A comparative study between conventional and ultrasound-guided supraclavicular brachial plexus block in upper limb surgeries

Background: The well-researched method of brachial plexus blocking is used in upper limb procedures. The blind paresthesia methodology used in the conventional approach has a greater failure rate and may cause damage to the tissues that surround and nerves. Peripheral nerve stimulators and ultrasound methods were used to better localise the nerve/plexus in order to prevent certain of these issues. Methods: A total of 50 patients were included in this prospective randomized trial and randomly assigned to two groups: US (Group US) and LM (Group LM) after receiving clearance from the institutional ethics committee and consent from the patients. Each of the two groups got 0.5% bupivacaine. The injection of local anaesthetic (bupivacaine, 2 mg/kg) did not exceed the hazardous dosage since the amount was determined based on body weight. Result: The demographic information for both groups was similar. When compared to ultrasound, the mean time required for the method to provide a block via inducing paraesthesia was much shorter. There was no statistically significant difference in the meantime of motor block start, sensory blockade, or the length of both types of blockades. The ultrasonic group had a higher block success rate than the traditional group, although this difference didn't prove clinically important. Conclusions: The most secure and effective approach to perform a supraclavicular brachial plexus block is using ultrasound guidance. Because ultrasonography allows for the transmission of local anaesthetic and instantaneous imaging of underlying structures, the incidence of problems is lower.

Efficacy of silicone as a dowel impression material.

Background: Different types of impression materials and different procedures or methods have been introduced in Dentistry for preparing dowel crown. Materials and Methods: Injection technique with silicone impression materials are being extensively used by the materials to get an accurate impression. But whether this material neither ensures similar accuracy nor produces absolute accuracy. This study evaluate silicone impression material was efficient enough to produce nearest to actual intraradicular surface reproduction by assessing the void formation and dimensional accuracy. Conclusion:By assessing all the parameters the silicone impression material was proved to be the efficient for intraradicular surface reproduction.

Ameloblastic carcinoma of the mandible.

Ameloblastic carcinoma is a highly malignant tumour and requires aggressive treatment. This case report describes an aggressive ameloblastic carcinoma that infiltrated the mandible. Mandibulectomy with right functional radical neck dissection and left supra omohyoid dissection was followed by primary reconstruction with a single free vascularised fibula flap. The post-operative course was uneventful. The 2 year regular follow up revealed no signs of recurrent tumour or metastasis. Future reporting of this rare condition is encouraged in lieu of limited information in its clinical course and prognosis.

Gene involvement in cleft lip and palate (CLP) patients.

It is supposed that the most frequent birth defect worldwide is clefts of the lip and/or palate (CL+-P). The frequency is non-syndromic where CL+-P happens in segregation of additional phenotypes; and syndromic clefts are referred when one or more additional features are involved. The etiologies of CL+-P is multifaceted and occupy both major and minor genetic influences with changeable relations from environmental factors. This study extends the involvement of various genes, which are responsible for both syndromic and non syndromic CL+-P patients.

Dentofacial changes in Class II division 1.

A 19 year-old Bangladeshi female presented with a severe Class II division 1 incisor relationship on a Skeletal II base and localized spacing in the upper arch. The lower arch was well aligned. Treatment was commenced using fixed appliances and followed by anterior retraction. This case illustrates the versatility of the fixed appliances in the treatment of those cases exhibiting Class II division 1 malocclusion with spacing.

Calcifying Epithelial Odontogenic Tumor (Ceot).

Calcifying epithelial odontogenic tumor is a rare benign epithelial odontogenic lesion that comprises from 0.2% to 1.1 of all odontogenic tumors. In the past a number of different names have been given to this lesion, such as calcifying ameloblastoma, cystic complex odontoma, uncommon ameloblastoma with calcifications and others. There is a need to study and explore various aspects of this tumour, this article gives a broad idea of the various aspects of this tumor and which aspect of this tumour needs more investigation

The occurrence of C-shaped root canal in Malaysian population.

Background: The recognition of unusual canal’s configurations and variations are essential for successful endodontic diagnosis and treatment. This study was aimed to investigate the occurrence of C- shaped root canal in Malaysian population. Design: This is an in vitro study whereby 241 extracted human first and second molars with intact root were collected from several dental clinics in Malaysia. Materials and Methods: The roots were sectioned at three levels: subpulpal level, 3mm from apical tip and middle level between the first and last level. The appearance of the root canal sections were assessed using stereomicroscope (Leica, Germany) and pictures were taken. Data were analyzed statistically using Fisher’s Exact and Binomial test with p<0.05 indicates statistically significant difference. Results: The occurrence of C- shaped canal among molars collected is 3.73%. Hundred percent of the molars with C- shaped root canal configuration are mandibular molars and 77.8% are belonged to Chinese racial. Conclusion: The findings show that C- shaped root canals do occur among Malaysian people especially Chinese racial. Besides, all the teeth that possess C- shaped root canal configuration are lower molars.

Photogrammetric Analysis of Nasolabial Angle and Mentolabial Angle norm in Malaysian Adults.

Introduction: While measurement of nasolabial angle and mentolabial angle is an important clinical examination in pre-orthognathic surgery assessment, data on non-western population is limited. This study was therefore conducted to determine the range of nasolabial angle and mentolabial angle in normal Malaysian adult with comparison of males and females. Materials and Methods: A total of 50 Class I males and 52 Class I females aged 19-30 years from three main ethnic groups were randomly selected from dental students, medical students and staffs in dental clinic of Hospital Universiti Sains Malaysia (HUSM). The photographic set-up consisted of a 50mm Nikon DAT camera held in position by a tripod. The photos taken in JPEG format were digitalized and analysed using ProVixwin software. Independent t-test was used to compare any possible gender difference in nasolabial and mentolabial angles. Results: The mean of nasolabial angle and mentolabial angle for male was 92.99? and 130.44? whereas for females it was 95.04? and 130.73? respectively. Gender differences were found to be insignificant for both nasolabial angle and mentolabial angle.Conclusion: Despite having great variation in our population, the nasolabial angle and mentolabial angle are gender independent.

Perception by Laypersons and Healthcare Professionals Towards Oral and Maxillofacial Surgery.

Background: Oral and maxillofacial surgery (OMFS) is a surgical branch of dentistry that deals with the wide spectrum of diseases, injuries and defects in the maxillofacial region. There are plenty of people who have lack of awareness towards the wide surgical scope provided by OMFS as reported by previous study done in Boston in 1996. The purpose of this study was to assess the level of awareness among the general public and healthcare professionals towards Oral and Maxillofacial Surgery specialty in Hospital Universiti Sains Malaysia (HUSM). Materials and Methods: A total of 186 standardized questionnaire was distributed to 6 groups of respondents which include laypersons attending HUSM, 4th year dental and medical students, dental officers, medical officers and paramedical workers from various departments such as Emergency department, Ear, Nose and Throat (ENT) department, medical family clinic and dental clinic of HUSM. Results: The data showed that 100% of students and practitioners had heard of OMFS, whereas only 68.9% of the laypersons have heard of the specialty. Furthermore, only 11.6% of the lay responders had been treated by an OMFS. The full results also suggested that about 50% of laypersons, 35% of medical professionals and 30% of dental professionals had lack of understanding about the range of care provided by OMFS specialty. Conclusion: A thorough education need to be implemented among dental and medical undergraduate students as well as professionals so that they can make a proper referral later on and automatically provide correct information to the laypersons.

An In Vitro study of Fracture Resistance of Weakened Tooth Roots Reinforced with Two Types of Adhesive Restorative Materials.

Introduction: Composite resin (CR) is among the commonly used material for intraradicular reinforcement of weakened tooth roots. Purpose: This study was to compare the fracture resistance of experimentally weakened tooth roots reinforced using auto-polymerized composite resin and light-polymerized composite resin. Materials and Methods: Fifty-six extracted human maxillary incisors were divided into 2 groups (n = 28) and the root canals were over prepared to weaken it. The samples in Group A were restored using light-cured CR Z100 and light-transmitting polymerizing post (Luminex), whereas Group B using auto-cured CR Alpha-dent. Both groups were placed with metal parapost cemented with a resin luting cement (Nexus 2). Specimens were subjected to compressive load (N) using Instron machine until fracture. Data were submitted to independent t test analysis of variance (p < 0.05). Results: There was no significant difference (p = 0.233) in fracture resistance between the teeth reinforced with light-polymerizing and auto-polymerizing CR are 549.3 (± 95.44) and 490.7 (± 110.37) respectively. Conclusion: The use of less technique sensitive auto-polymerizing CR give equivalent benefit effect on reinforcing weakened roots, as the more commonly light-polymerized composite resin.

Dental Education: Restorative dentistry in Malaysia.

Objectives: The aim of this study was to identify the requirements in restorative dentistry that undergraduate dental students have to fulfill in order to sit for final examinations in dental schools in Malaysia and to compare those requirement with the competencies stipulated by the Malaysian Qualification Agency (MQA). Materials and Methods: Questionnaire from a study done previously was modified and used in this study. All questionnaires were sent by post with a reply envelope. Eight dental schools had responded (72%) to the survey and the results showed that although dental schools may differ in the number of numerical requirements, their assessments were quite similar. One school does not practice numerical requirements at all. Results: In term of requirement for full crown, majority of the schools (88%) agreed that porcelain bonded to metal crown should be included in the numerical requirement. In contrast, majority of the schools (88%) did not include inlay/onlay in their numerical requirements. For plastic restorations like composite resin, amalgam and glass ionomer, majority of the schools (88%) used numerical requirements. Majority of the schools also agreed on numerical requirements for conventional bridge (88%) and incisor to molar endodontics (88%), but not for resin bonded bridge (75%). Conclusion: This study shows that there is a disparity among institutions in Malaysia in terms of finals requirement in restorative dentistry. Ideally, all requirements should be similar among institutions and should closely follow the guidelines provided by the MQA.

Apexification with the use of calcium hydroxide.

After traumatic injuries the pulps of young permanent teeth often necrose. This occurs most commonly in the permanent maxillary incisors leaving the teeth with incomplete radicular development and open apices. In these cases treatment is aimed at promoting complete apical closure. At a later date a complete filling of the root canal is carried out in order to prevent inflammatory stimulators affecting the periapex. Apexification is a method of treatment intended to induce formation of a calcific barrier in an immaturely developed or pulpless tooth. The intent of apexification is to attain narrowing of the canal or closure of the apex. Apexification is indicated in young patients, for reasons such as trauma, fracture or caries involving the pulp require root canal treatment prior to the apex fully developing and closing.

Contemporary treatment of a Class II division 1 case.

A 17 year-old Bangladeshi female presented with a severe Class II division 1 incisor relationship on a mild Skeletal II base. Crowding was moderate in the upper arch. The lower arch was well aligned. Treatment was commenced using fixed appliances and followed by extractions of upper first premolars. This case illustrates the versatility of the fixed appliances in the treatment of those cases exhibiting Class II division 1 malocclusion with crowding.

The multidisciplinary management of median diastema.

Maxillary midline diastemas are a common esthetic problem that dentists must treat. Many innovative therapies have been used, varying from restorative procedures to surgery (frenectomies) and orthodontics. The importance of the presence of a maxillary midline diastema resides in its position and the concern it causes to patients. This specific diastema has been attributed to genetic and environmental factors, even though it is often a normal feature of growth, especially in primary and mixed dentition. The need for treatment is mainly attributed to esthetic and psychological reasons, rather than functional ones. Although it is often the case, treatment plans should not be selected empirically but rather should be based on adequate scientific documentation. This paper reviews different treatment techniques to manage the situation and presents three cases to illustrate a range of restorative, prosthetic and orthodontic options.

Bimaxillary proclination with spacing: Treatment for Esthetic Improvement.

This paper concerns orthodontic treatment of a 20 years old Bangladeshi female with bimaxillary proclination, localized spacing in the maxillary and mandibular arch and rotations in the central incisors of the mandibular arch. Orthodontic treatment carried out with preadjusted MBT type (018 slot) fixed brackets with alignment and retroclination of the maxillary and mandibular incisors to accomplish the treatment for esthetic improvement. The esthetics and occlusion were maintained after retention.

Orthodontic treatment of mandibular anterior crowding.

This paper concerns orthodontic treatment of a 17 years old Bangladeshi female with a class I malocclusion along with anterior crowding in the mandibular arch. Orthodontic treatment carried out with preadjusted Roth type (018 slot) fixed brackets with labial flaring of the mandibular incisors to accomplish the treatment. The esthetics and occlusion were maintained after retention.