The assessment of resting tongue posture in different sagittal skeletal patterns

INTRODUCTION: Resting tongue posture affects the surrounding structures and, theoretically, may result in altered arch form and jaw relationship. OBJECTIVE: The objective of the present study was to investigate the association between resting tongue posture as observed in lateral cephalometric radiograph, sagittal jaw relationship and arch form. METHODS: The study was conducted on pretreatment lateral cephalograms and dental casts of 90 subjects. Subjects were equally divided into three groups, based on sagittal jaw relationship (Class I, II and III). Tongue posture was determined in terms of tongue-to-palate distances at six different points (distances 1 to 6) using ViewPro-X software, according to the method described by Graber et al in 1997. The arch widths (intercanine and intermolar widths) were evaluated on pretreatment dental casts. RESULTS: Tongue-to-palate distances were found to be comparable among different study groups. Significant differences were found in intercanine and intermolar widths at the cuspal and gingival levels among the study groups, except for intercanine width at cuspal level in maxilla and intermolar width at cuspal level in mandible. Moderate positive correlation was found between arch widths ratios at distances 3 and 4 in skeletal Class III group. Effect size was found to be moderate to large in different sagittal skeletal patterns and arch widths. CONCLUSION: The results of the current study showed no significant differences in the resting tongue posture among the groups, and moderate to weak correlation between tongue posture and dental arch widths

Dens Invaginatus Literature Review

Dens invaginatus is a developmental malformation of the tooth germ which originates as a result of the infolding of the enamel organ. It has been expressed as a ‘tooth within a tooth’ or ‘dens in dent’ or as an invagination of an enamel-lined tract extending into the root at a various depth, with or without involvement of the dental pulp. Search engines as Pak-Medinet, Pub Med, Medline and Google scholar were used to search literature about this abnormality. Dens invaginatus has complicated root canal morphology and the etiology of this developmental abnormality is still ambiguous. Possible causes include trauma, infection, development retardation of specific cells, interruption in factors regulating the development of enamel organ, and associations to genetic factors. Clinical features, radiological findings (periapical, occlusal radiograph, 3-dimensional imaging system CBCT) and surgical operating microscope help the clinician in classifying the morphology of the dens so that correct treatment planning and management alternative can be chosen. The treatments choices consist of; preventive sealing, restoration of the invagination, endodontic management, apical curettage and surgical endodontic, planned replantation and removal of tooth

The association between morphological characteristics of palatal rugae and sagittal skeletal patterns.

INTRODUCTION: To find the association between the morphological characteristics of palatal rugae and sagittal skeletal patterns. METHODS: The retrospective charts review was conducted at the Aga Khan University Hospital from April to June 2016, and comprised data obtained from the pretreatment dental cast of orthodontic patients visiting the dental clinics over 5 years from 2011 to 2015. The sample was divided equally in three malocclusion groups based on sagittal skeletal relationship Class I, Class II and Class III. The number of palatal rugae was recorded for both right and left sides. Morphological features of the three anterior most primary rugae were recorded for the length, pattern and orientation bilaterally. SPSS 20 was used to compare the number and lengths as well as the pattern and orientation of palatal rugae among the groups. RESULTS: Of the 165 subjects, there were 55(33.3%) in each of the three groups. Significant differences were recorded in rugae lengths among the groups at ruga 1 on both sides and rugae 2 and 3 on the left side (p\u3c0.05 each). There were significant differences in the palatal rugae patterns among the groups (p\u3c0.05) except at rugae 2 and 3 on the left side (p\u3e0.05). Orientation showed significant differences at ruga 2 on the right side (p=0.02). CONCLUSIONS: No specific pattern was associated with any skeletal pattern. Further studies are required to evaluate three-dimensional characteristics of rugae to assess the association between palatal rugae and sagittal skeletal patterns

The association between palatal rugae pattern and dental malocclusion

INTRODUCTION:Palatal rugae complete its development during early intrauterine life, whereas dental malocclusions in permanent dentition establishes several years into the post-natal life. OBJECTIVE: The objective of present study was to determine if there is an association between the palatal rugae pattern and Angle\u27s classes of malocclusion. METHODS: A cross-sectional study was conducted on pretreatment dental casts of 184 patients. The sample was divided into the following groups: Class I, Class II div. 1, Class II div. 2, and Class III. The number of palatal rugae was recorded, bilaterally. The length, pattern and orientation of three anterior-most primary rugae on both sides were recorded. RESULTS: The mean age of the study sample was 17.8 ± 5.4 years. The mean number of the palatal rugae was 11.18 ± 2.5, with significant differences among different malocclusion groups. The length of the first rugae on left side and third rugae on both sides varied significantly among the groups (p\u3c 0.05). Similarly, the pattern of palatal rugae was also found to be significantly different among the malocclusion groups. The right sided rugae did not have any significant difference in the orientation in different malocclusion groups; however, the left sided rugae showed significant differences among the four malocclusion groups (p\u3c 0.001). CONCLUSIONS: The current study showed subtle differences in the palatal rugae pattern among the Angle\u27s classes of malocclusion. Similarly, the length and orientation of some rugae were also found to be significantly different between malocclusion groups

Reliability of overbite depth indicator (ODI) and anteroposterior dysplasia indicator (APDI) in the assessment of different vertical and sagittal dental malocclusions: a receiver operating characteristic (ROC) analysis

Abstract INTRODUCTION:: Differential diagnosis of skeletal and dental relationships is crucial for planning orthodontic treatment. Overbite depth indicator (ODI) and anteroposterior dysplasia indicator (APDI) had been introduced in the past for assessment of vertical and sagittal jaw relationships, respectively. OBJECTIVE: : The objectives of this study were to evaluate the reliability of ODI and APDI in overbite and Angle malocclusions, as well as assess their diagnostic reliability among males and females of different age groups. MATERIAL AND METHODS: : This study was conducted using pretreatment dental casts and lateral cephalograms of 90 subjects. For ODI, subjects were divided into three groups based on overbite (normal overbite, open bite and deep bite). Likewise, the same subjects were divided for APDI into three groups, based on Angle\u27s malocclusion classification (dental Class I, II and III malocclusions). Mann-Whitney U test was applied for comparison of study parameters regarding sex and different age groups. The mean values of ODI and APDI were compared among study groups by means of Kruskal-Wallis and post-hoc Dunnet T3 tests. The receiver operating characteristic (ROC) curve was applied to test diagnostic reliability. RESULTS:: Insignificant differences were found for ODI and APDI angles, particularly in regards to sex and age. Significant intergroup differences were found in different overbite groups and Angle\u27s classification for ODI and APDI, respectively (p \u3c 0.001). ROC showed 91% and 88% constancy with dental pattern in ODI and APDI, respectively. CONCLUSIONS: : ODI can reliably differentiate deep bite versus normal overbite and deep bite versus open bite. APDI can reliably differentiate dental Class I, II and III malocclusions

A case report of ofloxacin induced fixed drug eruptions and hypersensitivity reaction

Ofloxacin is the most commonly used first generation fluoroquinolones. Its activity against gram negative organisms lie between Norfloxacin and Ciprofloxacin. It is used for treating infections like UTI, gastroenteritis etc. It is generally well tolerated, gastric upset is the most common adverse effect. However very few cases of Fixed Drug Eruptions have been reported. Here we report a case of a 16year old female patient who developed redness and rashes all over body along with nausea, vomiting, dizziness, palpitations, blurring of vision, headache and loss of consciousness after receiving Tab ofloxacin 200mg for gastroenteritis. Signs and symptoms subsided within 24 hrs after the drug was stopped and supportive treatment like IV fluids along with dexamethasone was given. Ofloxacin was strongly suspected as the causal drug for the hypersensitivity reaction as the subject had a history of allergic reaction to the same in the past. Early detection of cutaneous lesions and immediate withdrawal of the offending drug can prevent progression of such reactions to their severe variants as well as morbidity and mortality

A case of an intraocular glass piece that has remained quiescent for four years

An intraocular foreign body (IOFB) is mainly acquired via a penetrating globe injury. Some foreign bodies like glass have an inert nature, and the timing of intervention can be delayed, but foreign bodies like metals have a toxic effect on the eye and require urgent removal. We present a case of a young male with a penetrating globe injury following a road traffic accident. He acquired a foreign body glass piece in his left eye, which was initially missed. Upon thorough examination, it was found at the inferotemporal quadrant of the retina. Considering the inert nature of IOFB and the risks of bleeding and damage to the surrounding intraocular structures, we decided not to remove it. The patient has been stable for four years with good vision in the same eye

Learning approaches and performance of medical students

Objective: To identify the best assessment method for medical students with different learning approaches.Methods: The cross-sectional questionnaire-based study was conducted at Bahria University Medical and Dental College, Karachi, from March 2010 to April 2011, and comprised first year medical students. The questionnaire was tailored from the Approaches and Study Skills Inventory for Students on a five-point scale Deep approach, Surface apathetic approach and Strategic approach were assessed through relevant sub-scales. Response to questions was summed for the subscales and main scales for a learning approach. Mean scores for aggregate marks obtained by multiple choice questions, short answer questions, problem-based learning and objective structured physical examination were derived. Coefficient of variation was estimated to find the most reliable assessment method.Results: Of the 100 students enrolled, 98(98%) completed the study. Of them, 51(52%) were girls and 47(48%) were boys. Overall, 70(71.4%) students displayed Strategic approach, and 13(13.3%) showed Surface apathetic approach. Objective structured physical examination had the least variation (12.27) for all approaches whereas maximum variation (14.92) was observed by problem-based learning scores.Conclusions: Assessment by problem-based learning scores was able to demarcate deep learners whereas consistent scores were obtained by objective structured physical examination which failed to discriminate variance in performance by different learners

Rhesus and kell phenotyping of voluntary blood donors: foundation of a donor data bank

OBJECTIVE: To assess the Rhesus (Rh) and Kell (K) phenotype of voluntary blood donors and lay foundation of a data bank of voluntary blood donors. STUDY DESIGN: Cross-sectional study. PLACE AND DURATION OF STUDY: Blood Bank, The Aga Khan University Hospital, Karachi, in the year 2014. METHODOLOGY: Voluntary blood donors were inducted after taking written informed consent. Three -5cc of EDTA anticoagulated blood sample was taken to phenotype red cells for C, c, E, e, and Kell antigens using antisera. [DiaMedSwitzerland]. RESULTS: Hundred blood donors were included in the study. ABO blood groups of the donors were: O [37%], B [31%], A [21%] and AB [11%]. Ninety-seven percent were Rh D positive while 3% were Rh D negative; \u27e\u27 antigen had the highest frequency [99%], while \u27E\u27 antigen was the least frequent [19%]. The most common probable Rh phenotype was R1R1 ((DCe/DCe) in 44 [44%]. In the Kell system, all the donors [100%] had phenotype of K-k+. CONCLUSION: The most common blood group was O +ve. The pattern of Rhesus antigen expression and phenotype found in this study was concordant to that reported previously from Asia. However, there was a much lower frequency of K antigen

Adjunctive surgical procedures enhancing treatment outcome : A literature review

The face is the most expressive zone of the human body that communicates our feelings and thoughts. This may also influence the interaction between people. The aesthetic adjunctive procedures are life-changing. In contemporary orthodontic treatment, orthognathic surgeries are performed to correct the functional aspects of dento facial deformities. In cases where the aesthetic outcome is not improved, patient dissatisfaction is often encountered. Many adjunctive surgical procedures can be used to enhance the anaesthetics of orthodontic or orthognathic surgical cases. Dwelling not merely on the ideal occlusion, the results could be enhanced by analysing the whole-face to improve the overall treatment outcome