Decalcifying efficacy of different irrigating solutions: effect of cetrimide addition

Abstract: The objective of the present study was to evaluate and com-pare the influence of cetrimide on decalcifying capability of different irrigating solutions. Fifteen maxillary central incisor teeth has been col-lected. The canals were prepared in order to obtain four samples from each root. The specimens were randomly divided into 6 experimental groups (n=10) according to tested irrigating agents. Irrigating agents consisted in different composition of EDTA and citric acid solutions, addicted or not with cetrimide. Each specimen was submitted to three successive 5-min immersions in each solution. After exposures, the concentration of Ca2+ extracted was measured by inductively coupled plasma-atomic emission spectrometry (ICP-AES). Data were analysed by means of Kruskal Wallis and Mann Whitney tests. Significance was predetermined at p < 0.05. For all irrigants, the amounts of Ca2+ extract-ed from root canal dentin samples at 10 minutes were not significantly different from values reported after 15 minutes respectively. Therefore, for all irrigants tested, 10 minutes of application are sufficient to obtain maximum Ca2+ release. Moreover citric acid based agents observed a higher release of Ca2+. The addition of cetrimide did not affect the de-calcifying capability of the EDTA and citric acid solutions.Keywords: Chelating Agents; Dentin; Dentistry; Endodontics

Skeletal Divergence and Condylar Asymmetry in Patients with Temporomandibular Disorders (TMD): A Retrospective Study

Introduction. This study was aimed at evaluating the association between vertical skeletal patterns, condylar height symmetry, and temporomandibular disorders in adults. Methods. The study sample consisted of 200 patients (ages 18-30 years old) retrospectively recruited: 100 with temporomandibular disorders (TMD) and 100 without TMD (control), diagnosed by Diagnostic Criteria for the Temporomandibular Disorders (DC/TMD). For each subject, skeletal divergence was assessed on lateral cephalograms, and condylar height symmetry was evaluated by orthopantomography (Habets' method). Results. Subjects with temporomandibular disorders showed a strong association with condylar asymmetry (p0.29). Conclusions. Although it does not imply a direct cause-and-effect relationship, the present study suggests condylar asymmetry and hyperdivergent skeletal pattern are more likely to be associated with a higher risk of temporomandibular disorder joint diseases in adult patients

Imaging Software Programs for Reliable Mathematical Measurements in Orthodontics

Aim: To evaluate the reliability of linear and angular measurements taken using different software programs in orthodontics. Materials and Methods: A sample of four software programs from different manufacturers, namely MicroDicom viewer, Photoshop® CS3, AutoCAD®, and Image-Pro®, were used for measuring the geometric features of four types of miniscrews from different manufacturers. Each miniscrew type presented a group: Group I, Tomas® (Dentaurum, Ispringen, Germany); Group II, HUBIT® (HUBIT, Gyeonggi-do, Korea); Group III, AbsoAnchor® (Dentos, Daegu, Korea); and Group IV, Creative (Creative, Zhejiang, China). Measurements of apical face angle, thread angle, lead angle, flank, pitch depth, and width were taken on 45 × magnification scanning electron microscope images of the shafts of the miniscrews. One assessor measured the seven geometric features for the four types of miniscrews using the four software programs twice in two sessions separated by a three week interval. Results: Pairwise comparisons, for each of the four miniscrew groups, showed that the only common result observed was the significant difference (p < 0.001) between measurements of flank taken by the four software programs. When measurements of the four types of miniscrews were pooled into one group, a high degree of intra-rater reliability (ICC range from 0.9 to 1.0) for all the seven geometric features was found with all the four software programs. The paired t-test showed insignificant difference (at p ≤ 0.05) between the first and second measurements, except for a few measurements including pitch width measured by Image-Pro® (p = 0.012), MicroDicom (p = 0.023), and Photoshop® (p = 0.001). Conclusions: Results did not give absolute superiority to one software program over the others and suggested an assessor effect. Assessor estimates could have been affected, among other factors, by the design of the miniscrews and the technical features of the software programs

Clinical characteristics and premorbid variables in childhoodonset schizophrenia: a descriptive study of twelve cases from a schizophrenia founder population

Objective: To analyze clinical and demographic data of childhood-onset (12 years and younger) schizophrenia patients collected for a genetic study in schizophrenia, undertaken nationally in South Africa, using multiple parameters. Method: Patients with an onset of schizophrenia at 12 years or younger, were included. From the Diagnostic Interview for Genetic Studies (DIGS), patients’ information and summary report data was tabulated and analyzed. Specific subgroups were further compared. This sub-population of 12 subjects was further compared with a group of the adult sample. Results: Of the 12 patients recruited, prominent resultswere: male to female ratio of 1:1; all had insidious onset of psychosis; a third had all 3 multidimensional impairment (MDI) symptoms; all patients that received ADHD treatment had ADHD treatment failure; two thirds had milestone delay; 58% had birth complications; a third were predominantly bottle fed; 42% had family history of schizophrenia; a third had family history of other major psychiatric conditions; all patients had at least one non-psychotic deviant behaviour (NPDB); no patient used cannabis; alldelusions were paranoid; 92% had school achievement difficulty and a third had treatment resistance. Gender comparison included: earlier onset of psychosis in females; all females had aggression versus a third of males; more females had school achievement difficulty than males; males had more treatment resistance. Patients with MDI, compared to the sample average had: earlier onset of non-psychotic deviant behaviour; lower school drop-out rate; less social difficulty and no treatment resistance. Conclusion: The results compare well to previous research on this topic. The new concepts introduced by the present studyrequire further investigation

Pediatric oncological pain: the influence on the posture of the head and the spine. A narrative review

Pediatric oncological pain (OP) is a common condition in children with cancer, resulting in postural changes in the head and spine, which significantly impact their quality of life. Osteosarcoma is the most prevalent type of pediatric tumor affecting head and spine districts. Its exact cause is still unknown, although it may be attributed to DNA mutations in bone cells, either inherited or acquired after birth; it often leads to bone and muscle pain and discomfort. This can initiate a harmful cycle, including mood disorders like anxiety and depression and maladaptive thoughts. Conducting a thorough functional assessment of children with OP is crucial, involving clinical and psychological evaluations and multidisciplinary rehabilitative approaches. A physical evaluation of the head and spine primarily focuses on assessing motor abilities through inspection of joint mobility, muscle strength, palpation, reflexes, and sensitivity. This narrative review considered randomized clinical trials, observational and cohort studies, and case reports; studies that did not meet inclusion criteria were excluded; 41 studies were selected for this review. A team of healthcare professionals, including orthodontists, physiatrists, pediatricians, oncologists, and psychologists, collaboratively manage children with OP, aiming to minimize the physical and mental disability caused by OP. It is based on education, exercise therapy, and psychological approaches. Education should include proper ergonomic postural guidance for sitting and standing, pain education (neuroscience education), and management of mood disorders and maladaptive thoughts (cognitive-behavioral education). Exercise therapy should focus on active postural correction, including exercises to counteract forward head posture, hyperkyphosis, and swayback; strengthening exercises for spinal deep muscles; segmental stretching involving limbs and back muscles; and functional exercises. Psychological therapy, particularly cognitivebehavioral therapy, involves cognitive restructuring, time-based activity pacing, relaxation techniques, and adaptive coping strategies. This review pro vides a comprehensive overview of the clinical postural assessment of the head and spine, which is essential for planning effective multidisciplinary rehabilitative treatments

Pediatric oncological spondylolisthesis: the contribution of Physical Medicine and Rehabilitation and Orthodontics. A narrative review

Different forms of spondylolisthesis (SP) have been described. This pathological condition is often due to a birth defect in the lumbar area, but it can also be caused by a sudden injury resulting from an acute trauma. In athletic children and adolescents, SP may represent a stress fracture triggered by overuse. SP can also be consequent to cancer, although this clinical condition is rare. The first manifestation of SP is pain. Neoplasm related SP may also induce physical impairment and postural alterations of the spine, such as flatback and hyperkyphosis. These changes may also affect the entire spine, including the cervical region (i.e., forward neck) and the head (i.e., forward head). A prompt assessment of children with oncological SP is crucial and involves clinical and radiological evaluations. Multiple healthcare professionals are involved in the management of children with oncological SP, including spinal specialists, pediatricians, oncologists, and psychologists. Orthodontists may also contribute to cervical posture evaluation. The authors of this review aim to provide a comprehensive overview of the topic, particularly focusing on the clinical assessment of children with oncological SP and the possibilities for rehabilitative treatment

Diode laser-assisted surgical therapy for early treatment of oral mucocele in a newborn patient : case report and procedures checklist

Mucocele (also known as ranula or salivary gland mucous cyst) of the newborn is a lesion present on the intraoral cavity, with the potential to interfere with respiration and feeding. In the present report, a case of mucocele in a 4-month female patient has been described. As conventional surgery can be followed by several complications such as intraoperative bleeding, difficulties in wound healing, and maintenance of sterility during surgery, in the present case, the use of diode laser has been planned. A topic anesthesia with lidocaine gel was performed. A diode laser (810 nm wavelength, continuous wave mode, power output of 3 watt, and 0.4 mm diameter fiber optic) was set for excising the lesion. The tip was directed at an angle of 10 to 15\ub0, moving around the base of the lesion with a circular motion. The procedure was completed in 3 minutes. The patient was visited with a follow-up of 2 weeks and 4 months after excision. The intraoral wound healed without complications, and no signs of infection or mass recurrence were noted. The histopathological examination confirmed the diagnosis of mucocele. On the basis of the results of the present case report, the use of diode laser can be easily performed also in a noncompliant newborn patient for successful excision of mucocele lesions, and checklist of clinical procedures has been described

A retrospective evaluation of the impact of a dedicated obstetric and neonatal transport service on transport times within an urban setting

OBJECTIVE:To determine whether the establishment of a dedicated obstetric and neonatal flying squad resulted in improved performance within the setting of a major metropolitan area.DESIGN AND SETTING:The Cape Town metropolitan service of the Emergency Medical Services was selected for a retrospective review of the transit times for the newly implemented Flying Squad programme. Data were imported from the Computer Aided Dispatch programme. Dispatch, Response, Mean Transit and Total Pre-hospital times relating to the obstetric and neonatal incidents was analysed for 2005 and 2008. RESULTS: There was a significant improvement between 2005 and 2008 in all incidents evaluated. Flying Squad dispatch performance improved from 11.7% to 46.6% of all incidents dispatched within 4 min (p < 0.0001). Response time performance at the 15-min threshold did not demonstrate a statistically significant improvement (p = 0.4), although the improvement in the 30-min performance category was statistically significant in both maternity and neonatal incidents. Maternity incidents displayed the greatest improvement with the 30-min performance increasing from 30.3% to 72.9%. The analysis of the mean transit times demonstrated that neonatal transfers displayed the longest status time in all but one of the categories. Even so, the introduction of the Flying Squad programme resulted in a reduction in a total pre-hospital time from 177 to 128 min. CONCLUSION: The introduction of the Flying Squad programme has resulted in significant improvement in the transit times of both neonatal and obstetric patients. In spite of the severe resource constraints facing developing nations, the model employed offers significant gains

The global distribution of fatal pesticide self-poisoning: Systematic review

<p>Abstract</p> <p>Background</p> <p>Evidence is accumulating that pesticide self-poisoning is one of the most commonly used methods of suicide worldwide, but the magnitude of the problem and the global distribution of these deaths is unknown.</p> <p>Methods</p> <p>We have systematically reviewed the worldwide literature to estimate the number of pesticide suicides in each of the World Health Organisation's six regions and the global burden of fatal self-poisoning with pesticides. We used the following data sources: Medline, EMBASE and psycINFO (1990–2007), papers cited in publications retrieved, the worldwide web (using Google) and our personal collections of papers and books. Our aim was to identify papers enabling us to estimate the proportion of a country's suicides due to pesticide self-poisoning.</p> <p>Results</p> <p>We conservatively estimate that there are 258,234 (plausible range 233,997 to 325,907) deaths from pesticide self-poisoning worldwide each year, accounting for 30% (range 27% to 37%) of suicides globally. Official data from India probably underestimate the incidence of suicides; applying evidence-based corrections to India's official data, our estimate for world suicides using pesticides increases to 371,594 (range 347,357 to 439,267). The proportion of all suicides using pesticides varies from 4% in the European Region to over 50% in the Western Pacific Region but this proportion is not concordant with the volume of pesticides sold in each region; it is the pattern of pesticide use and the toxicity of the products, not the quantity used, that influences the likelihood they will be used in acts of fatal self-harm.</p> <p>Conclusion</p> <p>Pesticide self-poisoning accounts for about one-third of the world's suicides. Epidemiological and toxicological data suggest that many of these deaths might be prevented if (a) the use of pesticides most toxic to humans was restricted, (b) pesticides could be safely stored in rural communities, and (c) the accessibility and quality of care for poisoning could be improved.</p