No abstract

PurposeThe fractures of anterior mandible are subject to severe torsional forces due to muscles acting in opposite directions. 3D miniplate has been suggested as a good alternative by some researchers. However, finite element model (FEM) studies indicate that labio-inferior positioning of two miniplates perpendicular to each other offers better stability as compared to labial positioning. This study aims at combining the advantages of a single 3D miniplate and labio-inferior positioning of two conventional miniplates, which was assessed by finite element analysis along with a pilot clinical trial.MethodsTwo FEM models were created using CT data of a 24-year-old patient with Angle class I occlusion: control model with labial plating and study model with labio-inferior plating. The models were processed with MIMICS® (materialise, Leuven, Belgium), CATIA® (Dassault Systemes) and finite element analysis softwares. Parameters adopted for analysis were (1) displacement (mm) of fracture fragments during each screw fixation, (2) lingual splay and post fixation stability of fracture fragments with masticatory load, and (3) stress distribution (MPa) across fracture fragments. Moreover, a pilot clinical trial including five patients with anterior mandible fracture was conducted. The fractures were managed by intraoral open reduction and 3D miniplate fixation in labio-inferior position. Intraoperative interfragmentary gap, post fixation lingual splay and radiographic fracture union and complications were assessed clinically.ResultsLabio-inferior plating demonstrated less displacement (mm) of fracture fragments during screw fixation (0.059 vs. 0.079) as well as after application of masticatory load (1.805 vs. 1.860). Negligible lingual splay and less stress distribution (MPa) across fracture fragments (1.860 vs. 1.847) were appreciated in the study group as compared to control group. Clinical trial support the favorable outcome related to intraoperative and postoperative assessment parameters.ConclusionFEM analysis and clinical trial reveal better results with labio-inferior positioning of 3D miniplate when compared to labial positioning.

No abstract

No abstract

Patient anxiety in the dental office creates an unacceptable situation for the dentist as well as patient, during procedures. Patient position on a dental chair can influence the levels of patient anxiety. The aim of the study was to determine the best patient position for maximal comfort and minimal anxiety. The objectives were (1) to assess the heart rate and (2) to assess the oxygen saturation in five different positions on a dental chair. The study was a prospective clinical trial involving 108 subjects. The inclusion criteria were healthy patients, aged 18-25 years. The exclusion criteria were patients with respiratory disorders, anaemia, cardiac disorders and other systemic problems. Every patient was made to assume 5 different postures - (1) Standing, (2) Sitting upright, (3) Semi-supine, (4) Semi-supine with legs bent and (5) Supine. A pulse oximeter probe was attached and the SpO2 (in percentage) and pulse rate (in beats/min) of every subject was recorded. As a result, the oxygen saturation was the highest in the standing posture (98.07) followed by sitting upright (97.85), supine and semi-supine posture (97.79), respectively. The heart rate showed a marked reduction from sitting upright (86.19) to supine (77.46) posture and the difference was statistically significant. When the patients bent their legs, there was a sudden spike in SpO2 as well as heart rate (P value-0.03) which was statistically significant. The study concluded that patient was most comfortable in semi-supine or supine posture with periodic legs-bent position.