Objectives: To evaluate the clinical pain during local anesthetic injection using such intra-oral device. Study Design: A comparative split-mouth clinical study to evaluate clinical pain was conducted among the subjects who required bilateral local anesthetic intra-oral injections. Results: A total of 99 subjects participated in the study out of which 39 were female. A total of 256 local anesthetic injections were administered to all the subjects with at least one pair of similar local anesthetic injections. Comparison of mean VAS score for anticipated pain in without vibration group was significantly higher in all types of nerve blocks when compared to that of with vibration. Similarly, the comparison of mean VAS score for actual pain in without vibration group was significantly higher in all types of nerve blocks when compared to that of with vibration. No significant difference in the mean VAS score was seen between anticipated and actual pain in without vibration group with respect to inferior alveolar (p=0.673), infra-orbital (p=0.175) and palatal (p=0.343) local anesthetic injections. The mean VAS score was significantly lower for actual pain when compared to anticipated pain in vibration group with respect to inferior alveolar (p<0.001) and infra-orbital (p=0.002) local anesthetic injections. Conclusions: There was significant reduction in the pain encountered during local anesthetic injection with the use of intra-oral vibration device. Key words:Pain, vibration, visual analogue scale, local anesthesia.
ObjectivesThe aim of this study was to evaluate the distribution, etiology and type of mandibular fractures in subjects referred to our institution.MethodsA retrospective study of 689 subjects, during the period from May 2010 to September 2013 with mandibular fractures was conducted. Information on age, gender, mechanism of injury and sites of trauma was obtained from the trauma registry. Data were tabulated and analyzed statistically.ResultsA total of 653 subjects had mandibular fractures, out of which 574 were males. The mean age of the participants was 31.54 ± 13.07. The majority of the subjects were between 21-40 years of age, in both males (61.7%) and females (54.4%). The major cause of fractures was road traffic accidents (87.4%) followed by fall (6.9%) and assault (4%), with the least frequent being gunshot injuries (0.3%). Almost half of the patients had parasymphysis fractures (50.2%), followed by angle (24.3%), condyle (20.4%), ramus (2.3%) and coronoid (2%). A total of 115 patients had bilateral fractures out of which 29 had parasymphysis, 12 had body fractures and 74 had bilateral condylar fractures. Double mandibular fractures were reported in 193 subjects; out of which 151 subjects had double contralateral and 42 had double unilateral fractures. Triple unilateral fracture was reported in only one subject. A total of 338 subjects had multiple fractures among the study population.ConclusionsMandibular fractures can be complicated and demanding, and have a compelling impact on patients’ quality of life. Our study reported that parasymphysis was the most common region involved in mandible fractures.
Early screening of diabetes mellitus (DM) is essential for improved prognosis and effective delay of clinical complications and has been suggested as an important strategy to lower the incidence of this disease worldwide.1 Blood testing remains the standard for screening, monitoring, and diagnosis of DM, while being invasive and painful. But these techniques are inconvenient and perturb daily life, cause anxiety, and are difficult to do in long-term diabetics due to development of finger calluses, poor peripheral circulation, risk of infection, and need for skilled manpower.Recently, many studies have focused on the development of saliva-based tests for screening and monitoring systemic diseases, including DM.2-6 Saliva testing could potentially bypass the issues associated with blood tests with some distinctive advantages which would be particularly useful in the young, in the elderly, and for large-scale screening or epidemiological interventions. However, the effectiveness of saliva-based tests is still under debate. Our study was done to compare fasting salivary glucose (FSG) levels in diabetic and nondiabetic individuals and to evaluate normal cutoff of FSG levels.A total of 60 subjects known to have DM who were on medication, 60 subjects who were freshly diagnosed DM not under medication, and 60 controls (nondiabetic individuals) were included in the study. An informed consent was obtained from each subject. Subjects with xerostomia, salivary gland disorders, oral lesions with bleeding, or any other systemic illness were excluded from the study. Fasting blood glucose (FBG) was determined in all the subjects. Unstimulated whole saliva was collected in the morning after drawing the blood and salivary glucose was estimated by glucose oxidase-peroxidase method.There was significant difference in the mean salivary glucose levels among the 3 study groups (P < .001). Post hoc analysis showed that the mean FSG was highest in diabetics not under medication (11.68 ± 1.97 mg/dl) followed by diabetics on medication (9.68 ± 2.48 mg/dl) with least being in controls (6.50 ± 0.47 mg/dl). There was significant positive strong correlation between FSG and FBG in diabetics not under medication (r = .941, P < .001), diabetics on medication (r = .981, P < .001), and controls (r = .937, P < .001). ROC curves were plotted by calculating the sensitivity and specificity of salivary glucose in predicting the diagnosis of diabetes status. The area under the curve was 0.998 and was above the reference line, which suggests that the curve predicted individuals with disease. Optimal cutoff point was considered to be 7.05, with sensitivity of 99.1 and specificity of 93.7%. No studies previously have reported optimal cutoff point for salivary glucose concentration. Hence it can be extrapolated that individuals having salivary glucose level above 7.05 mg/dl may have uncontrolled DM. Thus in the present study, glucose was detectable in saliva in both diabetic and nondiabetic individuals. There was a positive correlation between FBG and FSG.H...
Our results together suggest that fC-MSC are primitive stem cell types with a high degree of plasticity and, in addition to their suitability for cardiovascular regenerative therapy, they may have a wide spectrum of therapeutic applications in regenerative medicine.
Objective:To compare the salivary MMP -9 concentration among subjects with oral squamous cell carcinoma (OSCC), oral potentially malignant disorders (OPMD), tobacco users, and control groups. Materials and methods: A total of 88 subjects were enrolled and divided into four study groups viz., OSCC (n=24), OPMD (n=20), tobacco habits (n=22), and healthy controls (n=22). All subjects gave unstimulated saliva samples for the evaluation MMP -9 by ELISA kit. Demographic information like age, gender, type of tobacco, and duration of the habit were recorded. Results: Subjects with OSCC and OPMD had significantly higher mean MMP-9 levels than subjects with tobacco habits and control groups (P<0.001). Also, poorly differentiated OSCC group had significantly higher mean saliva MMP-9 than moderate and well-differentiated OSCC. The optimal cut-off point was 214.37 ng/mL with a sensitivity of 100% and specificity of 59% for OSCC versus the control group. The optimal cut-off point was as 205.87 ng/mL with a sensitivity of 100% and a specificity of 54% for OPMD versus the control group. Conclusion: The data obtained from this study indicated that OSCC and OPMD had an increased level of salivary MMP-9. Salivary MMP-9 could be a useful, non-invasive adjunct technique in the diagnosis, treatment, and follow-up of OSCC and OPMD.
BackgroundDental procedures can be stressful and studies have shown that salivary cortisol is elevated during such procedures. Our study aimed to evaluate saliva cortisol levels among the subjects who underwent dental extractions and to compare it with that of the controls. The secondary objective of the study was to evaluate any correlation between salivary cortisol and hemodynamic parameters.Material and MethodsWe conducted this clinical study among subjects, who were indicated for dental extraction. Saliva samples from the subjects in the study group were collected before and after (10 mins) the dental extraction. Hemodynamic parameters like heart rate, systolic (SBP) and diastolic blood pressure (DBP) and oxygen saturation (Sp O2) were measured 10 minutes prior to the dental extraction and after completion of the extraction by a single trained examiner. Salivary cortisol was estimated by solid phase enzyme-linked immunosorbent assay (ELISA).ResultsA total of 31 subjects in the study group and 24 subjects in control group have participated in this study. The mean salivary cortisol concentration was significantly higher after extraction (27.94±7.94) than before extraction (24.67±8.31) in the study group (P<0.001). No significant correlations were seen between salivary cortisol concentration and hemodynamic parameters except for diastolic blood pressure after extraction.ConclusionsDental extractions and local anaesthetic procedures can induce stress in subjects. Dental care providers should try to minimise the subject’s anxiety and stress to the maximum extent. Key words:Cortisol, dental, extraction, saliva, stress.
Background Aggressive periodontitis is a specific type of periodontitis with clearly identifiable clinical characteristics such as “rapid attachment loss, bone destruction” and “familial aggregation”. Regeneration of mineralized tissues affected by aggressive periodontitis comprises a major scientific and clinical challenge. In recent years some evidence has been provided that bioactive glass is also capable of supporting the regenerative healing of periodontal lesions. Objective The aim of this clinical and radiological prospective study was to evaluate the efficacy of bioactive glass in the treatment of intra-bony defects in patients with localized aggressive periodontitis. Methods Twelve localized aggressive periodontitis patients with bilaterally located three-walled intra-bony defect depth ? 2 mm, preoperative probing depths ? 5 mm were randomly treated either with the bioactive glass or without the bioactive glass. The clinical parameters plaque index, gingival index, probing depth, gingival recession, clinical attachment level, and mobility were recorded prior to surgery as well as 12 months after surgery. Intraoral radiographs were digitized to evaluate the bone defect depth at baseline and 12 months after the surgery. Results After 12 months, a reduction in probing depth of 3.92 + 0.313 mm (P <0.001) and a gain in clinical attachment level of 4.42+0358mm (P <0.001) were registered in the test group. In the control group, a reduction in probing depth of 2.5 +0.230mm (P <0.001) and a gain in clinical attachment level of 2.58 + 0.149 mm (P<0.001) was recorded. Radiographically, the defects were found to be filled by 2.587 + 0.218 mm (P <0.001) in the test group and by 0.1792 + 0.031mm (P <0.001) in the control group. Changes in gingival recession showed no significant differences. . Conclusion Highly significant improvements in the parameters Probing depth, Clinical attachment level, and Bone defect depth were recorded after 12 months, with regenerative material. KATHMANDU UNIVERSITY MEDICAL JOURNAL VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 11-15 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6906
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