Comparative evaluation of the effects of bimaxillary and mandibular setback surgery on pharyngeal airway space and hyoid bone position in skeletal class III patients.

Background: To compare the effects of bimaxillary surgery ( Maxillary advancement and mandibular setback) and mandibular setback surgery (Bilateral Sagittal Split Osteotomy) on the pharyngeal airway space (PAS) and the hyoid bone position in a skeletal class III patients. Material and Methods: Thirty four subjects (21 males, 13 females, mean age 26.5 ± 8 years) with skeletal class III pattern (ANB angle of -2° to -6°) were divided into two groups of equal sizes. Group A consisted of 17 individuals who underwent Bilateral Sagittal Split Osteotomy (BSSO)and Group B consisted of 17 individuals who underwent bimaxillary surgery. In both the group, lateral cephalograms were taken, traced and analyzed for the specified parameters at 3 intervals, pre treatment (C1), post surgical (C2), and post orthodontic treatment (C3). Changes in PAS was evaluated at 3 levels i.e, nasopharynx (Upper PAS), oropharynx (Middle PAS) and hypopharynx (Lower PAS). Changes in hyoid bone position were evaluated in anteroposterior and vertical direction at all the 3 intervals. Results: There was a significant constriction of airway at oropharyngeal and hypo-pharyngeal level at C2 and C3 in both the groups. However, the reduction at the oropharyngeal airway was greater in group A. In group B, there was significant increase in the airway at the level of nasopharynx, Hyoid bone was positioned more posteriorly post-surgery in group A which did not return to its original position post treatment. In group B hyoid bone was positioned postero-inferiorly post surgically which came back to its original position by the end of orthodontic treatment. Conclusions: Patients undergoing bimaxillary surgery showed a significant increase in the airway at the level of nasopharynx. Hyoid bone returned to its original position by the end of orthodontic treatment in the bimaxillary surgery group. This study suggested that while treating a skeletal class III malocclusion it is advised to perform maxillary advancements along with mandibular setback surgery. Key words:Bimaxillary surgery, Hyoid bone, Bilateral Sagittal Split Osteotomy, Pharyngeal airway space.

Effect of polishing technique and immersion in beverages on color stability of nanoceramic composites.

BACKGROUND: Polishing of dental composite restorations to achieve a highly smooth and reflective surface not only enhances esthetics but also their color stability and improves resistance to staining. The objective of this study was to evaluate the effect of beverages on the color stability of nanoceramic composites polished using different techniques. METHODS: 80 samples of ceram. X SphereTEC one were prepared by condensing the material into a stainless-steel split mold and divided randomly into two groups. Group I was subjected to polishing using Sof-Lex system™ disks, and Group II was kept unpolished. Each group was subdivided into four sub-groups of 10 samples each. Each subgroup samples were immersed into designated beverages (Tropicana orange juice, Coco-cola, Nescafe coffee, and distilled water) for a duration of 15mins/day for 15 days. The color of all specimens before immersion, one day, and 15 days after immersion was measured using a Spectrophotometer. RESULTS: Significant staining of the material was found with cola drinks and coffee compared to orange juice and distilled water. Polished material showed better resistance to staining by various beverages compared to control group. CONCLUSION: Nanoceramic composites exhibited superior color stability after polishing with Sof-Lex system™. Among the beverages, coco-cola significantly altered the color of the composite.

Incidence of and Risk Factors for Emergence Delirium and Postoperative Delirium in Neurosurgical Patients- A Prospective Cohort Study.

BACKGROUND: Delirium after surgery is a spectrum of clinical syndrome constituting emergence delirium (ED) and/or postoperative delirium (POD). OBJECTIVES: The primary objective of this study was to evaluate the incidence of ED and POD in patients after neurosurgical procedures. The secondary objectives were to examine the relationship between ED and POD and identify perioperative risk factors of ED and POD. MATERIALS AND METHODS: This is a prospective cohort study conducted at the National Institute of Mental Health and Neurosciences. After obtaining the ethics committee approval, consecutive adult patients scheduled for elective neurosurgical procedures from February 2018 to November 2018 were included. We excluded children, patients with preoperative Glasgow Coma score <15, and patients with preoperative delirium. ED was assessed using Riker's Sedation-Agitation Score and POD was assessed using Confusion Assessment Method. Data collection included patient demographics, details of anesthetics and analgesics, and neurosurgical details. RESULTS: The incidence of ED and POD was 41% (N = 82/200) and 20% (N = 40/200), respectively. The occurrence of ED and POD coexisting as a continuous spectrum was 15%. Patients undergoing spine surgeries were found to have 44% less risk of ED than after cranial surgeries (P = 0.032). Presence of ED was associated with 1.8 times higher risk of POD (P < 0.001) and male gender was associated with 2.5 times higher risk of POD (P = 0.005). CONCLUSIONS: Incidences of ED and POD are higher after neurosurgery as compared with that reported in nonneurosurgical population previously.

Optimal sites for mini-implant insertion in the lingual or palatal alveolar cortical bone as assessed by cone beam computed tomography in South Indian population.

OBJECTIVES: To determine the optimal sites of mini-implant placement in the palatal alveolar cortical bone by using cone beam computed tomography (CBCT). SUBJECTS AND METHODS: Cone beam computed tomography records of 60 patients were divided into two groups of equal sizes, based on age and sex. The images were analysed using Planmeca Romexis Software (Version 4.1.2). The measurements were made in axial sections of the maxilla and mandible, at 2, 4 and 6 mm from the CEJ. The optimal sites were defined in terms of (a) Palatal or lingual alveolar cortical bone thickness and (b) Mesiodistal palatal or lingual inter-radicular width. RESULTS: The optimal site for mini-implant insertion, anteriorly, was the canine-lateral incisor embrasure in both the jaws. Posteriorly, the inter-molar embrasure in the mandible and the molar-premolar embrasure in the maxilla were optimal sites. Females demonstrated significantly lesser bone widths in all areas of the maxilla (P < .05) but greater bone thickness in the mandibular regions, as compared to males. The adolescent age group demonstrated a significantly lesser bone thickness but greater mesiodistal widths than the adult population in both the jaws (P < .05). CONCLUSION: The optimal sites for mini-implant insertion were the anterior canine-lateral incisor and posterior buccal inter-radicular embrasures, in both the jaws. Significant differences existed between age and gender groups, which need to be kept in mind while choosing the locations for placing mini-implants.

Prevalence of oral lesions in tuberculosis: A cross sectional study.

OBJECTIVE: Tuberculosis (Tb) is a fatal infectious disease that primarily affects the pulmonary system and rarely occurs in other body organs including oral cavity. The aim of this study was to report all patients with primary manifestations of oral tuberculosis and to evaluate the clinical characteristics of oral tuberculosis lesions. All these patients were subsequently diagnosed with tuberculosis based on oral histological findings and referred for management and therapy. MATERIALS AND METHODS: Twelve patients with oral lesions from the year 2010 to 2018 were histologically diagnosed as having tuberculosis, who did not give any history of the disease, following surgical biopsy. Clinical symptoms, auxiliary examinations, treatments, and outcomes were recorded and analyzed. RESULTS: Oral TB was found in all 12 patients; 8 males and 4 females, with male to female ratio 8:4. Involved oral sites included the angle of the mandible (one case), right mandibular molar region (two cases), left mandibular molar region (four cases), gingiva (three cases), buccal mucosa (one case), and the tongue (one case). Oral TB patients in this series ranged in the age group of 6-65 years. All the lesions were suggestive of primary tuberculosis. The appearance of the affected mucosa in oral TB was variable. The most common manifestation was ulceration and swelling of the mucosa. CONCLUSION: TB should be considered in patients with oral ulcerations and swellings. A biopsy specimen for histological study, acid-fast stains, and cultures should be obtained for confirmation and differential diagnosis along with other conditions.

Comparative evaluation of fluoride release and recharge potential of novel and traditional fluoride-releasing restorative materials: An in vitro study.

AIM: The aim of this study was to evaluate and compare the fluoride ion release and uptake of glass ionomer cement GP IX Extra (GE), EQUIA® Forte Fil (EF), Beautifil Bulk (BB), Dyract® XP (DXP), Tetric N-Ceram® (TNC) in vitro. MATERIALS AND METHODS: The restorative materials were divided into five groups (n = 12), namely G1 - GE, G2 - EF, G3 - BB, G4 - DXP, G5 - TNC. Fluoride release was checked using fluoride ion-selective electrode (Orion 9609BNWP, Ionplus Sure-Flow Fluoride, Thermo Scientific, USA) at time intervals of 1 day and thereafter at 3, 7, 14, 21, and 28 days. Following this, fluoride recharge was done with 1.23% acidulated phosphate fluoride gel (12,300 ppm, Pascal International Inc., 2929 Northup Way, Bellevue, USA) after 28 days and each sample was re-checked for fluoride release at the same time intervals. STATISTICAL ANALYSIS: One-way ANOVA with post hoc Games-Howell test for intergroup and repeated measures ANOVA with post hoc Bonferroni test for intragroup analysis. P < 0.05 was considered statistically significant. RESULTS: On intergroup analysis, Group 2 showed high values of fluoride release and recharge at all-time intervals which were significantly higher (P < 0.001) than Groups 1, 3, 4 and 5. Intragroup analysis showed significantly higher (P < 0.001) fluoride release and recharge at the end of day 1 which decreased progressively with time for all the tested materials. CONCLUSION: EF showed the highest fluoride release and recharge potential across all time intervals compared to other tested restorative materials and the greatest fluoride release was seen on day 1.

Comparison of Lip Print Patterns in Two Indian Subpopulations and Its Correlation in ABO Blood Groups.

BACKGROUND: The study of lip-print pattern (cheiloscopy) is a scientific method for personal identification and plays a major role in forensic and criminal investigations. OBJECTIVE: To compare the lip print patterns in Kerala and Maharashtra population and correlate between ABO blood groups. MATERIALS AND METHODS: Two hundred subjects, 100 from Maharashtra and 100 from Kerala were considered for the study. Lip prints were recorded, analyzed according to Tsuchihashi classification. The lip print patterns were compared in the two populations, correlated in ABO blood groups. The data obtained was statistically analyzed with SPSS software using chi-square test. RESULTS: In our study, predominant lip print pattern observed in Kerala population was type IV (53%) and Maharashtra population was type II (42%). The difference between the two population was statistically significant (p<0.001). Subjects with A+ and O- blood groups had type II lip print predominance. Subjects with B+, AB+ and O+ blood groups had type IV predominance. The lip print patterns do not show any correlation in ABO blood groups. CONCLUSION: Lip prints are unique to each individual and are different even in two persons. Lip print patterns were different in the two sub populations studied, and they showed no correlation in ABO blood groups.