Pain is important sequelae of orthodontic treatment and has a significant effect on the QOL of orthodontic patients, especially during the initial phases of treatment. Patient motivation and counseling by the orthodontist have a profounding effect in reducing the pain and discomfort, improving the QOL, and an overall improvement in the patient compliance affecting the successful outcome of the treatment.

PurposeProcedures such as Periodontally Accelerated Osteogenic Orthodontics (PAOO) support the use of osteotomy to aid tooth movement and rapid distraction of the periodontal ligament by utilizing tissue engineering principles with periodontal regenerative surgery. The aim of this study was to evaluate and compare the amount of tooth movement and the associated changes in buccal bone morphology between corticotomy and flapless Micro-Osteoperforation (MOP) assisted orthodontic treatment.Material and methodsA total of ten healthy patients between 18 and 25 years of age requiring orthodontic treatment were recruited for this clinical trial with a split mouth design. After orthodontic and periodontal examinations, Cone Beam Computed Tomography scans (CBCT) were done pre- (T1) and post- (T2) operatively for each patient to evaluate radiographic parameters such as buccal bone thickness, root resorption and dehiscence. Amount of tooth movement was also evaluated and compared.ResultsThe canine-premolar distance, measured in a time interval of 3 months and over a follow-up period of 6 months, reduced significantly from T1 to T2 at both corticotomy and MOP sites. At the corticotomy site, there was a mean increase in bone thickness of 1.15 ± 0.3 mm at coronal region, 0.48 ± 0.1 mm at mid-root region and 0.15 ± 0.0 mm at apical region. This increase in bone thickness was statistically significant at coronal level (p = 0.001) and mid-root level (p = 0.02). Significant increase in bone thickness was observed at MOP site. While on intergroup comparison, the difference was statistically significant at coronal level (p = 0.01).ConclusionBoth the techniques cause an increase in canine retraction in short period of time with almost no harm to periodontal structures. MOP being a flapless procedure allow clinicians to deliver an efficient orthodontic care.

Ephedrine either 75 or 100 microg kg(-1) given before rapid tracheal intubation using propofol and rocuronium bromide improves the intubation conditions. It is not effective in preventing the hypotension which follows ensuing induction of anaesthesia.

The main aim of this study was to evaluate and compare the ossification of the midpalatal suture using cross-sectional maxillary occlusal radiograph and computerized tomographic scan of the hard palate in the axial direction. The percentage of the ossification thus obtained was correlated with the skeletal maturation indicators like (CVMI categories and MP3 stages) in Group I subjects (8.0-16.0 years) and with chronological age in group II subjects (16.1-25.0 years). The radiograph of the middle phalanx of the third finger and lateral cephalogram in occlusion were taken for the Group I subjects. The total sample size of the study comprised of 21 subjects with transverse maxillary deficiency. The percentage of the ossification of the midpalatal suture was calculated using suture obliteration index described by Persson and Thilander. The results of the study revealed that the total amount of ossification of the MPS in Group I subjects with computerized tomographic scan (22.56 ± 3.62%) was significantly less compared to cross-sectional maxillary occlusal radiograph (58.22 ± 3.79) at the end of skeletal maturation (p < 0.001). There was sudden spurt in the ossification of the MPS after CVMI category 4/MP3 H stage. In Group II subjects CT scan again showed significantly less amount of the ossification (40.78 ± 19.73) compared to maxillary occlusal radiograph (60.32 ± 14.41) in the total length of the MPS (p < 0.05). Thus CT scan of the hard palate showed less than 50% of the midpalatal suture ossification at the age of 25 years approximately. This was due to advantages of the computed tomographic technology, i.e. no superimposition of the overlying and adjacent structure, exact localization and accurate assessment of the MPS ossification over the conventional radiography.

A 3-year-old child was successfully resuscitated following bupivacaine cardiotoxicity with 20% intravenous lipid emulsion (ILE). Large volume of ILE was used targeting clinically adequate perfusion. Subsequently, there were features of ventilation/perfusion (V/P) mismatch.