Malformed Teeth and Their Endodontic Implications

Increased dimension of a tooth indicates the presence of double tooth. Double tooth could be due to fusion or gemination. These are due to developmental disturbances of teeth.1 Gemination is an anomaly that occurs due to an attempt to form two teeth from a single tooth bud. This resulted in a large tooth without complete separation or alterations in the number of teeth.2 Fusion is caused by union of two discrete tooth germs, wherein they might be united by dental hard tissues. However they have separate pulp chambers. Developmental aberrations occur during morpho-differentiation of tooth bud. These occur due to local metabolic disturbances or due to pressure of crowding of tooth germs.3 Hereditary tendency has been reported for fusion between normal and supernumerary tooth.4

Comparison of the effects of intravenously administered dexmedetomidine with clonidine on hemodynamic responses during laparoscopic cholecystectomy

Clonidine, a selective alpha-2 adrenergic agonist, and dexmedetomidine, a new generation highly selective alpha-2 adrenoreceptor agonist, are well known to inhibit catecholamine release. The present study compares the effects of intravenously administered clonidine versus dexmedetomidine to attenuate hemodynamic responses to pneumoperitoneum during laparoscopic cholecystectomy under general anesthesia. 60 patients of ASA physical status I and II, aged between 18 to 50 years, of either sex. scheduled for elective laparoscopic cholecystectomy were randomized into 3 groups [Group C, D and K] in a double-blind fashion, to receive either clonidine 1 microg/kg in normal saline, dexmedetomidine 1 microg/kg in normal saline or normal saline IV respectively. Total volume of the study drug was adjusted to 50 ml and administered over a period of 15 minutes before induction. Following pneumoperitoneum, significant rise in heart rate and arterial pressure was observed in group K. Patients in group D showed best control of arterial pressure. No significant episodes of hypotension were found in any group. Administration of clonidine or dexmedetomidine attenuates hemodynamic response to pneumoperitoneum, dexmedetomidine being more effective in this regard