Evaluation of Midpalatal Suture Ossification Using Cone-Beam Computed Tomography: A Digital Radiographic Study.

BACKGROUND: Cone beam computed tomography (CBCT) imaging techniques are the recent rage in the field of oral diagnostic imaging modality. It is noninvasive, faster and lacks anatomic superimposition. Earlier maxillary occlusal radiographs were used to assess and evaluate the mid palatal suture, but being a two dimensional imaging modality it could not assess the ossification process which takes place in multiple planes mostly due to curved nature of the palate. In this study we assessed the mid palatal suture morphology and classify them according to the variants using CBCT images. MATERIALS AND METHODS: A total of 200 CBCT scans (95 males and 105 females) were evaluated in the present study from the archives of an imaging center. As per Angelieri classification the midpalatal suture was classified into five categories (A-E) depending on the degree of ossification that had taken place. Statistical analysis was done by Chi Square test using SPSS version 23.0. RESULTS: There is statistically significant difference present in the stages of maturity of mid palatal suture in various age groups with Stage B is most common in Group 1 (50%), Stage C most common in Group 2 (60%) and Group 3 (40%) and Stage E more common in Group 4 (50%). CONCLUSION: The results of the present study showed a wide variation in the initiation time and the degree of ossification and morphology of the midpalatal suture in different age groups. Although there was an increase in the closure of the suture with aging, age is not a reliable criterion for determining the open or closed nature of the suture. This finding is important in providing an idea as to how diverse is the ossification of maxillary sutures.

Salivary alterations in type 1 diabetes mellitus patients: Salivary glucose could be noninvasive tool for monitoring diabetes mellitus.

BACKGROUND: Diabetes mellitus (DM) is an endocrine disease characterized by hyperglycemia, the pathogenic mechanisms by which hyperglycemia arises differ widely. Monitoring people with diabetes involve repeated estimations of plasma glucose either by finger pricks or by intravenous blood sampling. Hence, a noninvasive procedure for glucose measurements would be most precious under the circumstances. AIMS: (1) To evaluate salivary glucose, total protein and albumin in type 1 DM (T1DM) patients and to compare with healthy nondiabetic control group. (2) To compare and correlate serum and salivary glucose levels in patients with T1DM. STUDY DESIGN: This study consisted of 30 T1DM patients and 30 controls. All subjects were subjected to the serum glucose, salivary glucose, and total protein and albumin estimations. MATERIALS AND METHODS: Glucose estimations were done by glucose oxidase-peroxidase method, total protein estimations were done by Biuret method, end point and albumin estimations were done by bromocresol green dye method, end point. All the estimations were performed using an autoanalyzer. STATISTICAL ANALYSIS: Mean and standard deviation, Student's t-test and Karl Pearson correlation co-efficient were calculated. All these statistical analyses were performed by using SPSS 11.5 software. RESULTS: The results showed elevated levels of salivary glucose, total protein and albumin in T1DM group compared to healthy controls. Further the levels of serum and salivary glucose in T1DM patients were significantly correlated. CONCLUSION: There are definite changes in salivary composition with increased levels of salivary glucose, total protein and albumin in T1DM patients compared with healthy controls. Salivary glucose could be used for monitoring of DM.

Magical NiTi expander.

A 24-year-old male patient was referred to our department for expansion of the constricted maxillary arch as a presurgical procedure for the correction of congenital facial disfigurement. On examination, the patient had a convex profile, increased interlabial gap, tongue thrust, limited mouth opening, posterior crossbite, asymmetric 'V'-shaped maxillary arch with severe constriction, crowding of anterior teeth in the maxillary arch and a massive open bite. Radiographic investigations included orthopantomograph and occlusal radiographs. The patient photographs and models were analysed. On careful evaluation, the treatment for maxillary arch expansion was planned with a nickel titanium (NiTi) slow maxillary expander along with fixed mechanotherapy for alignment of teeth. An unexpectedly successful outcome was appreciated from the treatment. An emphasis should be laid on selecting and treating the case of constricted arches with a surgical or non-surgical approach, as expansion can be achieved orthodontically by using NiTi expanders.