Morphometric analysis of maxillary arch dimensions using Cone Beam Computer Tomography (CBCT).

Knowledge of morphology of the maxillary arch is important in many spacialities of dentistry. This retrospective cross-sectional study was performed using 109 randomly selected maxillary CBCT images of patients in the age range of 18-60 from the archives in Faculty of Dental Sciences, University of Peradeniya, Sri Lanka. EzDent software was used for measurements. Measurements related to the width were acquired from coronal sections while the measurements related to antero-posterior dimensions were performed on axial sections. A majority had an oval shaped maxillary arch (64.8%) followed by V shaped one.(29.2%). The mean height of the alveolar ridge at the upper canine position was 8.9 mm and the mean height of the alveolar ridge at the first molar level was 20.1 mm. Mann Whitney U test was used to compare measurements of variables between males and females. Difference in the height of alveolar ridge at the junction of soft and hard palate, width of the alveolar ridge at the canine, first molar and second molar and also the antero-posterior distance of the arch at the inter canine distance and junction between the hard and soft palate were statistically significant. Kruskal Wallis test was used to compare the differences between age groups. Chisquare values didnot indicate significant differences of measurements according to the age group of the participants. In conclusion, there is a significant difference in all maxillary arch parameters between the different genders. No significant differences in arch parameters were observed among the different age groups.

Morphometric analysis of infraorbital foramen using cone beam computed tomography in a cohort of Sri Lankan adults / Análisis morfométrico del foramen infraorbitario mediante tomografía computarizada de haz cónico en una cohorte de adultos de Sri Lanka

SUMMARY: Infraorbital foramen (IOF) located bilaterally within the maxillary bone about 1 cm inferior to the infraorbital margin is a vital landmark when delivering local anesthesia and during surgical interventions in the midface region. A total of 122 infraorbital foramina in 61 cone beam computed tomographic (CBCT) images of 32 females and 29 males in the age range of 17 to 32 were analyzed to determine the shape, direction, presence of accessory foramina, size and the precise position of IOF in relation to the inferior orbital margin (IOM), maxillary midline (MM), lateral nasal wall (LNW), alveolus (ALV) and maxillary teeth in a group of Sri Lankan people. The IOF was oval in shape (80.3 % and 88.5 % on the right and left side, respectively) in a majority of individuals. The infraorbital foramina were located at a mean distance of 5.56 ± 3.95 and 4.91 ± 2.08 mm, below the IOM on the right and left side, 27.13 ± 2.6 and 26.99 ± 2.73 on the right and left side from the mid maxillary line, 11.96 ± 3.45 mm and 12.18 ± 3.35 from the LNW on the right and left side and 29.59 ± 3.59 and 29.65 ± 3.28 above the alveolar crest on the right and left side. There were no statistically significant differences between the left and right sides or between sexes. Majority of IOF (37.5 % and 55.9 % on the right and left side, respectively) were located in the vertical plane passing though the maxillary second premolar tooth.

RESUMEN: El foramen infraorbitario (FIO) ubicado bilateralmente dentro de la maxila, aproximadamente 1 cm inferior al margen infraorbitario, es un punto de referencia vital cuando se administra anestesia local y durante intervenciones quirúrgicas en la región media de la cara. Se analizaron un total de 122 forámenes infraorbitarios en 61 imágenes de tomografía computarizada de haz cónico (CBCT) de 32 mujeres y 29 hombres en un rango etario de 17 a 32 años para determinar la forma, dirección, presencia de forámenes accesorios, tamaño y posición precisa de FIO en relación con el mar- gen orbitario inferior (MOI), la línea mediana maxilar (MM), la pared nasal lateral (PNL), el alvéolo (ALV) y los dientes maxilares en un grupo de personas de Sri Lanka. En la mayoría de los adultos se observó que el FIO tenía forma ovalada (80,3 % y 88,5 % en el lado derecho e izquierdo, respectivamente) Los forámenes infraorbitarios se ubicaron a una distancia media de 5,56 ± 3,95 y 4,91 ± 2,08 mm, por debajo del MOI en los lados derecho e izquierdo; 27,13 ± 2,6 y 26,99 ± 2,73 en el lado derecho e izquierdo desde la línea maxilar mediana, 11,96 ± 3,45 mm y 12,18 ± 3,35 de la PNL en el lado derecho e izquierdo y 29,59 ± 3,59 y 29,65 ± 3,28 por encima de la cresta alveolar en los lados derecho e izquierdo. No hubo diferencias estadísticamente significativas entre los lados izquierdo y derecho o entre sexos. La mayoría de IOF (37,5 % y 55,9 % en el lado derecho e izquierdo, respectivamente) se ubicaron en el plano vertical que pasa por el segundo premolar maxilar.

Validity of Toluidine Blue test as a diagnostic tool for high risk oral potentially malignant disorders- a multicentre study in Sri Lanka.

INTRODUCTION: - Early detection plays a major role to reduce the mortality of oral squamous cell carcinoma (OSCC). Many adjunctive techniques have emerged with claims of differentiating high risk oral potentially malignant disorders (OPMDs) from benign lesions. Toluidine blue (TB) test has been established as a diagnostic adjunct in detecting high risk OPMDs and early asymptomatic OSCCs. As majority of OSCC are preceded by OPMDs, recognition of them at an early stage is important in the management of this devastating disease. METHODS: -This study was conducted as a multi-center study prospectively for a period of 2 years. Sixty five patients presented with OPMDs were selected and TB test was performed followed by a biopsy for histopathological confirmation. Criterion validity was assessed with histological diagnosis of the incisional biopsy of the OPMD as a gold standard test verses TB test results. RESULTS: The sensitivity of the TB test was 68.3% and the specificity 63.1% with a false positive rate of 36.8% and false negative rate of 31.7%. However, the predictive value of the positive test was 80%. CONCLUSION: - TB testing might be a potential adjunct diagnostic aid in identifying high risk OPMDs. Further studies with extensive sample size and different demographics are needed to validate our findings.

Morphometric analysis of nasopalatine foramen in Sri Lankan population using CBCT.

Nasopalatine canal (NPC) is an important anatomical structure present in the anterior mid maxilla. It has the synonyms of incisive canal or anterior palatine canal. The objective of this study was to identify the morphometric characteristics of the NPC in group of Sri Lankan people using Cone beam computer tomography (CBCT) and to determine normal morphological course and anatomical variations. Fifty Maxillary CBCT images of anterior maxilla, obtained from the archives of the University Dental Hospital, Peradeniya were retrospectively analyzed to determine the position of the NPC. Morphology, canal dimension of NPC and its relation to the maxilla. Majority had a single opening (48%) or 2 openings (46%). Average diameter of the canal was 3.692 mm with a range of 2-6 mm. Majority of the canals had funnel shape and were vertically curved. Average length of canal was 12.142 mm and angulations of the curvature was 115.6940. Average antero-posterior diameter at nasal fossa was 2.852 mm, at mid-palate 2.366 mm and at hard palate 3.034 mm. Our findings were different from the findings reported in the literature. This may be due to the differences in ethnicity or limited size of sample. Within the limits of this study, we conclude that the form of the NPC is variable; predominantly funnel shaped with a single or two openings and with an average diameter of 3.7 mm in Sri Lankan population. Identification of variations in the position and shape will help in clinical practice specially in introducing local anesthetic block injections during dental treatment.

A cone beam computed tomographic analysis of the greater palatine foramen in a cohort of Sri Lankans.

OBJECTIVES: To determine the size and position of the Greater Palatine Foramen using CBCT. MATERIALS AND METHOD: GPF was evaluated on 50 CBCT's which were obtained at the Division of Oral Medicine and Radiology, FDS, University of Peradeniya, The distance of each GPF to the mid maxillary suture (MMS), Anterior Nasal Spine (ANS), relationship of the GPF to the molar teeth and diameter were measured in different orthogonal planes using measurement tools integrated to the CBCT software. RESULTS: Mean diameter of the GPF in females and males were 3.72 mm for the right and 3.31 mm for the left and 4.56 mm and 4.30 mm. The antero-posterior distance measured from the ANS to mid GPF in axial sections among females was 45.70 mm and 44.81 mm for the right and left respectively whereas for males it was 48.37 mm and 47.6 mm. The distances in axial sections were 14.82 and 15.14 mm for right and left sides in females whereas in males it was 15.50 and 15.67 mm from the MMS. The same measurement in the coronal plane was 14.93 mm and 15.22 mm for females for the right and left GPF and was 15.63 mm and 15.49 mm in males respectively. There was a significant difference between the distance of ANS to the GPF on both sides and the diameters of GPF in both males and females (p < 0.005). CONCLUSION: A significant difference was seen between the mean distance from the ANS to the GPF in left and right sides and the diameter of the GPF on the sides among the genders.

Two synchronous malignant tumors of the pancreas: a case report.

BACKGROUND: Only a limited number of multiple synchronous primary malignancies of the pancreas have been reported in the medical literature. We report a case of two solid malignant tumors of the pancreas diagnosed preoperatively. CASE PRESENTATION: We describe a 65-year-old Sri Lankan woman who presented with progressive obstructive jaundice. Initial contrast-enhanced computed tomography imaging detected a malignant tumor at the tail of her pancreas. A second tumor of the pancreatic head was detected with integrated imaging using multidetector computed tomography and multimodal magnetic resonance imaging. She underwent total pancreaticoduodenectomy and splenectomy. Gross examination of the specimen confirmed the presence of two separate tumors. Histology of the ampullary tumor showed pancreatic-type adenocarcinoma and the tumor in the tail of her pancreas showed a colloid-type adenocarcinoma. CONCLUSION: The possibility of multiple primary malignant solid tumors of different types with malignant potential has to be considered even without background pathology when managing multiple tumors in the pancreas.

Respiratory illnesses and ventilatory function among gem cutters in Sri Lanka.

INTRODUCTION: This study explores the proportion of respiratory symptoms and ventilatory functions among gem cutters in the city of gems, in Sri Lanka. METHODS: All gem cutters in the Ratnapura Medical Officers of Health area were included and the control group was selected from the government officers residing in the same area. The gem cutters and the controls were matched according to their age and sex. Pulmonary function was measured with a spirometer and peak flow meter. RESULTS: A significantly higher percentage of the exposed workers reported recurrent and prolonged cough (35%) and chest tightening (10%). FEV1 and FEV1/FVC was significantly lower in the exposed workers compared with unexposed workers. The results remained the same for the FEV1/FVC ratio (p=0.004) after adjusting for age and body mass index. CONCLUSIONS: Adverse respiratory health effects observed among gem cutters were probably caused by exposure to gem dust.

Glycaemic indices of different varieties of rice grown in Sri Lanka.

OBJECTIVE: Varieties of red raw rice are widely believed to have a better nutritional quality. The physiological effects of consuming different varieties of rice may not be so. The glycaemic index has been developed as an indicator of the physiological effect of foods. It is the glycaemic response of a 50 g carbohydrate portion of food expressed as a percentage of that of a standard. The objective of this study was to determine the glycaemic indices of different varieties of rice grown in Sri Lanka. DESIGN: Digestible carbohydrate content of 11 varieties of rice flour and bread were determined. Fasting blood samples followed by half-hourly samples for two hours were drawn after giving portions of either cooked rice or bread containing 50 g carbohydrate each. SETTING: Fibre mill in Gampaha district. SUBJECTS: Twenty-two fibre mill workers aged between 25 and 50 years. MEASUREMENTS: The area under the blood glucose curve (AUC) for varieties of rice for a subject was calculated. Average AUC of 3 values for bread were calculated. Glycaemic index of each variety of rice was determined from the above variables. RESULTS: Glycaemic indices of varieties of rice differ. The glycaemic indices of varieties of red raw rice varied between 56 and 73 and the variety Bg 350 had the lowest glycaemic index. There was no significant difference between mean glycaemic index of varieties of white raw and some varieties of red raw rice (p = 0.2). Parboiled varieties of red raw rice had a significantly lower glycaemic index than white raw rice (p = 0.04) and some of the red raw rice (p = 0.005). CONCLUSIONS: The glycaemic index cannot be predicted from the colour of the rice grain. Red parboiled varieties of rice and Bg 350 can be recommended for patients with diabetes.