Biophysical therapy using the pulsating electromagnetic field as adjunctive therapy for implant osseointegration - A review.

Development of procedures which accelerate osseointegration of dental implants, reduce the period of healing, and lead to an early rehabilitation of the patient are required for successful oral rehabilitation. Pulsed electromagnetic field (PEMF) is a noninvasive, therapeutic form of low field magnetic stimulation that has been used for healing bone non unions and various fractures. It acts on osteoblasts and bone, affecting their metabolism, therefore, increasing the tissue integration of the implanted devices and their clinical success. A broad range of settings that includes magnetic field intensity, frequency and duration of application, etc. used for PEMFs stimulation is a hurdle to properly define treatment protocols and extensive research is needed to overcome this issue. The present review includes studies that investigated the effects of PEMFs on the response of bone cells to different classes of biomaterials and the reports that focused on in vivo and in vitro investigations of biomaterials implanted in bone. This study is expected to serve as a guide for researchers and clinicians to bring into their clinical use these strategies to improve implant osseointegration in deficient and osteoporotic bone.

Review on 3D printing in dentistry: conventional to personalized dental care.

The CAD (Computer-aided design) and CAM (computer-aided manufacturing) have most applications in the manufacturing of fully automated, personalized dental devices and tailor-made treatment plans. 3D printing is one of the most rapidly expanding and new methods of manufacturing different things because of its on-demand and high productivity within the cost-effective manner which have a variety of applications in healthcare, pharmaceuticals, orthopaedics, engineered tissue models, medical devices, defence industries, automotive and aerospace sectors. Due to its emerging applications in the various sectors, the healthcare, Industries, and academic sectors are attracted towards the 3D printed materials. This review talks about the dental implants, polymers that are employed in concocting dental implants, critical parameters, and challenges which are to be considered while preparing these implants, advantages of 3D printing in the field of dentistry and the current trends. it discusses the variety of applications of 3D printed materials in the field of dentistry. Along with their method of fabrication, their critical process parameters (CPPs) are also discussed.

Screening of obstructive sleep apnea (OSA) risk in adolescent population and study of association with craniofacial and upper airway morphology.

BACKGROUND: Obstructive sleep apnea (OSA) is a common form of sleep-disordered breathing with high prevalence and associated co-morbidities. It still goes largely under-reported due to events occurring in sleep and difficulty in identifying predisposing factors. AIMS: To perform questionnaire-based screening of OSA-risk in adolescents and study association of OSA-risk with craniofacial and upper airway morphology. MATERIAL AND METHODS: Modified STOP-BANG questionnaire was used for screening OSA-risk in adolescent orthodontic patients (10-19 years) in a government dental hospital in India. Patients were categorised into two groups: OSA-risk and non-risk, based on the questionnaire scores, and were subsequently evaluated for craniofacial and upper airway morphology, both on examination and on lateral cephalometric radiographs. RESULTS: Documented a high prevalence of 14% for OSA-risk in adolescent orthodontic patients. The extra-oral and intra-oral parameters found significantly associated with OSA-risk were convex profile [Odd's ratio (OR) - 3.824], steep mandibular plane angle [MPA] (OR- 79.75), Type 3/4 faucial pillars (OR- 11.227), Class II molar relationship (OR - 4.518), ovoid upper arch form (OR - 13.750). In addition, the cephalometric parameters: ANB (p- 0.025), SN-MP (p- 0.007), BA-SN (p- 0.020), PNS-AD1 (p < 0.001), PNS-AD2 (p - 0.001) also showed highly significant association to OSA-risk. The ROC curves demonstrated high sensitivity and specificity for PNS-AD1 (60%,83.3%), PNS-AD2 (73.3%, 70%) and SN-MP (60%,70%), respectively for OSA-risk. CONCLUSIONS: The study supported applicability of modified STOP-BANG questionnaire for OSA-risk in Indian adolescents. The parameters [extra-oral, intra-oral, cephalometric and upper airway (PNS-AD1, PNS-AD2, SN-MP)] significantly associated with OSA-risk, were identified.

Role of Oral Vitamin 'C' on Astigmatic Errors in Phacoemulsification.

Purpose: To evaluate the role of oral vitamin C on postoperative astigmatism in phacoemulsification and to assess its effect on postoperative symptoms. Methods: The patients were selected from Department of Ophthalmology, GSVM Medical College, Kanpur who came for cataract surgery. Design: Prospective, randomized double-blind study; 400 consecutive patients of cataract were randomized into two groups consisting of 200 patients each. Group "A" patients were started on oral vitamin C (1,500 mg per day in three divided doses) from the first postoperative day and Group "B" patients were given routine postoperative medications along with placebo. The keratometry of both the groups was done preoperatively and postoperatively at 2, 4, and 6 weeks. All patients underwent temporal clear corneal phacoemulsification by the same surgeon. Results: The mean difference of astigmatism preoperatively in the right eye of Group "A" patients was 1.049 ± 0.971 which reduced to 0.680 ± 0.554 at 6 weeks postoperatively (p-value = 0.0018), whereas in Group B, it changed to 1.141 ± 0.771 at 6 weeks from 1.116 ± 0.566 of preoperatively (p-value = 0.759). In the left eye of Group "A" patients, its value was 0.995 ± 0.899 which changed to 0.574 ± 0.528 at 6 weeks (p-value = 0.0001) which was highly significant, whereas that in Group "B" patients, it was 0.733 ± 0.440 preoperatively which modified to 0.877 ± 0.581 at 6 weeks (p-value = 0.004). In Group "A," 0.5% patients had pain, foreign body sensation, and photophobia at 6 weeks, whereas in Group "B" patients, 5% had pain, 1.5% had foreign body sensation, 1% had photophobia, and 0.5% had watering. Conclusion: Oral vitamin C may play a beneficial role in decreasing the postoperative astigmatism. It also enhances patients' comfort levels and ensures faster recovery after phacoemulsification.

OCT Based Macular Thickness in a Normal Indian Pediatric Population.

PURPOSE: Cirrus optical coherence tomography (OCT) provides high resolution cross-sectional images of the retina, vitreous humor, and optic nerve head with an axial resolution of 5 µm and a reproducibility of 1.6 µm. An integrated normative database is available only for adult subjects ≥18 years of age; the normal reference ranges of the macular thicknesses of pediatric subjects are not available. The purpose of this study was to determine the normal reference range of macular thickness of pediatric. METHODS: A total of 340 eyes of 170 children 5-17 years of age were recruited for this study. Participants received a full ophthalmic examination including a vision assessment, cycloplegic refraction, fundus examination, intraocular pressure measurement, assessment of ocular motility, and alignment. Macular thickness measurements were obtained through dilated pupils using Cirrus HD-OCT. RESULTS: The mean macular thickness was 114.88 ± 14.74 in the right eye and 113.99 ± 15.62 in the left eye (P = 0.589). On further evaluation, macular thickness was highest in the inner macula, followed by the outer macula and central fovea (P < 0.001). CONCLUSION: The normative data of macular thickness in pediatric subjects 5-17 years of age will help diagnose macular disorders.

Routine histopathology of gallbladder after elective cholecystectomy for gallstones: waste of resources or a justified act?

BACKGROUND: Selective approach for sending cholecystectomy specimens for histopathology results in missing discrete pathologies such as premalignant benign lesions such as porcelain gallbladder, carcinoma-in-situ, and early carcinomas. To avoid such blunders therefore, every cholecystectomy specimen should be routinely examined histologically. Unfortunately, the practice of discarding gallbladder specimen is standard in most tertiary care hospitals of Pakistan including the primary investigators' own institution. This study was conducted to assess the feasibility or otherwise of performing histopathology in every specimen of gallbladder. METHODS: This cohort study included 220 patients with gallstones for cholecystectomy. All cases with known secondaries from gallbladder, local invasion from other viscera, traumatic rupture of gallbladder, gross malignancy of gallbladder found during surgery was excluded from the study. Laparoscopic cholecystectomy was performed in majority of cases except in those cases where anatomical distortion and dense adhesions prevented laparoscopy. All gallbladder specimens were sent for histopathology, irrespective of their gross appearance. RESULTS: Over a period of two years, 220 patients with symptomatic gallstones were admitted for cholecystectomy. Most of the patients were females (88%). Ninety two per cent patients presented with upper abdominal pain of varying duration. All specimens were sent for histopathology. Two hundred and three of the specimens showed evidence chronic cholecystitis, 7 acute cholecystitis with mucocele, 3 acute cholecystitis with empyema and one chronic cholecystitis associated with poly. Six gallbladders (2.8%) showed adenocarcinoma of varying differentiation along with cholelithiasis. CONCLUSION: The histopathological spectrum of gallbladder is extremely variable. Incidental diagnosis of carcinoma gall bladder is not rare; if the protocol of routine histopathology of all gallbladder specimens is not followed, subclinical malignancies would fail to be identified with disastrous results. We strongly recommend routine histopathology of all cholecystectomy specimens.