Comparative Evaluation of Instrumentation Time and Quality of Obturation amongst Pediatric Rotary Endodontic System: An In Vivo Study.

Aim: This study assesses the instrumentation time and quality of obturation of three pediatric rotary endodontic systems-GT nickel-titanium (NiTi) (Prime Pedo), controlled memory (CM) NiTi (Pro-AF-Baby Gold) and NiTi-titanium oxide (NiTi-TiO) (Kedo SG Blue). Materials and methods: A total of 60 children aged 4-8 were chosen at random for the study based on inclusion criteria that required pulpectomy in any of the primary molars and were separated into three groups of 20 samples, each based on the file system employed. The instrumentation time during the preparation of the canal is recorded using a stopwatch. An expert dentist was blinded to the instrumentation type and showed the periapical radiograph, which he or she graded depending on the quality of the obturation by categorizing it as underfill, optimal fill, or overfill. The observations were then recorded, tabulated, and statistically analyzed for the results. Results: The least amount of instrumentation time was needed for NiTi-TiO (group III) files, followed by NiTi-CM (group II) and NiTi-GT (group I). NiTi-TiO (group III) has the most optimally filled and least underfilled obturations among the three rotary endodontic systems mentioned. Also, NiTi-TiO (group III) and NiTi-CM (group II) have the least similar overfilled obturations when compared with NiTi-GT (Group I). Conclusion: We conclude that NiTi-TiO needed the least amount of instrumentation time and generated the maximum optimally filled obturations based on our observations. Clinical significance: Pediatric rotary endodontic systems are more convenient to use and reduce chairside time; thus, their use in children with behavior control issues might be more suitable. How to cite this article: Kohli A, Chhabra J, Sharma K, et al. Comparative Evaluation of Instrumentation Time and Quality of Obturation amongst Pediatric Rotary Endodontic System: An In Vivo Study. Int J Clin Pediatr Dent 2023;16(2):338-343.

Comparative Evaluation between Lavender Essential Oil and Patchouli Essential Oil in Aromatherapy and Its Effect on Dental Anxiety in Children.

Introduction: Dental fear and anxiety is the most common distressing problem for children. Management of dental anxiety in children is one of the most difficult tasks in dentistry. Recently, alternative and contemporary medical approaches such as aromatherapy have received much attention. The potential effects of essential oils such as lavender and patchouli have been found to reduce anxiety, improve mood, and increase sedation. Thus, the study was conducted to compare the evaluation of lavender and patchouli essential oils used in aromatherapy and their effect on dental anxiety in children. Aim: To compare the efficacy of lavender and patchouli essential oils in aromatherapy and its effect on dental anxiety in children. Materials and methods: A total of 60 children between 6 and 12 years were randomly allocated to either an experimental or control group that received lavender and patchouli before dental treatment. Child anxiety was measured by using the Chotta Bheem-Chutki scale. A pulse oximeter was used to record the pulse rate. Data was tabulated and analyzed by Statistical Package for the Social Sciences (SPSS) software. Results: There was a significant reduction in anxiety score and pulse rate between the intervals. Statistical differences were observed in the lavender group compared to patchouli oil. Conclusion: The positive effects of both lavender and patchouli oil on children can be used to reduce anxiety in children. In our study, lavender oil showed slightly better results than patchouli oil. How to cite this article: Tripathy S, Kohli A, Sharma K, et al. Comparative Evaluation between Lavender Essential Oil and Patchouli Essential Oil in Aromatherapy and Its Effect on Dental Anxiety in Children. Int J Clin Pediatr Dent 2023;16(5):681-685.

Mixed Dentition Analysis in and around Kanpur City: An Existential and Illustrative Study.

Context: Mixed dentition space analysis helps in determining the discrepancy between the available and required space in each dental arch during the mixed dentition period; further, it helps to diagnose and plan the treatment of developing malocclusion. Aim: The aim of this study is to evaluate the applicability of Tanaka and Johnston's and Moyer's methods of predicting the size of permanent canines and premolars and compare the tooth size between the right and left sides between males and females, and also to compare the predicted values of mesiodistal widths of permanent canines and premolars from Tanaka and Johnston and Moyer's method with the measured values. Materials and methods: The sample consisted of 58 sets of study models, of which 20 were girls and 38 were boys, that were collected from the children of the 12-15 year age-group. A digital vernier gauge, whose beaks were sharpened, was used to measure the mesiodistal widths of the individual teeth in order to increase accuracy. Statistical analysis: The two-tailed paired t-tests were used to assess the bilateral symmetry of the mesiodistal diameter of all measured individual teeth. Results and conclusion: It was concluded that Tanaka and Johnston's method could not accurately predict the mesiodistal widths of unerupted canines and premolars of children of Kanpur city due to the high variability in estimation, whereas the least statistically significant difference was obtained only at 65% level of Moyer's probability chart for male, female, and combined sample. How to cite this article: Gaur S, Singh N, Singh R, et al. Mixed Dentition Analysis in and around Kanpur City: An Existential and Illustrative Study. Int J Clin Pediatr Dent 2022;15(5):603-609.

Osteotome-mediated sinus floor elevation using an in situ hardening biphasic calcium phosphate bone graft substitute compared to xenograft: A randomized controlled clinical trial.

AIM: To assess osteotome-mediated sinus floor elevation (OMSFE) with simultaneous implant placement using an in situ hardening biphasic calcium phosphate (BCP) compared to xenograft as a control. METHODS: Patient in need for sinus floor augmentation in one or both sinuses were selected for this randomised controlled clinical trial. Sites presenting a residual sinus floor height of 3-6 mm and eligible for OMSFE were randomly assigned to receive either BCP (test) or xenograft particles (control). CBCT scans were performed before and at the time of implant loading (180 days). The difference in sinus floor height gain between the two groups was set as the primary endpoint parameter for equivalence testing. The implant insertion torque (ITV) was recorded and Implant stability quotients (ISQ) was assessed upon implant placement, abutment connection (160 days) and implant loading (180 days). RESULTS: A total of 54 sinus lifts were performed in 42 patients including 12 bilateral cases. Four implants failed (two in each group) and a total of six patients were lost to follow-up. Statistical analysis of sinus floor height revealed no significant differences (p < 0.05) between groups at baseline nor at 180 days after augmentation. There was no statistical difference in sinus floor height gain between the two groups as supported by the 90% confidence intervals of the difference between groups. Good primary implant stability was confirmed in both treatment groups by ITV and ISQ measurements. CONCLUSIONS: Within the limits of this study, it can be concluded that OMSFE using in situ hardening BCP particles results in equivalent sinus floor height gain than using xenograft particles but offers an easier application.

Sudden death due to ruptured oesophageal varices - autopsy-based case report.

Acute haemorrhage from ruptured oesophageal varices is a serious consequence of portal hypertension in cirrhotic patients. It represents a medical emergency with a high morbidity and mortality rate. Studies over the years have shown a direct link with chronic alcoholism in the development of such complications. Although the gastrointestinal system accounts for a few numbers of sudden deaths, bleeding through ruptured varices represent a life-threatening condition. The role of forensic pathologist is vital in dealing with sudden deaths. Here, we report a case of a 46-year-old man who died suddenly following the rupture of oesophageal varices.

Exploring time of death from potassium, sodium, chloride, glucose & calcium analysis of postmortem synovial fluid in semi arid climate.

Estimation of time of death (TOD) with fair accuracy from postmortem changes still remains an important but difficult task to be performed by every autopsy surgeon under different climatic conditions. The environment plays an important role in the process of decomposition and thereby affecting the levels of electrolytes and other biochemical parameters in the postmortem samples. Since, there is limited information available on the levels of these biochemical parameters from semi arid environment, the present study was aimed to explore time of death by analyzing electrolyte, glucose and calcium levels of postmortem synovial fluid collected from samples under such climatic conditions. The synovial fluid samples from two hundred and ten bodies brought to University College of Medical Sciences and associated Guru Teg Bahadur Hospital Delhi for medico-legal postmortem examination, during the period of November 2010 to April 2012, were analyzed for potassium, sodium, chloride, glucose and calcium. Univariate regression analysis of electrolyte concentrations of synovial fluid showed significant positive relationship between time of death and potassium (r = 0.840, p = 0.000). However, there was negative relationship between time of death and sodium (r = -0.175, p = 0.011) & glucose (r = -0.427, p = 0.000) and no significant relationship was found between time of death and calcium (r = 0.099, p = 0.152) & chloride (r = 0.082, p = 0.24) among the samples analyzed.

A comparative evaluation of endodontic practice trends in India: "the Mumbai study".

INTRODUCTION: Multiple treatment protocols are available to the Indian endodontist. Hence a survey is required to recognize the common trends in endodontics and set a basic standard of treatment. AIMS AND OBJECTIVES: The aim of this article is to present practice trends among Indian endodontists and compare the same with established practice trends internationally through various surveys that have been conducted respectively. MATERIALS AND METHODS: Questionnaires were mailed to 1085 endodontists in dental schools and private practice in India. A response rate of 42% was observed. The data was analyzed and compared with other studies. RESULTS: Most of the endodontists in India follow the basic protocols and techniques in their practices. 40% of the Endodontists preferred digital radiography technique. 2.5% NaOCl is the most preferred irrigant of choice for primary root canal treatment and 2% chlorhexidine in retreatment cases. Calcium hydroxide was the most preferred intracanal medicament in all clinical situations. Lateral compaction (70.8%) was the most widely used method. AH Plus was the most preferred root canal sealer (46.6%). CONCLUSION: Indian endodontists are following the basic protocol but when compared to other studies there were concepts like, the use of rubber dam and microscope which need to be improved and raised to a level that ensures international standards in clinical practice.

Continuing professional development of dentists through distant learning: an Indira Gandhi National Open University-Dental Council of India experiment a report.

To keep themselves updated with all the advancements in the field of dentistry, dentists should involve themselves in some kind of professional development. Distance learning is the most appropriate way to serve the growing demand due to technological advancements. Indira Gandhi National Open University in collaboration with Dental Council of India (DCI) developed and launched two continuing professional development programs in Endodontics (postgraduate certificate in endodontics) and postgraduate certificate in oral implantology and has trained over 400 and 280 BDS dentists respectively till date. The program package consists of self-instructional material, assignments, videos and practical training. The training is conducted in premiere dental colleges and institutions recognized by DCI. The certificate is awarded after a term end examination, both in theory and practical. The pass percentages of the theory courses ranged from around 63% to 98%, and 90% of the candidates cleared the practical exam.

Estimation of time since death from electrolyte, glucose and calcium analysis of postmortem vitreous humour in semi-arid climate.

Estimating time since death (TSD) with fair accuracy from postmortem changes still remains an important but difficult task to be performed by every autopsy surgeon in medicolegal scenario. The aim of the present study was to estimate TSD from electrolyte analysis of postmortem vitreous humour collected from samples under semi-arid climate. Vitreous humour was collected from 210 dead bodies brought to University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, during the period of November 2010 to April 2012. The vitreous samples were analysed for sodium, potassium, calcium, chloride and glucose. The results showed a significant positive relationship between TSD and potassium (r = 0.841, p = 0.000) and a weak negative relationship between TSD and sodium (r = -0.137, p = 0.048) and glucose (r = -0.241, p = 0.000), whereas no significant relationship could be established between TSD and calcium (r = 0.055, p = 0.429) and chloride (r = 0.075, p = 0.11).

Fatal cardiac tamponade by Bodkin.

Cardiac tamponade is life-threatening, slow or rapid compression of the heart due to the pericardial accumulation of fluid, pus, blood, clots or gas, as a result of effusion, trauma or rupture of the heart. Penetrating injuries of the chest are most commonly the result of stab wounds and are often associated with a range of potentially life-threatening injuries. It must be treated by pericardial drainage as soon as possible. Sometimes the injury resulting in life-threatening conditions may be so small that it could be missed in the first instance. We present a case report in which the deceased was stabbed by Bodkin at road side. As the wound was so minute, it was not appreciated and time was lost in getting treatment, resulting in loss of a precious life.

Chronic suppurative osteomyelitis of the mandible.

Osteomyelitis is an infection of the bone or bone marrow, usually caused by pyogenic bacteria or mycobacterium. Osteomyelitis, inflammatory process of the bone and its structures, can be acute or chronic. Taking a journey from a nonsurgical approach to a surgical one, it appeared to be one osteomyelitis revenge against all our efforts. The pain, the pus, the new bone formation, and all the trouble, this case showed it all. The injudicious use of antibiotics and delay in providing the requisite treatment can cause devastating effects as in the case of an 11-year-old child. A case report on treating osteomyelitis through medication and realizing that surgical excision remains the only realistic approach, the report talks about the investigations and treatment planning done to deal with it.

Orthodontic Management of Midline Diastema in Mixed Dentition.

Midline diastema is a space between the central incisors. Although physiologic transitory maxillary midline diastema is observed in children during eruption of maxillary anterior teeth in most cases, it is self-corrected after eruption of maxillary canines. However, midline diastema unrelated to the eruption of teeth has been observed owing to various etiologic factors. Treatment to align the central incisors depends on the predisposing factors.

Study of age of fusion of hyoid bone.

The present study was conducted to determine the age of fusion of greater cornua with the body of hyoid bone. Age of fusion of hyoid bone can help in determining the age of an individual, especially of unknown dead bodies where only skeletal remains are available. A victim of compression of neck will more likely have fracture of hyoid bone if his hyoid bone is fused. Indian authors have reported that the fusion of hyoid bone occurs after 40 years of age. Studies done by foreign workers observed that hyoid bone fused at an earlier age (30-40 years). A total of 170 excised hyoid bones from dead bodies belonging to the age group of 20-65 years were studied. Fusion occurred earlier in females as compared to males by about 5 years. The mean age of unilateral and bilateral fusion in males was 38.25 and 53.16 years, respectively. The mean age of unilateral and bilateral fusion in females was 38.00 and 48.50 years, respectively. All the hyoid bones were fused after the age of 60 years. No significant differences were found between the fusion on right and left side.

Trivial trauma, heart disease and medico-legal interpretation of death.

Forensic experts are often required to give an opinion on the cause of death and its medico-legal interpretation in cases where an individual dies after receiving non-fatal injuries and at autopsy is discovered to have had a natural disease that alone could have caused death. The significance of this varies in different countries depending on the local laws relating to death in cases of trivial trauma associated with natural disease. This paper discusses this issue from an Indian perspective with the help of an illustrative case report and highlights the importance of the forensic pathologist in such cases.

Barriers to leadership positions for Indian women in academic dentistry.

Indian women, have come up a long way during the past 50 years. Gone are the days when the leadership positions in dentistry and health care professions were occupied solely by males and the women in-charge were looked down upon as anomalies. The staff rooms in dental and medical schools, the research laboratories in India today are employing women, who have quietly begun challenging the conventional male ideas that had shaped the policies earlier on. Women have advanced considerably in academic dentistry but like every coin, this story too, has two sides. In spite of the considerable gain in equity of status, women in research and academic careers related to health care professions still face innumerable barriers to their careers. This study was conducted with an aim to highlight the various barriers being faced by women in leadership positions in academic dentistry in India and this paper also suggests issues which require global concern for unbiased advancement of women. This was a questionnaire-based study in which the subjects were women in leadership positions in the various dental colleges in India. The questions are related to the various barriers like family commitments, attitude of the society, sexual harassment, gender bias and lack of cooperation from spouse which hinders the development of the careers of such women with tremendous potential. The results show that 67% of the subjects feel there are more barriers to their careers as women than men and health care professions definitely need more women leaders for improvement in women's health status globally. 63.5% of women in dentistry feel their family commitments are barriers to rising in their careers and 64.7% report that a marriage is happier if the husband's career graph is better than wife's. The survey results indicate that the same salary is paid to 93.5% women as their male colleagues. The results of the study show that there certainly has been a change in outlook of Indian women as they have broken the traditional norms and taken up careers in academic dentistry. There certainly is a positive side to this story but numerous challenges especially in the form of family commitments still remain for women in leadership positions in the dental colleges in India.

Pattern of injuries in fatal falls from buildings.

When bodies are brought for autopsy it is sometimes unclear whether the injuries are due to a fall from a height or due to blunt trauma from other causes, especially when the bodies are found near buildings with no eyewitnesses available. Studies discussing the injury patterns in adults after falls exclusively from buildings are rare. A five-year retrospective study was carried out on 151 cases of fatal falls from buildings brought for autopsy. The aim was to assess the pattern of these injuries and identify features helpful in discriminating between these and injuries due to blunt trauma from other causes. The majority of cases comprised subjects who fell from heights of 10-20 feet (3-6m) with most falls occurring late at night or in the early morning. The pattern that emerged is quite distinct from ground level falls and pedestrian injuries. Abrasions are the commonest injury and bruises very rare. Lacerations are mostly on the head and skull fractures are evenly distributed between the vertex, base and vertex plus base. Subarachnoid haemorrhage is the commonest intracranial lesion. Extradural haemorrhage alone is rare. Fractures of ribs and cervical vertebrae are common and fractures of thoracic vertebrae and long bones are uncommon. Safety measures to prevent such falls have been suggested.

Firearm fatalities in Delhi, India.

Studies on firearm fatalities in various countries have been published. However, pattern and incidence of fatal firearm injuries in Delhi has largely gone unreported. This study was taken up with the objective of reporting the pattern and incidence of fatal firearm injuries in Delhi and comparing it with the pattern seen in other countries. One hundred and seven firearm fatalities autopsied during the last 6 years were studied. 46.7% victims were aged between 20 and 30 years and 90.7% were males; similar findings were seen in other countries. 92.6% were victims of homicidal attacks, 6.5% suicidal and 0.9% accidental. This is in sharp contrast to the pattern in other countries where suicides were the predominant group and homicides accounted for a small number of cases. A high presence of illegal country made guns was an explanation for this trend. Single firings were the norm. Chest (39%) and head (29.6%) were the two most common entry sites for the bullets, a pattern somewhat similar to that of other countries. Survival time, cause of death and recovery of projectiles was also studied. Elimination of illegal country made guns is of the utmost importance in order to curb the high homicidal firearm fatality rate in this region.