacin. For the question of whether they use local antibiotics, about 35% answered yes of which 25% were endodontists, 2% were general dentists, 5% were other dental specialists, and 3% were post-graduates. About 77.3% of the total participants were unaware of the antimicrobial stewardship concept and AwaRe classification from WHO. About 53.2% (164) attended CDE programs with regard to antibiotic usage. Conclusion It is evident from the results of the present study that there is over-prescription of antibiotics by practitioners especially by general dentists without following proper guidelines for endodontic treatments. More emphasis should be made on the proper prescription pattern of antibiotics, proper understanding of endodontic diagnosis, and the need for antibiotics at the undergraduate level. In addition, proper awareness, as well as proper prescription of antibiotics, should be made for existing dental professionals.

Basic principles of AI simplified for a Medical Practitioner: Pearls and Pitfalls in Evaluating AI algorithms.

With the rapid integration of artificial intelligence into medical practice, there has been an exponential increase in the number of scientific papers and industry players offering models designed for various tasks. Understanding these, however, is difficult for a radiologist in practice, given the core mathematical principles and complicated terminology involved. This review aims to elucidate the core mathematical concepts of both machine learning and deep learning models, explaining the various steps and common terminology in common layman language. Thus, by the end of this article, the reader should be able to understand the basics of how prediction models are built and trained, including challenges faced and how to avoid them. The reader would also be equipped to adequately evaluate various models, and take a decision on whether a model is likely to perform adequately in the real-world setting.

Advances in the imaging of gastroenteropancreatic neuroendocrine neoplasms.

Gastroenteropancreatic neuroendocrine neoplasms comprise a heterogeneous group of tumors that differ in their pathogenesis, hormonal syndromes produced, biological behavior and consequently, in their requirement for and/or response to specific chemotherapeutic agents and molecular targeted therapies. Various imaging techniques are available for functional and morphological evaluation of these neoplasms and the selection of investigations performed in each patient should be customized to the clinical question. Also, with the increased availability of cross sectional imaging, these neoplasms are increasingly being detected incidentally in routine radiology practice. This article is a review of the various imaging modalities currently used in the evaluation of neuroendocrine neoplasms, along with a discussion of the role of advanced imaging techniques and a glimpse into the newer imaging horizons, mostly in the research stage.

An Interdisciplinary Management of Avulsed Maxillary Incisors: A Case Report.

The current case report presents a case of a road traffic accident comprising dental avulsion of maxillary incisors. A 30-year-old male reported missing teeth following trauma in his upper front tooth region. The avulsion of maxillary right central and lateral incisors along with laceration in upper and lower lips was evident. The avulsed teeth were stored in milk after a brief extra-oral dry time of one hour and were carried to the department with a one-hour delay. After clinical and radiographic investigations, no mobility or fractures were apparently noticed. The avulsed 11 and 12 had closed apices with intact crown and root surfaces. Following an extra-oral endodontic therapy, immediate replantation was scheduled. Subsequently, the alveolar sockets were irrigated with saline to dislodge the clot and any gross debris that was present. Teeth were reimplanted into the socket after placement of PRF membrane around the root surface. A semi-rigid wire and composite splinting were done for a span of two weeks and antibiotics were prescribed. An exploratory CBCT taken revealed a cortical bone loss in the buccal region of 12 and 11. An interdisciplinary approach to regenerate the osseous defect was then carried out. A follow-up of two weeks, four weeks, three months, six months, and a year was done. Evaluation performed after a year revealed the absence of clinical symptoms and satisfactory healing with no signs of resorption radiographically.

Finishing and Polishing of Composite Restoration: Assessment of Knowledge, Attitude and Practice Among Various Dental Professionals in India.

Aim The key to the success of a composite restoration lies in the important final step of finishing and polishing. This survey aims to assess the knowledge, attitude, and practice about finishing and polishing in composite restoration among various dental professionals in India. Materials and methods A cross-sectional questionnaire survey was conducted among various dental professionals in India. The participation of dentists was voluntary. A total of 350 responses were received, and the data were converted to Microsoft Excel 2019 program and descriptive statistics were analyzed using SPSS Version 21.0 software. Results Almost 99% of respondents know the importance of finishing and polishing procedures of composite restoration. Overall, 71% of respondents felt it is necessary to remove the surface layer to improve the surface characteristics of the composite restoration, 59.8% of professionals follow the sequential order of abrasives for finishing and polishing of composites, 74.2% use interproximal strips to finish interproximal areas of restoration, and 55.8% of professionals use polishing paste for the final polishing of composite restoration. Only 44.2% are aware of liquid polish/composite glaze, among which 12.4% of practitioners use liquid polish often. Conclusion Most of the respondents were aware of the benefits of proper finishing and polishing of composite restorations. However, still they need to follow proper sequential series of burs, abrasive points, disks, strips, and polishing pastes. The usage of surface sealants should be emphasized for enhanced results.

Neurotic personality trait as a predictor in the prognosis of composite restorations: A 24-month clinical follow up study.

The role of personality traits in modulating the incidence and progression of medical disease conditions are well documented, however, there is a paucity of information for its effects on dental health conditions and specifically on the prognosis of restorative dental materials. This study aims to evaluate the clinical performance of Micro-hybrid and Nano-ceramic composite restorations among patients with different personality traits. A total of 323 patients, indicated to receive operative treatment at a University Dental College Hospital, were invited to participate in this study. Consenting patients were requested to complete the Big Five Inventory (BFI-44 Item) personality questionnaire and were evaluated by a psychiatrist for categorizing the participants based on their personality traits. Out of the recruited patients, 124 patients falling in to the dominant trait of Agreeableness (n = 62) and Neuroticism (n = 62) were included in the study for further investigation. Next, patients from the Agreeableness (Group A) and the Neuroticism personality trait group (Group N) were randomly divided into two subgroups each-sub group Am (n = 44) and Nm (n = 48) for Micro-hybrid composite restorations and Sub group An (n = 42) and Nn (n = 47) for Nano-ceramic composite restorations. Two trained and calibrated dentists prepared the cavities according to previously published methodology. The restorations were evaluated at baseline (immediately after restoration), 6-months, 12-months and 24-months intervals by two blinded independent dental professionals for anatomical form, secondary caries, color match, retention, marginal adaptation, surface texture, marginal discoloration and post-operative sensitivity. There is no statistically significant difference noted in various parameters of restoration performance between Micro-hybrid composite and Nano-ceramic composite compared among 'agreeableness' personality group and among 'neuroticism' personality group after controlling the personality trait factor. Higher 'Neuroticism' individuals had higher restoration deterioration in color matching and surface texture when compared to higher 'Agreeableness' trait individuals. Regression analysis showed no effect of gender or cavity size on the outcome of results. Assessment of personality traits may serve as a useful tool during treatment planning which would aid clinicians in choosing suitable restorative dental material and prosthesis design according to individual patient's physiological and functional needs, thereby overall improving the quality of treatment provided.

Pattern of Traumatic Dental Injuries Among Adults.

BACKGROUND: The etiology, presentation and management of traumatic dental injuries (TDIs) vary significantly between the adult and the younger population. Most epidemiological studies on TDIs have focused on the pediatric age group. This study aims to report and compare the distributions of TDIs among adults in a sub-population in India. METHODS: This prospective observational study was performed on 1562 consecutively selected patients (1218 males and 344 females) from a university dental hospital in India, between July 2014 and June 2018. The clinical examinations were performed by a single trained and calibrated endodontist. Only TDIs to anterior teeth were recorded (canine to canine in the maxilla and mandible) and classified using a modified version of the World Health Organization's (WHO's) classification. Periapical and panoramic radiographs were taken for all the subjects. RESULTS: A total of 1562 patients aged between 20 and 73 years, with a mean age of 36 years, were examined during the study period. The total number of teeth with TDIs was 3044. Males (78%) clearly outnumbered the females (22%) in all the age groups. The most common type of injury occurring in both the genders is uncomplicated crown fractures (male=31.0% and female=36.6%). Avulsion injuries are more likely to be seen by a dentist within 1 hour post-trauma. About two-third of the TDIs were caused by road traffic accidents (RTAs) followed by falls in about 20% of the patients. CONCLUSION: Uncomplicated crown fracture was the most commonly observed type of TDI, and RTAs were the primary cause of TDI.

An Immature Traumatic Teeth Management With Apical Pathology Using the Novel Biodentine™ Obturation: A Case Report.

Pulpal and periapical pathosis in an immature anterior tooth following traumatic injury is a frequent occurrence, and management of open apices in such cases poses a constant challenge to endodontists. This is due to the absence of apical constriction that would result in poor three-dimensional seal/adaptation of the obturated material within the canal system. Treatment of immature pulpless teeth with long-term calcium hydroxide may consequently weaken the dentin and increase the fracture susceptibility. Obturating the root canals completely with bioactive agents like Biodentine/mineral trioxide aggregate (MTA) has benefits like increased fracture resistance when compared to apexification. When used for obturation, Biodentine™, a new calcium silicate-based cement, performs superior to other Portland cement derivatives. This case report demonstrates a six-month follow-up result of an open apex and a periapical lesion involving maxillary right central incisor #11 with the Biodentine obturation that was previously subjected to triple antibiotic paste as an intra-canal medicament for three weeks. The satisfactory healing rate of tooth 11 with the reduction in the size of periapical radiolucency at the end of the six-month follow-up in this current article is highly considerable.

Ultrasound Imaging of Renal Cysts in Children.

Renal cysts can be focal or diffuse and unilateral or bilateral. In childhood, most renal cysts are due to hereditary diseases rather than simple cysts or acquired cystic diseases, unlike adults. Inherited cystic diseases can be ciliopathies due to a primary ciliary defect (as in polycystic kidney diseases and nephronophthisis). Acquired causes include obstructive cystic dysplasia, dyselectrolytemia, and acquired cysts in renal replacement therapy. The final diagnosis requires a multispecialty approach, including radiology, pathology, and genetics. Imaging is a very important component in treating patients with cystic renal diseases. This article discusses the ultrasound findings of cystic renal diseases in children, along with a brief discussion of other imaging modalities and a suggested ultrasound reporting format.

Male genital tract tuberculosis: A comprehensive review of imaging findings and differential diagnosis.

Urogenital tuberculosis is the most common form of extrapulmonary tuberculosis. Genital organ involvement occurs as a continuum of urinary tract tuberculosis and often presents a diagnostic challenge due to the non-specific nature of the symptoms. Delay in diagnosis may lead to complications such as infertility and perineoscrotal sinuses. Imaging plays an important role in raising timely suspicion of tuberculosis. In this article, we describe the imaging findings of male genital tuberculosis and the differential diagnosis. High-resolution ultrasonography (HRUS) is the best modality for assessing the epididymis, testis, scrotum and vas deferens, whereas MRI is optimal for evaluating the prostate, seminal vesicles and ejaculatory ducts. Epididymis is the most common site of genital tuberculosis, and presents as a nodular lesion limited to the tail or as diffuse enlargement. The proximal vas deferens is also frequently involved due to anatomical contiguity and shows diffuse or nodular thickening. Advanced cases may show pyocele formation and scrotal wall sinuses. Testicular involvement is almost always secondary to epididymal tuberculosis and presents as single or multiple nodules, diffuse enlargement, or the 'miliary' pattern. Isolated testicular involvement should raise suspicion of malignancy. Tuberculosis of the prostate is often asymptomatic. The most common imaging manifestations are nodules and the diffuse forms, which may later evolve into abscesses. Fibrosis and calcification occur with healing. Seminal vesicle and ejaculatory duct involvement with fibrosis may cause infertility. Awareness of the imaging findings would enable the radiologist to raise timely suspicion, so that prompt treatment is initiated and complications are prevented.