Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study.

Aim: This current study evaluated and compared the skeletal changes in the head of the condyle, glenoid fossa, and articular space between the twin block appliance and PowerScope™ a fixed functional appliance. Materials and methods: This study was a pilot, randomized, single-blinded, assessing the skeletal changes in the components of the temporomandibular joint (TMJ) using cone-beam computed tomography (CBCT). The study was conducted in 20 subjects in the age range of 11-14 years with class II division 1 malocclusion. These subjects were distributed randomly between two groups with an allocation ratio of 1:1 (group I-twin block and group I-PowerScope™). Follow-ups of both groups were done till desirable skeletal correction was attained (clinical edge-to-edge incisor relation). Results: Condylar parameters such as position, height, and length were evaluated bilaterally in the CBCT scans. After using both devices, there was an increase in all condylar qualities; however, the twin block appliance showed a more noticeable difference, which has been determined to be statistically significant. In the twin block group, there was an average decrease of 0.56 mm in the anterior articular space and an increase of 1.2 and 2.64 mm in the middle and posterior articular spaces, respectively. In the PowerScope™ group, there was an average decrease of 0.23 mm in the anterior articular space and an increase of 2.55 and 1.85 mm in the middle and posterior articular spaces, respectively. In the case of the twin block device, the change in glenoid fossa angle was observed to be 6.1 mm on both sides and a mean difference of 1.25 mm on the right-side and 1.75 mm on the left-side was observed in the case of PowerScope™. The difference was established to be significant with a p < 0.05 in all cases. Conclusion: Condylar attributes increased after the application of both devices but the difference was more pronounced in the case of twin block appliances. The difference in articular space (middle and posterior) between the twin block group and PowerScope™ group, was not significant statistically. In the present study, the remodeling in the glenoid fossa was greater in the twin block group compared to the PowerScope™ group. How to cite this article: Halapanavar B, MN P, Deshmukh S, et al. Comparison of Skeletal Changes in the Temporomandibular Joint between the Twin Block Appliance and Fixed Functional Appliance: A Longitudinal Follow-up Study. Int J Clin Pediatr Dent 2024;17(1):7-14.

Orthomorphic Correction for Facial Asymmetry in a Patient With Long-Standing Temporomandibular Joint Ankylosis: A Case Report.

This case report presents the successful management of a 28-year-old female patient with facial deformity resulting from long-standing temporomandibular joint (TMJ) ankylosis. The patient underwent orthomorphic correction using a stereolithographic model of the upper and lower jaw to aid in surgical planning. The surgery was performed under general anesthesia via an intraoral approach. Cancellous bone graft harvested from the anterior iliac crest was utilized to cover the bone defect caused by the orthomorphic rotation of the lower jaw. The patient experienced satisfactory postoperative healing, and a six-month follow-up revealed significant improvement in facial symmetry and function.

"Pneumomediastinum: A marker of severity in Covid-19 disease".

Objective: The goal of this study was to look at the incidence, risk factors, clinical characteristics, and radiological aspects of COVID-19 patients who developed pneumomediastinum and compare these features between those who died and those who survived. Materials and methods: This retrospective observational study included COVID-19 patients having pneumomediastinum on CT from May 2020 to May 2021 in a COVID-19 care hospital. 1st wave patients were considered between the period of May 2020 to January 2021 and those in the second wave between February 2021 to May 2021. The clinical details were analyzed by a consultant intensivist and CT scans were read by a team of 6 resident radiologists and 5 experienced radiologists. Demographic data, co-morbidities, clinical parameters, hemodynamic markers, radiological involvement and associated complications were analyzed. Results: During the study period, 10,605 COVID-19 patients were admitted to our hospital of which 5689 underwent CT scan. 66 patients were detected to have pneumomediastinum on CT; 26 of them in the first wave and 40 in the second wave. Out of 66, 28 patients were admitted to ICU, 9 during the first wave and 18 during the second wave. The overall incidence of developing pneumomediastinum was 1.16%. Incidence in the 1st wave was 1.0% and in the 2nd wave was 1.29%. The overall mortality rate in admitted COVID-19 patients was 12.83% while it was 43.9% in COVID-19 patients who developed pneumomediastinum. Incidence of pneumomediastinum and pneumothorax was high in patients with extensive parenchymal involvement. 59/66 (89%) cases of pneumomediastinum had severe CT score on imaging. Conclusion: We conclude that pneumomediastinum is a marker of poor prognosis. Timely diagnosis of interstitial emphysema or pneumomediastinum will aid in planning early protective ventilation strategies and timely intervention of complications.

In Vivo Comparison of the Efficiency of En-Masse Retraction Using Temporary Anchorage Devices With and Without Orthodontic Appliances on the Posterior Teeth.

OBJECTIVE: To compare the effectiveness of en-masse retraction of maxillary anterior teeth using temporary anchorage devices with and without orthodontic appliances on the posterior teeth. METHODS: In the study, 20 participants (18.25 ± 4.07 years) meeting the inclusion criteria were randomly divided into 2 groups using the sequentially numbered opaque sealed envelopes method. In group I (control group, n = 10), en-masse retraction was carried out with conventional high hooks soldered to the retraction wire and posterior teeth were included. In group II (experimental group, n = 10), the en-masse retraction was carried out without an orthodontic appliance on posterior teeth and a modified retraction wire was incorporated. In both groups, mini-implants were placed bilaterally between the maxillary second premolar and maxillary first molar, and a retraction force of 6 ounces (180 g) was applied using power chains. Lateral cephalograms and study models were taken before retraction and 4 months after retraction. All statistical analyses were performed with Statistical Package for the Social Sciences soft- ware with a statistically significant level of 5%. We used unpaired t-tests for the comparison, and the error of the method was assessed using intraclass correlation coefficients and the Bland-Altman method. RESULTS: The maxillary incisor apex retraction, change in maxillary incisor in the vertical plane, and its inclination showed statistically significant differences (P < .05). The rate of retraction was significantly greater in the experimental group when evaluated clinically and in the study models (P < .05). CONCLUSION: The rate/amount of retraction evaluated clinically and in the study models was significantly faster/greater when the pos- terior teeth were not included during anterior retraction. Also, a greater amount of bodily retraction of anterior teeth was achieved.

Evaluation of Changes in Condylar Cartilage Thickness Using MRI and Ultrasound Imaging in Patients Treated by Mandibular Advancement With Myofunctional Appliance: An In-Vivo Pilot Study.

Introduction The changes occurring due to growth modulation of the condylar cartilage act as an important mechanism for mandibular advancement using myofunctional appliance therapy. So this study aims to evaluate the condylar cartilage thickness by using MRI and USG in patients undergoing myofunctional appliance therapy for mandibular advancement with the null hypothesis being that there are no changes seen in the thickness of condylar cartilage in growing children. Materials and methods A prospective evaluation of samples having skeletal Class-II malocclusion ranging between cervical vertebral maturation index (CVMI) stage II and III, requiring twin block functional therapy was performed. Ten patients were selected randomly who underwent MRI and USG in the open and close positions for the evaluation of condylar cartilage thickness and the dimensional changes in the width of the right and left condyle in mm at T0 and T1. Result There was no statistically significant difference between the values interpreted by MRI or USG imaging when compared at T0 and T1 and in the open and closed mouth on the left and right sides. At T0, the mean thickness noted was 0.49 mm and 0.48 mm during opening and closing on the left side and 0.52 mm in both positions on the right side. At T1, the mean thickness noted was 0.8 and 0.79mm during opening and closing on the left side, whereas it was 0.81 mm in both positions on the right side. Conclusion The condylar cartilage thickness increases significantly after twin block therapy suggestive of mandibular growth in skeletal class II malocclusion. It can be inferred that both MRI and USG carry equal diagnostic interpretation, as there was no statistically significant difference between the two imaging modalities.

Crystal structure of XCC3289 from Xanthomonas campestris: homology with the N-terminal substrate-binding domain of Lon peptidase.

LonA peptidase is a major component of the protein quality-control mechanism in both prokaryotes and the organelles of eukaryotes. Proteins homologous to the N-terminal domain of LonA peptidase, but lacking its other domains, are conserved in several phyla of prokaryotes, including the Xanthomonadales order. However, the function of these homologous proteins (LonNTD-like proteins) is not known. Here, the crystal structure of the LonNTD-like protein from Xanthomonas campestris (XCC3289; UniProt Q8P5P7) is reported at 2.8 Šresolution. The structure was solved by molecular replacement and contains one polypeptide in the asymmetric unit. The structure was refined to an Rfree of 29%. The structure of XCC3289 consists of two domains joined by a long loop. The N-terminal domain (residues 1-112) consists of an α-helix surrounded by ß-sheets, whereas the C-terminal domain (residues 123-193) is an α-helical bundle. The fold and spatial orientation of the two domains closely resembles those of the N-terminal domains of the LonA peptidases from Escherichia coli and Mycobacterium avium. The structure is also similar to that of cereblon, a substrate-recognizing component of the E3 ubiquitin ligase complex. The N-terminal domains of both LonA and cereblon are known to be involved in specific protein-protein interactions. This structural analysis suggests that XCC3289 and other LonNTD-like proteins might also be capable of such protein-protein interactions.

Impact of the pandemic on cancer care: Lessons learnt from a rural cancer center in the first 3 months.

INTRODUCTION: The COVID-19 outbreak and the subsequent declaration of pandemic was an unprecedented event, which created different complex situations for treatment of cancer patients. A critical assessment of the response to this calamity and its impact on healthcare workers (HCWs) and patient care in a dedicated cancer hospital is analyzed. SITE OF STUDY: Indrayani Cancer Hospital, Alandi, Pune, India. MATERIALS AND METHODS: Due to the pandemic, standard operating protocols were decided on for each department. Analysis of the impact on healthcare was done by comparing the number of patients taking treatment in the lockdown period in India with the previous year's data in the same corresponding period in all three departments. The impact of COVID infection on the HCW and its repercussions were analyzed. RESULTS: There was a marked decrease in the total number of patients during the lockdown period. The most affected department was surgical oncology. None of our patients contracted COVID-19, but one HCW was found to be positive. CONCLUSION: Strict adherence to protocols along with the support of the government authorities can prevent the spread of this virus thus providing optimal patient outcomes. The treatment of patients with cancer should not be delayed, even in times of a pandemic.

Halogenation of Biotin Protein Ligase Inhibitors Improves Whole Cell Activity against Staphylococcus aureus.

We report the synthesis and evaluation of 5-halogenated-1,2,3-triazoles as inhibitors of biotin protein ligase from Staphylococcus aureus. The halogenated compounds exhibit significantly improved antibacterial activity over their nonhalogenated counterparts. Importantly, the 5-fluoro-1,2,3-triazole compound 4c displays antibacterial activity against S. aureus ATCC49775 with a minimum inhibitory concentration (MIC) of 8 µg/mL.

Traumatic lumbar vertebral ring apophysis fracture with disk herniation in an adolescent.

We present a case of a 15-year-old male with history of back pain and bilateral lower limb radiculopathy due to fall. The magnetic resonance imaging scan showed disc bulge at L2-L3 level causing compression on contained nerve roots. In this case, computed tomography scan was indispensable for diagnosis and classification of the vertebral apophyseal fracture and to guide appropriate further management. Apophyseal ring fracture is an uncommon cause of back pain with radiculopathy in adolescents and athletes. High degree of suspicion is necessary to differentiate these injuries from disc herniation so as to further guide appropriate conservative or surgical management. The common cause of back pain in this population is related to musculoskeletal injuries. Lumbar disc herniation contributes to negligible number of cases in this age group, as against that seen in the adult population. An important and rare etiology to be considered for these patients includes vertebral ring apophyseal fracture.

Mean values of Arnett's soft tissue analysis in Maratha ethnic (Indian) population - A cephalometric study.

AIM: The aim of this article is to evaluate the mean cephalometric values for Arnett's soft tissue analysis in the Maratha ethnic (Indian) population. MATERIALS AND METHODS: Lateral cephalograms of 60 patients (30 males and 30 females) aged 18-26 years were obtained with the patients in the Natural Head Position (NHP), with teeth in maximum intercuspation and lips in the rest position. Moreover, hand tracings were also done. The statistical analysis was performed with the help of a statistical software, the Statistical Package for the Social Sciences version 16, and Microsoft word and Excel (Microsoft office 2007) were used to generate the analytical data. RESULTS: Statistical significance was tested atP level (1% and 5% level of significance). Statistical analysis using student's unpaired t-test were performed. Various cephalometric values for the Maratha ethnic (Indian) population differed from Caucasian cephalometric values such as nasolabial inclination, incisor proclination, and exposure, which may affect the outcome of the orthodontic and orthognathic treatment. CONCLUSION: Marathas have more proclined maxillary incisors, less prominent chin, less facial length, acute nasolabial angle, and all soft tissue thickness are greater in Marathas except lower lip thickness (in Maratha males and females) and upper lip angle (in Maratha males) than those of the Caucasian population. It is a fact that all different ethnic races have different facial characters. The variability of the soft tissue integument in people with different ethnic origin makes it necessary to study the soft tissue standards of a particular community and consider those norms when planning an orthodontic and orthognathic treatment for particular racial and ethnic patients.

Assessment of the Risk Factors for Oro-Dental Injuries to Occur during General Anesthesia and Measures taken by Anesthesiologist to Prevent them.

BACKGROUND AND AIM: Anesthesiologist gain access to the airway passage orally with the help of laryngoscope. Dental trauma can occur during different steps in anesthesia. The aim of the study is to evaluate the risk factor for dental trauma perioperatively and to look for the preventive measures mostly employed by the anesthesiologist to prevent dental insult. MATERIALS AND METHODS: The present study involved 40 anesthetists working in private hospitals using simple random sampling. They were asked to answer a questionnaire designed to look for the risk factors that makes tooth most prone for injury and find out the measures that anesthesiologists follow to prevent such injuries to occur. Codes were placed for the obtained data and Medcalc statistical package was used for analysis. RESULTS: Injuries mostly occur during intubation with a laryngoscope in patients where there is limited visibility to the hypopharynx. Maxillary left central incisor was mostly affected. Some anesthetists used plastic blades or curved blades to prevent such injury. CONCLUSION: Patient with poor dentition and history of difficult intubation should be sent for pre-operative dental evaluation to prevent dental injuries.

Elemental and organic carbon in ambient air of a major Indian urban community.

Recent epidemiological studies have demonstrated associations between residential proximity to traffic sources and adverse respiratory symptoms as the Diesel Exhaust Particulate surfaces act as a site for the concentration of thousands of organic compounds. Analysis of 24 h integrated samples of PM10 and PM2.5 collected at a kerb site in a major Indian urban community, heavily impacted by heavy commercial vehicles, showed elemental carbon concentrations higher (14.4-48.8 micrg/m(3)) than organic carbon (1.7-9.2 micrg/m(3)). The organic to elemental carbon ratio varied from 0.09 to 0.31. Average concentration of PM10 and PM2.5 ranged 133-492 micrg/m(3) and 87-160 microg/m(3), respectively.

Hormonal responses to fasting and refeeding in chronic renal failure patients.

To study anorexia in chronic renal failure (CRF) patients, we measured appetite-related hormones in seven CRF patients and four controls. Plasma concentrations and fractional changes from baseline (values from day 1, 0800) are listed as control vs. CRF (means +/- SE). Leptin, although higher in CRF (5.6 +/- 1.7 and 34 +/- 17 ng/ml), was suppressed after fasting; decrements were -51 +/- 9 and -55 +/- 8%. Nocturnal surge present during feeding was abolished upon fasting in both groups. Neuropeptide Y (NPY) was elevated in CRF (72 +/- 12 vs. 304 +/- 28 pg/ml, P = 0.0002). NPY rhythm, reciprocal to that of leptin, was muted in CRF. Basal cortisol was similar in both groups (17 +/- 3 and 17 +/- 2 microg/dl). In the controls, cortisol peaked in the morning and declined in the evening. CRF showed blunted cortisol suppression. Decrements were -61 +/- 3 and -20 +/- 9% at 1800 on day 1 (P = 0.008) and -61 +/- 8 and -26 +/- 8% at 2000 on day 2 (P = 0.02). Basal ACTH (25 +/- 5 and 54 +/- 16 pg/ml) as well as diurnal pattern was not statistically different between the groups. Baseline insulin was 6 +/- 1 and 20 +/- 9 microU/ml. During fasting, insulin was suppressed to -64 +/- 10 and -51 +/- 9%, respectively. Upon refeeding, increments were 277 +/- 96 and 397 +/- 75%. Thus, in our CRF patients, anorexia was not due to excess leptin or deficient NPY. Impaired cortisol suppression should favor eating. Insulin suppression during fasting and secretion after feeding should enhance both eating and anabolism. The constant high NPY suggests increased tonic hypersecretion.