Rotational panoramic radiographs-unusual triple images

Currently clinicians advice rotational panoramic radiography (RPR) for preliminary investigation. Despite few inherent limitations, rotational panoramic radiography still remains the diagnostic tool of choice. Abnormal structures such as a supernumerary tooth or a device falling within the certain central regions in conventional RPR images may mislead the clinicians towards an inaccurate diagnosis by producing multiple ghost images. Such cases must be treated with circumspect, and apart from RPR, additional imaging modalities need be employed to provide a judicious interpretation of the clinical situation. Thus this manuscript, we present a case where a paramedian supernumerary tooth which exhibited double ghost images on a conventional RPR. This prompted us to elicit the use of a CBCT and 3 dimensional images to determine the true nature of the problem. We outline the working of the diamond principle behind a conventional RPR which cause the appearance of multiple ghost images. The discerning clinician must be cognizant of the possible positional and analytical errors which may be prevalent in a conventional RPR when viewing structures lying in the palatal region, specifically in the midline while making diagnosis

Using smartphone video “selfies” to monitor change in toothbrushing behavior after a brief intervention: A pilot study

Background: Attempts to refine toothbrushing (TB) technique, an ingrained habit in adults, can meet with some challenges. Recently, the role of proactive interference as a barrier to improving the learning of proper brushing has been proposed. This pilot feasibility study was designed to investigate TB behavior and to see how it changes after training. Smartphone video “selfies” (SPVSs) are increasingly being used in the medical field to assess, monitor, and determine the progression of diseases. Materials and Methods: We used SPVS to study TB skills in a small sample of volunteers. Over a period of 14 days, after a one-time group training session, we observed TB behavior of volunteers using self-captured SPVS. Results: Following the brief intervention, we observed an 8% of improvement in TB skills. Discussion: To the best of our knowledge, this is the first report using SPVS to study TB behavior. We demonstrated initial feasibility of using SPVS in the dental setting. We observed modest improvements in toothbrushing accuracy and quality, and we generated important experiences about the use of Selfies for TB monitoring and intervention, and some interesting insights about where in the toothbrushing is more or less effective. Conclusion: Further investigation using a larger sample size is needed to thoroughly assess the effectiveness of this approach to improve TB skills and better understand the role of proactive interference

Analysis of adverse events with use of orthodontic sequential aligners as reported in the manufacturer and user facility device experience database

Background: Sequential aligners (SAs) introduced about a decade ago, changed the practice of orthodontics as we knew it but the adverse events and reactions (AER) associated with SA is not known. The Food and Drug Administration′s Manufacturer and User Facility Device Experience (MAUDE) database is a reliable database that has AERs reported. The manuscript attempts to review the AER associated with SA using the MAUDE database. Materials and Methods: The authors downloaded and reviewed the SA-related AER from MAUDE for a period of 5 years. In-depth analysis of the site and nature of intraoral and extraoral AERs were performed. We attempted to calculate the probability of pathologies being directly related to SA use, using Bayes′ theorem. Results: In the study period of 5 years, 175 cases of AER registered with MAUDE database owing to use of SA. Of the 175 cases, 129 (73.71%) instances were mandatory reports filed by the manufacturer. Of all AERs, 32 (18.29%) cases had been diagnosed/suspected to have an allergic reaction, 20 (11.43%) of them with anaphylactic reaction and 4 (2.29%) of them with angioedema. Lesions involving tongue, throat, and lip such as soreness, inflammation, and hives were more commonly reported. In addition, 12 cases (6.86%) reported of nausea, 11 (6.29%) of gastrointestinal issues (stomach upset, diarrhea, and vomiting), 13 (7.43%) of neuromuscular issues (muscle cramps, spasm, and pain), 13 (7.43%) of cough, 10 (5.71%) of persistent headache, 3 (1.71%) of fever, and 12 (6.86%) of cardiac-related issues were identified. Conclusions: The AERs associated with SA has been described. Though the MAUDE database is not an exact, wholesome and reliable source to identify the potential AER, currently, it is the only available source of AERs associated with SA use. The nature of AERs with the use of SA and its potential pathogenesis and implications has been discussed

Burden of exposure to lead as a risk factor for mental illness in Indian children 1990–2015: A systematic analysis based on global burden of disease approach

Background: The risk of lead exposure for mental illness and its burden on Indian children, as a society, is not studied till date. This study aims to present the same as well as to compare the risk and burden between 1990 and 2015. Materials and Methods: Using India-specific, Global Burden of Disease 2015 data health metrics-disability-adjusted life years (DALYs), we estimated the burden of mental illness and exposure to lead as a risk factor for the same. Descriptive estimates of prevalence and DALY for mental illness and risk of lead exposure are presented for various age groups of Indian children (0–14 years) of either gender. Results: In 2015, 26,450,345 Indian children were affected with mental illness contributing to DALYs of 2,453,344. In 2015, 162,492.1 DALYs were lost to mental illness due to risk factors and 130,429 lost DALYs due to risk attributed to lead exposure. The risk rate attribution and the difference of burden in 1990–2015 are presented. Years of life lost due to lead exposure for mental illness is high as compared to all attributed risks. Lead was identified as risk factor for intellectual disability among children. Conclusions: Lead continues to pose a significant overall health risk and specifically for mental illness. The estimated burden of mental illness and extent of association of risk indicate the urgent need of clear policies to reduce lead from our immediate environment

Contribution of Indian psychiatrists to PubMed listed mental health literature during 1995–2013: An exploratory study

Introduction: Contribution of Indian Psychiatrists as publications in peer-reviewed journals listed with PubMed and their impact has not been studied. The aim of this manuscript is to assess such contribution using a new article level metric measure. The relative citation ratio (RCR) has been used to assess the quality, quantity, and impact of research output of Indian Psychiatrists. Materials and Methods: Publications by Indian psychiatrists in PubMed during 1995–2013 were collected, their RCR and associated factors estimated. The nationality of the journals, type of manuscripts, PubMed Central (PMC) visibility and the type of the journals were factored in. The data collected was analyzed. Descriptive statistics, Chi-square tests, correlations, and linear regression were performed. P ≤ 0.05 was taken as significant. Results: Using the criteria set, 1914 manuscripts were identified. Of the 1914 manuscripts, 1007 were cited at least once and among this, 40.7% were listed with PubMed while of the 907 non-PMC listed manuscripts, only 180 were never cited (P = 0.000). Of the 1032 manuscripts published in Indian journals, 474 were never cited while 214 of the manuscripts published with non-India based journals were never cited even once (P = 0.000). Discussion: The difference in terms of manuscripts visibility in PMC, nationality of journals and article type in analysis indicate that there exists an innate difference between the cited and noncited manuscripts. The probable explanation behind this and its associated phenomenon are discussed

Tobacco use, oral cancer screening, and oral disease burden in Indian women

Introduction: India lacks data on national level adaptation of oral cancer screening measures and burden of oral diseases. We intend to address the issue through a secondary data analysis of existing data and reports. Materials and Methods: Data were acquired from the National Family Health Survey-4 (2015-2016). Of the 699,686 responses, representing 99% of India's women population living in all of India, the following data from the age group of 15–49 years were mined – any tobacco use, desire to quit tobacco use, and oral cavity screening for cancers. Data from Central Health Intelligence Bureau 2016 was used to identify population served by dentists in each state. The state-level data of the District Level Household and Facility Survey-4 (2012–2013) were mined for household population having symptoms of chronic illness including mouth/dental illness persisting for more than 1 month and had sought treatment. Statistical Analysis Used: SPSS version 20; Descriptive statistics for values in proportions; Pearson's correlation test assessed between the various factors. Results: Tobacco use in any form was highly prevalent among the North Eastern states, and there was also a lack of willingness to quit the habit. There was unequal distribution of dentists in different states. No significant statistical correlation was found between the proportions. Conclusion: There is disparity existing in treating seeking behavior of the general population as well as the need for dental treatment. The skewedness in dentists' distribution among the nation as compared with oral burden of diseases needs to be correlated before oral health policies are planned