detection of early inter proximal caries: DIAGNOdent, conventional and digital radiography

Detection of caries in early stages is necessary for prevention and conservative treatment. The aim of this study was to evaluate the accuracy of laser fluorescence [LF] using DIAGNOdent pen and to compare it with conventional Bite -Wing [BW] and Digital Radiography [DR]. In this survey, eighty extracted molars and premolars were mounted in stone blocks to simulate contact points. Proximal surfaces of each tooth were examined with LF. The teeth were also diagnosed using BW and digital radiography. After these procedures, the teeth were histologically prepared and assessed for caries extension as the gold standard. Sensitivity, specificity, positive and negative predictive values and accuracy were calculated for each diagnostic system in comparison with the gold standard. Cut-off points were calculated with ROC analysis. Comparisons between the accuracy of methods were performed using McNemar test. At dentinal caries, LF had the highest sensitivity and specificity [0.82 and 0.84, respectively]. For detection of early inter proximal caries, the sensitivity of LF [0.74] and specificity of DR [0.95] were the highest. The LF positive predictive values were the least and negative predictive values were the most. There was no significant difference between conventional and digital radiography in the detection of interproximal caries. DIAGNOdent might be a useful additional tool in detecting early interproximal caries, but due to the false positive responses at decision making for restorative treatments, auxiliary methods should be used

Cephalometric correlation between facial dimensions and sagital and vertical position of anterior teeth

Description of relationship between dental and skeletal parameters can help diagnosis and treatment of malocclusions. This study evaluated the relationship between facial height and vertical and sagital position of anterior teeth. The lateral cephalogerams of 89 patients between ages of 14 to 18 years old were studied. The study casts were analyzed then samples were divided into 2 groups of with or without crowding. Cephalograms were traced and Pearson correlation was determined between parameters that explain facial dimensions and parameters that showed sagital and vertical position of anterior teeth. High correlation was found between ANB and Ul to SN, Ul to FH, and Ui to NA [mm]. SNB had also correlation with Ui to FH and Ul to SN. Additionally, Jaraback index showed a great correlation with L to MP, IMP A and SNB. FMA was similarly correlated with IMP A and FMIA. Significant correlation was detected between basal angle and IMP A [P< 0.001]. The remaining subjects did not have crowding and demonstrated high correlation between ANB and LI to NB. SN-GoGn displayed a great correlation with SNB and FMIA. Ui to FH was highly correlated with FMA, SN-GoGn and L! to MP. High correlation was observed between LI to NB [mm] and LI to MP [P<0.001]. There was correlation between position of anterior teeth and facial dimensions that confirms the existence of balance between dentofacial parts. Therefore, establishment of equilibrium is essential for stability of treatment results

effectiveness of exercise-therapy on improvement of balance, gait, quality of life and depression in elderly patients with vertigo due to peripheral disturbances of vestibular system

Vertigo is the sign of vestibular system complications that induce sense of rotation in individual toward environment or the patient himself. It also induces imbalance in gait and operational activities of patients that may lead to depression in individuals. In this study Cawthorne-cooksey exercises were used to remove signs of vestibular system complications and consequently improve balance and gait in patients suffer from vestibular complications. This study was a non-randomized prospective quisi-experimental investigation done in physiotherapy clinic of Al-zahra hospital in Isfahan province during the year 2007. As a consultation with expert statisticians, among old patients with vestibular system complications referred Al-zahra hospital, 41 patients were enrolled in to our study non-randomly. The exercises were taught to patients during three steps. Patients were asked to perform each group of exercises 10 minutes three times a day for one week. To assess the balance, gait, quality of life and depression in patients before and after treatment and also after one month follow-up, we used Berg Balance Scale, Dynamic Gait Index, Dizziness Handicap Inventory, and Beck questionnaire respectively. To analyze data paired t-test and Wilcoxon test were used. There was statistical significant difference in balance before and after treatment [P < 0.001], before treatment and after follow-up [P < 0.001], and also after treatment and after follow-up [P < 0.001]. There was statistical significant difference in gait before and after treatment [P < 0.001], before treatment and after follow-up [P < 0.001], and also after treatment and after follow-up [P < 0.001]. There was statistical significant difference in quality of life before and after treatment [P < 0.001], before treatment and after follow-up [P < 0.001], and also after treatment and after follow-up [P < 0.001]. There was statistical significant difference in depression before and after treatment [P < 0.001], before treatment and after follow-up [P < 0.001], and also after treatment and after follow-up [P < 0.001]. We conclude that using Cawthorne-cooksey exercises lead to improve balance, gait, quality of life and depression in adult patients for at least one month. To achieve desired treatment goals, patients should continue their daily activities even after one month for a long period of time

[Non-alcoholic steatohepatitis presenting as metastatic liver masses]

Non-alcoholic steatohepatitis is a form of chronic hepatitis. Fatty degeneration may involve liver focally or as a whole. The patient was a 41-year-old woman who was diabetic and admitted in Buali hospital in Ghazvin because of right flank pain, fever, vomiting and diarrhea. The patient was treated as pyelonephriris. Liver function tests were as below: ALT: 62 [40] AST: 54 [40], Alkaline Phosohatase: 378 [306]. Imaging study of liver and kidney showed multiple masses in liver that documented again in CT scan of abdomen. Liver biopsy was performed ultrasonography guided. Macrovesicular fatty changes were seen histologically and documented again by review of liver specimens. No any malignant structure was identified. The patient was treated as diabetic patients. Focal fatty infiltration can be misdiagnosed as liver metastasis; it is seen as nonspherical lesion in CT scan, without mass effect, with density similar to water. Guided biopsy of the liver can help to have the correct diagnosis