Search results for: dental remains
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 2266

Search results for: dental remains

2086 Mothwash Formulation of Moringa Leaf (Moringa Oleifera) and Its Activity as an Antibacterial for Streptococcus Mutans

Authors: Amalia Dwi Berliyanti Amel

Abstract:

Streptococcus mutants bacteria are bacteria that are believed to be the cause of the growth of dental plaque which can further adversely affect dental caries if left unchecked. Previous research has shown that Moringa leaf extract can slow down the growth rate of this bacterium. This study aims to make the best formulation of mouthwash with the active ingredient of Moringa leaf extract based on its antibacterial and organoleptic test results. Nine mouthwash variations were carried out with two factors and three levels, namely a comparison of the concentration of sorbitol (A) with three levels namely 15% (A1), 20% (A2), and 25% (A3), and peppermint added (B) with three levels, namely 0.2% (B1), 0.25% (B2), and 0.3% (B3). The test parameters performed as the determination of the best mouthwash are based on physicochemical properties which include pH and viscosity as well as organoleptic test results which include color, viscosity, aroma, taste, sensation in the mouth, and general appearance. The results showed that the bright zone as a test for the antibacterial activity of Streptococcus mutants began to be seen at a concentration of 5%. Moringa leaf mouthwash formulation has a pH value between 6 - 7, with a control of 6. Whereas the mucosa leaf mouthwash vascularity produced between 1.1 - 1.7 cP with a control of 1.1 cP. Moringa leaf mouthwash and control have the same total number of microbes, namely 0 colonies / mL. Based on organoleptic tests performed with 20 panelists, it was shown that the best mouthwash formulation was formulation A1B3 with sorbitol composition 15% and peppermint 0.3%.

Keywords: antibasteria, formula, moringa leaf, mouthwash

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2085 Antimicrobial Value of Olax subscorpioidea and Bridelia ferruginea on Micro-Organism Isolates of Dental Infection

Authors: I. C. Orabueze, A. A. Amudalat, S. A. Adesegun, A. A. Usman

Abstract:

Dental and associated oral diseases are increasingly affecting a considerable portion of the population and are considered some of the major causes of tooth loss, discomfort, mouth odor and loss of confidence. This study focused on the ethnobotanical survey of medicinal plants used in oral therapy and evaluation of the antimicrobial activities of methanolic extracts of two selected plants from the survey for their efficacy against dental microorganisms. The ethnobotanical survey was carried out in six herbal markets in Lagos State, Nigeria by oral interviewing and information obtained from an old family manually complied herbal medication book. Methanolic extracts of Olax subscorpioidea (stem bark) and Bridelia ferruginea (stem bark) were assayed for their antimicrobial activities against clinical oral isolates (Aspergillus fumigatus, Candida albicans, Streptococcus spp, Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa). In vitro microbial technique (agar well diffusion method and minimum inhibitory concentration (MIC) assay) were employed for the assay. Chlorhexidine gluconate was used as the reference drug for comparison with the extract results. And the preliminary phytochemical screening of the constituents of the plants were done. The ethnobotanical survey produced plants (28) of diverse family. Different parts of plants (seed, fruit, leaf, root, bark) were mentioned but 60% mentioned were either the stem or the bark. O. subscorpioidea showed considerable antifungal activity with zone of inhibition ranging from 2.650 – 2.000 cm against Aspergillus fumigatus but no such encouraging inhibitory activity was observed in the other assayed organisms. B. ferruginea showed antibacterial sensitivity against Streptococcus spp, Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa with zone of inhibitions ranging from 3.400 - 2.500, 2.250 - 1.600, 2.700 - 1.950, 2.225 – 1.525 cm respectively. The minimum inhibitory concentration of O. subscorpioidea against Aspergillus fumigatus was 51.2 mg ml-1 while that of B. ferruginea against Streptococcus spp was 0.1mg ml-1 and for Staphylococcus aureus, Lactobacillus acidophilus and Pseudomonas aeruginosa were 25.6 mg ml-1. A phytochemical analysis reveals the presence of alkaloids, saponins, cardiac glycoside, tannins, phenols and terpenoids in both plants, with steroids only in B. ferruginea. No toxicity was observed among mice given the two methanolic extracts (1000 mg Kg-1) after 21 days. The barks of both plants exhibited antimicrobial properties against periodontal diseases causing organisms assayed, thus up-holding their folkloric use in oral disorder management. Further research could be done viewing these extracts as combination therapy, checking for possible synergistic value in toothpaste and oral rinse formulations for reducing oral bacterial flora and fungi load.

Keywords: antimicrobial activities, Bridelia ferruginea, dental disinfection, methanolic extract, Olax subscorpioidea, ethnobotanical survey

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2084 The Comparison of pH Saliva before and after Brushing Teeth Using Tooth Paste Containing Betel Leaf Extracts

Authors: Ika Anisyah, Nety Trisnawaty

Abstract:

Mechanical brushing can help control plaque and is the first step to control dental caries. The type of toothpaste used is one of the contributing factors in it since the benefits of toothpaste are to reduce plaque formation and strengthen the teeth against dental caries, clean and polish tooth surfaces, eliminate or reduce bad breath, give a fresh taste to the mouth and maintain gingival health. Betel leaf toothpaste has the ability to inhibit the Streptococcus mutans bacteria that can cause the increase of pH saliva. Betel leaf extracts can increase the pH saliva because betel leaf has an anti bacterial characteristic against Streptococcus mutans so that pH saliva increases. This study aims to see the difference between pH saliva before and after brushing teeth with toothpaste containing betel leaf extracts. This type of research is pre-experimental using One Group Pretest-Posttest Design. This study was conducted on 32 subjects taken randomly from the representatives of students aged 11-12 years old in SD Pesanggrahan 03. The result of statistic test using non parametric test showed a value of 0.000. The resulted value being smaller than 0.05 (p < 0.05) means there is a significant salivary pH difference before and after teeth brushing using toothpaste containing betel leaf. The conclusion of this study showed an increase in salivary pH after teeth brushing with toothpaste containing betel leaves extracts in children aged 11-12 years old.

Keywords: pH saliva, brushing teeth, tooth paste, betel leaves extracts

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2083 Applicability of Cameriere’s Age Estimation Method in a Sample of Turkish Adults

Authors: Hatice Boyacioglu, Nursel Akkaya, Humeyra Ozge Yilanci, Hilmi Kansu, Nihal Avcu

Abstract:

The strong relationship between the reduction in the size of the pulp cavity and increasing age has been reported in the literature. This relationship can be utilized to estimate the age of an individual by measuring the pulp cavity size using dental radiographs as a non-destructive method. The purpose of this study is to develop a population specific regression model for age estimation in a sample of Turkish adults by applying Cameriere’s method on panoramic radiographs. The sample consisted of 100 panoramic radiographs of Turkish patients (40 men, 60 women) aged between 20 and 70 years. Pulp and tooth area ratios (AR) of the maxilla¬¬ry canines were measured by two maxillofacial radiologists and then the results were subjected to regression analysis. There were no statistically significant intra-observer and inter-observer differences. The correlation coefficient between age and the AR of the maxillary canines was -0.71 and the following regression equation was derived: Estimated Age = 77,365 – ( 351,193 × AR ). The mean prediction error was 4 years which is within acceptable errors limits for age estimation. This shows that the pulp/tooth area ratio is a useful variable for assessing age with reasonable accuracy. Based on the results of this research, it was concluded that Cameriere’s method is suitable for dental age estimation and it can be used for forensic procedures in Turkish adults. These instructions give you guidelines for preparing papers for conferences or journals.

Keywords: age estimation by teeth, forensic dentistry, panoramic radiograph, Cameriere's method

Procedia PDF Downloads 427
2082 Community Perception and Knowledge on Oral Cancer Screening Methods in Kuwait

Authors: Lavanya Dharmendran, Shenuka Singh, Sona Baburathanam

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The aim of the study is to understand the level of awareness in a community of a specific region of Kuwait regarding oral cancer and its screening methods so as to enhance the uptake of oral cancer screening methods. This is a cross-sectional study comprising 100 adult participants residing in the governate of Farwaniya, Kuwait. Participants of above 18 years of both genders will be selected using convenience sampling. Data collection includes the administration of a self-administered questionnaire. The questionnaire comprises three sections, each section assessing the knowledge, attitudes and practices of the participants’ opinions about oral cancer and screening methods. Data will be analyzed using Humphris Oral Cancer Knowledge Scale. Inferential statistics will be done using Chi-Square or Fisher’s exact test for categorical data. A level of p<.05 will be established as being significant. All ethical considerations, such as respect for personal confidentiality and informed consent, will be applied in this study. This study revealed that although respondents were aware of the term oral cancer, more than half of the study participants were unaware of the symptoms associated with this condition. Smoking and alcohol were identified as risk factors for oral cancer, but the majority of participants did not identify the Human Papilloma Virus (HPV) as an added risk factor. This suggests a greater need for dental practitioners to include educational strategies in routine dental visits to ensure greater awareness of oral cancer.

Keywords: oral cancer, oral screening, oral public health, oral health

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2081 Oral Hygiene Behaviors among Pregnant Women with Diabetes Who Attend Primary Health Care Centers at Baghdad City

Authors: Zena F. Mushtaq, Iqbal M. Abbas

Abstract:

Background: Diabetes mellitus during pregnancy is one of the major medical and social problems with increasing prevalence in last decades and may lead to more vulnerable to dental problems and increased risk for periodontal diseases. Objectives: To assess oral hygiene behaviors among pregnant women with diabetes who attended primary health care centers and find out the relationship between oral hygiene behaviors and studied variables. Methodology: A cross sectional design was conducted from 7 July to 30 September 2014 on non probability (convenient sample) of 150 pregnant women with diabetes was selected from twelve Primary Health Care Centers at Baghdad city. Questionnaire format is tool for data collection which had designed and consisted of three main parts including: socio demographic, reproductive characteristics and items of oral hygiene behaviors among pregnant women with diabetes. Reliability of the questionnaire was determined through internal consistency of correlation coefficient (R= 0.940) and validity of content was determined through reviewing it by (12) experts in different specialties and was determined through pilot study. Descriptive and inferential statistics were used to analyze collected data. Result: Result of study revealed that (35.3%) of study sample was (35-39) years old with mean and SD is (X & SD = 33.57 ± 5.54) years, and (34.7%) of the study sample was graduated from primary school and less, half of the study sample was government employment and self employed, (42.7%) of the study sample had moderate socioeconomic status, the highest percentage (70.0%) of the study sample was nonsmokers, The result indicates that oral hygiene behaviors have moderate mean score in all items. There are no statistical significant association between oral hygiene domain and studied variables. Conclusions: All items related to health behavior concerning oral hygiene is in moderate mean of score, which may expose pregnant women with diabetes to high risk of periodontal diseases. Recommendations: Dental care provider should perform a dental examination at least every three months for each pregnant woman with diabetes, explanation of the effect of DM on periodontal health, oral hygiene instruction, oral prophylaxis, professional cleaning and treatment of periodontal diseases(scaling and root planing) when needed.

Keywords: diabetes, health behavior, pregnant women, oral hygiene

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2080 Use of Digital Forensics for Sex Determination by Nasal Index

Authors: Ashwini Kumar, Vinod Nayak, Shankar M. Bakkannavar

Abstract:

The identification of humans is important in forensic investigations not only in living but also in dead, especially in cases of mass disorders. The procedure followed in dead known as post-mortem identification is a challenging task for the forensic pathologist. However, it is mandatory in terms of the law to fulfill the social norms. Many times, due to mutilation of body parts, the normal methods of identification using skeletal remains cannot be used in the process of identification. In such cases, the intact components of the skeletal remains or bony parts play an important role in identification. In these situations, digital forensics can come to our rescue. The authors hereby made a study for determination of sex based on nasal index by using (Big Bore 16 Slice) Multidetector Computed Tomography 2D Scans. The results are represented as a poster.

Keywords: sex determination, multidetector computed tomography, nasal index, digital forensic

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2079 An Assessment of Inferior Dental (IDN) and Lingual Nerve (LN) Injuries Following Third Molar Removal Under LA, IVS, and GA - An Audit and Case-Series

Authors: Aamna Tufail, Catherine Anyanwu

Abstract:

Introduction/Aims: Neurosensory deficits following third molar removal affect the quality of life markedly. The purpose of this audit was to evaluate the incidence of IDN and LN damage and to compare departmental rates to an established standard. A secondary objective was to provide a descriptive summary of identified cases for clinical learning. Materials and Methods: A retrospective audit was conducted by a telephone survey of 101 patients who had third molar extractions performed under LA, IVS, or GA from January 2019 to June 2020 at a District General Hospital. The results were compared to a clinical standard identified as Cheng et al1. Data collection included mode of surgery, mode of anaesthesia, grade of clinician, assessment of difficulty, severity, and duration of symptoms. Results/Statistics: A total of 101 patients had 136 third molars extracted. Age range was 18-84 years. 44% extractions were under LA, 52% under GA, and 4% under IV sedation. 30% were simple extractions, 68% were surgical removals, 2% were unspecified. 89% extractions were performed by an Associate Specialist, 5% by a consultant, and 6% by unspecified grade of clinician. The rate of IDN injuries was 2.9% (n=4), higher than standard (0.3%). The rate of LN injuries was 0.7% (n=1), same as standard (0.7%). The 5 cases of neurosensory deficits are discussed in detail. Conclusions/Clinical Relevance: The rate of ID nerve injuries was higher than the standard. The rate of LN complications was lower than the standard.

Keywords: inferior dental nerve, lingual nerve, nerve injuries, third molars

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2078 Inhibition of Streptococcus Mutans Biofilm Development of Dental Caries In Vitro and In Vivo by Trachyspermum ammi Seeds: An Approach of Alternative Medicine

Authors: Mohd Adil, Rosina Khan, Danishuddin, Asad U. Khan

Abstract:

The aim of this study was to evaluate the influence of the crude and active solvent fraction of Trachyspermum ammi on S. mutans cariogenicity, effect on expression of genes involved in biofilm formation and caries development in rats. GC–MS was carried out to identify the major components present in the crude and the active fraction of T. ammi. The crude extract and the solvent fraction exhibiting least MIC were selected for further experiments. Scanning electron microscopy was carried out to observe the effect of the extracts on S. mutans biofilm. Comparative gene expression analysis was carried out for nine selected genes. 2-Isopropyl-5-methyl-phenol was found as major compound in crude and the active fraction. Binding site of this compound within the proteins involved in biofilm formation was mapped with the help of docking studies. Real-time RT-PCR analyses revealed significant suppression of the genes involved in biofilm formation. All the test groups showed reduction in caries (smooth surface as well as sulcal surface caries) in rats. Moreover, it also provides new insight to understand the mechanism influencing biofilm formation in S. mutans. Furthermore, the data suggest the putative cariostatic properties of T. Ammi and hence can be used as an alternative medicine to prevent caries infection.

Keywords: bio-film, Streptococcus mutans, dental caries, bio-informatic

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2077 Influence of Aluminum Content on the Microstructural, Mechanical and Tribological Properties of TiAlN Coatings for Using in Dental and Surgical Instrumentation

Authors: Hernan D. Mejia, Gilberto B. Gaitan, Mauricio A. Franco

Abstract:

420 steel is normally used in the manufacture of dental and surgical instrumentation, as well as parts in the chemical, pharmaceutical, and food industries, among others, where they must withstand heavy loads and often be in contact with corrosive environments, which leads to wear and deterioration of these steels in relatively short times. In the case of medical applications, the instruments made of this steel also suffer wear and corrosion during the repetitive sterilization processes due to the relatively low achievable hardness of just 50 HRC and its hardly acceptable resistance to corrosion. In order to improve the wear resistance of 420 steel, TiAlN coatings were deposited, increasing the aluminum content in the alloy by varying the power applied to the aluminum target of 900, 1100, and 1300 W. Evaluations using XRD, Micro Raman, XPS, AFM, SEM, and TEM showed a columnar growth crystal structure with an average thickness of 2 microns and consisting of the TiN and TiAlN phases, whose roughness and grain size decrease with a higher Al content. The AlN phase also appears in the sample deposited at 1300W. The hardness, determined by nanoindentation, initially increases with the aluminum content from 9.7 GPa to 17.1 GPa, but then decreases to 15.4 GPa for the sample with the highest aluminum content due to the appearance of hexagonal AlN and a decrease of harder TiN and TiAlN phases. It was observed that the wear coefficient had a contrary behavior, which took values of 2.7; 1.7 and 6.6x10⁻⁶ mm³/N.m, respectively. All the coated samples significantly improved the wear resistance of the uncoated 420 steel.

Keywords: hard coatings, magnetron sputtering, TiAlN coatings, surgical instruments, wear resistance

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2076 Impact Analysis of a School-Based Oral Health Program in Brazil

Authors: Fabio L. Vieira, Micaelle F. C. Lemos, Luciano C. Lemos, Rafaela S. Oliveira, Ian A. Cunha

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Brazil has some challenges ahead related to population oral health, most of them associated with the need of expanding into the local level its promotion and prevention activities, offer equal access to services and promote changes in the lifestyle of the population. The program implemented an oral health initiative in public schools in the city of Salvador, Bahia. The mission was to improve oral health among students on primary and secondary education, from 2 to 15 years old, using the school as a pathway to increase access to healthcare. The main actions consisted of a team's visit to the schools with educational sessions for dental cavity prevention and individual assessment. The program incorporated a clinical surveillance component through a dental evaluation of every student searching for dental disease and caries, standardization of the dentists’ team to reach uniform classification on the assessments, and the use of an online platform to register data directly from the schools. Sequentially, the students with caries were referred for free clinical treatment on the program’s Health Centre. The primary purpose of this study was to analyze the effects and outcomes of this school-based oral health program. The study sample was composed by data of a period of 3 years - 2015 to 2017 - from 13 public schools on the suburb of the city of Salvador with a total number of assessments of 9,278 on this period. From the data collected the prevalence of children with decay on permanent teeth was chosen as the most reliable indicator. The prevalence was calculated for each one of the 13 schools using the number of children with 1 or more dental caries on permanent teeth divided by the total number of students assessed for school each year. Then the percentage change per year was calculated for each school. Some schools presented a higher variation on the total number of assessments in one of the three years, so for these, the percentage change calculation was done using the two years with less variation. The results show that 10 of the 13 schools presented significative improvements for the indicator of caries in permanent teeth. The mean for the number of students with caries percentage reduction on the 13 schools was 26.8%, and the median was 32.2% caries in permanent teeth institution. The highest percentage of improvement reached a decrease of 65.6% on the indicator. Three schools presented a rise in caries prevalence (8.9, 18.9 and 37.2% increase) that, on an initial analysis, seems to be explained with the students’ cohort rotation among other schools, as well as absenteeism on the treatment. In conclusion, the program shows a relevant impact on the reduction of caries in permanent teeth among students and the need for the continuity and expansion of this integrated healthcare approach. It has also been evident the significative of the articulation between health and educational systems representing a fundamental approach to improve healthcare access for children especially in scenarios such as presented in Brazil.

Keywords: primary care, public health, oral health, school-based oral health, data management

Procedia PDF Downloads 110
2075 Reasons for Lack of an Ideal Disinfectant after Dental Treatments

Authors: Ilma Robo, Saimir Heta, Rialda Xhizdari, Kers Kapaj

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Background: The ideal disinfectant for surfaces, instruments, air, skin, both in dentistry and in the fields of medicine, does not exist.This is for the sole reason that all the characteristics of the ideal disinfectant cannot be contained in one; these are the characteristics that if one of them is emphasized, it will conflict with the other. A disinfectant must be stable, not be affected by changes in the environmental conditions where it stands, which means that it should not be affected by an increase in temperature or an increase in the humidity of the environment. Both of these elements contradict the other element of the idea of an ideal disinfectant, as they disrupt the solubility ratios of the base substance of the disinfectant versus the diluent. Material and methods: The study aims to extract the constant of each disinfectant/antiseptic used during dental disinfection protocols, accompanied by the side effects of the surface of the skin or mucosa where it is applied in the role of antiseptic. In the end, attempts were made to draw conclusions about the best possible combination for disinfectants after a dental procedure, based on the data extracted from the basic literature required during the development of the pharmacology module, as a module in the formation of a dentist, against data published in the literature. Results: The sensitivity of the disinfectant to changes in the atmospheric conditions of the environment where it is kept is a known fact. The care against this element is always accompanied by the advice on the application of the specific disinfectant, in order to have the desired clinical result. The constants of disinfectants according to the classification based on the data collected and presented are for alcohols 70-120, glycols 0.2, aldehydes 30-200, phenols 15-60, acids 100, povidone iodine halogens 5-75, hypochlorous acid halogens 150, sodium hypochlorite halogens 30-35, oxidants 18-60, metals 0.2-10. The part of halogens should be singled out, where specific results were obtained according to the representatives of this class, since it is these representatives that find scope for clinical application in dentistry. Conclusions: The search for the "ideal", in the conditions where its defining criteria are also established, not only for disinfectants but also for any medication or pharmaceutical product, is an ongoing search, without any definitive results. In this mine of data in the published literature if there is something fixed, calculable, such as the specific constant for disinfectants, the search for the ideal is more concrete. During the disinfection protocols, different disinfectants are applied since the field of action is different, including water, air, aspiration devices, tools, disinfectants used in full accordance with the production indications.

Keywords: disinfectant, constant, ideal, side effects

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2074 In silico Statistical Prediction Models for Identifying the Microbial Diversity and Interactions Due to Fixed Periodontal Appliances

Authors: Suganya Chandrababu, Dhundy Bastola

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Like in the gut, the subgingival microbiota plays a crucial role in oral hygiene, health, and cariogenic diseases. Human activities like diet, antibiotics, and periodontal treatments alter the bacterial communities, metabolism, and functions in the oral cavity, leading to a dysbiotic state and changes in the plaques of orthodontic patients. Fixed periodontal appliances hinder oral hygiene and cause changes in the dental plaques influencing the subgingival microbiota. However, the microbial species’ diversity and complexity pose a great challenge in understanding the taxa’s community distribution patterns and their role in oral health. In this research, we analyze the subgingival microbial samples from individuals with fixed dental appliances (metal/clear) using an in silico approach. We employ exploratory hypothesis-driven multivariate and regression analysis to shed light on the microbial community and its functional fluctuations due to dental appliances used and identify risks associated with complex disease phenotypes. Our findings confirm the changes in oral microbiota composition due to the presence and type of fixed orthodontal devices. We identified seven main periodontic pathogens, including Bacteroidetes, Actinobacteria, Proteobacteria, Fusobacteria, and Firmicutes, whose abundances were significantly altered due to the presence and type of fixed appliances used. In the case of metal braces, the abundances of Bacteroidetes, Proteobacteria, Fusobacteria, Candidatus saccharibacteria, and Spirochaetes significantly increased, while the abundance of Firmicutes and Actinobacteria decreased. However, in individuals With clear braces, the abundance of Bacteroidetes and Candidatus saccharibacteria increased. The highest abundance value (P-value=0.004 < 0.05) was observed with Bacteroidetes in individuals with the metal appliance, which is associated with gingivitis, periodontitis, endodontic infections, and odontogenic abscesses. Overall, the bacterial abundances decrease with clear type and increase with metal type of braces. Regression analysis further validated the multivariate analysis of variance (MANOVA) results, supporting the hypothesis that the presence and type of the fixed oral appliances significantly alter the bacterial abundance and composition.

Keywords: oral microbiota, statistical analysis, fixed or-thodontal appliances, bacterial abundance, multivariate analysis, regression analysis

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2073 Profitability of Milkfish Production from Three Mariculture Parks in the Philippines

Authors: Rosie S. Abalos, John Patrick M. Dizon

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The operation of fish cages in mariculture parks for milkfish production remains a lucrative business for aquaculture operators. Three areas in the Philippines where mariculture parks are still in active operation were identified as study sites for this research. Financial analysis was used to estimate profitability of mariculture operations in the selected study sites. Based on the result of this research, milkfish production in mariculture parks remains profitable both in terms of net profit generation and the return on investment. To improve the profitability of aquaculture operations in mariculture parks, the relatively high price of operational inputs should be managed. As a recommendation, further studies should be conducted on the profitability of aquaculture operations in mariculture parks in the country to include other factors which may cause losses on the part of the operator and factors that may affect price of produce upon harvest.

Keywords: mariculture parks, milkfish production, aquaculture, profitability

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2072 A Method for Evaluating the Mechanical Stress on Mandibular Advancement Devices

Authors: Tsung-yin Lin, Yi-yu Lee, Ching-hua Hung

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Snoring, the lay term for obstructive breathing during sleep, is one of the most prevalent of obnoxious human habits. Loud snoring usually makes others feel noisy and uncomfortable. Snoring also influences the sleep quality of snorers’ bed partners, because of the noise they do not get to sleep easily. Snoring causes the reduce of sleep quality leading to several medical problems, such as excessive daytime sleepiness, high blood pressure, increased risk for cardiovascular disease and cerebral vascular accident, and etc. There are many non-prescription devices offered for sale on the market, but very limited data are available to support a beneficial effect of these devices on snoring and use in treating obstructive sleep apnea (OSA). Mandibular advancement devices (MADs), also termed as the Mandibular reposition devices (MRDs) are removable devices which are worn at night during sleep. Most devices require dental impression, bite registration, and fabrication by a dental laboratory. Those devices are fixed to upper and lower teeth and are adjusted to advance the mandible. The amount of protrusion is adjusted to meet the therapeutic requirements, comfort, and tolerance. Many devices have a fixed degree of advancement. Some are adjustable in a limited degree. This study focuses on the stress analysis of Mandibular Advancement Devices (MADs), which are considered as a standard treatment of snoring that promoted by American Academy of Sleep Medicine (AASM). This paper proposes a new MAD design, and the finite element analysis (FEA) is introduced to precede the stress simulation for this MAD.

Keywords: finite element analysis, mandibular advancement devices, mechanical stress, snoring

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2071 The Effects of Mobile Communication on the Nigerian Populace

Authors: Chapman Eze Nnadozie

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Communication, the activity of conveying information, remains a vital resource for the growth and development of any given society. Mobile communication, popularly known as global system for mobile communication (GSM) is a globally accepted standard for digital cellular communication. GSM, which is a wireless technology, remains the fastest growing communication means worldwide. Indeed, mobile phones have become a critical business tool and part of everyday life in both developed and developing countries. This study examines the effects of mobile communication on the Nigerian populace. The methodology used in this study is the survey research method with the main data collection tool as questionnaires. The questionnaires were administered to a total of seventy respondents in five cities across the country, namely: Aba, Enugu, Bauchi, Makurdi, and Lagos. The result reveals that though there is some quality of service issues, mobile communication has very significant positive efforts on the economic and social development of the Nigerian populace.

Keywords: effect, mobile communication, populace, GSM, wireless technology, mobile phone

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2070 On the Development of Medical Additive Manufacturing in Egypt

Authors: Khalid Abdelghany

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Additive Manufacturing (AM) is the manufacturing technology that is used to fabricate fast products direct from CAD models in very short time and with minimum operation steps. Jointly with the advancement in medical computer modeling, AM proved to be a very efficient tool to help physicians, orthopedic surgeons and dentists design and fabricate patient-tailored surgical guides, templates and customized implants from the patient’s CT / MRI images. AM jointly with computer-assisted designing/computer-assisted manufacturing (CAD/CAM) technology have enabled medical practitioners to tailor physical models in a patient-and purpose-specific fashion and helped to design and manufacture of templates, appliances and devices with a high range of accuracy using biocompatible materials. In developing countries, there are some technical and financial limitations of implementing such advanced tools as an essential portion of medical applications. CMRDI institute in Egypt has been working in the field of Medical Additive Manufacturing since 2003 and has assisted in the recovery of hundreds of poor patients using these advanced tools. This paper focuses on the surgical and dental use of 3D printing technology in Egypt as a developing country. The presented case studies have been designed and processed using the software tools and additive manufacturing machines in CMRDI through cooperative engineering and medical works. Results showed that the implementation of the additive manufacturing tools in developed countries is successful and could be economical comparing to long treatment plans.

Keywords: additive manufacturing, dental and orthopeadic stents, patient specific surgical tools, titanium implants

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2069 A Lost Tradition: Reflections towards Select Tribal Songs of Odisha

Authors: Akshaya K. Rath, Manjit Mahanta

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The paper aims at examining the oral tradition of the Kondh and Oroan people of Odisha. Highlighting the translated versions of Kondh and Oroan songs—chiefly highlighting issues on agriculture—we argue that the relevance of these songs have fallen apart in the recent decades with the advancement of modern knowledge and thinking. What remains instead is a faint voice in the oral tradition that sings the past indigenous knowledge in the form of oral literature. Though there have been few attempts to document the rich cultural tradition by some individuals—Sitakant Mahapatra’s can be cited as an example—the need to document the tradition remains ever arching. In short, the thesis examines Kondh and Oroan “songs” and argues for a need to document the tradition. It also shows a comparative study on both the tribes on Agriculture which shows their cultural identity and a diversification of both the tribes in nature and how these tribal groups are associated with nature and the cycle of it.

Keywords: oral tradition, Meriah, folklore, karma, Oroan

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2068 Solar Radiation Studies and Performance of Solar Panels for Three Cities of Sindh, Pakistan

Authors: M. A. Ahmed, Sidra A. Shaikh, M. W. Akhtar

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Solar radiation on horizontal surface over three southern cities of Sindh, namely Karachi, Hyderabad and Nawabshah has been investigated to asses the feasibility of solar energy application for power generation. In the present work, measured data of bright sunshine hour of the region have been used to estimate the global and diffuse solar radiation. The regression coefficient 'a' and 'b' have been calculated using first order Angstrom type co-relation. The result obtained shows that the contribution of direct solar radiation is low and diffuse radiation is high during the monsoon months July and August for Karachi and Hyderabad. The sky remains clear from September to June, whereas for Nawabshah the global radiation remains high throughout the year. The potential of grid quality solar photovoltaic power in Karachi is estimated for 10 square meter area of solar panel.

Keywords: solar potential over Sindh, global and diffuse solar radiation, radiation over three cities of Sindh, solar panels

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2067 Oral Health of Tobacco Chewers: A Cross-Sectional Study in Karachi, Pakistan

Authors: Warsi A. Ibrahim, Qureshi A. Ambrina, Younus M. Anjum

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Introduction: Oral lesions related to commercially available Smokeless Tobacco (ST), such as, Pan, Gutka, Mahwa, Naswar is considered a serious challenge for dental health care providers in Pakistan. Majority of labored Pakistani population consume ST, where public transporters and drivers are no exception. It was necessary to identify individuals of this particular population group and screen their oral health and early signs of pre-cancerous lesions so that appropriate preventive measures could be taken to reduce the burden on health providers. Aim of Study: To estimate Prevalence of ST consumption and perception of use, and to evaluate Oral Health status among public drivers of Karachi. Material & methods: A cross-sectional study survey was conducted over duration of 2 months, through convenient sampling. Sample size (n=615) of public drivers (age > 18 years) all over Karachi was gathered. A structured proforma was used to record socio-demographics, addiction profile, perception of use and oral health status (oral lesions, oral sub-mucosal fibrosis and dental caries) of study participants. Data was entered and analyzed using SPSS version 16.0 using descriptive statistics only. Results: Prevalence of ST consumption among the study participants was figured to 92.5%. Out of these almost 70% suffered from one or the other form of oral lesion(s). Four major types of ST consumption were observed out of which 60 % of oral lesion were related to Gutka chewers showing early signs of oral cancer. In addition, occurrence of Oral sub-mucosal fibrosis (OSF) was found to be significantly high around 54.8%. Overall dental caries status was also high, showing on an average 5 teeth of an individual were decayed, missing or filled deviating from WHO normal criteria (mean < 3). It was thus proven from the study that public drivers relied on oral tobacco consumption because it helps them ‘Improve consciousness’ (p-value: < 0.01; using chi-square test). Multivariate analysis showed that there were higher prevalence of smokeless tobacco among highway drivers versus local drivers (A.O.R: 2.82 [0.83-9.61], p-value: < 0.01) Conclusion: Smokeless tobacco (ST) consumption has a direct effect on oral health. However, the type of ST, the duration of consumption are factors which are directly related to the severity. Moreover, Gutka may be considered as having most lethal effects on oral health which may lead to oral cancer and affect individual’s quality of life. Specific preventive programs must be undertaken to reduce the consumption of Gutka among public transporters and drivers.

Keywords: smokeless tobacco, oral lesions, drivers, public transporters

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2066 Health Status among Government and Private Primary School Children in the Central of Thailand

Authors: Petcharat Kerdonfag, Supunnee Thrakul

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School health services through regular screening of school students’ health status have been the main responsibility for community or school health nurses. The purposes of these retrospective study were to assess and compare health problems between government and private primary school students in the central region of Thailand. The data were collected from the school health records in October at the end of the first semester in the academic year 2018. Two thousand and fifty primary school health records from government and private primary schools were gathered to assess health problems regarding anthropometric measurements, physical examination/personal hygiene, and clinical findings for this study. Descriptive statistics and Chi-square were used to be analyzed. The results revealed that health problems of all the school students remained high magnitude. The five top ranks for prevalence rate of health problems were dental caries (36.6%), visual acuity problem (27.7%), over-nutrition (16.8%), head lice (12.8%), and under-nutrition (6.8%), respectively. However, when compared between government and private schools among five health problems; dental caries (55.0% vs 19.9%), visual acuity problem (23.1% vs 31.9%), over-nutrition (20.2% vs 13.8%), head lice (26.5% vs 0.3%), and under-nutrition (10.6% vs 3.4%) with Chi-square analysis, there were significantly different (p < .001). The problem of visual acuity seems to be more serious in private schools while other health problems tend to be more critical in government schools. The findings have suggested that parents who have children in the private primary schools should pay more attention to visual health defects whereas parents with children in the government school should pay more vigilance regards to hygiene and health behavior problems.

Keywords: community health nursing, school health service, health status, primary school children

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2065 Cone Beam Computed Tomography: A Useful Diagnostic Tool to Determine Root Canal Morphology in a Sample of Egyptian Population

Authors: H. El-Messiry, M. El-Zainy, D. Abdelkhalek

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Cone-beam computed tomography (CBCT) provides high-quality 3-dimensional images of dental structures because of its high spatial resolution. The study of dental morphology is important in research as it provides information about diversities within a population. Many studies have shown different shapes and numbers of roots canals among different races, especially in molars. The aim of this study was to determine the morphology of root canals of mandibular first and third molars in a sample of Egyptian population using CBCT scanning. Fifty mandibular first Molars (M1) and fifty mandibular third (M3) extracted molars were collected. Thick rectangular molds were made using pink wax to hold the samples. Molars were embedded in the wax mold by aligning them in rows leaving arbitrary 0.5cm space between them. The molds with the samples in were submitted for CBCT scan. The number and morphology of root canals were assessed and classified according to Vertucci's classification. The mesial and the distal roots were examined separately. Finally, data was analyzed using Fisher exact test. The most prevalent mesial root canal frequency in M1 was type IV (60%) and type II (40 %), while M3 showed prevalence of type I (40%) and II (40%). Distal root canal morphology showed prevalence of type I in both M1 (66%) and M3 (86%). So, it can be concluded that CBCT scanning provides supplemental information about the root canal configurations of mandibular molars in a sample of Egyptian population. This study may help clinicians in the root canal treatment of mandibular molars.

Keywords: cone beam computed tomography, mandibular first molar, mandibular third molar, root canal morphology

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2064 A Voice Retrieved from the Holocaust in New Journalism in Kazuo Ishiguro's the Remains of the Day

Authors: Masami Usui

Abstract:

Kazuo Ishiguro’s The Remains of the Day (1989) underlines another holocaust, an imprisonment of human life, dignity, and self in the globalizing sphere of the twentieth century. The Remains of the Day delineates the invisible and cruel space of “lost and found” in the postcolonial and post-imperial discourse of this century, that is, the Holocaust. The context of the concentration camp or wartime imprisonment such as Auschwitz is transplanted into the public sphere of modern England, Darlington Hall. The voice is retrieved and expressed by the young journalist and heir of Darlington Hall, Mr. David Cardinal. The new media of journalism is an intruder at Darlington Hall and plays a role in revealing the wrongly-input ideology. “Lost and Found” consists of the private and public retrieved voices. Stevens’ journey in 1956 is a return to the past, especially the period between 1935 and 1936. Lost time is retrieved on his journey; yet lost life cannot be revived entirely in his remains of life. The supreme days of Darlington Hall are the terrifying days caused by the Nazis. Fascism, terrorism, and militarism destroyed the wholesomeness of the globe. Into blind Stevens, both Miss Kenton and Mr. Cardinal bring out the common issue, that is, the political conflicts caused by Nazis. Miss Kenton expresses her own ideas against anti-Semitism regarding the Jewish maids in the crucial time when Sir Oswald Mosley’s Blackshirts organization attacked the Anglo Jews between 1935 and 1936. Miss Kenton’s half-muted statement is reinforced and assured by Cardinal in his mention of the 1934 Olympic Rally threatened by Mosley’s Blackshirts. Cardinal’s invasion of Darlington Hall embodies the increasing tension of international politics related to World War II. Darlington Hall accommodates the crucial political issue that definitely influences the fate of the house, its residents, and the nation itself and that is retrieved in the newly progressive and established media.

Keywords: modern English literature, culture studies, communication, history

Procedia PDF Downloads 553
2063 The Correlation between Three-Dimensional Implant Positions and Esthetic Outcomes of Single-Tooth Implant Restoration

Authors: Pongsakorn Komutpol, Pravej Serichetaphongse, Soontra Panmekiate, Atiphan Pimkhaokham

Abstract:

Statement of Problem: The important parameter of esthetic assessment in anterior maxillary implant include pink esthetic of gingiva and white esthetic of restoration. While the 3 dimensional (3D) implant position are recently concerned as a key for succeeding in implant treatment. However, to our knowledge, the authors did not come across any publication that demonstrated the relations of esthetic outcome and 3D implant position. Objectives: To investigate the correlation between positional accuracy of single-tooth implant restoration (STIR) in all 3 dimensions and their esthetic outcomes. Materials and Methods: 17 patients’ data who had a STIR at central incisor with pristine contralateral tooth were included in this study. Intraoral photographs, dental models, and cone beam computed tomography (CBCT) images were retrieved. The esthetic outcome was assessed in accordance with pink esthetic score and white esthetic score (PES/WES). While the number of correct position in each dimension (mesiodistal, labiolingual, apicocoronal) of the implant were evaluated and defined as 'right' or 'wrong' according to ITI consensus conference by one investigator using CBCT data. The different mean score between right and wrong position in all dimensions was analyzed by Mann-Whitney U test with 0.05 was the significant level of the study. Results: The average score of PES/WES was 15.88 ± 1.65 which was considered as clinically acceptable. The average PES/WES score in 1, 2 and 3 right dimension of the implant position were 16.71, 15.75 and 15.17 respectively. None of the implants placed wrongly in all three dimensions. Statistically significant difference of the PES/WES score was found between the implants that placed right in 3 dimensions and 1 dimension (p = 0.041). Conclusion: This study supported the principle of 3D position of implant. The more properly implant was placed, the higher esthetic outcome was found.

Keywords: accuracy, dental implant, esthetic, 3D implant position

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2062 Comparing the Apparent Error Rate of Gender Specifying from Human Skeletal Remains by Using Classification and Cluster Methods

Authors: Jularat Chumnaul

Abstract:

In forensic science, corpses from various homicides are different; there are both complete and incomplete, depending on causes of death or forms of homicide. For example, some corpses are cut into pieces, some are camouflaged by dumping into the river, some are buried, some are burned to destroy the evidence, and others. If the corpses are incomplete, it can lead to the difficulty of personally identifying because some tissues and bones are destroyed. To specify gender of the corpses from skeletal remains, the most precise method is DNA identification. However, this method is costly and takes longer so that other identification techniques are used instead. The first technique that is widely used is considering the features of bones. In general, an evidence from the corpses such as some pieces of bones, especially the skull and pelvis can be used to identify their gender. To use this technique, forensic scientists are required observation skills in order to classify the difference between male and female bones. Although this technique is uncomplicated, saving time and cost, and the forensic scientists can fairly accurately determine gender by using this technique (apparently an accuracy rate of 90% or more), the crucial disadvantage is there are only some positions of skeleton that can be used to specify gender such as supraorbital ridge, nuchal crest, temporal lobe, mandible, and chin. Therefore, the skeletal remains that will be used have to be complete. The other technique that is widely used for gender specifying in forensic science and archeology is skeletal measurements. The advantage of this method is it can be used in several positions in one piece of bones, and it can be used even if the bones are not complete. In this study, the classification and cluster analysis are applied to this technique, including the Kth Nearest Neighbor Classification, Classification Tree, Ward Linkage Cluster, K-mean Cluster, and Two Step Cluster. The data contains 507 particular individuals and 9 skeletal measurements (diameter measurements), and the performance of five methods are investigated by considering the apparent error rate (APER). The results from this study indicate that the Two Step Cluster and Kth Nearest Neighbor method seem to be suitable to specify gender from human skeletal remains because both yield small apparent error rate of 0.20% and 4.14%, respectively. On the other hand, the Classification Tree, Ward Linkage Cluster, and K-mean Cluster method are not appropriate since they yield large apparent error rate of 10.65%, 10.65%, and 16.37%, respectively. However, there are other ways to evaluate the performance of classification such as an estimate of the error rate using the holdout procedure or misclassification costs, and the difference methods can make the different conclusions.

Keywords: skeletal measurements, classification, cluster, apparent error rate

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2061 The Fracture Resistance of Zirconia Based Dental Crowns from Cyclic Loading: A Function of Relative Wear Depth

Authors: T. Qasim, B. El Masoud, D. Ailabouni

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This in vitro study focused on investigating the fatigue resistance of veneered zirconia molar crowns with different veneering ceramic thicknesses, simulating the relative wear depths under simulated cyclic loading. A mandibular first molar was prepared and then scanned using computer-aided design/computer-aided manufacturing (CAD/CAM) technology to fabricate 32 zirconia copings of uniform 0.5 mm thickness. The manufactured copings then veneered with 1.5 mm, 1.0 mm, 0.5 mm, and 0.0 mm representing 0%, 33%, 66%, and 100% relative wear of a normal ceramic thickness of 1.5 mm. All samples were thermally aged to 6000 thermo-cycles for 2 minutes with distilled water between 5 ˚C and 55 ˚C. The samples subjected to cyclic fatigue and fracture testing using SD Mechatronik chewing simulator. These samples are loaded up to 1.25x10⁶ cycles or until they fail. During fatigue, testing, extensive cracks were observed in samples with 0.5 mm veneering layer thickness. Veneering layer thickness 1.5-mm group and 1.0-mm group were not different in terms of resisting loads necessary to cause an initial crack or final failure. All ceramic zirconia-based crown restorations with varying occlusal veneering layer thicknesses appeared to be fatigue resistant. Fracture load measurement for all tested groups before and after fatigue loading exceeded the clinical chewing forces in the posterior region. In general, the fracture loads increased after fatigue loading and with the increase in the thickness of the occlusal layering ceramic.

Keywords: all ceramic, cyclic loading, chewing simulator, dental crowns, relative wear, thermally ageing

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2060 Greening the Blue: Enzymatic Degradation of Commercially Important Biopolymer Dextran Using Dextranase from Bacillus Licheniformis KIBGE-IB25

Authors: Rashida Rahmat Zohra, Afsheen Aman, Shah Ali Ul Qader

Abstract:

Commercially important biopolymer, dextran, is enzymatically degraded into lower molecular weight fractions of vast industrial potential. Various organisms are associated with dextranase production, among which fungal, yeast and bacterial origins are used for commercial production. Dextranases are used to remove contaminating dextran in sugar processing industry and also used in oral care products for efficient removal of dental plaque. Among the hydrolytic products of dextran, isomaltooligosaccharides have prebiotic effect in humans and reduces the cariogenic effect of sucrose in oral cavity. Dextran derivatives produced by hydrolysis of high molecular polymer are also conjugated with other chemical and metallic compounds for usage in pharmaceutical, fine chemical industry, cosmetics, and food industry. Owing to the vast application of dextran and dextranases, current study focused on purification and analysis of kinetic parameters of dextranase from a newly isolated strain of Bacillus licheniformis KIBGE-IB25. Dextranase was purified up to 35.75 folds with specific activity of 1405 U/mg and molecular weight of 158 kDa. Analysis of kinetic parameters revealed that dextranase performs optimum cleavage of low molecular weight dextran (5000 Da, 0.5%) at 35ºC in 15 min at pH 4.5 with a Km and Vmax of 0.3738 mg/ml and 182.0 µmol/min, respectively. Thermal stability profiling of dextranase showed that it retained 80% activity up to 6 hours at 30-35ºC and remains 90% active at pH 4.5. In short, the dextranase reported here performs rapid cleavage of substrate at mild operational conditions which makes it an ideal candidate for dextran removal in sugar processing industry and for commercial production of low molecular weight oligosaccharides.

Keywords: Bacillus licheniformis, dextranase, gel permeation chromatograpy, enzyme purification, enzyme kinetics

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2059 Establishment and Characterization of a Dentigerous Cyst Cell Line

Authors: Muñiz-Lino Marcos Agustín, Vazquez Borbolla Jessica, Licéaga-Escalera Carlos

Abstract:

The ectomesenchymal tissues involved in tooth development and their remnants are the origin of different odontogenic lesions, including tumors and cysts of the jaws, with a wide range of clinical behaviors. Dentigerous cyst (DC) represents approximately 20% of all cases of odontogenic cysts, and it has been demonstrated that it can develop benign and malignant odontogenic tumors. DC is characterized by bone destruction of the area surrounding the crown of a tooth which has not erupted and it contain is liquid. The treatment of odontogenic tumors and cysts usually are partial or total removal of the jaw, causing important secondary co-morbidities. However, molecules implicated in DC pathogenesis as well in its development to odontogenic tumors remains unknown. A cellular model may be useful to study these molecules, but that model has not been established yet. Here, we reported the establishment of a cell culture derived from a dentigerous cyst. This cell line was named DeCy-1. In spite of its ectomesenchymal morphology, DeCy-1 cells express epithelial markers such as cytokeratins 5, 6, and 8. Furthermore, these cells express the ODAM protein, which is present in odontogenesis and in dental follicle, indicating that DeCy-1 cells derived from odontogenic epithelium. Analysis by electron microscopy of this cell line showed that it has a high vesicular activity, suggesting that DeCy-1 could secrete molecules that may be involved in DC pathogenesis. Thus, secreted proteins were analyzed by PAGE-SDS, where we observed approximately 11 bands. In addition, the capacity of these secretions to degrade proteins was analyzed by gelatin substrate zymography. A degradation band of about 62 kDa was found in these assays. Western blot assays suggested that the matrix metalloproteinase 2 (MMP-2) is responsible of this protease activity. Thus, our results indicate that the establishment of a cell line derived from DC is a useful in vitro model to study the biology of this odontogenic lesion and its participation in the development of odontogenic tumors.

Keywords: dentigerous cyst, MMP20, cancer, cell culture

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2058 The Use of Video Conferencing to Aid the Decision in Whether Vulnerable Patients Should Attend In-Person Appointments during a COVID Pandemic

Authors: Nadia Arikat, Katharine Blain

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During the worst of the COVID pandemic, only essential treatment was provided for patients needing urgent care. With the prolonged extent of the pandemic, there has been a return to more routine referrals for paediatric dentistry advice and treatment for specialist conditions. However, some of these patients and/or their carers may have significant medical issues meaning that attending in-person appointments carries additional risks. This poses an ethical dilemma for clinicians. This project looks at how a secure video conferencing platform (“Near Me”) has been used to assess the need and urgency for in-person new patient visits, particularly for patients and families with additional risks. “Near Me” is a secure online video consulting service used by NHS Scotland. In deciding whether to bring a new patient to the hospital for an appointment, the clinical condition of the teeth together with the urgency for treatment need to be assessed. This is not always apparent from the referral letter. In addition, it is important to judge the risks to the patients and carers of such visits, particularly if they have medical issues. The use and effectiveness of “Near Me” consultations to help decide whether vulnerable paediatric patients should have in-person appointments will be illustrated and discussed using two families: one where the child is medically compromised (Alagille syndrome with previous liver transplant), and the other where there is a medically compromised parent (undergoing chemotherapy and a bone marrow transplant). In both cases, it was necessary to take into consideration the risks and moral implications of requesting that they attend the dental hospital during a pandemic. The option of remote consultation allowed further clinical information to be evaluated and the families take part in the decision-making process about whether and when such visits should be scheduled. These cases will demonstrate how medically compromised patients (or patients with vulnerable carers), could have their dental needs assessed in a socially distanced manner by video consultation. Together, the clinician and the patient’s family can weigh up the risks, with regards to COVID-19, of attending for in-person appointments against the benefit of having treatment. This is particularly important for new paediatric patients who have not yet had a formal assessment. The limitations of this technology will also be discussed. It is limited by internet availability, the strength of the connection, the video quality and families owning a device which allows video calls. For those from a lower socio-economic background or living in some rural areas, this may not be possible or limit its usefulness. For the two patients discussed in this project, where the urgency of their dental condition was unclear, video consultation proved beneficial in deciding an appropriate outcome and preventing unnecessary exposure of vulnerable people to a hospital environment during a pandemic, demonstrating the usefulness of such technology when it is used appropriately.

Keywords: COVID-19, paediatrics, triage, video consultations

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2057 A Disappearing Radiolucency of the Mandible Caused by Inadvertent Trauma Following IMF Screw Placement

Authors: Anna Ghosh, Dominic Shields, Ceri McIntosh, Stephen Crank

Abstract:

A 29-year-old male was a referral to the maxillofacial unit following a referral from his general dental practitioner via a routine pathway regarding a large periapical lesion on the LR4 with root resorption. The patient was asymptomatic, the LR4 vital and unrestored, and this was an incidental finding at a routine check-up. The patient's past medical history was unremarkable. Examination revealed no extra or intra-oral pathology and non-mobile teeth. No focal neurology was detected. An orthopantogram demonstrated a well-defined unilocular corticated radiolucency associated with the LR4. The root appeared shortened with the radiolucency between the root and a radio-opacity, possibly representing the displacement of the apical tip of the tooth. It was recommended that the referring general practitioner should proceed with orthograde root canal therapy, after which time exploration, enucleation, and retrograde root filling of the LR4 would be carried out by a maxillofacial unit. The patient was reviewed six months later where, due to the COVID-19 pandemic, the patient had been unable to access general dental services for the root canal treatment. He was still entirely asymptomatic. A one-year review was planned in the hope this would allow time for the orthograde root canal therapy to be completed. At this review, the orthograde root canal therapy had still not been completed. Interestingly, a repeat orthopantogram revealed a significant reduction in size with good bony infill and a significant reduction in the size of the lesion. Due to the ongoing delays with primary care dental therapy, the patient was subsequently internally referred to the restorative dentistry department for care. The patient was seen again by oral and maxillo-facial surgery in mid-2022 where he still reports this tooth as asymptomatic with no focal neurology. The patient's history was fully reviewed, and noted that 15 years previously, the patient underwent open reduction and internal fixation of a left angle of mandible fracture. Temporary IMF involving IMF screws and fixation wires were employed to maintain occlusion during plating and subsequently removed post-operatively. It is proposed that the radiolucency was, as a result of the IMF screw placement, penetrating the LR4 root resulting in resorption of the tooth root and development of a radiolucency. This case highlights the importance of careful screw size and physical site location, and placement of IMF screws, as there can be permeant damage to a patient’s dentition.

Keywords: facial trauma, inter-maxillary fixation, mandibular radiolucency, oral and maxillo-facial surgery

Procedia PDF Downloads 95