Evaluation of the effect of different kinds of treatment modalities for temporomandibular joint pain and its relevance to chronic cervical pain: A randomized controlled trial.

AIM: The aim of this study was to evaluate the effect of different treatment modalities for temporomandibular joint (TMJ) pain and their relevance to chronic cervical pain after 12 months. SETTINGS AND DESIGN: This was a randomized controlled trial. MATERIALS AND METHODS: Forty-eight participants with chronic cervical and TMJ pain were selected using research diagnostic criteria and randomized into four groups (n = 12), which included control, soft splints, transcutaneous electrical nerve stimulation (TENS), and low-level laser (LLL). The cervical and TMJ pain was recorded using visual analog scale (VAS) scores at baseline, 3 months, 6 months, and 12 months. Occlusal equilibration was done for all groups except for the control. STATISTICAL ANALYSIS USED: The mean pain scores were statistically analyzed using one-way analysis of variance and posthoc test. RESULTS: The mean VAS scores in TMJ pain patients between the four groups at baseline and at final follow-up were 7.27 ± 1.29 in Group 1, 7.53 ± 0.70 in Group 2, 7.76 ± 0.80 in Group 3, and 7.61 ± 0.61 in Group 4. The mean difference between Groups 1 and 3, Groups 1 and 4, and Groups 2 and 3 was statistically significant (P < 0.00). Pearson correlation test yielded a mild and negative correlation between TMJ and cervical pain. CONCLUSION: TENS and LLL were found to be equally effective in reducing pain in the jaw joint region, followed by soft splints, and there was no correlation between TMJ and cervical pain.

Laser Indicated Occlusal Plane Device: A Novel Technique for Occlusal Plane Orientation.

Parallelism to the ala-tragus line is commonly used as a guide for the orientation of the occlusal plane with the help of a fox plane. The accuracy of parallelism is affected by improper judgment or patient movement. This report describes a method with a modified fox plane that aids in occlusal plane determination. The device is placed in the patient's mouth with the maxillary occlusal rim to determine parallelism to the ala-tragus line and interpupillary line. The adjustments are made until the laser light on the device runs parallel to the ala-tragus line, and the spirit bubble is centered between the lines of the tube. This technique facilitates direct visualization of parallelism, thereby avoiding parallax errors.

Assessment of effectiveness of cricoid pressure in preventing gastric insufflation during bag and mask ventilation: A randomized controlled trial.

BACKGROUND: Rapid sequence induction and intubation (RSII) with application of "Cricoid pressure" and avoidance of "facemask ventilation" (FMV) is believed to minimize the risk of pulmonary aspiration of gastric contents during general anesthesia. However, some patients may be at risk of developing hypoxemia and may benefit from FMV during RSII. The purpose of this study was to assess the effectiveness of "cricoid pressure" in preventing gastric insufflation during FMV using gastric ultrasonography. MATERIALS AND METHODS: Eighty-four adult patients were randomized to receive cricoid pressure (CP) or no cricoid pressure (NCP), during FMV after induction of general anesthesia. Gastric antral cross-sectional area (CSA) was measured with ultrasonography before and after FMV in supine and right lateral decubitus positions (LDP). Appearance of "comet tail" artifacts created by acoustic shadows of gas in the gastric antrum was noted. RESULTS: The incidence of insufflation indicated by "comet tail" artifacts during FMV was lower in group CP (17 vs 71%; P < 0.001). The lowest P aw at which gastric insufflation occurred was higher in group CP (20 vs 14 cmH2O). The change in mean gastric antral CSA was significantly lower in group CP than in group NCP in supine (0.02 vs 0.36 cm2, P = 0.012) and right LDP (0.03 vs 0.67 cm2, P < 0.001). CONCLUSION: Cricoid pressure is effective in preventing gastric insufflation during FMV at P aw less than 20 cmH2O. Observation of comet tail artifacts in gastric antrum along with measurement of change in antral CSA on ultrasound examination is a feasible and reliable method to detect gastric insufflation.

Evaluation of Bond Strength between Grooved Titanium Alloy Implant Abutments and Provisional Veneering Materials after Surface Treatment of the Abutments: An In vitro Study.

INTRODUCTION: Titanium has become the material of choice with greater applications in dental implants. The success of the dental implant does not only depend on the integration of the implant to the bone but also on the function and longevity of the superstructure. The clinical condition that demands long-term interim prosthesis is challenging owing to the decreased bond between the abutment and the veneering material. Hence, various surface treatments are done on the abutments to increase the bond strength. AIM: This study aimed to evaluate the bond strength between the abutment and the provisional veneering materials by surface treatments such as acid etching, laser etching, and sand blasting of the abutment. MATERIALS AND METHODS: Forty titanium alloy abutments of 3 mm diameter and 11 mm height were grouped into four groups with ten samples. Groups A, B, C, and D are untreated abutments, sand blasted with 110 µm aluminum particles, etched with 1% hydrofluoric acid and 30% nitric acid, and laser etched with Nd: YAG laser, respectively. Provisional crowns were fabricated with bis-acrylic resin and cemented with noneugenol temporary luting cement. The shear bond strength was measured in universal testing machine using modified Shell-Nielsen shear test after the cemented samples were stored in water at 25°C for 24 h. Load was applied at a constant cross head speed of 5 mm/min until a sudden decrease in resistance indicative of bond failure was observed. The corresponding force values were recorded, and statistical analysis was done using one-way ANOVA and Newman-Keuls post hoc test. RESULTS: The laser-etched samples showed higher bond strength. CONCLUSION: Among the three surface treatments, laser etching showed the highest bond strength between titanium alloy implant abutment and provisional restorations. The sand-blasted surfaces demonstrated a significant difference in bond strength compared to laser-etched surfaces. The results of this study confirmed that a combination of surface treatments and bond agents enhances the bond strength.

Evaluation of Shear Bond Strength of Feldspathic CAD/CAM Ceramic with Dentin using 2 Bonding Agents and 2 Surface Treatments- An Invitro Study.

BACKGROUND: All ceramics are the material of choice for aesthetic tooth replacements. The success of all ceramic restoration depends on the bond between the ceramic and the tooth surface hence this study was done to evaluate the shear bond strength of Feldspathic CAD/CAM ceramic with <5% hydrofluoric acid and hydrofluoric acid combined with silane coupling agent. AIM: To evaluate the shear bond strength of Feldspathic CAD/CAM ceramic with Dentin using bonding agents Prime & Bond NT, XenoIII and surface treatments <5% hydrofluric acid, hydrofluric acid combined with silane coupling agent. MATERIALS AND METHODS: Forty cylinders with 6mm diameter and 5mm height were milled from CEREC Blocs through CAD/CAM technology. Cerec blocks were bonded to etch freshly extracted tooth surface using a self etch and total etch bonding agent. The samples were divided into 4 groups. Group A1-Ceramic cylinders were treated with < 5% HF and bonded using Prime & Bond NT and Variolink II. Group A2- treated with < 5% HF and silane coupling agent and bonded same as group A1. Group B1- treated with < 5% HF and bonded using Xeno III and Variolink II. Group B2- treated with < 5% HF and silane coupling agent, and bonded same as Group A3. The shear bond strength was evaluated after 24 hours by Storing in distilled water in Instron 3385 universal testing machine with 10-KN force. RESULTS: Statistical analysis was done using student's t-test and Lavene's test. The p-value <0.05 shows significant difference in bond strength between A1 and A2 & B1and B2. CONCLUSION: The application of a silane coupling agent to the ceramic surface after etching with hydrofluoric acid increased the adhesion strength with both bonding agents. Student's t-test revealed a significant effect of silanization.

Evaluation of the efficacy of titanium plates as denture markers under various heat sources and pressure - An in vitro study.

INTRODUCTION: Denture Markers are used as one of the main identifying aid in mass disasters. Dental description of missing person in mass disasters plays a vital role in forensic research. Difficulties arise when the teeth are missing. In such situation the prosthodontic identification (ID) of replaced teeth becomes the priority. Till recently, there was no development of denture marker that could withstand massive fire accidents. AIM: To determine the use of titanium chips with identity code engraved on it as denture markers that could withstand high temperature and pressure. MATERIALS AND METHODS: Wax patterns were fabricated with identity code moulded on a rubber stamp. It was invested and casted with titanium. Titanium chips were inserted into the polymethylmethacrylate (PMMA) block and subjected to various heat treatments. RESULTS: There was no loss of identity when subjected to 1,500°C overnight but only residues left under pressure of 200 kg/cm(3). CONCLUSION: The literature recommends the metallic denture markers in order to withstand the post morten assaults. Titanium denture markers could be a preferred option as it can withstand high temperatures under pressure also.

Marginal mass islet transplantation with autologous mesenchymal stem cells promotes long-term islet allograft survival and sustained normoglycemia.

Allogeneic islet transplantation is an option to treat diabetes however there are obstacles that are limiting its clinical use. We have examined whether mesenchymal stem cells (MSC) improve islet graft survival and whether such therapy allows for better graft acceptance with reduced requirement for immunosuppression. In vitro-expanded syngeneic bone marrow-derived MSC were co-transplanted with islets into omental pouch in a rat model of streptozotocin-induced diabetes. Marginal mass syngeneic islet transplantation into the omentum with MSC promoted sustained normoglycemia. Interestingly, allogeneic islets +MSC, but not islets alone, with short-term use of immunosuppression enhanced long-term islet graft survival, insulin expression in the grafts and induced normal serum insulin levels and normoglycemia. T cells from recipients transplanted with allogeneic islets +MSC produced low levels of IFN-gamma and TNF-alpha upon ex-vivo activation, and this transplantation protocol promoted the generation of IL-10-secreting CD4(+) T cells. These data encourage further preclinical and eventually, clinical MSC-based islet transplantation to improve the outcome of allogeneic islet transplantation in the treatment of diabetes.

Autologous bone marrow-derived rat mesenchymal stem cells promote PDX-1 and insulin expression in the islets, alter T cell cytokine pattern and preserve regulatory T cells in the periphery and induce sustained normoglycemia.

Cell-based therapies offer considerable promise for prevention or cure of diabetes. We explored the potential of autologous, self-renewing, mesenchymal stem cells (MSC) as a clinically-applicable approach to promote glucose homeostasis. In vitro-expanded syngeneic bone marrow-derived MSC were administered following or prior to diabetes induction into a rat model of streptozotocin-induced beta cell injury. MSC were CD45(-)/CD44(+)/CD54(+)/CD90(+)/CD106(+). MSC spontaneously secreted IL-6, HGF, TGF-beta1 and expressed high levels of SDF-1 and low levels of VEGF, IL-1beta and PGE(2), but no EGF, insulin or glucagon. MSC homed to the pancreas and this therapy allowed for enhanced insulin secretion and sustained normoglycemia. Interestingly, immunohistochemistry demonstrated that, the islets from MSC-treated rats expressed high levels of PDX-1 and that these cells were also positive for insulin staining. In addition, peripheral T cells from MSC-treated rats exhibited a shift toward IL-10/IL-13 production and higher frequencies of CD4(+)/CD8(+) Foxp3(+) T cells compared to the PBS-treated rats. These data suggest that the bioactive factors secreted by MSC establish a tissue microenvironment that supports beta cell activation/survival in the pancreas. In addition, because of anti-inflammatory and immunoregulatory effects of MSC on T cells, this work can lead to clinical trial of autologous MSC to prevent/cure type-1 diabetes.