Comparison of oral midazolam and triclofos in conscious sedation of uncooperative children.

OBJECTIVE: To compare the safety and efficacy of two orally administered conscious sedation agents, Triclofos 70mg/kg and Midazolam 0.5mg/kg in pediatric dental patients. STUDY DESIGN: In this cross over study twenty four sedation sessions were carried out with twelve children between the age group of 3 to 9 years. Children exhibiting negative behavior according to Frankl behavior rating scale (Rating No.2) were selected. Patients were randomly assigned to receive oral midazolam 0.5mg/kg or triclofos 70mg/kg. The alternate drug was administered at the next appointment. Patients' behavioral responses were recorded using a scoring system established by Houpt et al and modified by Badalaty et al considering the degree of sleep, body movement, crying and overall behavior Scoring was done for both midazolam and triclofos session as well as for the session which was tried without medication. Ratings were made during all the procedures like injection of LA, extraction, cavity preparation, restoration and pulp therapy. Statistical analysis was done using Friedman test and Wilcoxon sign rank test. RESULTS: Both the drugs showed significantly higher scores when compared to the session which was tried without medication although the scores for midazolam were significantly higher than triclofos. CONCLUSION: Oral midazolam in a dose of 0.5mg/kg is more effective in regulating patient behavior when compared to triclofos.

Effect of fluorides from various restorative materials on remineralization of adjacent tooth: an in vitro study.

The aim of the study was to evaluate the extent of surface zone remineralization and the effect of fluoride at the inter-proximal adjacent tooth surface, using restorative materials FusionAlloy, Ketac-Fil and Heliomolar. Ninety extracted molar teeth were used of which 45 were placed in artificial caries for 10 weeks. The remaining 45 teeth were filled with the respective restorative materials, mounted with the artificial carious teeth in proximal contact with plaster and placed in artificial saliva for a period of 28 days. Finally, sectioning of artificially carious teeth was done mesio-distally and observed under the optical microscope and scanning electron microscope. Comparison among the groups was done by one-way analysis of variance [ANOVA] and Fischer's F test. Intercomparison between the groups was done by using Dunnett's t-test. Results obtained from transmitted electron microscopic and scanning electron microscopic observations were almost similar with the Ketac-Fil and Heliomolar showing better results in surface zone remineralization compared to FusionAlloy. Also, Ketac-Fil is a good material in releasing fluoride to remineralize enamel when compared to Heliomolar and FusionAlloy. Thus, it can be used mainly in class II cavity restorations of primary and permanent dentitions due to the potential ability of fluoride containing glass ionomer cements and composite resins to remineralize incipient carious lesions on adjacent teeth.

Endometrial stromal nodule with smooth muscle differentiation.

Uterine tumors composed of a prominent component of smooth muscle and endometrial stroma (so-called stromomyoma) are distinctly uncommon. This article describes the morphological features of one such tumor discovered as an incidental finding in a hysterectomy specimen of a 49-year-old lady with a clinical diagnosis of dysfunctional uterine bleeding. Morphological and immunohistochemical (IHC) evaluation were performed and a final diagnosis of endometrial stromal nodule with smooth muscle differentiation was rendered.

Disruption of DMD and deletion of ACSL4 causing developmental delay, hypotonia, and multiple congenital anomalies.

We have studied a male patient with significant developmental delay, growth failure, hypotonia, girdle weakness, microcephaly, and multiple congenital anomalies including atrial (ASD) and ventricular (VSD) septal defects. Detailed cytogenetic and molecular analyses revealed three de novo X chromosome aberrations and a karyotype 46,Y,der(X)inv(X) (p11.4q11.2)inv(X)(q11.2q21.32 approximately q22.2)del(X)(q22.3q22.3) was determined. The three X chromosome aberrations in the patient include: a pericentric inversion (inv 1) that disrupted the Duchenne muscular dystrophy (DMD) gene, dystrophin, at Xp11.4; an Xq11.2q21.32 approximately q22.2 paracentric inversion (inv 2) putatively affecting no genes; and an interstitial deletion at Xq22.3 that results in functional nullisomy of several known genes, including a gene previously associated with X-linked nonsyndromic mental retardation, acyl-CoA synthetase long chain family member 4 (ACSL4). These findings suggest that the disruption of DMD and the absence of ACSL4 in the patient are responsible for neuromuscular disease and cognitive impairment.

Laser and sound scanner for non-contact 3D volume measurement and surface texture analysis.

Non-invasive three-dimensional measurement of volume and analysis of surface texture is desired in various medical applications, particularly wound healing measurements. In this paper we present a PC-based non-contact laser scanner for volume measurements, and a sound scanner that can accurately measure volumes and analyse surface textures. The non-invasive laser and sound sensors, which are lightweight, are mounted inverted on an X-Y table and the sensor heads are held at a distance of 3 cm from the object to be scanned. Volumes of various shapes on different materials, simulating depth profiles and surfaces of wounds, have been measured accurately and surface textures of varying softness have been analysed. The ratios of measured to actual volume range between 0.8 for the sound sensor and 1.1 for the laser sensor. A linear relation between hardness of 50%-20% concentration gelatin gel surfaces and amplitude of reflected sound waves is also observed. The average time per pass of a scan, for a distance of 3 cm, is 4 s and the computation time for measuring volume and reconstruction of a 3D image using ten passes per scan is 1 min. The unique features of this scanner are its speed, portability, accuracy and simple operation as well as its ability to be used on both soft and hard surfaces.

Acidogenic potential of Soya infant formula in comparison with regular infant formula and bovine milk: a plaque pH study.

Soya infant formulas are essential for infants intolerant to cow's milk. Soya formulas contains glucose syrup or maltodextrins instead of Lactose, which has led to concern that they are potentially more cariogenic than standard infant formulas containing lactose. The study was conducted to compare the acidogenic effect of Soya Infant formula, infant formula and bovine milk. The study group consisted of 75 children in the age group of 7-10 years. The plaque pH was measured using plaque pH meter, before and after rinsing with different samples for sixty minutes Soya infant formula is found to be more acidogenic than infant formula (with lactose) and bovine milk. This study demonstrates high caries inducing potential of Soya infant formula. Further awareness of the possible role of Soya infant formula in early childhood caries is required.

Traumatic bone cyst--a case report.

Traumatic bone cyst is an asymptomatic, slow growing, non expansile lesion commonly diagnosed during routine radiographic examination of the jaw bones. It is more frequently seen in young age, with predilection for anterior region of the mandible leading to a dramatic healing of the lesion. A typical case of traumatic bone cyst in a 12 year old girl is reported. A routine radiologic assessment of the patient with panoramic radiograph revealed a fairly large lesion in the anterior region of the mandible. On surgical exploration, clinical diagnosis was confirmed. Post operative successive radiograph shows progressive osseous healing.

Oral melanotic macule--a case report.

A melanotic macule is a benign pigmented lesion of oral cavity characterised by increase in melanin pigmentation. Presented here is a case report of 12 year old girl with black pigmented area on right buccal mucosa. An excision biopsy was done which confirmed the diagnosis by as melanotic macule.

Radicular cyst associated with endodontically treated deciduous tooth: a case report.

This article presents a case report of radicular cyst associated with an endodontically treated deciduous second molar causing displacement of the permanent successor, with accompanying buccal expansion. Cystic sac was removed surgically along with the involved tooth under general anesthesia. Healing was uneventful. Histopathologically the cystic sac was consistent with the features of radicular cyst. Unusual amorphous, eosinophilic, atubular material incorporated within the cystic epithelium was observed.

Microbial contamination of tooth brushes and their decontamination.

With the dawn of the new century, dentistry has seen a new face in the fields of diagnosis, treatment and prevention. Twenty one children were asked to brush their teeth for five days. The brushes were put in Robertson's Cooked Meat broth and cultured. Growth of Streptococcus Mutans were seen. These brushes were then placed in disinfectants such as 0.2% chlorhexidine gluconate (Gp I), 1% sodium hypochlorite(Gp II) and water (Gp III) for 24 hrs and then cultured. Disappearance of growth of microorganisms was seen in Gp I and Gp II and remnants of growth seen in Gp III. It can be concluded that the use of disinfectant is a must for every individual at regular intervals.

Peripheral giant cell granuloma--a case report.

Peripheral giant cell granuloma is a lesion arising mainly from the connective tissue of gingiva or periosteum of alveolar ridge. A case of peripheral giant cell granuloma involving a deciduous molar and the succedaneous tooth is reported. The lesion was large and interfered with occlusion. Surgical excision of the lesion along with the deciduous first molar was done. The underlying permanent first premolar was also involved, and had to be removed. The importance of an adequate salivary flow and maintenance of oral hygiene in the prevention of such lesions is stressed.

Oral health status of Tibetan and local school children of Kushalnagar, Mysore district, India: a comparative study.

UNLABELLED: The presence of migrants culturally different from inhabitants of the host country is now a widespread phenomenon. It is known that dietary habits and oral hygiene practices vary from country to country, which in turn has a profound effect on oral health. OBJECTIVES: To assess and compare the oral health status of Tibetan school children and local school children of Kushalnagar (Bylakuppe). STUDY DESIGN: A survey was conducted at Kushalnagar (Bylakuppe), in Mysore district, India to assess the oral health status of Tibetan school children (n = 300) and local school children (n = 300) and compared using World Health Organization oral health proforma (1997). RESULTS: The proportional values are compared using chi-square test and the mean values are compared using Student's t-test. Statistically significant results were obtained for soft tissue lesions, dental caries, malocclusion, and treatment needs. However, results were not significant when gingivitis was compared in the two populations. CONCLUSIONS: Tibetan school children showed higher prevalence of Angular cheilitis, gingival bleeding, dental caries experience, malocclusion, and treatment needs in comparison with non-Tibetans. Among the Tibetan school children, the requirement for two or more surface filling was more.

Evaluation of resistance of teeth subjected to fracture after endodontic treatment using different root canal sealers: an in vitro study.

AIMS: The aim of this study was to compare the ex-vivo effects of different root canal sealers on the fracture resistance of endodontically treated teeth. MATERIALS AND METHODS: Seventy-five freshly extracted human mandibular premolars were used for the study. The length was standardized to 14 mm and all the teeth were biomechanically prepared and divided into five different groups based on the type of root canal sealers used. Group I:- Roeko seal + gutta percha, Group II: AH plus ® root canal sealer + gutta percha, Group III: PULPDENT root canal sealer + gutta percha, Group IV: Zinc oxide-eugenol sealer + gutta percha, Group V: Control (unobturated teeth). The teeth were embedded in acrylic resin blocks and compressive strengths were measured using universal testing machine (Instron). STATISTICAL ANALYSIS USED: One-way ANOVA, unpaired t- test. RESULTS: Data obtained were statistically evaluated using one-way ANOVA and unpaired t-test. All groups showed a statistically significant result (P < 0.05). Teeth obturated with Group I and Group II showed higher resistance to fracture than teeth obturated with other three Groups. It was seen that the teeth obturated with group III showed a better fracture resistance than Group IV and there was no statistical significance found between Group and Group V. CONCLUSIONS: From this study, it has been concluded that both the resin based sealers that were used in this study were equally effective compared to that of the zinc oxide-based sealers and the control group. However, no significant results were obtained when the comparison was made between zinc oxide-eugenol and gutta-percha and the control group.

Prevention of post-transfusion hepatitis by screening of antibody to hepatitis B core antigen in healthy blood donors.

BACKGROUND: Transfusion-associated hepatitis B viral infection continues to be a major problem in India even after adoption of mandatory screening for HBsAg by ELISA method. The high incidence of TAHBV is reported in patients receiving multiple transfusions. OBJECTIVE: To study the seroprevalence of hepatitis B core antibody among healthy voluntary blood donors SUBJECTS AND METHODS: The study was conducted in the department of Transfusion Medicine of a tertiary care referral hospital. A total of 12,232 volunteers after passing through the stringent criteria were selected for blood donation. Donor samples were tested for all mandatory transfusion transmissible infections and anti HBc IgM (Monolisa HBc IgM PLUS:BIO-RAD, France). Reactive results were confirmed by repeat testing in duplicate. Donor data was analyzed using SPSS software and Chi-square test was used to calculate the significance of difference between the groups. RESULTS: A total of 12,232 healthy voluntary blood donors were recruited. Majority (93.4%) were males. Median age of donor population was 26 years (range: 18-60 years). Eighty six (0.7%) were positive for HBsAg, which comes under "low prevalence (<2%) zone" as per WHO. On screening for HBcAg Ig M, 15 (0.1%) were found to be positive and none were HBsAg reactive. There was no significance of difference in the mean age between reactive and non-reactive donors. CONCLUSION: Evaluating the usefulness of anti-HBc screening is critical. Anti HBcAg IgM screening may be included in routine screening of donors as it is an indicator of occult HBV during window period. The cost and the unnecessary wastage of the blood units when they are positive for anti HBsAg along with the core antibody need to be studied.

Incontinentia pigmenti.

Incontinentia pigmenti or Bloch-Sulzberger syndrome, is a rare X linked dominant disorder with characteristic skin, hair, eye, dental and neurological abnormalities commonly affecting females. This article reports the clinical features and management of a 11 year old girl diagnosed with Incontinentia pigmenti.