In Vitro Comparison of Diagnostic Accuracy of DIAGNOdent and Digital Radiography for Detection of Secondary Proximal Caries Adjacent to Composite Restorations

Introduction: Early detection of secondary proximal caries is critical for the preservation of tooth vitality. This study sought to assess and compare the diagnostic accuracy of DIAGNOdent and digital radiography for detection of secondary proximal caries adjacent to composite restorations.Methods: Sixty extracted molars including 30 teeth with carious lesions and 30 sound teeth were randomly selected. Class II cavities were prepared in all teeth and carious dentin was intentionally left in the gingival floor of cavities in 30 carious teeth. All cavities were restored with composite resin. The teeth were mounted in wax blocks (three teeth per block) and examined for caries using (DIAGNOdent kaVo Dental, Biberach, Germany). Digital radiographs using DIGORA photostimulable phosphor (PSP) plates (Soredex Corporation, Helsinki, Finland) were obtained from all teeth using the parallel technique and were evaluated by 4 observers. Repeated measure analysis of variance (ANOVA) was applied to calculate sensitivity and specificity values of the two diagnostic techniques. Receiver operating characteristic (ROC) curve was plotted for DIAGNOdent results and based on that, the cutoff points were determined.Results: The sensitivity and specificity values at the cut-off point of 10.5 were 0.622 ± 0.038 and 0.822 ± 0.077 for DIAGNOdent and 0.591 ± 0.093 and 0.891 ± 0.083 for digital radiography, respectively. The area under the ROC curve was 0.7 for DIAGNOdent. Weighted kappa revealed moderate to almost perfect intra-observer agreement (0.46-0.99). Intraclass correlation coefficient (ICC) for DIAGNOdent was calculated to be 0.88.Conclusion: No statistically significant difference was noted in diagnostic accuracy of DIAGNOdent and digital radiography for detection of secondary proximal caries adjacent to composite restorations. Thus, DIAGNOdent may be used as an adjunct diagnostic tool for detection of secondary proximal caries beneath composite restorations

Comparison of Apical Transportation with the Use of Rotary System and Reciprocating Handpiece with Precurved Hand Files: An In Vitro Study

Introduction: Success of root canal treatment depends on several factors; among which, maintaining the original canal path during mechanical preparation is extremely important. This in vitro study aimed to compare apical transportation using RaCe NiTi rotary system and precurved stainless steel (SS) hand files in a reciprocating handpiece. Methods and Materials: Mesiobuccal canals of 40 extracted human mandibular first and second molars with 20 to 45° curvatures and 3 to 7 mm curve radius were chosen for this study. After working length determination, the teeth were divided into two groups (n=20). Root canals were prepared with RaCe in group 1 and NSK handpiece and precurved SS hand files in group 2 up to #30 with 2% taper in both groups. Radiographs were taken of teeth before and after instrumentation from buccolingual and mesiodistal directions. The images were superimposed using Adobe Photoshop CS3 software. Degree of straightening and amount of apical transportation at 0, 0.5, 1, 2, 3, 4 and 5 mm levels short of the working length were determined using digital subtraction radiography. The student’s t test was used to compare the degree of straightening and Mann Whitney test was applied to compare apical transportation (millimeters) between the two groups. Results: No significant difference was noted between the two groups on buccolingual or mesiodistal views in degree of straightening and apical transportation on buccolingual view (P>0.05). However, on mesiodistal view, NSK reciprocating handpiece caused greater apical transportation at 0. 0.5 and 1 mm levels (P<0.05). Conclusion: The RaCe system and precurved SS files in reciprocating handpiece were highly similar in terms of degree of straightening and apical transportation. Thus, engine-driven NSK reciprocating handpiece can be used as an efficient adjunct for root canal preparation.Keywords: Canal Transportation; RaCe Instruments; Reciprocating Handpiec

Consensus Statement on Bone Conduction Devices and Active Middle Ear Implants in Conductive and Mixed Hearing Loss

Nowadays, several options are available to treat patients with conductive or mixed hearing loss. Whenever surgical intervention is not possible or contra-indicated, and amplification by a conventional hearing device (e.g., behind-the-ear device) is not feasible, then implantable hearing devices are an indispensable next option. Implantable bone-conduction devices and middle-ear implants have advantages but also limitations concerning complexity/invasiveness of the surgery, medical complications, and effectiveness. To counsel the patient, the clinician should have a good overview of the options with regard to safety and reliability as well as unequivocal technical performance data. The present consensus document is the outcome of an extensive iterative process including ENT specialists, audiologists, health-policy scientists, and representatives/technicians of the main companies in this field. This document should provide a first framework for procedures and technical characterization to enhance effective communication between these stakeholders, improving health care

The Relationship Between Social Support and Life Satisfaction Among Elderly Nursing Home Residents in Tehran

Objectives: The purpose of this study was to investigate the relationship between social support and life satisfaction in nursing home residents in Tehran. Methods & Materials: The study was a cross-sectional-correlational research. The statistical society consists of all elderly people living in nursing homes in Tehran. The sample size which reduced to 150 (105 males and 45 females) of the 3, 10 and 20 urban districts of Tehran through cluster and random sampling methods. Measurement instruments were Vaux social support questionnaire (SS-A) and Diener life satisfaction questionnaire. Data were analyzed using SPSS-17 software through descriptive (mean and standard deviation) and inferential statistics (independent t test, Pearson correlation, Kolmogorov-Smirnof and enter sample liner regression). Results: The results showed that there was a significant relationship between social support and life satisfaction in elderly nursing home residents (P=0.035), However, significant differences was not found in social support (P=0.082) and life satisfaction (P=0.061) betweenelderly men and women. Regression analysis indicated that social support has a liner relationship with life satisfaction, and can predict its changes. Conclusion: Based on mentioned results, receiving social support from family, friends and acquaintances, can contribute to a greater life satisfaction in the elderly living in nursing homes

Root Morphology of the Maxillary First and Second Molars in an Iranian Population Using Cone Beam Computed Tomography

Objectives: This study sought to assess the root morphology and root canal anatomy of the maxillary first and second molars in an Iranian population using cone-beam computed tomography (CBCT). Materials and Methods: Sound fully-developed maxillary first (n=345) and second (n=423) molars were evaluated on 450 CBCT scans ordered for pre-operative assessment for implant placement. The (I) number of roots and their morphology (II) number of canals per root, (III) canal configuration and presence of a second mesiobuccal canal according to the Vertucci’s classification and (IV) unilateral or bilateral occurrence of a second mesiobuccal canal (MB2) were evaluated. Results: Single roots were found in 1.1% of the first and 11.3% of the second molars. Four separate roots were identified in 0.5% of the first molars; none of the second molars had four separate roots. First and second molars showed a higher prevalence of three separate roots of mesiobuccal, distobuccal and palatal with one canal in each root (54% and 86 %, respectively). The most common anatomical variation in the maxillary first molars was related to the configuration of the MB root; the root canal system of the maxillary second molars showed more anatomical variations. Conclusions: Mesiobuccal roots of the maxillary molars had more variations in their canal system than the distobuccal or palatal roots. The root canal configuration of the maxillary second molars was more diverse than that of first molars; CBCT enhances mapping of the mesiobuccal root canal system with the potential to improve the quality of root canal treatment

Diagnostic Accuracy of Inverted and Unprocessed Digitized Periapical Radiographs for Detection of Peri-Implant Defects

Objectives: This study aimed to compare the diagnostic accuracy of inverted and unprocessed digitized periapical radiographs for detection of peri-implant defects. Materials and Methods: A total of 30 osteotomy sites were prepared in three groups of control, study group 1 with 0.425 mm defects and study group 2 with 0.725 mm defects using the SIC and Astra Tech drill systems with 4.25mm and 4.85mm diameters. Small and large defects were randomly created in the coronal 8mm of 20 implant sites; implants (3.4mm diameter, 14.5mm length) were then placed. Thirty periapical (PA) radiographs were obtained using Digora imaging system (Soredex Corporation, Helsinki, Finland), size 2 photostimulable storage phosphor (PSP) plate sensors (40.0mm×30.0mm) and Scanora software. Unprocessed images were inverted using Scanora software by applying image inversion and a total of 60 images were obtained and randomly evaluated by four oral and maxillofacial radiologists. Data were analyzed using the t-test. Results: Significant differences were observed in absolute and complete sensitivity and specificity of the two imaging modalities for detection of small and large defects (P<0.05). Unprocessed digital images had a higher mean in terms of absolute sensitivity for detection of small defects, complete sensitivity for detection of large peri-implant defects and definite rule out of defects compared with inverted images. Conclusion: Unprocessed digital images have a higher diagnostic value for detection of small and large peri-implant defects and also for definite rule out of defects compared with inverted images

Effects of bladder irrigation with chlorhexidine and normal saline on prevention of bacteriuria in patient with foley catheter

Effects of bladder irrigation with chlorhexidine and normal saline on prevention of bacteriuria in patient with foley catheter Samimi, Gh. 1 (MSN); Ezzati, Zh. *2 (MSN); Sarokhani, M. R.3 (PhD); Mosalaii, S. S.4 (MD); Mehrabi, Y.5 (PhD) 1. Alumnus, Faculty of Nursing and Midwifery, International Branch of Shahid Beheshti University of    Medical Sciences, Tehran, Iran.2. Lecturer, Dept. of Medical-Surgical Nursing, Faculty of Nursing and Midwifery, Shahid Beheshti    University of Medical Sciences, Tehran, Iran. 3. Associate Professor, Dept. of Laboratory Science, Faculty of Health, Qazvin University of Medical     Sciences, Qazvin, Iran.4. Nephrologist, Bo-Ali Hospital, Qazvin University of Medical Sciences, Qazvin, Iran.5. Professor, Dept. of Epidemiology, Faculty of Health, Shahid Beheshti University of Medical Sciences,    Tehran, Iran. Abstract Background and aimUrinary tract infection (UTI) is the most common infection acquired in both hospitals and nursing homes and is usually associated with catheterization. The aim of this study was to compare the effects chlorhexidine 0.2% with saline for bladder irrigation on preventing bacteriuria in patients with foley catheter. Materials and MethodsIn this randomized clinical trial, 60 neurologic patients 50 years old and over in need of foley catheter for at least 14 days with no UTI at the beginning of the study were enrolled, catheterized by one of the researchers and randomly divided into two groups of chlorhexidine %0.2 and saline. Bladder irrigation was performed on days 3 and 10 following catheterization. A questionnaire and urine analysis as well as culture were used for data collection, each of which was validated and made reliable. Different statistical tests including T-student and Chi square as well as logistic regression were used for data analysis. Findings With respect to negative culture results in both groups on days 1 and 2, a significant difference was found between chlorhexidine (30%) and saline (77.3%) groups (

Evaluation of the Position and Course of the Posterior Superior Alveolar Artery by Cone-Beam Computed Tomography in an Iranian Population

Background and Aim: Understanding the vascular anatomy of the maxillary sinus plays an important role in the success of sinus grafting and determining the location of lateral osteotomy. The aim of the present study was to localize the posterior superior al-veolar artery (PSAA) and to measure the distance from this vascular canal to the maxil-lary sinus floor and alveolar crest by cone-beam computed tomography (CBCT). Materials and Methods: This study was conducted on 600 CBCT scans. The distance from the inferior border of the PSAA to the maxillary sinus floor and alveolar crest was measured and the position of this vascular canal was evaluated. The distance from the vascular canal to the maxillary sinus floor was also compared in dentulous and edentulous patients. The results were analyzed by repeated measures ANOVA and Tukey’s post-hoc test. Results: The PSAA was detected on 150 scans. The intraosseous position of the canal was seen in 51.30% of the cases. There were insignificant differences among the distances from the vascular canal to the maxillary sinus floor in different dental areas. However, there were significant differences in the distances from the vascular canal to the alveolar crest in different regions (P<0.001). Conclusion: In this study, the PSAA was detected in 25% of the cases. The smallest distance between the vascular canal and maxillary sinus floor was observed in the first premolar and first molar regions, respectively. Determining the position of the PSAA by CBCT is useful for reducing perioperative bleeding; therefore, CBCT is recommended as a routine imaging technique prior to sinus lifting

Microstructure, texture, and anisotropic mechanical behavior of selective laser melted maraging stainless steels

In present research, the effect of building orientation on microstructure, texture and mechanical properties of a low carbon maraging steel processed by selective laser melting (SLM) technique is studied. The microstructural characterization and grain structure observations of the fabricated samples are conducted using electron microscopies and electron backscatter diffraction. It is observed that by altering the building orientation from vertical to horizontal, the morphology of the grains changes from columnar-dendritic to equiaxed. In addition, a higher volume fraction of austenite is retained in the horizontal sample compared with the vertically printed sample due to a faster cooling rate, higher degree of micro-segregation, and smaller prior austenite grains. Consequently, a higher strength and better ductility are achieved in the horizontally printed sample. The Taylor factorshows that different obtained tensile properties are not related to the crystallographic texture but are affected by grain size, retained austenite, and stress concentration conditions