ABSTRACT
Abstract Dental age estimation is very important for individual identification in criminal and civil forensic investigations. One of the methods for age estimation is studying age related changes in pulp volume of teeth. The objective of the current study was to estimate dental age from the pulp volume of five different categories of teeth of a Peruvian sample using cone beam computed tomography (CBCT). Retrospective CBCT records of 231 patients (females (134), males (97), age: 12-60 years) were included in the study, categorized into five different age groups (12-19, 20-29, 30-39, 40-49, 50-59, 60 years and older). Dental pulp volume of five categories of teeth(upper canines, left upper central incisors, left upper first molars, lower left first premolars, first molars) were analyzed using Romexis® 5.3.3.5 software for each patient. There was a reduction in the pulp volume of upper right and left canine with age. The Pulp volume was lowest in people aged 60 years and over. Linear regression analysis of the pulp volume and chronological age showed a coefficient of determination of 30%, suggesting a weak correlation. A weak correlation between dental pulp and age is derived. But, a robust large homogenous sample of teeth in future for different age groups may establish a reliable regression equation.
Resumen La estimación de la edad dental en personas vivas y cadáveres es muy importante para la Odontología Forense, sobre todo en casos de identificación en investigaciones legales y sociales. El objetivo del estudio fue estimación de la edad dental mediante la medición del volumen pulpar de imágenes dentales en tomografía computarizada de haz cónico (TCHC) de pacientes peruanos. Fueron analizadas 231 TCHC de pacientes entre 12 a 60 años a más. (Mujeres (134), hombres (97)) se dividieron en seis grupos de edad (12-19, 20-29, 30-39, 40-49, 50-59, 60 años a más). El análisis volumétrico de la pulpa dental se realizó en un total de 1155 dientes (caninos superiores, incisivos centrales superiores izquierdos, primeros molares superiores izquierdos y primeros premolares inferiores izquierdos), mediante el software Romexis® 5.3.3.5. El análisis de regresión lineal mostró un coeficiente de determinación del 30% que sugiere una correlación débil entre la relación del volumen pulpar de los dientes y la edad. El volumen pulpar de los caninos superiores derecho e izquierdo disminuyó a medida que aumentaba la edad y el volumen pulpar en dientes de personas de 60 años a más fue el más bajo. Sin embargo, se pueden proponer estudios futuros para incluir una gran muestra homogénea de dientes en diferentes categorías y grupos de edad para confirmar la correlación y establecer una ecuación de regresión confiable.
Subject(s)
Humans , Male , Female , Child , Adolescent , Adult , Middle Aged , Age Determination by Teeth/methods , Dental Care for Children/statistics & numerical data , Dental Pulp/anatomy & histology , Forensic Dentistry/methods , Peru , Cone-Beam Computed Tomography/statistics & numerical dataABSTRACT
SUMMARY: Dental morphology (DM) is the first introduction of dental graduates towards the identification of tooth; hence it is an important component of the dental curriculum. Traditionally, it is taught by manual carving of wax blocks, but the limitations of this method have been highlighted. There is a need to adopt innovative teaching methodologies to invigorate the concepts of dental anatomy (DA) and reduce the stress in teaching and learning with a proposal in standardization of training methodologies worldwide. Methods: A three-phased project was designed with an aim to collect global data related to teaching dental morphology within the dental curriculum. One dental professional actively involved in university teaching of DM subject was invited from 11 countries. The present study involved compilation of data from phase 1 questionnaire responses, followed by its discussion and analysis, and generation of preliminary report. Results: It is universally acknowledged that acquiring dental morphology knowledge by dentists is a prerequisite before they commence clinical practice. Our data points that no uniformity in DA course modules exists throughout the world and globally the subject requires curriculum redesigning. Conclusions: Consensus should be achieved amongst academicians in DM teaching and learning context. Innovative and standardized DM modules with component of computer-based and remote learning techniques should also be introduced.
La morfología dental (MD) es el primer contacto de los estudiantes de odontología con la identificación del diente; por lo tanto, es un componente importante del plan de estudios de la carrera. Tradicionalmente, se enseña mediante el tallado manual de bloques de cera, pero se han destacado las limitaciones de este método. Existe la necesidad de adoptar metodologías de enseñanza innovadoras para dinamizar los conceptos de anatomía dental (AD) y reducir el estrés en la enseñanza y el aprendizaje con una propuesta de estandarización de metodologías de formación, a nivel mundial. Métodos: Se diseñó un proyecto de tres fases con el objetivo de recopilar datos globales relacionados con la enseñanza de la morfología dental dentro del plan de estudios dental. Se invitó a un profesional de la odontología de cada uno de 11 países que participa activamente en la enseñanza universitaria de la MD. Esto incluyó la recopilación de datos de las respuestas a un cuestionario en la fase 1, seguida de su discusión y análisis, y la generación de un informe preliminar. Resultados: Se reconoce universalmente que la adquisición de conocimientos de morfología dental por parte de los odontólogos es un requisito previo antes de comenzar la práctica clínica. Nuestros datos indican que no existe uniformidad en los módulos del curso de AD en todo el mundo, por lo que el tema requiere un rediseño del plan de estudios. Conclusiones: Debe lograrse consenso entre los académicos en el contexto de enseñanza y aprendizaje de MD. También se deben introducir módulos innovadores y estandarizados de MD con componentes de aprendizaje remoto y de base digital.
Subject(s)
Tooth/anatomy & histology , Curriculum , Education, Dental , Global HealthABSTRACT
The aim of this paper is to highlight the iatrogenic aspect of secondary cleft deformity, methodologies to treat them and the importance of reporting such cases. Secondary deformities are common in cleft lip and palate patients. Primary aim of treatment incleft patients is to enhance their normal growth and development and minimize morbidity and number of operative procedures. Meticulous diagnosis, treatment planning and execution of primary surgery are of utmost importance in such cases to prevent majority of secondary deformities. Treatment of secondary deformity depends on the degree of deformity and the severity of impact on normal functions and growth. Following is a case of 16-year-old female patient who incurred secondary cleft deformities after undergoing multiple surgical interventions for congenital bilateral cleft lip alveolus and palate, last of which was conducted at the age of 6 years. Lip revision and tongue flap surgeries to close the palatal fistula were performed to address the patient‘s complaint and improve quality of life. Performing a tongue flap for anterior palatal fistula was more successful than Bardach‘s palatoplasty technique.It is important that each case encountered at various congenital defect care facilities is reported in literature to make the masses aware of probably outcomes and also help maintain a database to have more accurate data of such cases.
ABSTRACT
Introduction: Rabies is a zoonotic disease having almost100% fatality. Proper and timely management of animal bitecases can prevent the fatal disease. We conducted this studyto assess the attitude and practices of animal bite victimregarding animal bite management at Anti rabies clinic, RDBPJaipuria hospital.Methods: This observational study was conducted among 107attendees of anti-rabies clinic of Govt. R.D.B.P. Jaipuriahospital associated with RUHS College of medical sciences,Jaipur from February 2018 to July 2018. Data was collectedusing a predesigned semi-structured questionnaire. Data wereanalysed using IBM SPSS software version 20.0.Results: 107 participants were enrolled in the study. Maximumparticipants were males (72%), from age group of 26–35 years(43%), urban area (72%), and studying in 10th standard(22.5%). 76% of the participants were having good attitude butonly 36% participants were having good practices regardingmanagement of animal bite cases. Good attitude regardingreaction after animal bite, seriousness of disease, whom toconsult, what to do immediately after bite of animal, vaccinationof bite victim, pet dog vaccination and vaccination of contactswas among 55.14%, 48.6%, 88.78%, 56.07%, 93.46%,66.35% and 37.38% respondents respectively. Only 56% werehaving practice of washing wound with soap and water while16.82% were practicing application of red chilli, 14% werepracticing lime application and 13% participants were havingpractice of applying nothing on animal bite wound. 44% victimsdid not wash the wound before visiting the clinic. Majority(98.13%) visited doctor after animal bite while 1.87% visited totraditional healers first.Conclusion: Practices of applying red chilli and lime on theanimal bite wound is widely prevalent in the community.Community health awareness campaign should involvepreventive measures of rabies and immediate actions afteranimal bite.
ABSTRACT
Abstract Objective: Orthodontic force application releases multiple enzymes in gingival crevicular fluid (GCF) for activation, resorption, reversal, deposition of osseous elements and extracellular matrix degradation. The current systematic review critically evaluated all existing evidence on enzymes in orthodontic tooth movement. Methods: Literature was searched with predetermined search strategy on electronic databases (PubMed, Scopus, Embase), along with hand search. Results: Initial search identified 652 studies, shortlisted to 52 studies based on PRISMA. Quality assessment further led to final inclusion of 48 studies (13 moderately and 35 highly sensitive studies). Primary outcomes are significant upregulation in GCF levels of enzymes-aspartate aminotransferase (AST), alkaline phosphatase (ALP), matrix metalloproteinases (MMPs), lactate dehydrogenase (LDH), β-glucuronidase (βG), tartrate resistant acid phosphatase (TRAP), acid phosphatase (ACP) and down regulation in cathepsin B (Cb). Site specificity is shown by ALP, TRAP, AST, LDH, MMP9 with levels at compression site increasing earlier and in higher quantities compared with tension site. ALP levels are higher at tension site only in retention. A positive correlation of LDH, ALP and AST is also observed with increasing orthodontic force magnitude. Conclusions: A strong evidence of variation in enzymes (ALP, AST, ACP TRAP, LDH, MMPs, Cb) in GCF is found in association with different magnitude, stages and sites of orthodontic force application.
Resumo Objetivo: a aplicação da força ortodôntica libera múltiplas enzimas no fluído crevicular gengival (FCG), desencadeando a ativação, reabsorção, reversão, deposição de elementos ósseos e degradação da matriz extracelular. A presente revisão sistemática avaliou criticamente toda a evidência disponível sobre os níveis de enzimas durante a movimentação ortodôntica. Métodos: utilizando-se estratégias predeterminadas, foram realizadas buscas em bases de dados eletrônicas (PubMed, Scopus, Embase), sendo também feitas buscas manuais. Resultados: a busca inicial identificou 652 estudos e, com base nas diretrizes do PRISMA, foram selecionados 52 estudos. A avaliação qualitativa resultou na inclusão final de 48 estudos (13 estudos com moderada sensibilidade e 35 com alto nível de sensibilidade). Os desfechos primários foram o aumento significativo dos níveis no FCG das enzimas aspartato aminotransferase (AST), fosfatase alcalina (FA), metaloproteinases de matriz (MMPs), lactato desidrogenase (LDH), β-glucuronidase (βG), fosfatase ácido-resistente ao tartarato (TRAP), fosfatase ácida (FAC) e baixa regulação de catepsina B (Cb). Especificidade quanto ao local foi mostrada para FA, TRAP, AST, LDH e MMP9 com os níveis no lado de compressão aumentando mais rápido e em maiores quantidades, quando comparado ao lado de tensão. Os níveis de FA foram maiores no lado de tensão somente no período de contenção. Uma correlação positiva de LDH, FA e AST também foi observada à medida que a magnitude de força ortodôntica aumentou. Conclusões: há fortes evidências indicando que as variações nas enzimas (FA, AST, FAC, TRAP, LDH, MMPs, Cb) presentes no FCG estão associadas a diferentes magnitudes, estágios e locais de aplicação da força ortodôntica.