Distribution and Uniqueness in the Pattern of Lip Prints.

Introduction Lip prints are the characteristic pattern of wrinkles and grooves on the labial mucosa. Lip prints can be classified into various patterns and can be used for personal identification as they are unique and do not change during the life of a person. Cheiloscopy is a forensic investigation technique that deals with the identification of humans based on lip traces. Objectives This study aimed to investigate the distribution of lip print patterns, to assess gender differences, and to calculate the lip score using a weighted value scoring system. Material and methods A cross-sectional study was carried out in the Department of Anatomy, All India Institute of Medical Sciences (AIIMS), Guwahati, India, from May to October 2023, after getting approval from the Institutional Ethics Committee (IEC). A total of 200 individuals (100 males and 100 females) were included in the study. Each lip print was divided into four quadrants. In each quadrant, up to 14 grooves were marked from the midline, and the pattern of each groove was observed. Each pattern was given an Arabic numeral score. Weighted values were given for the grooves in descending order from 15 to 1 with reference to their position from the midline of the lip print. The product of the Arabic numeral score of the groove and the weighted value of the groove is the lip line score. The sum of the lip line scores was calculated. Results The most common pattern observed in the present study is type II, with 3,816/12,000 (31.8%), followed by type I' with 3,146/12,000 (26.21%), type I with 1,865/12000 (15.54%), type III with 1,491/12,000 (12.42%), type IV with 1,133/12,000 (9.44%), and type V with 549/12,000 (4.5%). The mean total lip score is 1,467.68 (1,486.41 in males and 1448.96 in females). Conclusion Lip prints are unique and useful for personal identification, as the lip score in various quadrants and the total lip score are different for different individuals.

Phytic Acid: A Novel Dentine Conditioning Agent for Glass Ionomer Cement Restorations: An In Vitro Scanning Electron Microscopic Study.

Background: Various dentin conditioners have been recommended to enhance the bond strength of glass ionomer cement (GIC) to dentin. The purpose of the in vitro study was to determine the efficacy of three dentin conditioners on the microshear bond strength of GIC and the failure patterns of the restoration, as well as the efficacy of removing the smear layer using a scanning electron microscope (SEM). Materials and Methods: Eighty healthy mandibular premolars were cleaned, isolated, and divided into four groups (n = 20). Flat coronal dentinal surfaces were accomplished by removing the occlusal surface of the crowns. Each group received the following treatment: group 1 with 10% polyacrylic acid; group 2 with 10% ethylenediaminetetraacetic acid (EDTA); group 3 with 1% phytic acid; and group 4 with no conditioning (control). High-strength Fuji IX GIC was applied to the dentin, and samples were thermocycled and de-bonded with a crosshead speed of 0.5 mm/min employing a shear force. A stereomicroscope and a SEM were used to examine the dentin surface at magnifications of 2000× and 5000×. One-way analysis of variance (ANOVA), Tukey's post hoc test, and Chi-squared test were used to assess data on microshear bond strength, smear layer removal, and failure modes. Results: The bond strength of group 4 was statistically highly significant (P ≤ 0.001) compared to the other groups. However, the differences between groups 2 and 3 were insignificant. Mixed pattern of failure was the least in group 3 (IP6). In group 3, the SEM photomicrograph revealed open dentinal tubules with complete removal of the smear layer. Conclusion: The results of the present study affirm that phytic acid enhances the bond strength of GIC restorations and removal of smear layer to a level comparable to EDTA as a dentin conditioner.

Comparison of Team-Based Learning Over Conventional Didactic Lecture Among Second-Year MBBS Students.

Introduction Team-based learning (TBL) is an active and structured learning process. This study was undertaken to develop interest among the students over the subject and to analyze the academic performance over routine conventional lecture method of teaching. This was a comparative study organized to know the effectiveness of TBL over conventional didactic lecture (CDL) and also to assess the student's perception towards TBL. Methods This was an interventional study where second-year MBBS students took part. Students were divided into two groups and the same topic was discussed by using two different teaching-learning methods. Similar sessions were conducted with crossing over of groups for four different topics and assessments were done after each session simultaneously for both the groups and the results were analyzed. Results Assessment of each session has been counted and the mean marks with standard deviation have been tabulated for both groups A & B. The results were statistically significant for the TBL group. Students' perception was also evaluated by using 5-point Likert scale for both the teaching methods, which revealed statistically significant score for TBL over CDL with the a p-value of 0.001. Conclusion Overall, TBL was a good teaching-learning method according to the students' performance and perception. Interactive innovative and small-group sessions can be an effective tool to overcome the limitation of conventional method.

SARS-CoV-2 infection and mortality during the first epidemic wave in Madurai, south India: a prospective, active surveillance study.

BACKGROUND: SARS-CoV-2 has spread substantially within India over multiple waves of the ongoing COVID-19 pandemic. However, the risk factors and disease burden associated with COVID-19 in India remain poorly understood. We aimed to assess predictors of infection and mortality within an active surveillance study, and to probe the completeness of case and mortality surveillance. METHODS: In this prospective, active surveillance study, we used data collected under expanded programmatic surveillance testing for SARS-CoV-2 in the district of Madurai, Tamil Nadu, India (population of 3 266 000 individuals). Prospective testing via RT-PCR was done in individuals with fever or acute respiratory symptoms as well as returning travellers, frontline workers, contacts of laboratory-confirmed COVID-19 cases, residents of containment zones, patients undergoing medical procedures, and other risk groups. Standardised data collection on symptoms and chronic comorbid conditions was done as part of routine intake. Additionally, seroprevalence of anti-SARS-CoV-2 immunoglobulin G was assessed via a cross-sectional survey recruiting adults across 38 clusters within Madurai District from Oct 19, 2020, to Nov 5, 2020. We estimated adjusted odds ratios (aORs) for positive RT-PCR results comparing individuals by age, sex, comorbid conditions, and aspects of clinical presentation. We estimated case-fatality ratios (CFRs) over the 30-day period following RT-PCR testing stratified by the same variables, and adjusted hazard ratios (aHRs) for death associated with age, sex, and comorbidity. We estimated infection-fatality ratios (IFRs) on the basis of age-specific seroprevalence. RESULTS: Between May 20, 2020, and Oct 31, 2020, 13·5 diagnostic tests were done per 100 inhabitants within Madurai, as compared to 7·9 tests per 100 inhabitants throughout India. From a total of 440 253 RT-PCR tests, 15 781 (3·6%) SARS-CoV-2 infections were identified, with 8720 (5·4%) of 160 273 being positive among individuals with symptoms, and 7061 (2·5%) of 279 980 being positive among individuals without symptoms, at the time of presentation. Estimated aORs for symptomatic RT-PCR-confirmed infection increased continuously by a factor of 4·3 from ages 0-4 years to 80 years or older. By contrast, risk of asymptomatic RT-PCR-confirmed infection did not differ across ages 0-44 years, and thereafter increased by a factor of 1·6 between ages 45-49 years and 80 years or older. Seroprevalence was 40·1% (95% CI 35·8-44·6) at age 15 years or older by the end of the study period, indicating that RT-PCR clinical testing and surveillance testing identified only 1·4% (1·3-1·6%) of all infections in this age group. Among RT-PCR-confirmed cases, older age, male sex, and history of cancer, diabetes, other endocrine disorders, hypertension, other chronic circulatory disorders, respiratory disorders, and chronic kidney disease were each associated with elevated risk of mortality. The CFR among RT-PCR-confirmed cases was 2·4% (2·2-2·6); after age standardisation. At age 15 years or older, the IFR based on reported deaths was 0·043% (0·039-0·049), with reported deaths being only 11·0% (8·2-14·5) of the expected count. INTERPRETATION: In a large-scale SARS-CoV-2 surveillance programme in Madurai, India, we identified equal risk of asymptomatic infection among children, teenagers, and working-age adults, and increasing risk of infection and death associated with older age and comorbidities. Establishing whether surveillance practices or differences in infection severity account for gaps between observed and expected mortality is of crucial importance to establishing the burden of COVID-19 in India. FUNDING: The Bill & Melinda Gates Foundation, the National Science Foundation, and the National Institute of General Medical Sciences. TRANSLATION: For the Hindi translation of the abstract see Supplementary Materials section.

Efficacy of Case-Based Learning in Anatomy.

Introduction In the present Competency-Based Medical Education (CBME), learning is more student-centered where the students take the responsibility for their learning. Anatomy is an important basic science that lays the foundation for clinical courses in the Bachelor of Medicine and Bachelor of Surgery (MBBS) curriculum. To make it interesting and clinically useful, several innovative teaching-learning methods like case-based learning (CBL) and problem-based learning (PBL) are introduced. The present study was taken up to know the effectiveness of CBL as a teaching-learning method in Anatomy in improving the knowledge and retention of acquired knowledge. Material and Methods This was an interventional cross-over study carried out at NRI Medical College and General Hospital, Guntur, Andhra Pradesh. Two hundred students studying in first-year MBBS were included in the study and divided into two batches. The batches - A and B - were exposed to CBL and didactic lecture, respectively, in the first month for Topic I, and then cross-over was done in the second month for Topic II. The knowledge of the students before and after the sessions was assessed by pre-session and post-session multiple-choice question (MCQ) tests. Knowledge retention was assessed by another MCQ test conducted four weeks after the post-session test. Results The average difference of the scores between pre-session and post-session tests in the CBL group for Topics I and II (4.01±1.17 and 3.8±1.6) are significantly more compared to the didactic lecture method (3.3±1.3 and 1.9±1.2). The average difference of the scores between the post-session tests and retention-tests in the CBL group (0.122±1.05 and 0.18±1.04) were further compared to the lecture method (0.016±0.95 and 0.09±0.8) for Topics I and II, respectively. There was a significant increase in the proportion of students with scores above 50% in the post-session test and retention test in the CBL group compared to the didactic lecture group. Conclusion Results from the pre-session tests, post-session tests, and retention tests for both the topics indicate that CBL as a teaching-learning method in Anatomy is a more effective method for improving and retention of knowledge.

Is odontogenic keratocyst an endodontic enigma? A rare case report of management of odontogenic keratocyst in anterior mandible.

Odontogenic keratocyst (OKC), a rare, locally aggressive developmental cyst, is found incidentally on dental radiographs, most commonly in the posterior mandible. When it occurs in the periapical region in association with nonresponding teeth to pulp sensibility tests, it is often misdiagnosed as other endodontic lesions such as radicular cyst, lateral periodontal cyst and dentigerous cyst. This case report describes the rare occurrence of OKC in the anterior mandibular region managed successfully with endodontic treatment and re-interventional surgery in a conservative approach. This case report also emphasizes on the importance of histopathological examination of the surgically excised tissue specimens as the clinical, radiographic and histopathological correlations are essential for successful treatment.

Effect of conventional irrigation and photoactivated disinfection on Enterococcus faecalis in root canals: An in vitro study.

AIMS: A study was done to evaluate the antimicrobial efficacy of sodium hypochlorite (NaOCl) and photoactivated disinfection (PAD) on Enterococcus faecalis. SETTINGS AND DESIGN: Random sampling, in-vitro study. SUBJECTS AND METHODS: Access opening and biomechanical preparation were performed on fifty freshly extracted mandibular second premolars. The specimens were sterilized; 15 µm of E. faecalis was inoculated into each canal and incubated at 36°C for 24 h. Later, specimens were randomly divided into two groups of fifty each and following procedures was carried out: (i) conventional irrigation with 2.25% NaOCl (ii) PAD using diode laser, and toluidine blue photosensitizer. Samples were collected from each canal using sterile paper points which were deposited in brain heart infusion broth, and microbiological evaluation was carried out. STATISTICAL ANALYSIS USED: Student's t-test was used to find the significant difference in the reduction of colony forming unit (CFU) between the groups. RESULTS: The mean CFUs of the two groups showed statistically significant difference (P = 0.001). Improved antibacterial efficacy was seen with PAD group compared to conventional NAOCL irrigation. CONCLUSIONS: NaOCl alone was not effective in eliminating E. faecalis completely from the root canals. PAD compared to conventional irrigation showed the best results in removing E. faecalis from root canals.

Sex determination of human mandible using metrical parameters.

INTRODUCTION: Determination of sex from an unknown human bone is an important role in forensic and anthropology field. The mandible is the largest and hardest facial bone, that commonly resist post mortem damage and forms an important source of information about sexual dimorphism. AIM: To determine the sex of unknown human adult mandible using metrical parameters. MATERIAL AND METHODS: A random collection of 250 dry, complete, undamaged human adult mandibles of South Indian population were subjected to metrical parameters like Bigonial breadth, Bicondylar breadth and Mandibular length using Mandibulometer and Vernier caliper. STATISTICAL ANALYSIS USED: The data's were expressed as Mean ± SD and then analyzed by t-test by using SPSS software. Discriminating point and limiting points were also calculated. RESULTS: The mandibular length, bigonial breadth and bicondylar breadth showed significant statistical gender difference. CONCLUSION: The present study revealed that the sex of human mandible can be assessed by using metrical parameters as an additional tool to establish the identity of a person.

Nonsurgical management of large periapical lesion in mature and immature teeth using different calcium hydroxide formulations: case series.

This case series evaluates the effectiveness of different calcium hydroxide formulations with various vehicles in management of large periapical lesion in mature and immature teeth. This will help clinicians to make informed judgments about which formulations of calcium hydroxide should be used for specific endodontic procedures.

Comparative evaluation of self-etching primers and phosphoric acid effectiveness on composite to enamel bond: an in vitro study.

AIM: The aim of the present study was to investigate the effectiveness of the one total-etch self-priming adhesive, one two-step self-etching primer adhesive, and one 'all-in-one' self-etching adhesive system on the adhesion of a resin composite to enamel. MATERIALS AND METHODS: Thirty-six freshly extracted human mandibular molars were selected for this study. A fat area about 5 mm in diameter was created on the exposed mesial surface of enamel of each tooth by moist grinding with 320, 420 and 600 grit silicon carbide paper. Twelve teeth were randomly assigned into three groups. In group 1, Adper Easy One (3M ESPE), a one step self-etching primer adhesive was applied and light curing unit for 10 seconds. In group 2, Adper SE Plus, a two-step self-etching primer with bottle A containing the aqueous primer and bottle B containing the acidic adhesive was applied and light cured for 10 seconds. Group 3 (control)-etchant 37% phosphoric acid is applied to the surface for 15 seconds and rinsed with water and air dried and adhesive (single bond 2) is applied to the surface and tube is placed and light cured for 20 seconds. Composite material (Z350) was placed in the tube and light cured for 40 seconds in all the groups. Bond strength testing was done using universal testing machine at the enamel-composite interface. The debonded enamel surface was evaluated in stereomicroscope to assess the cohesive, adhesive or mixed fracture. Data was statistically analyzed by one way analysis of variance (ANOVA). RESULTS: Group 1 performed least among all groups with a mean score of 19.46 MPa. Group 2 had a mean score of 25.67 MPa. Group 3 had a mean score of 27.16 MPa. CONCLUSION: Under the conditions of this in vitro study, the bond strength values of the two-step self-etching primer systems tested were similar to the total-etch. And, one step self-etching primers have lower bond strength compared to the total-etch.

Endodontic treatment of mandibular canine with two roots and two canals.

In majority of cases, mandibular canines have one root and one root canal, although 15% may have two canals. Literature report shows incidence of two-rooted canine as low as 1.7%. This article reports a clinical case of endodontic treatment of mandibular canine with two roots and two canals.

Role of povidone iodine in periapical surgeries: Hemostyptic and anti-inflammatory?

INTRODUCTION: Periapical surgery needs asepsis, a bloodless field for ensuring success of the treatment. Efficacy of Povidone Iodine (PVI) in the elimination of pathogen causing periapical lesions is well established. PVI is also widely used as a disinfectant, sclerosing agent, styptic as well as an anti-odematous agent. MATERIALS AND METHODS: This prospective pilot study done on 20 males between 20-40 years age group with periapical lesions in single rooted maxillary anterior tooth of 1-2 cm in diameter. The bleeding time, clotting time, bleeding time at the apex, drugs used and visual analogue scale of oedema on postoperative days were obtained. Descriptive statistics, paired t test and independent t-test were used. RESULTS AND CONCLUSION: Results show a statistically significant reduction in the time required to achieve a bloodless field and a marked decrease in oedema in the first and second postoperative days resulting in lesser consumption of NSAIDs. In conclusion, the effect of PVI in periapical surgery seems to reduce the bleeding time at apex, total dose of NSAIDs used, oedema on first two postoperative days with high statistical significance. Hence the routine use of saline in periapical surgeries may be effectively substituted with PVI. The finding of this pilot study has to be evaluated using wider samples for effective clinical translations.

A comparative study of inter-abutment distance of dies made from full arch dual-arch impression trays with those made from full arch stock trays: an in vitro study.

OBJECTIVES: The dual-arch impression technique is convenient in that it makes the required maxillary and mandibular impressions, as well as the inter-occlusal record in one procedure. The accuracy of inter-abutment distance in dies fabricated from dual-arch impression technique remains in question because there is little information available in the literature. MATERIALS AND METHODS: This study was conducted to evaluate the accuracy of inter-abutment distance in dies obtained from full arch dual-arch trays with those obtained from full arch stock metal trays. RESULTS AND CONCLUSION: The metal dual-arch trays showed better accuracy followed by the plastic dual-arch and stock dentulous trays, respectively, though statistically insignificant. The pouring sequence did not have any effect on the inter-abutment distance statistically, though pouring the non-working side of the dual-arch impression first showed better accuracy.