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Aims and Objective: The purpose of this study was to assess the use and accuracy of the titanium micromesh for primary internal orbital reconstruction in cases of either pure or impure orbital blowout fractures. Design: Retrospective case series of 21 patients with a mean follow-up of 12 months. Place: Department of Dental Surgery of a teaching tertiary medical college Hospital. Material and Methods: Twenty-one consecutive patients who underwent surgical reconstruction of orbital floor/or Combination of floor and rim fractures using titanium micromesh. Outcome and Evaluation: Persistence of diplopia, orbital dystopia, implant extrusion, enophthalmos, infection, and complications. The recorded data included age, gender, cause of trauma, diplopia, enophthalmos, ocular motility, preoperative orbital PNS/CT, and postoperative paranasal sinus view skull preoperative and postoperative ophthalmological examination. Results: Most of the patients were males and resulted from trauma inflicted during RTA, sport injuries or assault. The most Common fracture pattern was impure Blow out fractures, and commonly associated other facial fractures were midfacial fractures. Clinical examination along with diagnostic aids such as computed tomography of orbital fractures was used. Orbital floor exploration was performed in 21 cases due to functional or aesthetic deficits. All orbital floor bone defects required reconstruction. In these cases, orbital floor was reconstructed with .3 mm titanium micromesh implant. We did not encounter any major complications related to the incisions or implant material, though sample size was small. The rate of complication in which correction was difficult (diplopia) was lower [4%, 1 case]. Conclusion: Titanium mesh gives excellent result in orbital floor fractures. Surgical anatomical landmarks knowledge is very important to prevent any intra- or postoperative complications.
ABSTRACT
INTRODUCTION: Considering the staggering number of drugs being prescribed to the patients for dental ailments, the ability of the dentists to recognize potential drug-drug interactions (DDIs) is essential to reduce their occurrence. This study aims to assess the dentist's ability to recognize the potentially clinically significant DDIs in clinical practice. SUBJECTS AND METHODS: This questionnaire-based study was carried out among the dentists working at private tertiary care teaching dental hospitals in Jaipur city. Eighty-five dentists working as faculty members in various departments and having postgraduate degree in their respective specialty were enrolled after taking their written informed consent. A prevalidated close-ended questionnaire was given to the respondents to check their knowledge about common DDI possible in clinical dentistry practice. STATISTICAL ANALYSIS USED: Statistical analysis was done using descriptive statistics. Data were collected in a predesigned Microsoft Excel 2010. Continuous variables were presented as mean values ± standard deviation, and categorical variables were presented as percentages. RESULTS: Among 85 dentists recruited for the study, no one had knowledge about all the common DDIs in dental practice. The participants could correctly identify only 47.86% of drug pairs. Drug information services available on the Internet were the most common source (32%) of knowledge of DDIs among them. Knowledge of the prescribed drug (40%) and complete drug history including over-the-counter and herbal products (35%) were the two important ways identified by them for avoiding unwanted drug interactions in clinics. CONCLUSION: The study revealed that the existing knowledge of the dentists was not adequate. Hence the knowledge of the dentists about DDIs pertinent to dentistry should be enriched and should be reinforced by arranging training sessions at constant intervals of time.
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BACKGROUND: Pain control is one of the most important factors for successful treatment. Each new measure to control pain has been looked as miraculous act at the initial stages. The improvements in agents and techniques for local anaesthesia are probably the most important advances in dental science to have occurred in the past years. AIM: To evaluate 4% articaine hydrochloride against 2% lignocaine hydrochloride anaesthesia in providing adequate palatal anaesthesia in maxillary posterior regions, without the need for a palatal block. SETTINGS AND DESIGN: Healthy patients above 15 y of age and requiring bilateral extraction of their maxillary posterior teeth were included in this crossover study. The exclusion criteria included medical history of cardiovascular and kidney diseases, gastrointestinal bleeding or ulceration, allergic reactions to local anaesthetic, pregnancy or current lactation. MATERIALS AND METHODS: Eighty patients, requiring bilateral extraction of their teeth due to various reasons were enrolled for this study. Each patient received both lignocaine and articaine anaesthetic in equivalent dose at two different appointments. Maxillary infiltration technique was used for extraction of maxillary posterior teeth at both the appointments. A 170-mm Heft Parker visual analogue scale was used to assess the pain on the palatal mucosa after buccal infiltration of either anaesthetic agent. Blood pressure, Pulse rate and electrocardiographic monitoring were done during the procedure. Adverse effects during the study period were also monitored. STATISTICAL ANALYSIS: Data was analysed by Z-test and student's t-test. RESULTS: Pain scores on probing palatal mucosa after buccal infiltration of the anaesthetic were more for lignocaine as compare to articaine and it was statistically significant (p <.001). However, for hemodynamic parameters and electrocardiographic monitoring, there was no statistically significant difference in blood pressure, pulse rate and electrocardiograph before and after the completion of extraction (p > 0.05). CONCLUSION: Four percent articaine offers better clinical performance than 2% Lignocaine, particularly in terms of providing adequate palatal anaesthesia with only buccal infiltration.
ABSTRACT
CONTEXT: There is a growing concern about ever-burgeoning list of irrational fixed dose combinations (FDCs) which have flooded pharmaceutical market recently in India. Till date no structured study has evaluated the level of understanding among the dental clinicians and residents about these concepts. The present study is designed to fulfil that lacuna. OBJECTIVE: To evaluate the knowledge, attitude and practice, regarding the use of FDCs by the dental residents and dental clinicians in a tertiary care teaching dental hospital. MATERIALS AND METHODS: The present study was carried out among postgraduate students and dental clinicians working at Rajasthan Dental College, a tertiary care teaching dental hospital, in Jaipur, India. Sixty residents and 77 dental clinicians from the departments of Orthodontics, Prosthodontics, Oral Medicine, Periodontology, Conservative Dentistry & Endodontics, Oral & Maxillofacial Surgery, Pedodontics who gave their informed consent were enrolled. A prevalidated questionnaire regarding knowledge, attitude and prescribing practice of fixed dose combinations was filled up. Data was analysed with suitable statistical tests. RESULTS: Out of the 60 residents and 77 dental clinicians recruited for the study, none of them were aware about all of the advantages and disadvantages of FDCs. On an average, only 47% of residents and 61% dental clinicians were aware of FDC included in WHO Essential Medicines List (EML). Only 47% residents and 58% dental clinicians could recall a single banned FDC in India. Common sources of information about FDCs were Monthly Index of Medical Specialities (MIMS), medical representatives and internet. The most commonly prescribed irrational FDC was diclofenac + paracetamol combination, 42% residents and 41% dental clinicians and residents believed that regular Continuous Medical Education (CMEs) stressing upon rational use of medicine could reduce the magnitude of this problem. CONCLUSION: It is the need of the hour to reduce the magnitude of this problem by sensitizing dental residents and prescribers regarding the efficacy, safety, suitability, rationality and cost benefit of FDCs available for patient use.
