Understanding, being, and doing of bioethics; a state-level cross-sectional study of knowledge, attitude, and practice among healthcare professionals.

BACKGROUND: The field of bioethics examines the moral and ethical dilemmas that arise in the biological sciences, healthcare, and medical practices. There has been a rise in medical negligence cases, complaints against healthcare workers, and public dissatisfaction with healthcare professionals, according to reports from the Indian Medical Council and other healthcare associations. We intend to assess the level of knowledge, attitude, and practice of bioethics among the registered healthcare professionals (HCPs) of Maharashtra, India. METHODS: A State-level online survey was conducted among the registered HCPs (n = 2143) casing all five regions of the Maharashtra state using a pre-tested self-administered questionnaire. The responses were expressed as mean, and proportions with their standard deviation and 95% CI respectively. Binary logistic regression and a multivariate logistic model were used to determine factors associated with knowledge, attitude, and practice of bioethics. RESULTS: Of the 2143 registered HCPs in Maharashtra included in this study, most of them (65.2%) had adequate knowledge of bioethics. Adequate knowledge was associated with lower age, profession (nurses and dentists), employment in the private sector, HCPS at Marathwada and Pune, and higher educational attainment. About 3 in 5 HCPs (59.4%) had a favorable attitude towards the ethical practice of bioethics, and was associated with profession, place of work, region of practice, and work experience. The distribution of unethical bioethics practices among 10 items was proportionally high, and only 34.4% reported good/fair practice. The common unethical practices in the state were allowing patients to be examined by interns, and not informing them about professional misconduct to the regulatory bodies. CONCLUSION: Most HCPs had adequate knowledge of bioethics, which is encouraging and would favor the laying foundation for forming a good bioethics framework. Only 3/5 HCPs demonstrated a favorable attitude, and the observed unethical practice is alarmingly common. A serious consideration to evaluate the compliance level of bioethics practice periodically and measures to educate, sensitize, and train bioethics among HCPs in Maharashtra is warranted.

Effect of fluoride on mechanical properties of NiTi and CuNiTi orthodontic archwires: an in vitro study.

INTRODUCTION: After debonding, white spot may appear on the area below the bracket, which is the early clinical sign of carious lesion. There is increased caries risk underneath and adjacent to orthodontic bands and brackets, which call for maximum use of caries preventive procedures using various fluoride application methods. OBJECTIVE: The aim of the study was to evaluate alterations in the mechanical properties (modulus of elasticity and yield strength) in loading and unloading phases for different orthodontic archwires (nickel-titanium [NiTi] and copper-nickel-titanium [CuNiTi]) when exposed routinely to fluoride prophylactic agents for a predetermined period of time. METHODS: Preformed rectangular NiTi and CuNiTi wires were immersed in fluoride solution and artificial saliva (control) for 90 minutes at 37ºC. After immersion, specimens were tested using a 3-point bend test on a universal testing machine. RESULTS: There is a significant reduction in the unloading yield strength when the NiTi and CuNiTi wires were exposed to APF gel. CONCLUSION: The result suggests that use of topical fluoride agents affect the mechanical properties of the wires, leading to increase in treatment duration. Fluoride prophylactic agents must be used with caution in patients undergoing orthodontic treatment. Injudicious use of these agents may cause corrosive effects on the orthodontic wire surfaces, with alteration in their mechanical properties.

Effect of fluoride on mechanical properties of NiTi and CuNiTi orthodontic archwires: an in vitro study

ABSTRACT Introduction: After debonding, white spot may appear on the area below the bracket, which is the early clinical sign of carious lesion. There is increased caries risk underneath and adjacent to orthodontic bands and brackets, which call for maximum use of caries preventive procedures using various fluoride application methods. Objective: The aim of the study was to evaluate alterations in the mechanical properties (modulus of elasticity and yield strength) in loading and unloading phases for different orthodontic archwires (nickel-titanium [NiTi] and copper-nickel-titanium [CuNiTi]) when exposed routinely to fluoride prophylactic agents for a predetermined period of time. Methods: Preformed rectangular NiTi and CuNiTi wires were immersed in fluoride solution and artificial saliva (control) for 90 minutes at 37ºC. After immersion, specimens were tested using a 3-point bend test on a universal testing machine. Results: There is a significant reduction in the unloading yield strength when the NiTi and CuNiTi wires were exposed to APF gel. Conclusion: The result suggests that use of topical fluoride agents affect the mechanical properties of the wires, leading to increase in treatment duration. Fluoride prophylactic agents must be used with caution in patients undergoing orthodontic treatment. Injudicious use of these agents may cause corrosive effects on the orthodontic wire surfaces, with alteration in their mechanical properties.

RESUMO Introdução: Após a remoção dos braquetes, manchas brancas podem aparecer na área embaixo deles, as quais são o sinal clínico inicial da lesão cariosa. Existe um maior risco de cáries embaixo e ao redor das bandas e braquetes ortodônticos, o que exige a máxima utilização de procedimentos preventivos de cárie, usando diferentes métodos com aplicação de flúor. Objetivo: O objetivo do presente estudo foi avaliar alterações nas propriedades mecânicas (módulo de elasticidade e resistência ao escoamento), nas fases de carregamento e descarregamento de diferentes fios ortodônticos (níquel-titânio [NiTi] e níquel-titânio com adição de cobre [CuNiTi]), quando expostos rotineiramente a agentes profiláticos fluoretados, utilizados durante um período de tempo predeterminado. Métodos: Os fios pré-contornados retangulares de NiTi e CuNiTi foram imersos em solução fluoretada e saliva artificial (controle) durante 90 minutos a 37°C. Após a imersão, as amostras foram testadas utilizando-se um teste de flexão em três pontos, em uma máquina universal de testes. Resultados: Houve uma redução significativa na resistência ao escoamento na fase de descarregamento quando os fios de NiTi e CuNiTi foram expostos ao gel fluoretado. Conclusão: O resultado sugere que o uso tópico de agentes fluoretados afeta as propriedades mecânicas dos fios, levando a um aumento na duração do tratamento. Os agentes profiláticos fluoretados devem ser utilizados com cautela em pacientes submetidos a tratamento ortodôntico. O uso indiscriminado desses agentes pode causar efeitos corrosivos na superfície dos fios ortodônticos e consequente alteração das suas propriedades mecânicas.

Awareness of orthodontic treatment among school teachers in Karad Taluka.

INTRODUCTION: Health is defined as a state of complete physical, mental, and social well-being. Awareness of orthodontic treatment varies in different regions. Undergoing orthodontic treatment to correct malocclusion would be very beneficial to children as it could help eliminate bullying by peers regarding facial appearance. This kind of bullying by peers could affect the child psychologically. MATERIALS AND METHODS: A questionnaire survey was conducted in Karad Taluka in Maharashtra. A total of 378 subjects were selected. The schools were randomly selected. A questionnaire including general information, knowledge, and awareness of orthodontic treatment was prepared, and the teachers were given 15 min to fill it. Since it was a short period of time to gather information from other sources, the participants answered the questionnaire using their own knowledge. The purpose of this questionnaire, which consisted of 12 questions in both English and Marathi was to evaluate the level of knowledge the teachers had about orthodontic treatment. The purpose of the study and questionnaire forms were explained by the examiner. The responses of the teachers to the questions were recorded on a 2-point Likert scale {YES or NO}. RESULTS: Simple descriptive statistics was applied to describe the study variables. A Chi-square test of independence was performed to check independence between answers and gender for each question. CONCLUSION: Within limits of this study, it may be concluded that knowledge of available treatments was more in males compared to females in rural areas.

Gender determination by radiographic analysis of mental foramen in the Maharashtra population of India.

CONTEXT: Identification of gender is of primary importance in forensic investigations when only fragment of skull remains. Mandible is a hard bone and exhibits a high degree of sexual dimorphism. Gender differences were observed in the height of mandible, gonial angle, bigonial breadth, bicondylar breadth, and position of mental foramen (MF). AIMS OF THE STUDY: The purpose of this study is to evaluate gender differences in distances from superior border of MF (SMF) and inferior border of MF (IMF) to the lower border of mandible (LBM) and height of mandible in the Maharashtra population. MATERIALS AND METHODS: A total of 400 patients (200 males and 200 females) were considered for the study. The panoramic radiographs of patients were captured using Xtropan 2000 system and Carestream (T-Mat GIRA) films. The distance from SMF and IMF to the LBM and the height of mandible was measured. STATISTICAL ANALYSIS USED: Unpaired t-test was applied to calculate the differences between the genders. RESULTS: The distance from SMF and IMF to LBM and height of mandible was more in males when compared to females, which was statistically significant. CONCLUSION: The distances from SMF and IMF to the LBM and height of the mandible showed sexual dimorphism in the Maharashtra population of India.

Post-retention Development of Curve of Spee in Pre-adjusted Edgewise Appliance Cases, Its Correlation to Dentoskeletal Parameters: An In vitro Study.

BACKGROUND: Curve of Spee was first described by Ferdin and Graf Von Spee in 1890. The curve of Spee is an important characteristic of the mandibular dental arch. One of the most frequently encountered problems in the treatment of orthodontic patients is an excessive overbite. Deep bite has been found to be associated with abnormal mandibular function. Temporomandibular joint disorders also have potentially detrimental effects on mandibular development. Andrews advocated leveling the curve of Spee to aflat curve, in order to facilitate construction of an optimal occlusion and that a flat plane should be given as a form of over treatment. There is no reliable information currently available from the literature about the long-term stability of the curve of Spee and the factors influencing the same. The objective of this study was to assess the post-retention development of the curve of Spee and to evaluate the dental and skeletal parameters as predictors of its post-retention stability. MATERIALS AND METHODS: Pre-treatment (Tl), post-treatment (T2) and post-retention (T3) dental casts and lateral cephalograms of 24 orthodontically treated patients having a mean age of 14.5 years were evaluated. The mean period of the study group after retention was up to 2.6 years (range = 1-5 years). Pre-treatment T1, post-treatment T2, and post-retention T3 casts and radiographs were measured. The data were tabulated and statistically analyzed. RESULTS: A highly significant positive correlation was observed between the changes in the curve of Spee during treatment (T2-T1) and the net result after retention (T3-T2). This means that much of the treatment results remained stable at T3. However, slight change was noticed in curve of Spee's depth during the time interval T3-T2. This finding was very negligible and was not statistically significant. CONCLUSION: The leveling of the curve of Spee during the treatment is a stable treatment objective on long term basis. There was a mild correlation existing between the curve of Spee and the different dental and skeletal parameters.

Estimation of dental and facial proportions using height as criteria.

BACKGROUND: Ideal dental restoration is one which not only restores optimal functions but also confirm to standard dental and facial relations. This is important to achieve long term patient satisfaction both with regard to esthetics as well as functions. Objective was to find a credible relationship between dental and facial proportions using height of individuals as the criteria in a specific group of population. To determine a regression equation for determination of various dental and facial proportions using height. MATERIALS AND METHODS: One hundred and forty-four (n = 144) students, of which 91 were males (n = 91) and 53 were females (n = 53) of the dental college participated in this study. Height of the individual, the lower facial height, inter-incisal and inter-canine and inter-commissural width was measured as per protocol and resulting data was analyzed using SPSS 17 (SPSS Statistics for Windows, Version 17.0. Chicago SPSS Inc. Released 2008) version software regression equations were obtained. RESULTS: The study included 144 college students significant correlations were found between height of the individuals, inter-canine distance and lower facial height using Pearson correlation coefficient. The calculated values of t-test were significant. Regression equations were determined for determination of various parameters using height as the sole criteria. CONCLUSION: There exists a definite relationship between height of the individual and their dental and facial parameters in this group of population and values of maxillary anterior teeth can be determined using regression equations.

Unusual presentation of 'u-shaped' impacted maxillary central incisor with intranasal root: successful surgical management.

BACKGROUND: Dilacerations is a tooth deformity characterized by an angulation between crown and root causing non-eruption of the tooth. It generally occurs following trauma to the deciduous dentition apices of which lie close to the permanent tooth buds. According to Neville, maxillary and mandibular incisors contribute only approximately to 1% of the incidence of dilacerated teeth. CASE DETAILS: A 15 year old male patient reported with chief complaint of missing anterior teeth in the left side of maxillary arch. Radiographic evaluation showed impacted maxillary left central incisor. The radiograph depicted very unusual extreme curve in the root of the same tooth giving it characteristic U-morphology. The root of this tooth was curving into the nasal cavity. Due to extreme curve, surgical removal was suggested by orthodontist. Surgically removing this highly placed tooth with apex into nasal cavity was a surgical challenge. This was done effectively by removing the tooth under local anesthesia itself. CONCLUSION: U-shaped morphology in single rooted tooth is observed very rarely. This root curvature predisposes to fracture of root during surgical removal. Proper surgical protocol is to be followed during surgical removal of a tooth with such extreme root curvature to prevent fracture of the root and accidental displacement of the tooth into nasal cavity.

Effect of fluoride prophylactic agents on the surface topography of NiTi and CuNiTi wires.

AIM: The aim of this study was to see the effect of topical fluoride on surface texture on nickel-titanium and copper-nickel-titanium orthodontic archwires. MATERIALS AND METHODS: Preformed rectangular NiTi and CuNiTi wires were immersed in in fluoride solution and artificial saliva (control) for 90 minutes at 37°C. after immersion optical microscope was used to see the fluoride effect on the wire topography. RESULTS: The acidulated fluoride agents appeared to cause greater corrosive effects as compared to the neutral fluoride agents. CONCLUSION: The result suggest that using topical fluoride agents leads to corrosion of surface topography indirectly affecting the mechanical properties of the wire that will lead to prolonged orthodontic treatment. CLINICAL SIGNIFICANCE: The use of topical fluoride agents has to be limited in patients with prolonged orthodontic treatment as it causes the corrosion of the NiTi and CuNiTi wires.