Reduction in post extraction waiting period for dental implant patients using plasma rich in growth factors: an in vivo study using cone-beam computed tomography.

OBJECTIVES: This study examined the effects of plasma-rich growth factors (PRGF) on accelerating bone regeneration/repair in fresh extraction sockets, and determined the quality and quantity of bone by assessing the bone density using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Twenty patients, who had undergone bilateral extractions, were included in this study. In one extraction socket, PRGF was used and covered with an autologous fibrin plug. Nothing was used in the opposite side extraction socket. Thirteen weeks post extraction, the level of bone regeneration was evaluated on both sides with CBCT. RESULTS: At the end of the study, the mean bone density according to the Hounsfield units (HU) in the control group and PRGF group was 500.05 HU (type III bone type) and 647.95 HU (type II bone type), respectively. CONCLUSION: This study recommends the use of PRGF in post extraction sites to accelerate the rate of bone regeneration and improve the quality of regenerated bone. The technique to process PRGF was simple compared to previously mentioned techniques used for platelet-rich plasma (PRP) preparation. PRP preparation requires a two-cycle centrifugation procedure, leading to a longer processing time.

Lateral arthroplasty along with buccal fat pad inter-positioning in the management of Sawhney type III temporomandibular joint ankylosis.

OBJECTIVES: The objective of this study was to highlight the role of lateral arthroplasty along with interposition of the buccal fat pad (BFP) in the management of Sawhney type III temporomandibular joint (TMJ) ankylosis. MATERIALS AND METHODS: Ten patients with TMJ ankylosis (7 unilateral and 3 bilateral, total of 13 joints) were treated with lateral arthroplasty and BFP interposition. The bony bridge of the ankylotic mass on the lateral aspect was resected, leaving a distance of 1.5 to 2.0 cm from the base of the skull to the neck of the condyle. The condyle was left intact. Coronoidectomy was performed on the ipsilateral side via the same approach in all cases. The inter-incisal opening was measured at that time, and if it was less than 35 mm, contralateral coronoidectomy was performed by using the intra-oral approach. After satisfactory inter-incisal mouth opening (≥35 mm) was achieved, the TMJ surgical site was revisited, and BFP was retrieved and used to cover the lateral aspect of the medially placed condyle. RESULTS: With lateral arthroplasty, the medially displaced condyle can be left in-situ to maintain the mandibular ramal height and function and to act as a growth center in children. Interposition of the BFP prevents reformation of the lateral bony bridge that was removed. CONCLUSION: Lateral arthroplasty along with interpositioning of the BFP is a novel technique for managing Sawhney type III ankylosis that achieves management goals while avoiding complex and advanced reconstructive surgical procedures.

Dexmedetomidine as an Additive to Local Anesthesia: A Step to Development in Dentistry.

PURPOSE: The study aimed to compare the effect of dexmedetomidine added to lidocaine against epinephrine added to lidocaine on local anesthetic potency and to look for future prospects of dexmedetomidine as an additive to local anesthesia in dentistry. MATERIALS AND METHODS: The study included 25 healthy volunteers in whom extraction of all first premolars was scheduled as part of their orthodontic treatment plan. In this split-mouth, double-blind, crossover, randomized controlled trial, patients were randomized into 2 groups: Group 1 received injection lidocaine plus dexmedetomidine, and group 2 was administered lidocaine plus epinephrine. Patients were assessed for the onset of action of anesthesia, duration of analgesia, pain perception, and vital signs. RESULTS: The mean values (±standard deviations) for the onset of anesthetic action in groups 1 and 2 were 113 ± 24.9 and 141 ± 34.8 seconds, respectively, for the mandible. For the maxilla, the mean values were 113 ± 24.9 seconds for group 1 and 165 ± 43.8 seconds for group 2. The duration of anesthesia was longer in group 1 (lidocaine plus dexmedetomidine), in which the requirement for the first analgesic on request was seen after a longer time interval, when compared with group 2 (lidocaine plus epinephrine). Pain perception elicited statistically significant results with less perception of pain in group 1 (lidocaine plus dexmedetomidine). The vital parameters remained stable, and the results were not statistically significant. CONCLUSIONS: In this study, we observed that the addition of dexmedetomidine to lidocaine for maxillary and mandibular nerve blocks significantly prolonged the block duration and shortened the onset of action, as well as improved postoperative analgesia in terms of the need for fewer analgesics in the postoperative period. Furthermore, the vital parameters remained stable and no complications were encountered. The findings were supportive of the use of dexmedetomidine as an adjunct to local anesthetics in dental procedures.

Dexmedetomidine Supported Office Based Genioplasty: A Pilot Study.

INTRODUCTION: Despite the availability of wide variety of pharmacological agents for dental procedural sedation, there has always been a continuous search for newer sedative agents. Dexmedetomidine is a newer sedative agent for provision of short-term sedation (<24 h) in adult patients in the intensive care unit setting. It is a selective α2 adrenergic receptor agonist. The reports on off-label use of this drug in a variety of settings for invasive and non invasive procedural sedation have provided encouraging results. MATERIAL AND METHODS: The present paper reports a pilot study observing clinical efficacy of the newer drug dexmedetomidine in patients undergoing office based sliding genioplasty for correction of facial asymmetry. Subjects were sedated with dexmedetomidine with a loading dose of 0.5 mcg/kg over 10 min followed by a continuous infusion dose of 0.1 mcg/kg/h, the recovery process was observed for 60 min after the dexmedetomidine infusion was stopped. The patients were observed pre operatively, intra operatively (every 10 min) and postoperatively for the following parameters-oxygen saturation (SpO2), mean arterial pressure (MAP), heart rate (HR), and Ramsay sedation score (RSS), respiratory rate, pain scale.

Clicking hyoid: A rare case report and review.

Painful conditions of unexplained origin pose a challenging task for the clinician from both the diagnosis and treatment perspective. This might be accounted due to overlapping symptomatology; moreover, nonspecific subjective findings push the diagnostic process to a more perplexing direction. The main loophole in their management lies in difficulty to make an appropriate diagnosis. Clicking hyoid is an extremely rare anomaly of hyoid bone which produces painful clicking in throat. Here, we report a case of a young patient presented with pain and clicking in throat which aggravated on swallowing. After a series of examinations, it was diagnosed as clicking hyoid and was managed successfully by surgical treatment. The objective of this article is not only to increase awareness of the ailment so as to validate its existence but also demonstrate the significant utility of the surgical management.

Translation initiation factor 5A in Picrorhiza is up-regulated during leaf senescence and in response to abscisic acid.

Translation initiation, the first step of protein synthesis process is the principal regulatory step controlling translation and involves a pool of translation initiation factors. In plants, from recent studies it is becoming evident that these translation initiation factors impact various aspects of plant growth and development in addition to their role in protein synthesis. Eukaryotic translation initiation factor eIF5A is one such factor which functions in start site selection for the eIF2-GTP-tRNAi ternary complex within the ribosomal-bound preinitiation complex and also stabilizes the binding of GDP to eIF2. In the present study we have cloned and analysed a gene (eIF5a) encoding eIF5A from Picrorhiza (Picrorhiza kurrooa Royle ex Benth.) a medicinal plant of the western Himalayan region. The full length eIF5a cDNA consisted of 838 bp with an open reading frame of 480 bp, 88 bp 5' untranslated region and 270 bp 3' untranslated region. The deduced eIF5A protein contained 159 amino acids with a molecular weight of 17.359 kDa and an isoelectric point of 5.59. Secondary structure analysis revealed eIF5A having 24.53% α-helices, 8.81% ß-turns, 23.27% extended strands and 43.40% random coils. pk-eIF5a transcript was found to be expressing during the active growth phase as well as during leaf senescence stage, however, highest expression was observed during leaf senescence stage. Further, its expression was up-regulated in response to exogenous application of abscisic acid. Both high intensity as well as low intensity light decreased the expression of pk-eIF5a. The findings suggest eIF5a to be an important candidate to develop genetic engineering based strategies for delaying leaf senescence.