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Background: Acute appendicitis is one of the most common emergency clinical conditions among children. It has two-way treatment options, one is surgical procedures, and another is a conservative approach. In the modern arena conservative treatment approach for acute appendicitis is one of the most preferred options. The aim of the study was to find out the solution to clinical conditions and reduce the procedure of injudicious appendectomy.Material & Methods:This prospective observational study was carried out at the Department of Paediatric Surgery, Dhaka Medical College Hospital, Dhaka to assess the necessity of appendectomy following conservatively managed uncomplicated acute appendicitis. A total of 62 children with uncomplicated acute appendicitis were included in the study. Then a conservative treatment started with the combination of inj. Ceftriaxone (100 mg/kgper day), inj. Metronidazole (1.5 mg/kg/ tds) and inj. Amikacin (7.5 mg/kg/ bd) therapy for five days with associated supportive management. The patients were assessed after 24 hours of treatment, who responded to the above management were the continued for same treatment at least five days then discharged and were followed up for 6 months.Results:Mean age was 8.95 ± 2.10 years within range from 4 years12 years. The male-female ratio was 1.58:1. The mean duration of hospital stay was 5.26 ± 0.63 days. On day 5, 59 (95.1%) were discharged and 3 (4.9%) underwent surgery during the conservative treatment period. A total of 8(13of .0%) cases have recurred during the first 6 months after treatment. Conclusions:Antibiotic treatment in patients with acute appendicitis is quite effective, the success rate is 95.1% during the period of treatment, and the recurrence rate is 13.0%.
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@#Conservative endodontic access cavity (CEC) is the first step of minimally invasive endodontics. After that operation, teeth retain the dental hard tissue, such as crest and peri-cervical dentin, to a large extent. It is of great significance to reduce the tissue excision and achieve a favorable prognosis. There are a variety of approaches and corresponding cavities in CEC. The methods to determine the medullary approach include X-ray localization, micro CT/cone beam CT localization and digital guide plate localization. Among them, X-ray film and micro CT/cone beam CT are simple and commonly used in the clinic. For more complex root canal systems, the use of a digital guide plate can establish a more accurate pulp opening pathway and reduce the unnecessary loss of tooth hard tissue. However, the positioning price of a digital guide plate is high, and it has not been widely used in the clinic. The hole types of CEC include minimally invasive medullary hole type, super conservative minimally invasive medullary hole type, "Truss" hole type and cutting end hole type. The stress analysis of CEC and traditional endodontic access (TEC) cavity are mainly based on the loading of teeth by a universal mechanical testing machine in vitro, finite element analysis and clinical observation. Most scholars’ studies have shown that minimally invasive endodontics can improve the fracture resistance of teeth, but the differential capacities of CEC and TEC remain controversial. How does on balance the purpose of pulp treatment and the maximum retention of tooth tissue? Further exploration is still needed.
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Crown fractures are the most frequent traumatic injuries to permanent teeth and mainly involve the maxillary incisors due to their exposed position in the dental arch. One option for managing crown fractures, when the tooth fragment is present and in good condition, is reattachment of the fragment to its original position. This paper reports on three crown fracture cases in which successful esthetic and functional results were achieved by reattachment of the tooth fragment.
Subject(s)
Crowns , Dental Arch , Incisor , ToothABSTRACT
STATEMENT OF PROBLEM: The current trend in prosthodontics is the adoption of a conservative approach to preparing dental prostheses by minimizing the amount of sound tooth structure removal during preparation. PURPOSE: The major disadvantage of the adhesion bridge is the inherently poor resistance to dislodgement that its use in areas subjected to high occlusal load is limited. The purpose of this study was to compare the dislodgement resistance of Bio-pin(R), conventional 3-unit and adhesion bridges. MATERIAL AND METHODS: The experimental groups were classified as follows: .Group I : 3-unit bridge cemented using Super-Bond. C&B .Group II : Adhesion bridge cemented using Super-Bond. C&B .Group III : Bio-pin(R) design adhesion bridge without incorporation of Bio-pin(R) (cemented using Super-Bond. C&B) .Group IV-1: Bio-pin(R) retained adhesion bridge incorporating a single Bio-pin(R) (cemented using Super-Bond. C&B) .Group IV-2: Bio-pin(R) retained adhesion bridge incorporating a single Bio-pin(R) (cemented using Panavia. F) .Group V : Bio-pin(R) retained adhesion bridge incorporating two Bio-pins. (cemented using Super-Bond. C&B) RESULTS: The results of this study were as follows: 1. Significant differences in dislodgement resistance of the restorations were found between Group I, Group II and Group III (p<0.05). No significant differences in dislodgement resistance of the restorations were observed between Group I, GroupIV-1 and GroupV. However, there were significant differences in dislodgement resistance between GroupII and the other groups (p<0.05). 2. No significant differences in dislodgement resistance of the restorations were observed between GroupIV-1 and GroupIV-2, both of which utilized a single Bio-pin(R). However, significant differences were observed when GroupIII was compared to either GroupIV-1 or GroupV (p<0.05). 3. No significant differences in dislodgement resistance relative to the type of dental cements used were found. CONCLUSION: From the above results, it is concluded that the dislodgement resistance of Biopin. bridge restorations utilizing a single Bio-pin(R) is similar to that of a conventional 3-unit bridge. The results also suggest that Bio-pin(R) bridge restorations using a single Bio-pin(R) are a viable alternative to the conventional 3-unit bridge when minimal removal of sound tooth structure and fulfillment of both function and esthetic aspects are considered.