Posterior superior alveolar nerve block alone in the extraction of upper third molars: a prospective clinical study

Background@#Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. @*Methods@#A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. @*Results@#In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. @*Conclusion@#The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

Preoperative Anxiety Among Cardiac Surgery Patients and Its Impact on Major Adverse Cardiac Events and Mortality– A Randomized, Parallel?Group Study

Background:Patients undergoing elective cardiac surgery often experience pre?operative anxiety. Preoperative anxiety influences surgical outcome. There are very few studies which have assessed the impact of clonidine and Gabapentin in the treatment of anxiety especially in Indian populations and its implications on major adverse cardiac events (MACE) and 30 days mortality. Materials and Methods: Adult patients aged 18 to 80 years old who were scheduled to have an elective coronary artery by?pass graft (CABG) were included in the study.Those who satisfied the inclusion criteria were given either Gabapentin (800 mg) or Clonidine (300 mcg) 90?120 minutes before the induction. State trait anxiety inventory (STAI) was used to assess anxiety in baseline and taking just before operating room. The primary endpoint was a reduction in the STAI associated with the study drug, while the secondary endpoint was the incidence of MACE in the perioperative period (30 days), which included composite episodes of non?fatal cardiac arrest, chaotic rhythm, acute myocardial infarction, congestive heart failure, cardiac arrhythmia, angina, and death. Results: A total of 75 patients were considered for the statistical analysis. The demographic and clinical features of the study participants were similar in both groups. Nearly 75?80% of participants had severe anxiety in the preoperative period while 10?20% had moderate anxiety. While both the drugs showed a reduction in the anxiety levels, the clonidine group fared better (statistically insignificant). The incidence of MACE was similar in both groups. Conclusion:The preoperative anxiety levels were high among cardiac surgery patients.Both clonidine and gabapentin were equally effective in reducing the levels of preoperative anxiety. Preoperative STAI scores in the range of 32?53 is not associated with MACE and 30?day mortality among cardiac surgery patients.

Focus on periodontal engineering by 3D printing technology ­ a systematic review / Enfoque en la ingeniería periodontal mediante la tecnología de impresión 3D: una revisión sistemática

Three-dimensional (3D) bioprinting of cells is an emerging area of research but has not been explored yet in the context of periodontal tissue engineering. Objetive: This study reports on the optimization of the 3D bioprinting scaffolds and tissues used that could be applied clinically to seniors for the regenerative purpose to meet individual patient treatment needs. Material and Methods: We methodically explored the printability of various tissues (dentin pulp stem/progenitor cells, periodontal ligament stem/progenitor cells, alveolar bone stem/progenitor cells, advanced platelet-rich fibrin and injected platelet-rich fibrin) and scaffolds using 3D printers pertaining only to periodontal defects. The influence of different printing parameters with the help of scaffold to promote periodontal regeneration and to replace the lost structure has been evaluated. Results: This systematic evaluation enabled the selection of the most suited printing conditions for achieving high printing resolution, dimensional stability, and cell viability for 3D bioprinting of periodontal ligament cells. Conclusion: The optimized bioprinting system is the first step towards the reproducible manufacturing of cell laden, space maintaining scaffolds for the treatment of periodontal lesions.

La bioimpresión tridimensional (3D) de células es un área emergente de investigación, pero aún no se ha explorado en el contexto de la ingeniería de tejidos periodontales. Objetivo: Este estudio informa sobre la optimización de los tejidos y andamios de bioimpresión 3D utilizados que podrían aplicarse a personas mayores en el entorno clínico con fines regenerativos para satisfacer las necesidades de tratamiento de cada paciente. Material y Métodos: Exploramos metódicamente la capacidad de impresión de varios tejidos (células madre / progenitoras de la pulpa de dentina, células madre / progenitoras del ligamento periodontal, células madre / progenitoras de hueso alveolar, fibrina rica en plaquetas avanzada y fibrina rica en plaquetas inyectada) y andamios utilizando impresoras 3D que pertenecen solo a defectos periodontales. Se ha evaluado la influencia de diferentes parámetros de impresión con la ayuda de andamios para promover la regeneración periodontal y reemplazar la estructura perdida. Resultados: Esta evaluación sistemática permitió la selección de las condiciones de impresión más adecuadas para lograr una alta resolución de impresión, estabilidad dimensional y viabilidad celular para la bioimpresión 3D de células del ligamento periodontal. Conclusión: El sistema de bioimpresión optimizado es el primer paso hacia la fabricación reproducible de andamios de mantenimiento de espacio cargados de células para el tratamiento de lesiones periodontales

Analysis of Ultrasonography and Diagnostic Laparoscopy in Nonpalpable Testis

Undescended testis is one of the common disorders encountered in a male child. In nonpalpable testis, ultrasound often fails to locate the testis. Hence, diagnostic laparoscopy has recently replaced it in the management of nonpalpable testis. METHODSThis is a cross-sectional study conducted among all patients who presented between October 2018 and March 2020 with a nonpalpable testis and in whom ultrasound could not locate the testis. Analysis of ultrasound and diagnostic laparoscopy in nonpalpable testis was done. Statistical analysis was done by calculating accuracy, sensitivity, and specificity for selected tests. RESULTS20 patients were included in the study. Most of them (95%) presented after 1 year. Most cases were unilateral 80%; left-sided in 45%, right sided in 35%, and 4 (20%) were bilateral. In 25% cases, the testis was located at the deep inguinal ring, and in 70% cases, it was intra-abdominal, although in 2 cases the testes were tiny like a nubbin. In 1 case, the vessels and vas entered the deep inguinal ring; hence inguinal exploration was done; however, as only a nubbin was found on exploration, orchidectomy was done. In 1 patient inguinal exploration done, whereas other patients were managed laparoscopically. In 2 patients, laparoscopic orchidectomy and in others, laparoscopic-assisted orchiopexy were done. CONCLUSIONSLaparoscopy is superior to ultrasound because of increased sensitivity in localizing a nonpalpable testis, time- and cost-effectiveness, and diagnostic as well as therapeutic options.

A comparative study in the outcome between the two fixed doses of polyvalent anti snake venom, 10 vials versus 20 vials, with mechanical ventilation in children with severe neurotoxic snake envenomation

Background: Every year about 50,000, people die of snake bites in India. Anti-snake venom and mechanical ventilation is mainstay of treatment in cases with severe neurotoxic envenomation. ASV is costly and scarce resource. There is lack of universal consensus towards the optimal dose of ASV in management protocol for children with severe neurotoxic snake envenomation. Objective was to compare the difference in outcome between two fixed doses of ASV, 10vials versus 20 vials, in children with severe neurotoxic snake envenomationMethods: This comparative observational study was carried out for a period of 3 years in Department of Pediatrics of SVS Medical College, Mahabubnagar, Telangana, India. Children with history of snake bite and clinical evidence of neuroparalysis were included. In addition to the mechanical ventilation and other supportive measures, every alternate patient was administered with 10vials (low dose) and 20 vials (high dose) of ASV over 1 hour. Outcome was compared between the two groups.Results: Of the 62 patients, 32 were in each group. The median time to extubation was 41 hours and 39.5 hours and mean duration of the hospital stay was 4.6 days and 4.5 days among the low dose and high dose groups, respectively. There were three deaths, one from low dose group and two from high dose group.Conclusions: There was no significant difference in outcome between the 10 vials vs 20 vials of ASV in addition to mechanical ventilation in treatment of children with severe neurotoxic snake envenomation. So, 10 vials of ASV can be utilized to reduce the cost of treatment.

Two cases with pycnodysostosis in a family: a case report

Pycnodysostosis (Greek, pycnos - density, dys - defect, ostosis - bone) is a rare inherited disorder of the bone, first described by Maroteaux and Lamy. Pycnodysostosis is an autosomal recessive disorder, with incidence estimated to be 1.7 per 1 million births. Clinical presentation of this disorder include short stature, dolichocephalic skull, frontal bossing, obtuse mandibular angle, dysplastic clavicles, and short hands and feet, diffuse osteosclerosis, acro-osteolysis along with the finger and nail abnormalities. The main oral aspects are midfacial hypoplasia, a grooved palate, and dental abnormalities include double row of teeth, delayed eruption of permanent dentition, multiple caries. Pathological fractures of the bones occur due to sclerosis. Radiologically, skull bones appear thickened with open fontanels which look like 'lakes of bones', hypoplasia of facial bones, generalized osteosclerosis, open fontanels and cranial sutures, non pneumotization of paranasal sinuses, and fractures commonly in lower limbs.

A prospective study to determine the application of site, ischemia, neuropathy, bacterial infection and depth scoring in the outcome and management of diabetic foot ulcers

Background: The objective of the study was to classify diabetic ulcers based on the recently described SINBAD classification system and to determine the management based on SINBAD score.Methods: Prospective study, conducted in Victoria Hospital from November 2017 to May 2019.  120 patients with diabetic ulcers were classified according to the SINBAD classification system, wherein a score of one is given for site beyond forefoot, presence of ischemia, presence of neuropathy, bacterial infection, area >1 cm2 and depth beyond subcutaneous tissue. The wounds are scored at presentation and the outcome are evaluated according to respective score.Results: In this study 120 patients with mean age of 50.12 years were included. Lower socio-economic groups correlated with higher incidence of diabetic foot. According to SINBAD classification 42.5% had forefoot, 57.5% had hind foot wounds, 56.3% were purely ischemic ulcers, 19.2% were neuropathic ulcers, 40.0% were neuro-ischemic ulcers 68.3% had bacterial infection, 70.8% had ulcer, size >1 cm2, 55% had ulcer deeper than skin & sub cutaneous tissues. Healing probability in score 1 was 100%, score 2 was 87.5%, Score 3 was 70%, score 4 was 58.6% healing, score 5 was 7.1% and score 6 was 1.1% healing (p=0.004). Ischemia, neuropathy, bacterial infection, area >1 cm2 and depth beyond subcutaneous tissue had significant effect on healing.Conclusions: SINBAD classification system includes 6 parameters, describing the pathological evolution of diabetic ulcers. Treatment protocols can be determined based on the score. The system is easy to score and apply in routine practise.

Clinico-laboratory profile and outcome of dengue fever among children attending a tertiary care hospital of rural Telangana, India

Background: Dengue is a self-limiting, vector-borne disease transmitted by Aedes mosquito, causing a major public health threat globally. The objective of this study is to assess the clinical profile and outcome of the dengue infection in children less than 14 years of age September 2018 to August 2019 at the Pediatric Department of S.V.S. Medical College, the tertiary care hospital in Mahabubnagar, Telanagana.Methods: Prospective study of 82 hospitalized children of <14 years with the diagnosis of dengue illness. Children with diagnosis of dengue were classified further in to two groups as per WHO guidelines, Non-severe dengue fever (probable dengue, dengue with warning signs) and 'Severe Dengue' (Dengue Haemorrhagic Fever and/or Dengue Shock Syndrome (DHF/DSS). A separate questionnaire form used for documenting clinical history, laboratory parameters. Haematological parameters were noted, chest x-ray, ultra-sonogram in required cases was done. Children were managed as per WHO protocol. The outcomes of the cases were mentioned as discharge, left against medical advice and death.Results: A total of 82 children with dengue were divided in to 55(67%) non severe dengue and 27(33%) severe dengue with males 56(68.2%) and females 26(31.7%). The most common age of presentation was between 6-10 years 34(41.5%). Fever 73(89%) was the most common presenting symptoms. Pleural effusion and hepatomegaly were the commonest clinical findings 28(34.1%) each, which were more among the severe dengue patients. Gall bladder edema 29(35.3%) was the most common ultra-sonogram finding. Significant elevation of transaminases (SGOP, SGPT) was seen in 39(47.5%). Severe thrombocytopenia was observed in 22(26.8%) children. Management was by administration of colloids and crystalloids.Conclusions: Dengue is a global problem. Presenting features include high grade fever, vomiting, abdominal pain, skin rash. Early recognition of symptoms and proper management can reduce the mortality.

A Newly Proposed Regression Equation for Mixed Dentition Analysis Using the Sum of the Width of Permanent Mandibular Central Incisors and Permanent Mandibular First Molars as a Predictor of Width of Unerupted Canine and Premolars

Objective: To determine linear regression equation to predict the mesiodistal widths of the permanent canines and premolars based on the sum of the widths of the two permanent mandibular first molars and two mandibular central incisors. Material and Methods: The sample consisted of 800 (400 males and 400 females) permanent dentition casts of Chhattisgarh population. Mesiodistal crown widths of teeth were measured with digital caliper. The correlation and linear regression equations between the calculated four teeth (two permanent mandibular first molars and two central incisors) and the canine-premolars segments of both the arches were developed. Results: No significant differences were found in right and left side of the arch. Sexual dimorphism was significant in teeth sizes with higher mesiodistal dimension in males. A good correlation values varying from 0.51 to 0.67 was found. New standardized regression equations were formulated for the prediction of the mesiodistal widths of unerupted canines and premolars for Chhattisgarh population. Conclusion: Calculating mesiodistal widths of unerupted canine and premolars with help of two permanent mandibular molars and two mandibular central incisors, which erupt early in the oral cavity, can be an alternative and best predictor for the mixed dentition analysis.

Severity of Nonalcoholic Fatty Liver Disease in Type 2 Diabetes Mellitus: Relationship between Nongenetic Factors and PNPLA3/HSD17B13 Polymorphisms

BACKGROUND: The prevalence of nonalcoholic fatty liver disease (NAFLD) in patients with type 2 diabetes mellitus (T2DM) is high, though its severity is often underestimated. Our aim is to provide an estimate of the prevalence of severe NAFLD in T2DM and identify its major predictors. METHODS: T2DM patients (n=328) not previously known to have NAFLD underwent clinical assessment, transient elastography with measure of liver stiffness (LS) and controlled attenuation parameter (CAP), and genotyping for patatin like phospholipase domain containing 3 (PNPLA3) and 17β-hydroxysteroid-dehydrogenase type 13 (HSD17B13). RESULTS: Median LS was 6.1 kPa (4.9 to 8.6). More than one-fourth patients had advanced liver disease, defined as LS ≥7.9 kPa (n=94/238, 29%), and had a higher body mass index (BMI) than those with a LS <7.9 kPa. Carriage of the G allele in the PNPLA3 gene was associated with higher LS, being 5.9 kPa (4.7 to 7.7) in C/C homozygotes, 6.1 kPa (5.2 to 8.7) in C/G heterozygotes, and 6.8 kPa (5.8 to 9.2) in G/G homozygotes (P=0.01). This trend was absent in patients with ≥1 mutated HSD17B13 allele. In a multiple linear regression model, BMI and PNPLA3 genotype predicted LS, while age, gender, disease duration, and glycosylated hemoglobin did not fit into the model. None of these variables was confirmed to be predictive among carriers of at least one HSD17B13 mutated allele. There was no association between CAP and polymorphisms of PNPLA3 or HSD17B13. CONCLUSION: Advanced NAFLD is common among T2DM patients. LS is predicted by both BMI and PNPLA3 polymorphism, the effect of the latter being modulated by mutated HSD17B13.

A New Regression Equation Proposed For Mixed Dentition Analysis in Chhattisgarh, Central India Population

Objective: To develop and propose a new regression for mixed dentition analysis in Chhattisgarh, Central India population. Material and Methods: The permanent dentition dental casts of 800 (400 males and 400 females) Chhattisgarh subjects were selected. Digital caliper was used to measure the mesiodistal crown widths of teeth. The linear regression equations and correlation between four mandibular incisors and the canine-premolars segments of maxillary and mandibular arches were developed (modified Tanaka-Johnston equation) and proposed for Chhattisgarh population. Results: New standardized regression equations were formulated to predict the mesiodistal widths of unerupted canines and premolars especially for Chhattisgarh, Central India population. The equation in males for maxillary arch was Y = 11.90 + 0.39 (X) and for mandibular arch was Y = 12.23 + 0.36 (X). Similarly, the equation in females for maxillary arch was Y = 14.40 + 0.26 (X) and for mandibular arch was Y= 10.26 + 0.43 (X). A significant sexual dimorphism in teeth sizes was seen with higher mesio distal dimension in males in Chhattisgarh population. Conclusion: Sum of the mesiodistal diameter of permanent mandibular incisors can be used reliably to predict/estimate the sum of mesiodistal diameters of unerupted canines and premolars with the new regression equations.

Orthoptic parameters and asthenopic symptoms analysis after 3D viewing at varying distances / 国际眼科杂志(Guoji Yanke Zazhi)

AIM:To analyse visual modifications such as amplitude of accommodation, near point of convergence (NPC) reopsis and near phoria associated with asthenopic symptoms after 3D viewing at varying distances. METHODS: A prospective study. Thirty young adults were randomly selected. Each individual was exposed to 3D viewing thrice in a day for a fixed distance and the distance was varied on three consecutive days. Same video of equal duration and different screen sizes were used for every distance. Cyclic 3D mode of K-multimedia (KM) player was used for projecting the 3D video. Different variables like stereopsis, amplitude of accommodation, near point of accommodation, near phoria and asthenopic symptoms were recorded immediately after 3D video viewing. Stereopsis was measured with "Toegepast Natuurwetenschappelijk Onderzoek冶 or"Netherlands Organisation for Applied Scientific Research 冶 ( TNO test ), amplitude of accommodation and NPC were measured using RAF ruler, near phoria was measured using prism bar and a closed ended sample questionnaire was used to know the occurrence of asthenopic symptoms. Statistical analyses were performed using descriptive statistics, paired t-test etc. Qualitative data was analyzed using Chi-square test. RESULTS: For every distance of 40 cm, 3 m and 6 m, amplitude of accommodation was significantly reduced by 0.66 D,1.12 D and 1.44 D. NPC got significantly receded by 0.63 cm, 0.93 cm and 1.23 cm, and the near phoria was significantly increased by 0. 87, and 2. 2 prism dioptres (PD) base-in respectively. It was found that most of the subjects got pain around the eyes, headache and irritation for each viewing distance. This study also revealed that 3D video viewing in theaters may increase the symptoms of headache, watering and irritation. Symptoms like headache,watering,fatigue,irritation and nausea may increase considerably at home environment and symptoms such as headache and watering may cause significant discomfort by 3D viewing using a laptop. CONCLUSION: There was a significant difference in amplitude of accommodation, NPC, near phoria and asthenopic symptoms before and after viewing a 3D video and also at three viewing distances. There was a predominant occurrence of asthenopic symptoms after 3D video viewing at different distances.

Effect of co-morbidities on disease course in human immunodeficiency virus-infected illicit drug users in the era of highly active antiretroviral therapy / 한국역학회지

No abstract available.

Predictors of human immunodeficiency virus and tuberculosis co-infection / 한국역학회지

No abstract available.

Antimicrobial properties of nanomolecules: potential candidates as antibiotics in the era of multi-drug resistance / 한국역학회지

OBJECTIVES: The emergence of multi-drug resistance among various microbial pathogens has been a cause of serious concern to the medical world, limiting the choice of antibiotics. Considering that it may take decades to synthesize new antimicrobial drugs that combat resistant pathogens, the search for alternatives to conventional antimicrobial agents has begun. METHODS: In his paper we attempted to review the physico-chemical properties of nanoparticles, their modes of action and potential use in medicine and research with special reference to antimicrobial properties. RESULTS: Nanomolecules and nanoparticles have in recent years been extensively studied for their utility not only as antibiotics but also as vehicles to carry antibiotics or other agents such as cancer chemotherapeutics to target sites and limit damage to host cells. CONCLUSION: Nanomolecules were positively evaluated for their antimicrobial activities. Anti-biofilm activities of nanoparticles, utility of nanomaterials as carrier agents of drugs signifies their importance in medicine and research.

Virtual screening studies to identify novel inhibitors for Sigma F protein of Mycobacteriumm tuberculosis

Tuberculosis [TB] is one of the oldest threats to public health. TB is caused by the pathogen Mycobacterium tuberculosis [MTB]. The Sigma factors are essential for the survival of MTB. The Sigma factor Sigma F [SigF] regulates genes expression under stress conditions. The SigF binds to RNA polymerase and forms a holoenzyme, which initiates the transcription of various genes. The Usfx, an anti-SigF protein, binds to SigF and alters the transcription initiation and gene expression. In the present work, virtual screening studies are taken up to identify the interactions between SigF and small molecular inhibitors which can inhibit the formation of holoenzyme. The studies reveal that ARG 104 and ARG 224 amino acid residues of SigF protein are forming important binding interactions with the ligands. The in silico ADME properties for the ligand data set are calculated to check the druggability of the molecules

Zooplankton diversity of Chikkadevarayana canal in relation to physico-chemical characteristics.

Plankton diversity and physico-chemical parameters are an important criterion for evaluating the suitability of water for irrigation and drinking purposes. In this study, we tried to assess zooplankton species richness, diversity and evenness to predict the state of Chickadevarayana canal water of Cauvery River according to physico-chemical parameters. A total of 51 taxa were recorded with 22 rotifers, 5 copepods, 6 cladocerans, 1 ostracoda and 17protozoans. More number of zooplankton species were recorded in Darasaguppe (30) followed by Edmuri (26), Kennala (20), Pandavpura (19) and Gendehosahalli (16). Among the rotifers, Euchlanis sp. species was abundant (194). Acantholeberis curvirostris was predominant among cladocerans (970). Among copepods, numerical superiorities were found in the case Cyclops sp. Cypris sp. was recorded in the ostracoda. Centropyxis aculeate repeated abundance in protozoans (412). The water samples analyzed for temperature, pH, electrical conductivity, alkalinity, hardness, dissolved oxygen, phosphate, sulphate and nitrate did not indicate variation. The occurrence of Asplanchna herricki, Lacrymaria sp, Brachionus pala and Monostyla lunaris showed highest similarity of occurrence reaching above 90%. The study revealed that the presence of certain species like Monostyla, Lepadella, Leydigia, Keratella, Branchionus and Cypris species can be considered as a biological indicator for eutrophication.

Incidence and multiplex PCR based detection of trichothecene chemotypes of Fusarium culmorum isolates collected from freshly harvested Maize kernels in Southern India

Hundred Fusarium culmorum strains, isolated from freshly harvested maize grain samples from Southern parts of India, were incubated in czapek-dox medium and analyzed for trichothecene (DON/NIV) production. The mPCR assay was standardized targeting trichothecene metabolic pathway genes viz., Tri6, Tri7, Tri13 for detection of trichothecene (DON/NIV) chemotypes and rDNA gene for specific detection of F. culmorum species. Primers for targeted genes were designed and used to predict whether these isolates could produce deoxynivalenol/nivalenol, 94 isolates were able to produce DON/NIV by mPCR assay. Chemical analysis of DON/NIV was carried out for mPCR positive isolates by high performance-thin layer chromatography (HPTLC). To check the practical usefulness of developed mPCR assay, 150 field samples of maize were evaluated and results were compared with conventional HPTLC method. Out of 150 samples, 34% samples stayed as a positive for NIV contamination whereas 44% were found to have deoxynivalenol contamination. Moreover, mPCR results are equivocally matched with the HPTLC chemical analysis for field samples. Chemotyping of F. culmorum isolates were reported for the first time from India, and highlights the important potential of F. culmorum to contaminate maize with DON/NIV.

Coated, uncoated stainless steel ligatures versus self ligation- In the perspective of friction

Friction has intrigued Orthodontists for decades. Various appliance and mechanics have been thought to reduce or enhance friction which is the reason for continuous study on the topic. Hence the purpose of this study was to evaluate the effect of Teflon coated arch wires and ligatures on resistance to sliding during simulated canine retraction with conventional and self ligating ceramic brackets with metal slot. Total 120 samples were taken and divided into six groups and for each group [20 brackets] twenty readings were taken. Tidy's frictional test design was used to simulate canine retraction. The test was done under dry condition. To visualize the surface morphology of Teflon coated and uncoated arch wires, they were subjected to scanning electron microscopic evaluation, before and after experiment. Mean values were compared by student's t- test/one way ANOVA appropriately. Multiple range tests by Tukey - HSD [Honesty Significant Difference] analysis were employed to identify the significant groups at 1% level and comparison of least friction groups at 5% level. Teflon coated wires and ligatures produced significantly less resistance to friction than stainless steel wires and ligatures. [p=0.001]. The resistance to friction was less with a combination of conventional ceramic brackets, Teflon coated wires and Teflon coated ligatures when compared with all other groups [p=0.05]

Overview of Clinical Issue Associated With Bisphosphonates In General Dentistry And Orthodontic Speciality.

Modern day general dental practice and orthodontic specialty practice is no longer limited only for healthy and younger individuals. Bisphosphonates ( Bp) have gained much popularity with regard to treatment of calcium metabolic disorders. In every part of the world currently adult patients under bisphosphonate therapy are visiting dental and orthodontic clinics to resolve their problems. So far there is no contraindication for orthodontic patients who are under bisphosphonate therapy. Even though there is no contraindication for orthodontic intervention, few general dental procedures like surgical or invasive treatments are avoided as a precautionary measure. Considerable modifications of regular dental and orthodontic procedures should be enforced in their management. This article reviews the clinical implication of the patients under bisphosphonate therapy who are in need of dental and orthodontic procedures.