Effectiveness of low-level laser therapy after surgical removal of impacted mandibular third molars: A randomized clinical trial.

Introduction: The low-level laser therapy has been accepted globally as cell bio-modulator, used to reach ideal therapeutic effects, acting in the reduction of the pain response, with anti-inflammatory effects, stimulating local micro-circulation and wounds repair, promoting a rapid recovery, which brings a better quality of life to the patient. In this study, we aim to to determine the effectiveness of low-level laser therapy on reducing the pain and swelling after removal of impacted third molars. Materials and Methods: In this present prospective randomized clinical study, third molar surgeries were performed in thirty patients who were divided into two equal groups (placebo group and study group) a placebo group with routine treatment and a study group with low-level laser therapy which was applied both intraorally and extraorally after the surgical extraction of mandibular third molar. Results: The parameters such as postoperative pain, edema, and trismus were assessed on 1st and 7th day. All these parameters showed statistically significant results in patients with low-level laser therapy. Conclusions: Low-level laser therapy was effective in reducing the postoperative pain, edema, and trismus in the third molar surgeries.

Tramadol versus ketorolac for pain management after third molar surgery.

OBJECTIVES: To compare the analgesic efficacy of preoperative intravenous (IV) ketorolac versus tramadol in preventing postoperative pain after mandibular third molar surgery. METHODOLOGY: Two hundred patients in the age group of 18-40 years with asymptomatic impacted mandibular molars were randomly allocated into one of the two groups (100 in each group) and underwent third molar surgery under local anesthesia. Group I received IV ketorolac 30 mg and Group II received IV tramadol 50 mg preoperatively. The difference in postoperative pain was assessed by five primary end points: pain intensity being measured hourly by Wong-Baker pain assessment scale for 6 h, onset of analgesia, duration of action, total number of analgesics consumed, and patient's global assessment. RESULTS: Throughout the 6 h investigation period, patients reported significantly lower pain intensity scores, longer duration of action, lesser postoperative analgesic consumption, and better global assessment in ketorolac when compared to tramadol group. Patients in the ketorolac group significantly performed better than the tramadol group in terms of all parameters except onset of analgesia. All the drug-related complications were mild and did not require any investigation. CONCLUSION: The result of the present study shows that preoperative IV ketorolac 30 mg is more effective than tramadol 50 mg for postoperative pain following third molar surgery.

Inferior alveolar nerve canal position in relation to mandibular molars: A cone-beam computed tomography study.

OBJECTIVE: This study was carried out to prevent the risk of iatrogenic injuries to the inferior alveolar nerve (IAN) canal associated with various surgical interventions in the area of mandibular molars, by using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: The present retrospective study was carried out by using CBCT of 100 patients between 18 and 40 years of age group. The linear measurements were made in relation to the 1st and 2nd mandibular molars on both the sides. Linear distances between buccal and lingual aspects to the mandibular, buccal, and lingual cortical bone thickness; IAN canal diameter; and the superior corticated border of the IAN canal from the periapex of the 1st and 2nd mandibular molars. The statistical evaluation was done using SPSS V.20 (SPSS: an IBM company), and P < 0.05 was considered statistically significant. RESULTS: Both genders of all age groups showed statistically significant result (P < 0.00). All the linear measurements were statistically significant in relation to both the 1st and 2nd mandibular molars (P < 0.005), and also the bilateral comparison of the linear measurements showed statistically significant difference in relation to the mandibular 2nd molar (P < 0.03) and 1st molar (P < 0.04) among both the sexes. CONCLUSION: Clinicians should be aware of the proximity of root apices and cortical plates to the mandibular canal when performing surgical and root canal procedures in the posterior mandible to avoid serious nerve injuries.

Readiness of Accredited Social Health Activist Workers for Tobacco Cessation Counseling after a Brief Intervention in Odisha, India: A Quasi-experimental Study.

AIM: The aim of the study was (1) to explore the baseline beliefs and practices of accredited social health activist (ASHA) workers of Khurda district of Orissa with respect to tobacco cessation and (2) to assess whether a brief intervention will be effective in improving the beliefs and practices of ASHA workers. The results of this study could be utilized by policy makers for framing important strategies for tobacco cessation in rural areas utilizing ASHA workers. MATERIALS AND METHODS: A quasi-experimental study (before and after comparison) was performed in Khurda district of Orissa to find out whether a brief intervention could improve the beliefs and practices of ASHA workers related to antitobacco counseling in rural areas. A 14-item structured, interviewer-administered questionnaire, written in English (translated in Odiya), was used. The final sample size was estimated as 135. Data were entered into Statistical Package for the Social Sciences (version 21) for analysis. RESULTS: All the mean belief items, practice items, degree of preparedness, and interest in training scores of study population increased significantly from baseline to postintervention. The study population showed a statistically significant improvement in postintervention composite belief and composite practices score. CONCLUSION: The majority of ASHA workers had positive beliefs and favorable practices after attending a brief intervention toward smoking cessation in their community. After attending the intervention, nearly half of the respondents felt themselves either somewhat or very well prepared for tobacco cessation. Most of them showed their interest toward getting further training in the field. CLINICAL SIGNIFICANCE: Training programs and regular tobacco cessation activities should be planned in the primary health-care delivery system of India.

Awareness, Attitude, and Knowledge of Basic Life Support among Medical, Dental, and Nursing Faculties and Students in the University Hospital.

OBJECTIVE: To assess the awareness, attitude, and knowledge about basic life support (BLS) among medical, dental, and nursing students and faculties and the proposal of BLS skills in the academic curriculum of undergraduate (UG) course. Recognition, prevention, and effective management of life-threatening emergencies are the responsibility of health-care professionals. These situations can be successfully managed by proper knowledge and training of the BLS skills. These life-saving maneuvers can be given through the structured resuscitation programs, which are lacking in the academic curriculum. MATERIALS AND METHODS: A questionnaire study consisting of 20 questions was conducted among 659 participants in the Kalinga Institute of Dental Sciences, Kalinga Institute of Medical Sciences, KIIT University. Medical junior residents, BDS faculties, interns, nursing faculties, and 3rd-year and final-year UG students from both medical and dental colleges were chosen. The statistical analysis was carried out using SPSS software version 20.0 (Armonk, NY:IBM Corp). RESULTS: After collecting the data, the values were statistically analyzed and tabulated. Statistical analysis was performed using Mann-Whitney U-test. The results with P < 0.05 were considered statistically significant. Our participants were aware of BLS, showed positive attitude toward it, whereas the knowledge about BLS was lacking, with the statistically significant P value. CONCLUSION: By introducing BLS regularly in the academic curriculum and by routine hands on workshops, all the health-care providers should be well versed with the BLS skills for effectively managing the life-threatening emergencies.

Measurement of Lingual Cortical Plate Thickness and Lingual Position of Lower Third Molar Roots Using Cone Beam Computed Tomography.

OBJECTIVE: The objective of the study was to determine the potential risk of tooth/root displacement into the soft tissue during the third molar surgery. While performing third molar surgeries, one of the many complications is displacement of the tooth into the soft tissues. This can be due perforation of the lingual cortical bone during surgery or the position of the tooth root which may be close to the lingual bone. MATERIALS AND METHODS: Retrospective samples of 251 patients were collected who had undergone cone-beam computed tomography (CBCT) for various reasons. Measurements were performed independently and recorded twice by one surgeon and one radiologist; the average of the two measurements was calculated and evaluated using MyRay CBCT. RESULTS: On the right and the left side, the average distances in males for AL were 3.31 and 2.96 mm, respectively, whereas in females was found to be 3.98 and 3.56 mm which were statistically significant. On the right and left side, the average distances in males for RL were 2.03 and 1.78 mm, respectively, whereas in females, it was 2.41 and 1.99 mm, respectively, with the significant P value in the right side. CONCLUSION: Despite the sample size being of 251 patients, a large number of root of the third molar (95.62%) were not in contact with lingual cortical bone, but still practitioner should be careful during surgery as there might be the risk for displacement of the tooth. The images used were of impacted molar used in this study and these teeth were not subjected to surgery. Hence, the results can be only correlated theoretically, i.e., there would be a risk of displacement of the tooth during extraction.

Inhibition of bacterial adhesion by subinhibitory concentrations of antibiotics.

BACKGROUND: Urinary Tract Infections (UTIs) due to Escherichia coli is one of the most common diseases encountered in clinical practice. Most common recognised pathogenic factor in E.coli is adhesion. There is accumulating evidence that through subinhibitory concentrations (sub-MICs) of many antibiotics do not kill bacteria, they are able to interfere with some important aspects of bacterial cell function. MATERIALS AND METHODS: A study was conducted to investigate the effect of sub MICs (1/2-1/8 MIC) of ciprofloxacin, ceftazidime, gentamicin, ampicillin and co-trimoxazole on E. coli adhesiveness to human vaginal epithelial cells using three strains ATCC 25922, MTCC 729 and U 105. RESULTS: The 1/2 MIC of all the antibiotics tested produced the greatest inhibition of bacterial adhesion. Morphological changes were observed with ciprofloxacin, ceftazidime and ampicillin at 1/2 MIC and to a lesser extent at 1/4 and 1/8 MIC. Co-trimoxazole caused the greatest suppression of adhesion at 1/2 MIC of E. coli strain MTCC 729 when compared with the controls, followed by ceftazidime. CONCLUSION: These results suggest that co-trimoxazole is the most effective antibiotic in the treatment of urinary tract infections caused by uropathogenic E. coli.

A microbiological study of ophthalmia neonatorum in hospital-born babies.

A retrospective microbiological analysis of ophthalmia neonatorum among the hospital-born babies of a rural multispecialty hospital over a period of 2 years was made. Diagnostic cultures were performed in all the affected babies and 30 cases were found to be culture positive for bacterial species. The spectrum of various bacterial isolates and their antibiotic sensitivity patterns were studied. Pseudomonas aeruginosa was found to be the commonest causative organism according to this study and newer fluoroquinolones like ciprofloxacin and norfloxacin were the antibiotics that showed the best sensitivity pattern.