Accuracy of torque controllers on healing abutments in implant dentistry-an in vitro study.

PURPOSE: To evaluate the accuracy of three torque-control devices used on healing abutments in implant prosthodontics. MATERIALS AND METHODS: In this in vitro experiment, three torque controllers, Ankylos friction-based, Straumann spring-based, and Anthogyr pre-calibrated torque control devices were used to tighten the healing abutments of Ankylos and Straumann dental implants to a pre-determined value of 15 Ncm. A digital torque meter (DT), Cedar DID-4A, was used to assess removal torque as a surrogate for the accuracy of the torque controllers to apply a tightening force of 15 Ncm on healing abutments.  One-way analysis of variance (ANOVA) was used to identify differences between each torque controller and the digital torquemeter, a p < 0.05 was considered significant. RESULTS: The torque required to remove the healing abutments was 16.05 ± 0.66 Ncm for the Ankylos ratchet, 12.61 ± 0.90 Ncm for the Straumann ratchet, and 14.37 ± 1.08 Ncm for the Anthogyr torque-control device. Significant statistical differences were observed between Ankylos and the control digital torquemeter (p = 1.84E-8 ; F = 50.3); Anthogyr and control digital torquemeter (p = 0.01; F = 6.79); and Straumann and control digital torquemeter (p = 0.01; F = 141.15). CONCLUSION: Friction-based (Ankylos), spring-based (Straumann), and pre-calibrated (Anthogyr) torque control devices present over-torque and under-torque values when used over healing abutments of Ankylos and Straumann implant systems.

Management of peripartum intra-abdominal hypertension and abdominal compartment syndrome.

Normal pregnancy leads to a state of chronically increased intra-abdominal pressure. Obstetric and non-obstetric conditions may increase intra-abdominal pressure further, causing intra-abdominal hypertension and abdominal compartment syndrome, which leads to maternal organ dysfunction and a compromised fetal state. Limited medical literature exists to guide treatment of pregnant women with these conditions. In this state-of-the-art review, we propose a diagnostic and treatment algorithm for the management of peripartum intra-abdominal hypertension and abdominal compartment syndrome, informed by newly available studies.

Comparing bite force in untreated and orthodontically treated non- extraction cases with MBT appliance and self ligation technique using T-scan.

AIM: Aim of this cross sectional study was to compare the bite force and the individual tooth load among three groups of patients: cases finished with the Self ligation appliance (Damon-Q®, 0.022"X0.028" prescription) cases finished with the MBT (McLaughlin, Bennett and Trevisi) appliance system (0.022"X0.028"prescription) and orthodontically untreated cases using T-Scan® 9.0 version. MATERIAL & METHODS: A sample size of sixty non-extraction cases were divided equally into three groups - Group 1: patients treated with Self-ligation appliance (Damon Q®), Group 2: cases treated with the MBT prescription and Group 3: untreated subjects with Class I canine and molar relationship who were used as the control group. The bite force and distribution of force was measured on the right and left side as well as individual tooth loads were measured using the T-Scan® 9.0 device and inter-and intra-group comparisons made using Paired t-Test, ANOVA and Chi-square test. RESULT: The bite forces were balanced on both the sides in cases treated with Self-ligation and MBT appliance. The Self-ligation finishes were marginally better than the MBT group but the difference was statistically insignificant. CONCLUSION: Orthodontically treated individuals had a better (or more even) bite force distribution compared to untreated participants.

Comparative Assessment of Clinical and Predicted Treatment Outcomes of Clear Aligner Treatment: An in Vivo Study.

OBJECTIVE: The objective of this clinical study was to assess the predicted software models and clinical models and to compare the stage models of both the groups so as to evaluate the efficacy of tooth movement with clear aligner. METHODS: The sample size included 10 cases with mild anterior crowding treated with aligner therapy. The predicted software models were superimposed on the clinical stereolithography (STL) models at various stages by using the MeshLab software. The predicted software models showing orthodontic tooth movement were compared with the actual movement achieved clinically. RESULTS: The results of the present study have shown that when a comparison was made on the basis of irregularity scores in both the groups, it was seen that the irregularity score was higher at 2.55 at T4, 1.65 at T6, and 1.0 at T8 in the clinical STL group at each stage, whereas it was 2.0 at T4, 0.90 at T6, and 0.25 at T8 in the software model group. In addition, in comparing the mean accuracy of these three stages, the analysis of data showed that the mean accuracy is 62.5% at T4, 68.8% at T6, and 78.1% at T8. CONCLUSION: The predicted software models do not accurately reflect the patient's tooth position. There is an overestimation by predicted software as compared with actual clinically achieved tooth position. There is a need of overcorrection to be built in the treatment planning stage itself and execution of the anticipated end result.

Transoral robotic surgery and transoral laser microsurgery for oropharyngeal squamous cell cancer.

The aim of our study was to compare transoral laser microsurgery (TLM) and transoral robotic surgery (TORS) for primary resection of oropharyngeal squamous cell cancer (OPSCC). This was a retrospective chart analysis of 33 patients with OPSCC treated at one academic medical center with either TORS (n = 17) or TLM (n = 16) between July 2008 and December 2010. Six patients in the TLM group and seven patients in the TORS group had primary cancer of the tonsil; the remaining patients had base of tongue cancer. Two patients in the TORS group had Stage I or II disease; the other 31 patients had Stage III [1/16 (6 %) TLM; 5/17 (29 %) TORS] or Stage IV cancer [15/16 (94 %) TLM; 10/17 (59 %) TORS]. The intervention was transoral surgery for OPSCC, and the main outcome measures were perioperative variables and functional outcomes. Mean operative time was 170 versus 115 min for TLM and TORS, respectively (p = 0.057). One patient, in the TLM group, required a temporary tracheostomy. Perioperative feeding tubes were placed in 6/16 (38 %) patients who underwent TLM and in 4/17 (24 %) patients who underwent TORS (p = 0.465). At a median follow-up of 14.5 months, the average MD Anderson Dysphagia Inventory score was 65.2 for TLM and 70.8 for TORS (p = 0.431). All TORS procedures were performed with a single oral retractor, while multiple laryngoscopes were required in 9/16 (56 %) TLM cases (p = 0.0003). The mean number of total specimens were 6.2 for TORS and 13.6 for TLM (p = 0.002). These results demonstrate that TLM and TORS have comparable perioperative variables with no significant differences in functional outcomes. For a subset of patients, TORS reduced the spatial complexity of surgery, suggested by the decreased need for multiple laryngoscopes, fewer specimens, and shorter operative times, while larger tumors were more amenable to TLM.

Treatment of division II malocclusion in young adult with Forsus fatigue-resistant device.

The traditional technique for correcting class II malocclusion - involving the use of class II elastics and headgear - has been problematic due to its dependence on patient compliance. Functional orthopedic treatment seeks to correct malocclusions and harmonize the shape of the dental arch and orofacial functions. Removable functional appliances are normally very large in size, have unstable fixation, cause discomfort, exert pressure on the mucosa, reduce space for the tongue, cause difficulties in deglutition and speech, and very often affect esthetic appearance. With a fixed appliance like the Forsus fatigue-resistant device (FRD), as the appliance is fixed, there is less dependence on patient compliance and the remaining growth after the pubertal growth spurt can be harbored effectively. The Forsus FRD is not as rigid as the previous fixed functional appliances and hence is comfortable for the patients. In this case report we describe a patient at the end of the growth stage who had mandibular retrognathia and was successfully treated with the Forsus FRD.

Complete Management of a Mutilated Young Permanent Central Incisor.

This case report throws light on treatment of immature apices through apexogenesis and an esthetic postobturation restoration of traumatized young permanent central incisor using a relatively newer methodology of anatomic posts, i.e. shaping the post to the root anatomy. The authors would also like to underline the significance of rubber dam isolation for more predictable outcomes. The new method of anatomic post is simple, viable, practical, and less time consuming than thought.

Two-phase treatment of class II malocclusion in young growing patient.

The use of functional jaw orthopedics, at the correct time during growth, can ultimately result in malocclusion patients achieving a broad beautiful smile, an excellent functional occlusion, a full face with a beautiful jaw line and lateral profile. Following is a case report of a young growing individual with mandibular retrognathia. Treatment was planned in two stages with the use of twin block during the first phase for correction of skeletal malocclusion and forward positioning of the mandible, followed by the second phase of fixed pre-adjusted edgewise orthodontic appliance for camouflaging the remaining skeletal discrepancy and achieving a stable harmonious occlusion.

Evaluation and comparison of biological cleaning efficacy of two endofiles and irrigants as judged by microbial quantification in primary teeth - an in vivo study.

The endodontic triad comprises of cleaning and shaping, disinfection and obturation. Success of root canal therapy is majorly achieved by proper cleaning and shaping. However, elimination of bacterial contaminants as well as necrotic debris of the canals requires the adjunctive use of irrigants. To achieve a satisfactory biological and mechanical preparation proper selection of endodontic instruments and irrigants is necessary. In this study we are comparing and evaluating cleaning efficacy of endofiles (K-files and handprotapers ) and root canal irrigants (sodium hypochlorite and chlorhexidine) by microbial quantification. Root canal samples were collected in autoclavable bottles containing transport media (nutrient broth) and samples were cultured in tryptose soya agar at incubation temperature of 37°C for 24-48 hours and colonies were counted with digital colony counter. The significance of this study is to help the clinician select proper instrument and irrigant which minimize the failure rate of root canal treatment for the benefit of patients.

Treatment of division II malocclusion in young adult with Forsus™ fatigue-resistant device.

The traditional technique for correcting class II malocclusion - involving the use of class II elastics and headgear - has been problematic due to its dependence on patient compliance. Functional orthopedic treatment seeks to correct malocclusions and harmonize the shape of the dental arch and orofacial functions. Removable functional appliances are normally very large in size, have unstable fixation, cause discomfort, exert pressure on the mucosa, reduce space for the tongue, cause difficulties in deglutition and speech, and very often affect esthetic appearance. With a fixed appliance like the Forsus™ fatigue-resistant device (FRD), as the appliance is fixed, there is less dependence on patient compliance and the remaining growth after the pubertal growth spurt can be harbored effectively. The Forsus™ FRD is not as rigid as the previous fixed functional appliances and hence is comfortable for the patients. In this case report we describe a patient at the end of the growth stage who had mandibular retrognathia and was successfully treated with the Forsus™ FRD.