Data Analysis and Memory Methods for RSS Bluetooth Low Energy Indoor Positioning

The thesis aims at finding a feasible solution to Bluetooth low energy indoor positioning (BLE-IP) including comprehensive data analysis of the received signal strength indication (RSSI) values. The data analysis of RSSI values was done to understand different factors influencing the RSSI values so as to gain better understanding of data generating process and to improve the data model. The positioning task is accomplished using a methodology called \textit{fingerprinting}. The fingerprinting based positioning involves two phases namely \textit{calibration phase} and \textit{localization phase}. The localization phase utilises the memory methods for positioning. In this thesis, we have used \textit{Gaussian process} for generation of radio maps and for localization we focus on memory methods: \textit{particle filters} and \textit{unscented Kalman filters}. The Gaussian process radio map is used as the measurement model in the Bayesian filtering context. The optimal fingerprinting phase parameters were determined and the filtering methods were evaluated in terms root mean square error

Efficacy of Buccal Infiltration with or without Palatal Injection for Posterior Maxillary Teeth Extraction – A Split-Mouth Randomized Trial

Objective: To evaluate the feasibility of posterior maxillary teeth extraction buccal infiltration with or without the use of palatal injection. Material and Methods: A total of 70 patients underwent extraction of bilateral maxillary posterior teeth under 2% lignocaine hydrochloride with 1:2,00000 adrenaline infiltration in this single-centric split-mouth randomized trial. The test side was administered with a buccal infiltration of 2 mL of anesthetic alone. An extended waiting period of 10 minutes was given before the commencement of the procedure. A standard protocol was followed for the control side. A single operator performed all extractions. Results: A total of 140 posterior maxillary teeth were extracted. Patients marked pain perception on a visual analogue scale in three different instances. During the administration of injections for the test side, the pain score was less than that of the control side and was statistically significant. The overall pain during the extraction procedure was comparable and statistically insignificant. The overall success of the method was 90%. Conclusion: Extraction of posterior maxillary teeth was feasible with a single buccal infiltration without palatal injection in most cases using an extended waiting period. Dentists can attempt extraction without palatal injections with optimal success. However, the alternate technique could be used when there is a necessity for rescue palatal anesthesia

Efficacy of Higher Gauged Needles or Topical Pre-Cooling for Pain Reduction during Local Anesthesia Injection: A Split-Mouth Randomized Trial

Objective: To evaluate the efficacy of pre-cooling and the use of higher gauged needles in reducing pain during local anesthetic infiltration. Material and Methods: We conducted a split-mouth randomized controlled trial among 70 patients who require bilateral maxillary local anesthetic (LA) injections for dental treatment. After applying the topical anesthetic, each participant received four local anesthetic injections, two on buccal and two palatal sides. At each visit, the participants received one buccal and one palatal infiltration based on the randomization. On the buccal aspect, participants received LA with a 26G needle injection on one side (control) and a 31G needle (test) on the contralateral side. On the Palatal aspect, participants either received LA with a 31G needle on one side (control). In contrast, the opposite side was preceded by topical ice application (iced cotton swab) before LA with a 31G needle (test). Both the visits were spaced with a gap of 7-10 days based on the participants' feasibility. Participants were asked to rate the pain on a visual analog scale independently for buccal and palatal LA injections. Results: On the Buccal aspect, the mean pain scores were 2.74 ± 1.26 and 2.11 ± 1.26 for control and test groups, respectively (p=0.002). On the Palatal aspect, the mean pain scores were 4.14 ± 1.49 and 4.3 ± 1.80 for control and test groups, respectively (p=0.295). Conclusion: Significant lower pain scores were reported with higher gauge needles (31G) when compared to traditional (26G) needles on the buccal aspect. No significant difference was seen with pre-cooling the injection site on the palatal aspect when used with higher gauged needles (31G)

Efficacy of Higher Gauged Needles or Topical Pre-Cooling for Pain Reduction during Local Anesthesia Injection: A Split-Mouth Randomized Trial

Objective: To evaluate the efficacy of pre-cooling and the use of higher gauged needles in reducing pain during local anesthetic infiltration. Material and Methods: We conducted a split-mouth randomized controlled trial among 70 patients who require bilateral maxillary local anesthetic (LA) injections for dental treatment. After applying the topical anesthetic, each participant received four local anesthetic injections, two on buccal and two palatal sides. At each visit, the participants received one buccal and one palatal infiltration based on the randomization. On the buccal aspect, participants received LA with a 26G needle injection on one side (control) and a 31G needle (test) on the contralateral side. On the Palatal aspect, participants either received LA with a 31G needle on one side (control). In contrast, the opposite side was preceded by topical ice application (iced cotton swab) before LA with a 31G needle (test). Both the visits were spaced with a gap of 7-10 days based on the participants' feasibility. Participants were asked to rate the pain on a visual analog scale independently for buccal and palatal LA injections. Results: On the Buccal aspect, the mean pain scores were 2.74 ± 1.26 and 2.11 ± 1.26 for control and test groups, respectively (p=0.002). On the Palatal aspect, the mean pain scores were 4.14 ± 1.49 and 4.3 ± 1.80 for control and test groups, respectively (p=0.295). Conclusion: Significant lower pain scores were reported with higher gauge needles (31G) when compared to traditional (26G) needles on the buccal aspect. No significant difference was seen with pre-cooling the injection site on the palatal aspect when used with higher gauged needles (31G)

Clinical pain evaluation with intraoral vibration device during local anesthetic injections

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

Estimation of salivary cortisol among subjects undergoing dental extraction

Dental 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. We 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). A 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. Dental 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

Radiographic Assessment of Third Molars Agenesis Patterns in Young Adults

Objective: To determine the prevalence of third molar agenesis and associated characteristics. Material and Methods: A total of 2374 panoramic radiographs were retrieved from the radiological archives and evaluated in a computer monitor under optimum viewing conditions. The basic demographic data (age and sex) and the primary findings regarding the presence or absence of third molars in the maxillary and mandibular arches were recorded systematically in a specially designed proforma. Categorical variables were compared using the Chi-square test. Results: A total of 2000 panoramic radiographs were included in the study, of which 1004 were females (50.2%), and 996 were of males (49.8%). The incidence of third molar agenesis was 486 patients (24.3%). Maxillary third molar showed a higher prevalence of agenesis (28.8%) than mandibular third molars (16.4%). A total of 1514 patients (75.7%) had third molars in all four quadrants, and the remaining 486 patients (24.3%) had agenesis of third molar tooth in at least one of the quadrants. Single tooth agenesis was observed in 219 (11%) patients, two teeth agenesis in 172 (8.6%) patients, three teeth agenesis in 39 (2%) patients, and four teeth agenesis in 56 (2.8%) patients. Conclusion: The present study exhibited a maximum number of single tooth agenesis. It was also observed that maxillary third molar agenesis is more than the mandibular third molar and the right side is more than the left side. Agenesis of the third molar is more prevalent in males as compared to females

Radiographic Assessment of Third Molars Agenesis Patterns in Young Adults

Objective: To determine the prevalence of third molar agenesis and associated characteristics. Material and Methods: A total of 2374 panoramic radiographs were retrieved from the radiological archives and evaluated in a computer monitor under optimum viewing conditions. The basic demographic data (age and sex) and the primary findings regarding the presence or absence of third molars in the maxillary and mandibular arches were recorded systematically in a specially designed proforma. Categorical variables were compared using the Chi-square test. Results: A total of 2000 panoramic radiographs were included in the study, of which 1004 were females (50.2%), and 996 were of males (49.8%). The incidence of third molar agenesis was 486 patients (24.3%). Maxillary third molar showed a higher prevalence of agenesis (28.8%) than mandibular third molars (16.4%). A total of 1514 patients (75.7%) had third molars in all four quadrants, and the remaining 486 patients (24.3%) had agenesis of third molar tooth in at least one of the quadrants. Single tooth agenesis was observed in 219 (11%) patients, two teeth agenesis in 172 (8.6%) patients, three teeth agenesis in 39 (2%) patients, and four teeth agenesis in 56 (2.8%) patients. Conclusion: The present study exhibited a maximum number of single tooth agenesis. It was also observed that maxillary third molar agenesis is more than the mandibular third molar and the right side is more than the left side. Agenesis of the third molar is more prevalent in males as compared to females

Profile of Patients with Maxillofacial Space Infections and Associated Risk Factors

Objective: To evaluate the profile of patients operated for maxillofacial space infections and associated risk factors for the length of hospital stay. Materials and Methods: We conducted a retrospective study among patients operated for maxillofacial infections at our center from 2010 to 2020. Information collected from the records were age, sex, type and number of spaces involved, clinical signs and symptoms (pain, swelling, toothache, sore throat, otalgia, hoarseness, headache, cough, neck swelling, rancid breath, sialorrhea, gingival swelling, muffled voice, trismus, fever, dysphagia, odynophagia, malaise, lymphadenopathy, dyspnoea, pus discharge), treatment modality, total leukocyte count, evidence of bacterial growth, comorbidities, complications if any and length of hospital stay. Results: A total of 128 medical records were examined, out of which 59 were female. The mean age was 38.59 ± 19.7 and the length of hospital stay was 7.56 ± 3.8 days. The most commonly involved space was submandibular space (46.1%) and the common symptoms reported were swelling (99.2%), pain (86.7%), and trismus (68%). Four patients had complications like necrotizing fasciitis (1.6%), pneumonia (0.8%), and death in one patient (0.8%). Logistic regression showed that patients more than 36 years of age, male sex, evidence of bacterial growth, and diabetics had higher odds of increased hospital stay (>6 days). Multiple logistic regression analysis showed that age (P=0.015; OR: 2.98) and evidence of bacterial culture (P=0.001; OR:6.64) were potential predictors associated with increased hospital stay. Conclusion: Our study showed that the age of the patient and evidence of bacterial culture were potential predictors of prolonged hospital stay among patients operated for maxillofacial space infections

Biomechanical Behavior of Bioactive Material in Dental Implant: A Three-Dimensional Finite Element Analysis

Dental implants are widely accepted for the rehabilitation of missing teeth due to their aesthetic compliance, functional ability, and great survival rate. The various components in implant design like thread design, thread angle, pitch, and material used for manufacturing play a critical role in its success. Understanding these influencing factors and implementing them properly in implant design can reduce cases of potential implant failure. Recently, finite element analysis (FEA) is being widely used in the field of health sciences to solve problems in designing medical devices. It provides valid and accurate assessment in the clinical and in vitro analysis. Hence, this study was conducted to evaluate the impact of thread design of the implant and 3 different bioactive materials, titanium alloy, graphene, and reduced graphene oxide (rGO) on stress, strain, and deformation in the implant system using FEA. In this study, the FEA model of the bones and the tissues are modeled as homogeneous, isotropic, and linearly elastic material with a titanium implant system with an assumption of it 100% osseointegrated into the bone. The titanium was functionalized with graphene and graphene oxide. A modeling software tool Catia® and Ansys Workbench® is used to perform the analysis and evaluate the von Mises stress distribution, strain, and deformation at the implant and implant-cortical bone interface. The results showed that the titanium implant with a surface coating of graphene oxide exhibited better mechanical behavior than graphene, with mean von Mises stress of 39.64 MPa in pitch 1, 23.65 MPa in pitch 2, and 37.23 MPa in pitch 3. It also revealed that functionalizing the titanium implant will help in reducing the stress at the implant system. Overall, the study emphasizes the use of FEA analysis methods in solving various biomechanical issues about medical and dental devices, which can further open up for invivo study and their practical uses