Identifying the Potential Determinants of Tobacco Counseling Implementation among Oral Health Professionals of India: A Cross-Sectional Survey

ABSTRACT Objective: To identify the potential determinants of tobacco counseling implementation among oral health professionals in India. Material and Methods: A cross-sectional survey was carried out among the 298 dentists of Aligarh and Gwalior. The questionnaire used in the study had sections on dentists' sociodemographic data and a 35-item questionnaire to assess the potential determinants of tobacco cessation counseling. Descriptive statistics were carried out, and a Chi-square test was utilized to determine the association. P-value <0.05 was considered statistically significant. Results: Domains "knowledge", "Professional Responsibility and Identity", and "Remembrance, awareness, and judgment" showed a statistically significant correlation with most tobacco cessation counseling behaviors. In addition, undergraduate education received in Tobacco Cessation counseling, and Continuing education received in Tobacco Cessation counseling had significantly impacted the practice of tobacco cessation counseling (p=0.02 and 0.04, respectively). Conclusion: This study suggests that "Knowledge", "Professional Responsibility and Identity" and "Remembrance, awareness, and judgment" are the potential determinants that could be used to design effective strategies to enhance tobacco counseling among dentists in India.

SMF/FSO integrated dual-rate reliable and energy efficient WDM optical access network for smart and urban communities.

To handle the massive high-speed internet traffic, free space optics (FSO) or single-mode fiber (SMF) based fiber optic communication is being used everywhere across the world. These technologies are capable of providing huge bandwidth and transmitting the data at very high speed with low energy consumption. FSO is a very convenient technology to quickly expand the legacy network in the adverse geographical areas. However, its link performance is highly dependent of inconsistent weather conditions. SMF based fiber optic link has a very low loss and its performance is almost independent on the weather conditions. Though, the installation and maintenance of fibers are quite complex and costly. Individually, FSO or SMF links have their limitations and have to be integrated to leverage their benefits. In this paper, we integrated FSO/SMF links and compared the performance of the proposed architecture which is capable of providing high-speed dual-rate data transmission. The proposed architecture transmits data over either FSO or SMF or both links simultaneously and has 100% more reliability against any one of the link failures. In case of operational link failure (FSO/SMF), data may be switched to the alternative working link (SMF/FSO), simply by tuning the transmitted signal by 50 GHz. The proposed architecture is also reliable against the optical line terminal transceiver (TRx) failure as each user located in the network can be served by two transceivers (1 Gbps and 10 Gbps). The proposed architecture also supports the wavelength division multiplexing overlay transmission for broadcasting the common signal to all the available users in the networks. The architecture reduces ~ 27% of the energy consumption by utilizing the appropriate link of hybrid architecture and TRx according to weather conditions and traffic load. The integrated architecture looks attractive for providing energy-efficient, high speed, and reliable internet coverage to the areas where there is a difficulty of laying fibers and has frequent fiber faults. The architecture is useful for strengthening and boosting rural and urban development.

Repair of a Perforation Defect With Calcium Silicate-Based Cement Using an Internal Matrix.

This case report describes the nonsurgical endodontic management of a distolingual floor perforation in a mandibular first molar using an internal matrix and mineral trioxide aggregate (MTA) cement. The pulp chamber was properly cleaned, and after placement of a synthetic collagen material that served as a barrier at the level of furcation, MTA was used to repair the perforation defect. Root canal treatment was completed and the tooth was restored with a composite restoration followed by a porcelain-fused-to-metal crown.

Artificial Intelligence-assisted chest X-ray assessment scheme for COVID-19.

OBJECTIVES: To study whether a trained convolutional neural network (CNN) can be of assistance to radiologists in differentiating Coronavirus disease (COVID)-positive from COVID-negative patients using chest X-ray (CXR) through an ambispective clinical study. To identify subgroups of patients where artificial intelligence (AI) can be of particular value and analyse what imaging features may have contributed to the performance of AI by means of visualisation techniques. METHODS: CXR of 487 patients were classified into [4] categories-normal, classical COVID, indeterminate, and non-COVID by consensus opinion of 2 radiologists. CXR which were classified as "normal" and "indeterminate" were then subjected to analysis by AI, and final categorisation provided as guided by prediction of the network. Precision and recall of the radiologist alone and radiologist assisted by AI were calculated in comparison to reverse transcriptase-polymerase chain reaction (RT-PCR) as the gold standard. Attention maps of the CNN were analysed to understand regions in the CXR important to the AI algorithm in making a prediction. RESULTS: The precision of radiologists improved from 65.9 to 81.9% and recall improved from 17.5 to 71.75 when assistance with AI was provided. AI showed 92% accuracy in classifying "normal" CXR into COVID or non-COVID. Analysis of attention maps revealed attention on the cardiac shadow in these "normal" radiographs. CONCLUSION: This study shows how deployment of an AI algorithm can complement a human expert in the determination of COVID status. Analysis of the detected features suggests possible subtle cardiac changes, laying ground for further investigative studies into possible cardiac changes. KEY POINTS: • Through an ambispective clinical study, we show how assistance with an AI algorithm can improve recall (sensitivity) and precision (positive predictive value) of radiologists in assessing CXR for possible COVID in comparison to RT-PCR. • We show that AI achieves the best results in images classified as "normal" by radiologists. We conjecture that possible subtle cardiac in the CXR, imperceptible to the human eye, may have contributed to this prediction. • The reported results may pave the way for a human computer collaboration whereby the expert with some help from the AI algorithm achieves higher accuracy in predicting COVID status on CXR than previously thought possible when considering either alone.

Design and Analysis of Multi Junction Solar Photovoltaic Cell with Graphene as an Intermediate Layer.

An efficacious Intermediate Layer (IML) is important for multi junction solar Photo Voltaic Cell (PVC) owing to its good electrical conductivity and optical transparency. In this research work, the use of Graphene as an IML with varied thickness on InGaP/GaAs/InGaAs multi-junction solar PVCs is investigated using virtual fabrication TCAD tool SILVACO-Atlas. The detail absorption rate from wavelength 300 nm (ultraviolet)-2500 nm (middle infra-red region) is determined and the effected modelling stages are recounted. The results after simulation are further confirmed with experimental data to prove accuracy of the research work proposed. The performance parameters with Jsc = 33.4 mA/cm², Voc = 1.27 V, fill factor (FF) = 99.5% and conversion efficiency of 30.91% (1 sun) are obtained under AM1.5G illumination.

Endodontic management of mesiobuccal-2 canal in four-rooted and five-canalled mandibular third molar.

AIM: A case of unusual Root morphology is presented to demonstrate anatomic variations in mandibular third molar. BACKGROUND: The most common configuration of mandibular third molar is two Roots and three canals; however they may have many different combinations. Endodontic treatment was performed in mandibular third molar having aberrant anatomy. CASE DESCRIPTION: Four Root canal orifices were located with the aid of dental operating microscope (DOM) and three separate Roots were diagnosed with radiographs. Spiral computed tomography (SCT) showed the presence of an extra canal and extra Root, indicating a rare anatomic configuration. Looking for additional canals and Roots are important part of successful endodontics, as the knowledge of their existence enable clinicians to treat a case successfully that otherwise might end in failure. CONCLUSION: The use of DOM and SCT in this case greatly contributed toward making a confirmatory diagnosis and successful endodontic treatment of four-rooted and five-canalled mandibular third molar. CLINICAL SIGNIFICANCE: Variation in Root canal anatomy is very common. Knowledge of these variations is very essential for successful Root canal outcome, inability to do so can lead to missed canals and failures. Hence, thorough knowledge of Root canal anatomy and advances in diagnostic aids are essential.

Antibiotic prescription pattern among Indian oral healthcare providers: a cross-sectional survey.

OBJECTIVES: Inappropriate prescribing of antibiotics by healthcare professionals is a worldwide concern. The purpose of this study was to determine the pattern of antibiotic prescription among oral healthcare providers in India. METHODS: A one-page questionnaire was sent to 1600 oral healthcare practitioners registered under the Indian Dental Association by using multistage sampling; 552 (34.5%) responded to the survey. The data were analysed using the χ(2) test and multiple logistic regression analysis. RESULTS: Of 552 questionnaire respondents, 405 (73.4%) chose amoxicillin in non-allergic patients, alone [279 (50.5%)] or associated with clavulanic acid [126 (22.8%)]. The average duration of antibiotic therapy was 4.26 ±â€Š1.26 days. The drug of first choice for patients with an allergy to penicillin was erythromycin [242 (43.8%) of respondents]. A majority prescribed antibiotics for irreversible pulpitis and acute apical periodontitis [395 (71.6%)] and necrotic pulp, acute apical periodontitis and no swelling [326 (59.1%)]. Five hundred and ten (92.4%) of the oral healthcare providers overprescribed antibiotics. CONCLUSIONS: Oral healthcare providers in India are overprescribing, which could be a major contributor to the world problem of antimicrobial resistance. As there is overprescription of antibiotics by Indian oral healthcare providers, there is an urgent need to raise public and professional awareness regarding the risks of antibiotic use.

Prevalence of Three-Rooted Mandibular First Molars among Indians Using SCT.

Undetected extra roots or root canals are a major reason for failure of endodontic treatment. Failure to recognize an extra distolingual (DL) root in mandibular first molar may lead to incomplete debridement of the root canal system and eventually treatment failure. Therefore, it is crucial that atypical anatomy is identified before and during dental treatment. Spiral computed tomography (SCT) images can show 3D images, and therefore much detail can be used when traditional methods prevent adequate endodontic treatment. The overall incidence of DL roots on the mandibular first molars was 6.40% for all patients and 5.00% for all teeth, respectively. The occurrence of DL roots on the right side and on the left side showed a statistically significant difference. The bilateral incidence of symmetrical distribution of DL roots was 56.25%. The DL root canal orifice was separated from DB canal orifice by 2.79 ± 0.34 mm, from the MB canal orifice by 4.23 ± 0.81 mm, and from the ML canal orifice by 3.29 ± 0.52 mm. The high prevalence of the DL root in permanent mandibular first molars among the Indian population by using SCT and estimations of the interorifice distance of such teeth might be useful for successful endodontic treatments.

Single Step Endodontic Management of Immature Apices using MTA.

AIM: To examine the clinical and radiographic appearance of teeth with immature apices that were treated by single step procedure using mineral trioxide aggregate (MTA). SUMMARY: Creation of a physiological hard tissue barrier with calcium hydroxide in a nonvital tooth although quite predictable has certain limitations, such as the very long duration of the treatment spread over multiple visits and increased risk of root fracture. Plugging the root canal end with MTA has been advocated as an alternative treatment modality for open apices. The technique has been proven to be successful in many recently reported cases. The cases reported here present the successful treatment of two traumatized maxillary central incisors with open apices and periapical lesions using MTA. In this case report, MTA has been used to create a hard tissue barrier after disinfection of the root canal.

Prevalence of three-rooted mandibular permanent first molars among the Indian Population.

INTRODUCTION: The aim of this retrospective study was to determine the prevalence of three-rooted mandibular permanent first molars among the Indian population by using periapical radiographs. METHODS: Five hundred eighty-six patients (320 females and 266 males) were selected, with at least 1 mandibular first molar. A total of 1054 periapical radiographs of mandibular first molars, comprising 526 right side and 528 left side, were included. The radiographs were taken at 30-degree mesial angulation and were evaluated by using the magnifying lens. The incidence, gender, and symmetry of three-rooted mandibular first molars were recorded and analyzed by using the chi(2) test. RESULTS: The prevalence of three-rooted mandibular first molars was 5.97% for all patients and 4.55% for all teeth, respectively. The incidence of bilateral symmetrical distribution was 37.14%. The incidence was 6.88% for female patients and 4.89% for male patients (chi(2) = 1.02, P > .05) and 4.94% for the right side and 4.17% for the left side, respectively (chi(2) = 0.36, P > .05). No statistically significant differences were found between female and male patients and between the right-side and left-side occurrences. CONCLUSIONS: Clinicians should be aware of the high racial prevalence of this unusual root morphology in mandibular first molars among the Indian population before and during the root canal treatment of three-rooted mandibular first molars.

Radix Entomolaris: A Clinical Challenge.

A major anatomical variant of the two-rooted mandibular first molar is a tooth with an additional distolingual third root: The radix entomolaris (RE). It is essential to anticipate and find all roots and canals during root canal treatment. Proper angulations and interpretation of radiographs help to identify pulp chamber and root anatomy. If present, an awareness and understanding of this unusual root and its root canal morphology can contribute to the successful outcome of root canal treatment.