Comparative Evaluation of Open Reduction with Internal Fixation Against Closed Reduction Methods for Condylar Fracture Management: A Systematic Review and Meta- analysis.

Background: Mandibular fractures are frequent in facial trauma. Management of mandibular condylar fractures (MCF) remains an ongoing matter of controversy in maxillofacial injury. A number of techniques, from closed reduction (CR) to open reduction and internal fixation (ORIF), can be effectively used to manage these fractures. The best treatment strategy, that is, closed reduction or open reduction with internal fixation, remains controversial. Aim: The aim of this study is to systematically review the existing scientific literature to determine whether open reduction with internal fixation or closed reduction is a better treatment alternative for the patients with condylar fractures through a meta-analysis. Methods: A systematic review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Electronic databases like PubMed, google scholar and Ebsco Host were searched from 2000 to December 2021 for studies reporting management of condylar fractures through open reduction with internal fixation against closed reduction and reporting the outcome in terms of mean and standard deviation (SD). Quality assessment of included case control and cohort studies was performed using Newcastle-Ottawa Scale, and randomized studies were evaluated using Cochrane risk-of-bias (ROB)-2 tool through its domains. The risk of bias summary graph and risk of bias summary applicability concern was plotted using RevMan software version 5.3. The standardized mean difference (SDM) was used as summary statistic measure with random effect model and p value <0.05 as statistically significant. Results: Seventeen studies fulfilled the eligibility criteria and were included in qualitative synthesis, of which only nine studies were suitable for meta-analysis. The pooled estimate through the Standardized Mean Difference (SMD) of 0.80, 0.36 and 0.42 for maximum inter incisal opening, laterotrusion and protrusion favours CR compared to ORIF for condylar fracture management. Also, most results of heterogeneity tests were poor and most of the funnel plots showed asymmetry, indicating the presence of possible publication bias. Conclusion: The results of our meta-analysis suggest that CR provides superior outcomes in terms of maximum inter incisal opening, laterotrusion and protrusion compared to ORIF in condylar fractures management. It is necessary to conduct more prospective randomized studies and properly control confounding factors to achieve effective results and gradually unify clinical guidelines.

Stress Propagation in the Craniofacial Skeleton on Frontal Impact-A Virtual Simulation Study.

Background: The research paper emphasizes on virtual simulation of craniofacial skeleton to understand its Biomechanics. Methods: In this study, a 3D finite element model of the skull was created using CT scan data. All complexities of the skull geometry are simulated using ABAQUS software. The model was validated and then, subjected to frontal impact. Energy plots for the same were obtained. Impact analysis was done, and weak areas susceptible to fracture and hence, failure are identified. Results & Discussion: One of the emerging areas of applications of computational bio-mechanics is to understand the behavior of the skull during a traumatic injury, such as head impact during accidents. Finite element study is one such part where significant amount of research is being carried out to understand and predict the craniofacial injuries. For the head and brain trauma analysis, there are many software packages available, including ANSYS, LS-DYNA and ABAQUS. Research is being carried out towards developing high-fidelity human models, especially of the human skull to understand the bio-mechanical behavior when subjected to external impact. Impact analysis done in our study showed that a small change in impact velocity can result in a large change in damage that can happen. Conclusion: The study is expected to complement the existing treatment methodologies. Further, appropriate knowledge of fracture biomechanics can be used to design and develop safety measures in automobiles, sport guards, helmets to prevent and reduce facial injuries.

Efficacy of Nasal Floor Augmentation on the Survival Rate of Dental Implants: A Systematic Review.

Aim: To systematically review the existing scientific literature, to summarize and assess the efficacy of the nasal floor augmentation on the survival rate of dental implants by systematically reviewing the available literature. Methodology: Review was performed in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines and registered in PROSPERO-CRD42027289143. Electronic databases like PubMed, google scholar and Ebsco Host were searched from 2000 to December 2021 for studies reporting efficacy of nasal floor augmentation and reporting outcomes in terms of survival rates of dental implants. Quality assessment of included comparative follow-up studies was done using the critical checklist put forward by the Joanna Briggs Institute (JBI) was used. Results: Only nine studies fulfilled the eligibility criteria and were included in the qualitative synthesis. Of those nine studies, five were case reports and four comparative follow-up studies. A total of 14 implants were placed in five patients with a survival rate of 100% in included case reports, while a total of 408 implants were placed in 130 patients with survival rates ranging from 89% to 100% in included comparative follow-up studies. No complications were observed during follow-ups, and the patients were satisfied with the functional and aesthetic results of the treatment. Quality assessment of included studies showed moderate to low risk of bias with overall high quality of studies. Conclusion: The results of this systematic review indicate that implant placement by nasal floor augmentation techniques can be considered as a predictable treatment modality. However, due to the scarcity of literature, more studies should be carried out on proving the efficacy of nasal floor augmentation on survival rate or success of dental Implants.

Induction of cell wall phenolic monomers as part of direct defense response in maize to pink stem borer (Sesamia inferens Walker) and non-insect interactions.

Pink stem borer (PSB) causes considerable yield losses to maize. Plant-insect interactions have significant implications for sustainable pest management. The present study demonstrated that PSB feeding, mechanical wounding, a combination of mechanical wounding and PSB regurgitation and exogenous application of methyl jasmonate have induced phenolic compound mediated defense responses both at short term (within 2 days of treatment) and long term (in 15 days of treatment) in leaf and stalk tissues of maize. The quantification of two major defense related phenolic compounds namely p-Coumaric acid (p-CA) and ferulic acid (FA) was carried out through ultra-fast liquid chromatography (UFLC) at 2 and 15 days after imposing the above treatments. The p-CA content induced in leaf tissues of maize genotypes were intrinsically higher when challenged by PSB attack at V3 and V6 stages in short- and long-term responses. Higher p-CA content was observed in stalk tissues upon wounding and regurgitation in short- and long-term responses at V3 and V6 stages. Significant accumulation of FA content was also observed in leaf tissues in response to PSB feeding at V3 stage in long-term response while at V6 stage it was observed both in short- and long-term responses. In stalk tissues, methyl jasmonate induced higher FA content in short-term response at V3 stage. However, at V6 stage PSB feeding induced FA accumulation in the short-term while, wounding and regurgitation treatment-induced defense responses in the long-term. In general, the resistant (DMRE 63, CM 500) and moderately resistant genotypes (WNZ ExoticPool) accumulated significantly higher contents of p-CA and FA content than susceptible ones (CM 202, BML 6) in most of the cases. The study indicates that phenolic mediated defense responses in maize are induced by PSB attack followed by wounding and regurgitation compared to the other induced treatments. Furthermore, the study confirmed that induced defense responses vary with plant genotype, stage of crop growth, plant tissue and short and long-term responses. The results of the study suggested that the Phenolic acids i.e. p-CA and FA may contribute to maize resistance mechanisms in the maize-PSB interaction system.

Efficacy of Platelet Rich Fibrin versus chitosan as a hemostatic agent following dental extraction in patients on antiplatelet therapy.

OBJECTIVES: The aim of this study is to compare the effectiveness of Platelet Rich Fibrin gel and Chitosan gel dressing in providing hemostasis in patients receiving Oral Antiplatelet Therapy and also to evaluate their surgical healing outcome following dental extractions. METHODOLOGY: A total of 60 patients under Oral Antiplatelet Therapy indicated for tooth extraction were included for treatment in the study without altering the oral antiplatelet regimens. Patients were allocated equally in two groups; Group A: where PRF gel was packed into the extraction socket, while Group B: Chitosan hydrogel was packed. Timing of hemostasis was noted for each patient of both the groups. Patients were examined for any pain/secondary bleeding/healing/soft tissue dehiscence/alveolar osteitis in the extraction site on first, third and seventh post-operative days. RESULTS: All extraction sockets with Platelet-rich fibrin achieved hemostasis in 2.64 min and sockets with Chitosan hydrogel achieved hemostasis in 1.182 min (p < 0.001). Post-operative pain in Group A sites (3.2, 1.4, 0.37 on 1st, 3rd & 7th day respectively) was significantly lower than the control sites (3.4, 1.67, 0.53 on 1st, 3rd & 7th day respectively) p-value 0.001, 0.001 respectively. CONCLUSION: In this study, Chitosan hydrogel dressing thus proved to be a superior hemostatic agent compared to PRF gel, that significantly shortens the clotting time following dental extraction in patients under antiplatelet therapy. But, PRF gel has superior wound healing properties than Chitosan with less postoperative pain following minor oral surgical procedures under local anesthesia.

Anxiety and Depression in Facial Injuries: A Comparative Study.

BACKGROUND: This study was performed to identify the presence of anxiety and depression in patients who had sustained facial injuries; additionally we aimed to identify other variables that may modify the psychological response to trauma that include gender and age. MATERIALS AND METHODS: The participants were 153 patients from multimodal trauma centers in Bangalore city who sustained disfiguring facial injuries were taken up. Of the 153 patients, 81 patients were male (51 less than 50 years of age and 30 more than 50 years of age) and 72 patients were female (40 less than 50 years of age and 32 more than 50 years of age) and 111 patients with non-disfiguring facial injuries out of which 54 were male patients and 57 were female patients. The assessments were carried out at 3 time intervals (the date of discharge [DOD], 1-month post-operatively and 6 months post-operatively) of the follow-up. The hospital anxiety and depression scale (HADS) was used to assess the anxiety and depression of the facial trauma patients. RESULTS: Statistically significant higher means of HADS both for anxiety and depression were present in patients with disfiguring facial injuries compared to non-disfiguring facial injuries, female patients compared to male patients after the 1-month and 6 months post-operatively, the mean anxiety and depression scores of males and female patients were significantly higher for those who aged less than 50 years compared to those who aged more than 50 years. CONCLUSION: The results of this study led to the conclusion that in comparison with patients who had facial disfiguring injuries and non-disfiguring facial injuries, the mean HADS scores were significantly higher in the disfiguring facial injury patient. This indicates increased Anxiety and Depression levels and this was observed at all three study intervals (DOD, 1-month and 6 months post-operatively). The HADS was higher in female patients who were lesser than 50 years age compared to male patients of the same age group, which implies higher anxiety and depression levels.

Post-traumatic Stress Disorder in Facial Injuries: A Comparative Study.

AIM: The aim of the study was to identify the presence of post-traumatic stress disorder (PTSD) in patients who had sustained facial injuries, additionally, we aimed to identify other variables that may modify the psychological response to trauma that include gender, age and presence of disfigurement post-treatment and visible scars/orthopedic injuries. MATERIALS AND METHODS: Participants comprised of 460 patients from several multinodal trauma centers in Bengaluru City, Karnataka, who had sustained facial injuries that had healed either with or without significant disfigurement or scarring and with visible/orthopedic injuries. One hundred and eleven patients of the chosen 460 had sustained nondisfiguring facial injuries while 153 patients sustained disfiguring facial injuries, 64 patients who sustained facial injury (i.e. 19.5%) were lost to follow-up and were not included in the study. One hundred and thirty-two had sustained orthopedic/visible injuries; however, in this group, 18 (i.e. 13.6%) patients were lost to follow-up and were excluded from the study. The impact of events scale (IES) was used to check the presence of PTSD. RESULTS: Statistically significant higher means of IES were present in patients with disfiguring facial injuries compared to nondisfiguring facial injuries, female patients compared to male patients, patients with disfiguring facial injuries compared to orthopedic/visible injuries and patients who were younger than 50 years of age compared to patients who were older than 50 years of age and the results observed were similar at all three study intervals (date of discharge (DOD), 1 month and 6 months postoperatively). CONCLUSION: Patients with disfiguring facial injuries had significantly higher PTSD levels compared to patients with nondisfiguring facial injuries, patients with orthopedic/visible injuries had statistically significant lower IES scores which could not be strictly termed PTSD when compared to patients with disfiguring facial injuries who had high scores of IES corresponding to high levels of PTSD and these results were observed at all three study intervals (DOD, 1 and 6 months postoperatively). Female patients with disfiguring facial injuries had significantly higher PTSD levels compared to male patients (at all the study intervals) and patients younger than 50 years of age had significantly higher PTSD levels compared to older patients.

A Comparative Study of Post-traumatic Stress Disorder, Anxiety, Depression and Change in Sexual Functioning of Patients with Facial Injuries and Patients with Extremity Injuries.

BACKGROUND: This study was performed to identify and compare the presence of and the levels of post-traumatic stress disorder (PTSD), anxiety, depression and if any change in sexual functioning is present in patients with disfiguring facial injuries, nondisfiguring facial injuries and visible extremity injuries. MATERIALS AND METHODS: A total of 378 patients from multi modal trauma centers in Bengaluru city were included for the study. A total of 153 patients were those who had disfiguring facial injuries, 111 patients with nondisfiguring facial injuries and 114 patients had sustained a visible extremity injury that was not covered by clothing (disfigurement /scarring). The assessments were carried out at three time intervals (the date of discharge, 1 month postoperatively and 6 months postoperatively) of the follow-up. The impact of events scale (IES), the hospital anxiety and depression scale (HADS) and changes in sexual functioning questionnaire (CSFQ) were used. RESULTS: Statistically significant higher means of IES, HADS (both for anxiety and depression) were present in patients with disfiguring facial injuries compared to patients with nondisfiguring facial injuries and visible extremity injuries and this was present at all three study intervals (date of discharge,1 st postoperative month and 6th postoperative month). There was a statistically significant change in the means of CSFQ scores of visible extremity injuries compared to other groups at the date of discharge bordering on sexual dysfunction, there was a raise in CSFQ scores among all three groups at the 1st postoperative month and the 6th postoperative month which was above the dysfunction cut-off. CONCLUSION: The results of this study led to the conclusion that in comparison with patients who had sustained disfiguring facial injuries, nondisfiguring facial injuries and visible extremity/ orthopedic injuries, the mean IES scores, HADS scores for both anxiety and depression of the facial disfiguring injury patients was higher at all three study intervals (date of discharge,1st postoperative month and 6 months postoperatively), indicating higher PTSD levels, anxiety and depression in patients with disfiguring facial injuries, CSFQ scores were above the cutoff suggested at the 1st month and 6th month postoperative indicating no sexual dysfunction in all the three groups.

Validation of a Kannada version of the Impact of Events Scale (IES).

BACKGROUND: This study presents a Kannada translation and validation of the Impact of Event Scale in a population of men and women exposed to maxillofacial trauma and orthopedic/ general trauma. MATERIALS & METHODS: A total of 96 study subjects from multi modal trauma centers in Bangalore city completed the Kannada translated questionnaire at the time of discharge, the first post- operative month and the sixth month of follow up. RESULTS: The Kannada IES is reliable when analyzed with the students T-test, it has good internal consistency with Cronbach's α-coefficients ranging from .970 to .974, the test-retest reliability with Karl Pearson's correlation of the scale at all three time intervals showed significant correlation. A principal component analysis was conducted to ascertain the validity and two components were derived from the 15 questions which were able to explain 88% of the variation and the two were retained (intrusion and avoidance). CONCLUSION: The Kannada version of the IES has satisfactory reliability, internal validity, test-retest reliability and the factor structure was similar to the proposed theoretical structure of the IES. How to cite this article: Tavane PN, Raghuveer HP, Kumar RD, Shobha ES, Rangan V, Dutt CS. Validation of a Kannada version of the Impact of Events Scale (IES). J Int Oral Health 2013; 5(5):38-47.

Rhodoplanes piscinae sp. nov. isolated from pond water.

Two strains (JA266(T) and JA333) of Gram-negative, rod-shaped, phototrophic, purple non-sulfur bacteria were isolated from a freshwater fish pond and an industrial effluent. Both strains were capable of phototrophic and chemotrophic growth. Bacteriochlorophyll a and carotenoids of the spirilloxanthin series were present as photosynthetic pigments. The major fatty acid for both strains was C(18 : 1)ω7c (>65 %), with minor amounts of 11-methyl C(18  : 1)ω7c, C(16 : 0), C(16 : 1)ω7c and C(18 : 0) also present. Both strains have the lamellar type of intracellular photosynthetic membranes. Ubiquinone-10 (Q(10)) and rhodoquinone-10 (RQ(10)) were present as primary quinone components. Diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine and phosphatidylcholine were the major polar lipids, while minor amounts of amino lipids (AL1, AL2) and an unidentified lipid (L1) were common to both strains. The DNA G+C contents of strains JA266(T) and JA333 were 71.3 and 69.9 mol%, respectively. Phylogenetic analysis on the basis of 16S rRNA gene sequences showed that both strains clustered with members of the genus Rhodoplanes in the class Alphaproteobacteria. Strains JA266(T) and JA333 had gene sequence similarity of 98.7 and 98.9 % with Rhodoplanes serenus TUT3530(T), 96.4 and 96.5 % with Rhodoplanes elegans AS130(T), respectively, and less than 96 % with other members of the genus Rhodoplanes. 16S rRNA gene sequence similarity between the two strains was 99.3 % and they exhibited high (84.7 %) relatedness based on DNA-DNA hybridization. Furthermore, both strains had less than 65 % DNA-DNA relatedness with the type strain R. serenus TUT3530(T). On the basis of phenotypic and genotypic data, it is proposed that strain JA266(T) be classified as a novel species of the genus Rhodoplanes, with the species name Rhodoplanes piscinae sp. nov. The type strain of the proposed novel species is JA266(T) ( = JCM 14934(T) = KCTC 5627(T)), while strain JA333 ( = NBRC 107574 = KCTC 5962) is an additional strain.

Descriptions of Rhodopseudomonas parapalustris sp. nov., Rhodopseudomonas harwoodiae sp. nov. and Rhodopseudomonas pseudopalustris sp. nov., and emended description of Rhodopseudomonas palustris.

Four strains (JA310(T), JA531(T), JA447 and JA490) of red to reddish brown pigmented, rod-shaped, motile and budding phototrophic bacteria were isolated from soil and freshwater sediment samples from different geographical regions of India. All strains contained bacteriochlorophyll a and carotenoids of the spirilloxanthin series. The major cellular fatty acid of strains JA310(T) and JA531(T) was C(18:1)ω7c, the quinone was Q-10 and polar lipids were diphosphatidylglycerol, phosphatidylglycerol, phosphatidylethanolamine, phosphatidylcholine, an aminohopanoid and an unidentified aminolipid. Phylogenetic analysis based on 16S rRNA gene sequences showed that all strains clustered with species of the genus Rhodopseudomonas in the class Alphaproteobacteria. Strains JA531(T), JA447 and JA490 were genotypically (>80% related based on DNA-DNA hybridization) and phenotypically closely related to each other and the three strains were distinct from strain JA310(T) (33% related). Furthermore, all four strains had less than 48% relatedness (DNA-DNA hybridization) with type strains of members of the genus Rhodopseudomonas, i.e. Rhodopseudomonas palustris ATCC 17001(T), Rhodopseudomonas faecalis JCM 11668(T) and Rhodopseudomonas rhenobacensis DSM 12706(T). The genomic DNA G+C contents of strains JA310(T) and JA531(T) were 63.8 and 62.4 mol%, respectively. On the basis of phenotypic, chemotaxonomic and molecular genetic evidence, it is proposed that strains JA310(T) ( = NBRC 106083(T) = KCTC 5839(T)) and JA531(T) ( = NBRC 107575(T) = KCTC 5841(T)) be classified as the type strains of two novel species of the genus Rhodopseudomonas, Rhodopseudomonas parapalustris sp. nov. and Rhodopseudomonas harwoodiae sp. nov., respectively. In addition, we propose that strain DSM 123(T) ( = NBRC 100419(T)) represents a novel species, Rhodopseudomonas pseudopalustris sp. nov., since this strain differs genotypically and phenotypically from R. palustris ATCC 17001(T) and other members of the genus Rhodopseudomonas. An emended description of R. palustris is also provided.

Blastochloris gulmargensis sp. nov., isolated from an epilithic phototrophic biofilm.

A novel Gram-negative, motile, bacteriochlorophyll b-containing purple non-sulfur bacterium, strain JA248(T), was isolated from phototrophic enrichments of a yellow-green epilithic biofilm sample collected from Gulmarg, India. The genomic DNA G+C content of strain JA248(T) was 63.8 mol%. A phylogenetic tree based on 16S rRNA gene sequence analysis showed that strain JA248(T) had highest similarity to members of the genus Blastochloris and was closely related to Blastochloris sulfoviridis DSM 729(T) (98.5 % sequence similarity) and Blastochloris viridis DSM 133(T) (98.4 %) of the class Alphaproteobacteria. Strain JA248(T) was characterized based on polyphasic taxonomy, and distinct phenotypic and molecular differences based on DNA-DNA hybridization (relatedness of <46.5 % with the two species of the genus Blastochloris), multilocus sequence analysis, and phenotypic and chemotaxonomic evidence separated strain JA248(T) from other species of the genus Blastochloris. Strain JA248(T) therefore represents a novel species in the genus Blastochloris, for which the name Blastochloris gulmargensis sp. nov. is proposed. The type strain is JA248(T) ( = JCM 14795(T)  = DSM 19786(T)).