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Intentional Replantation with 180° Rotation of a Crown-Root Fracture as a Last Expedient: A Case Report

The treatment of complicated crown-root fractures of tooth is often compromised by a fracture apical to the gingival margin and/or bone. This makes isolation difficult and compromises the adhesive union which is critical for a successful treatment. In the present case, the fracture line extended from cervical third of labial surface to cervical third of palatal surface sub gingivally which made the case a complicated crown root fracture. The reattachment of fragments would bring the vulnerable joint in the primary stress bearing area and in the subgingival region. Hence the tooth was removed traumatically with the help of periotome and intentional replantation was done which facilitated the attachment of fragments extra orally. Fragments reattachment was reinforced with the intraradicular fiber post and glass ionomer cement. Then the tooth was rotated 1800 to bring the subgingival fracture line to the labial surface where the occlusal load is less. As the amount of extra oral time is a critical factor in the success of reimplantation, the procedure was completed in 20 minutes. The teeth were stabilized with semi rigid splint for 6 weeks. Later full veneer crown was cemented on the tooth. The patient was followed up with clinical examination for mobility test, gingival sulcus depth and radiographic analysis to analyze the integrity of root, the alveolar cortex and the periodontal space for 12 months. The treatment is successful so far and has rendered satisfaction to both the clinician and patient.

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Examining the Features of NaCl Activated Kaolinite Nano-layers for Use in Excipients

Successful application of 1:1 layered phyllosilicates as excipients of drugs and agrochemicals depends on the efficiency and effectiveness of activation reactions carried out prior to their usage. Reluctance of kaolinite to direct reactions involving interlayer spaces created a challenge which requires a sustainable search for optimum activation agents. This study investigated the features of cyclone based wet beneficiated kaolinite with kaolinite sheets activated using solid dispersion of NaCl. Starting materials and the resulting activated counterparts were characterized for their chemistry, functionalities (as per mineral phases present), and variation of crystal sizes upon each treatment cycle along with lattice contraction and expansion in the interlayer spaces and orientation of layers (as per their morphological changes) as well as molecular vibration. It was observed that, upon successful activation with NaCl, there was a significant change in the orientation of kaolinite sheets from euhedral pseudohexagonal platelets into vermiform whose pattern offer a maximum orientation for reactions involving interlayer spaces. The formation of vermiform which may be due to packing of nano-layers was noted to be associated with the contraction of interlayer spaces of about 0.018 nm from 2θ = 12.543o to 12.552o as revealed in the x-ray diffraction trials. Therefore, the ability of NaCl activation reactions to orient kaolinite layers into well-ordered vermiform pattern makes NaCl a suitable activation agent for use when kaolinite is to be used for design of excipients for drugs and agrochemicals.

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