Postgraduate Clinic Research Articles

Endodontic treatments on permanent teeth in pediatric patients aged 6–12 years old

The prevalence of carious lesions and traumatic injury in individuals between ages 6 and 12 is high. This study aimed to characterize pediatric patients aged 6–12 treated in the endodontic clinic and investigate the prevalence and patterns of their provided endodontic treatments. Clinical and radiographic records of patients (ages 6–12) referred to the postgraduate Endodontics clinic from June 2017 to June 2020 were reviewed. Demographics, pre-and post-operative conditions, type of endodontic treatment, and behavioral management were collected. A total of 6350 teeth from 6089 patients were treated in this period, and 425 teeth (6.7%) from 405 patients were included. Ages 9–11 were the most commonly treated age group. Significantly more lower molars (41.9%) and upper anterior teeth (36.7%) were treated ( P < 0.05). The majority of teeth were diagnosed with pulp necrosis (39.5%), and the most common periapical diagnosis was normal apical tissues (39.8%), then symptomatic apical periodontitis (38.8%). The most common etiological factor was caries (63.5%). Two hundred six teeth (48.5%) were treated with root canal therapy, 161 teeth (37.9%) with vital pulp therapy, 46 teeth (10.8%) with apexification or regenerative endodontic procedure, 12 teeth (2.8%) with non-surgical retreatment. A statistically high number of patients (87.8%) tolerated the endodontic procedures without any sedation ( P < 0.0001). Pediatric patients aged 6–12 compose around 7% of the population treated at the postgraduate Endodontics clinic, reflecting the high demand for endodontic treatment in a pediatric mixed dentition population.

Oral surgery waiting lists at an Australian university dental school

AbstractObjectiveThe aim of this study was to investigate the waiting times experienced by patients referred to an Australian University oral surgery clinic over a 2‐year period.Materials and methodA single‐centre retrospective study was conducted to determine the waiting times for oral surgery services at the Griffith University postgraduate clinic. The first 233 patients were selected out of a total of 587 randomised patients and data collected regarding referral sources, procedures undertaken and the number of days from referral to consultation, then to treatment collected from the clinic's management software.ResultsOf the 233 referrals, 121 were female (52%) and 112 male (48%). Many patients were between 20 and 29 years representing approximately 40% (n = 93) of the sample. Analyses of referred patients showed that a significant number of public (i.e. non‐private‐paying) patients (73%, n = 170) were treated in the study period. Most patients waited only 1–2 weeks to be seen for a consultation from date of referral and treatment from date of consultation. Nearly half (49.7%, n = 116) were treated within 2 months of being referred. Once the patient was referred, the overall mean waiting time was 44 days from referral to treatment. Treatment comprised of either procedures undertaken under local anaesthesia (LA) (76.7%, n = 179) or consultations only with patients either declining treatment, deemed not in need of surgical intervention, or referred for more advanced management such as the need for general anaesthesia (23.3%, n = 54). Surgical removal of third molars (36.1%, n = 84) was the most common reason for referral.ConclusionA variety of minor oral surgery procedures can be provided under local anaesthesia with acceptable accessibility and shorter public oral surgery waiting lists.

Prevalence of Intimate Partner Violence and Endodontic Treatment Needs: Pilot Study.

ObjectiveThe aim of this study was to assess the prevalence and potential association between intimate partner violence (IPV) with traumatic dental injuries (TDIs) and the subsequent need for root canal treatment (RCT).MethodsA total of 100 subjects with TDIs presented at emergency or postgraduate restorative clinics at University Dental Hospital, King Abdulaziz University, Jeddah, Saudi Arabia post-TDI. All study subjects completed the Hurt-Insult-Threaten-Scream (HITS) domestic violence screening tool and were clinically and radiographically examined to determine the type of TDI they suffered along with the pulp and periapical status of affected teeth. Demographic data were also recorded. Based on the findings, management included regular follow-up, splinting, reattachment of broken tooth part, vital pulp therapy and/or RCT as seen appropriate.ResultsMean age of participants was 28.4±5.7 years. Prevalence of IPV among subjects presented with TDIs was 18%. Most of the IPV victims held a bachelor’s degree (67%) and were unemployed (61%). Most of TDI cases were crown fracture (84%) followed by luxation and avulsion (10% and 6%, respectively). Among all TDI cases, 73% required RCT. Crown fracture was the most prevalent TDI among IPV victims followed by luxation and avulsion with prevalence of 56%, 33%, and 11%, respectively. Out of a total of 73 patients requiring RCT, nine were IPV victims (12.3%) which indicated that one of each eight TDI cases requiring RCT might be a potential IPV victim. Half of the IPV victims required RCT to manage their TDIs.ConclusionPrevalence of IPV among TDIs was 18%. IPV screening should be included as routine assessment part for TDIs. Identification of IPV victims could be difficult, however, employment status, type of TDI, and RCT needs were suggested as potential predictors of positive IPV cases.

Acceptance of Parents for Behavior Management Technique with Reference to Previous Dental Expertise and Dental Anxiety.

IntroductionBehavior management of pediatric patients may be done by behavioral and pharmacological techniques. Parents play a vital role when making a decision for treatment for the kid.AimTo evaluate parental acceptance towards behavior management techniques (BMT) at the side of its reference to previous dental expertise and dental anxiety.Materials and methodsA descriptive cross-sectional survey was conducted among forty parents of children between three to twelve years before dental treatment. The statistical analysis was done using the Chi-square test, Student's paired and unpaired t -test. p < 0.05 was considered statistically significant. Data analysis was performed using software package of statistical analysis (SPSS 22.0 version and GraphPad Prism 6.0 version).ResultsThe most accepted technique was audiovisual technique followed by tell-show-do and anesthesia. The least accepted technique was oral sedation. Parents whose children were treated at the Postgraduate Clinic of Department of Pediatric Dentistry had lower incomes than those from the private practice. 24% preferred general anesthesia compared to active restraint.ConclusionAudiovisual technique is the most accepted behavior management technique by parents and is an efficient distraction technique for behavior management for anxious pediatric patients. Postgraduate clinic parents had lower incomes than those at the private practice. Parental dental experience and dental anxiety didn't have an effect on the acceptance of any specific behavior management technique.How to cite this articleShukla H, Kulkarni S, Wasnik MB, et al. Acceptance of Parents for Behavior Management Technique with Reference to Previous Dental Expertise and Dental Anxiety. Int J Clin Pediatr Dent 2021;14(S-2):S193-S198.

Cost Analysis on Non-surgical and Surgical Therapy for the Management of Residual Pockets of Periodontitis Patients in Faculty of Dentistry Universiti Teknologi MARA: A Pilot Study

This study aims to quantify and analyze the cost distribution of periodontal intervention that includes non-surgical and surgical therapy in residual pockets management. Immediately after initial cause-related therapy (ICRT), subjects were allocated into two treatment groups: non-surgical (NS) or surgical (S) therapy. Clinical and cost data were recorded at baseline (Phase I) and periodontal review (Phase II). Direct and indirect cost distribution were estimated from patients' perspective and recorded in Ringgit Malaysia (RM) using activity-based costing methods. Indirect cost was calculated via productivity loss. The total average cost was RM1115.68 for the NS group and RM4558.28 for the S group. 46% and 66%of these were attributed to indirect cost while 54% and 34%to direct cost in NS and S groups respectively. Treatment charges and productivity lost attributed to the highest cost distribution in direct and indirect cost respectively. In conclusion, the cost of management of residual pockets in postgraduate periodontic clinic, Faculty of Dentistry UiTM was considered substantial and comparable to other non-communicable diseases and higher compared to management by government-based Periodontic Specialist clinics in Malaysia. These findings may assist in cost-reduction strategies and further justify the need for early detection and prevention of further disease progression.

Repercusiones estéticas, funcionales, psicológicas y económicas de iatrogenia en el tratamiento de la avulsión dental. Relato de caso.

Abstract &#x0D; Introduction: dental avulsion is the complete removal of the tooth out of the socket with aesthetic, functional, psychological, and economic consequences. The International Association of Dental Traumatology establishes that among the actions to favor the prognosis is the immediate reimplantation. Objective: to report a case of probable iatrogenesis in the treatment of dental avulsion and the repercussions on the quality of life of a child. Case Presentation: 9-year-old male patient who suffered a 1-1 avulsion from a direct hit against the swing at school; the mother reports that he was immediately transferred to a private clinic. The tooth was not reimplanted, indicating a fixed partial prosthesis as treatment. Two weeks later, he was presented to the Postgraduate Clinics of the Faculty of Dentistry at the University of El Salvador. It was comprehensively evaluated, and the psychological impact as a result of tooth loss was prioritized. As emergency empathic treatment the crown of the avulsed tooth was used, fixing it with a palatal wire-resin splint, generating evident satisfaction in the patient at the end. Conclusions: Child-Oral index in Daily Performances confirmed an important impact on the quality of life the child as a consequence of the loss of an anterior tooth. According to questioning, it is suspected that iatrogenesis originated from insufficient knowledge of first aid to adequately resolve the avulsion. The incorrect approach generated the irreparable loss of the permanent upper central incisor, with repercussions on the quality of life the patient.&#x0D; Keywords: Iatrogenesis; Tooth Avulsion; esthetic; smile; Self-image.

Outcomes of referrals from endodontic to orofacial pain specialists: A retrospective cohort study.

ObjectivesDiagnosis and treatment of non‐odontogenic pain is challenging for endodontists. The purpose of the study was to investigate the outcomes of referrals to orofacial pain specialists made for patients with suspected non‐odontogenic pain, after evaluation and/or treatment by an endodontist.Materials and MethodsA retrospective review of dental records was conducted for 60 patients referred from a postgraduate endodontic clinic to an orofacial pain clinic. Patient demographics, pain history, endodontic, and orofacial pain diagnoses were collected. Number of visits, length of treatment, and treatments prescribed were recorded. For analysis of outcomes, data pertinent to resolution/persistence of symptoms and patient compliance were analyzed.ResultsThirty‐five patients were included in the study. The most frequent pulpal and periapical diagnoses were previously treated (62%) and symptomatic apical periodontitis (72%), respectively. The most common orofacial pain diagnosis was temporomandibular disorder. The average time spent to diagnose and treat the pain was 17 months. Pain reduction varied and was documented for 51% of patients. Indications of non‐compliance with orofacial pain appointments and treatments were documented for 66% of patients.ConclusionsNon‐odontogenic pain diagnosis and treatment are challenging. Patients may have an increased predilection for developing persistent pain after endodontic treatment and/or have an undiagnosed, chronic orofacial pain condition as a true source of their chief complaint. It may be helpful for endodontists to set expectations of typical treatment times/plans when referring patients for evaluation and treatment of non‐odontogenic pain.

Influence of Hypnotic Suggestions to Increase Periodontal Patients' Compliance

Objective: To evaluate the effectiveness of hypnosis 1) to reduce dental anxiety in periodontal patients, and 2) to increase periodontal patients’ compliance through the reduction of dental anxiety. Methods: This was a randomized control trial of 22 patients (13 males, 9 females; 40.14 ± 19.59 years) who underwent non-surgical periodontal therapy in the Postgraduate and Undergraduate Clinics. Patients were divided into the case, H, (hypnosis; n=11) and controlled, N, (no hypnosis; n=11) groups, where patients’ dental anxiety level was assessed twice for both groups using IDAF-4C+ during the first visit and the second visit. The compliance was evaluated during the follow-up visit. Results: The result showed statistically significant differences (p &lt; 0.05) in the H group during the second visit indicating a reduction in dental anxiety as compared to N group. However, there were no statistically significant differences (p &gt; 0.05) in the pattern of reduction of blood pressure between both case and control groups. Based on the heart rate, patients were found to be more relaxed with hypnotherapy at the beginning of the treatment but halfway through, patients without hypnotherapy had a more significant reduction in heart rate level. Conclusion: Hypnotic suggestions were found to help reduce patient’s fear and anxiety. However, the compliance of the patients with or without hypnotherapy proved to have a similar outcome.

Use of the cone-beam computed tomography-endodontic radiolucency index for determination of lesion extension in periapical periodontitis

Background: Periapical periodontitis is caused by extension of necrotic pulp tissue into the periodontal ligament area. cone-beam computed tomography (CBCT) facilitates better diagnosis for periapical periodontitis, especially in the absence of clinical symptoms. This study aims to use cone-beam computed tomography-endodontic radiolucency index (CBCT-ERI) to determine the extension of periapical periodontitis in post-graduate clinics of Riyadh Elm university (REU) and to record the extension of periapical periodontitis in the coronal direction along the root surface and evaluate the degree of cortical bone involvement associated with periapical radiolucency.Methods: CBCT images for patients treated at the endodontic clinics of REU were selected for this retrospective observational study. Images were examined after inter-examiner calibrations under the same magnification, slice thickness, and resolution and the measurements were analyzed statistically.Results: The first permanent molars were the most frequently affected by periapical periodontitis, followed by the second molars. The majority of lesions were graded with a score of 6 in length and width according to CBCT-ERI.Conclusions: The use of CBCT-ERI revealed extensive involvement of periodontal tissues around the apices of the roots of the examined teeth. Coronal extension of periapical periodontitis was observed along the root surface. The axial view accurately detected cortical bone involvement, including thinning of the cortical bone, which was the most common manifestation (11.76%). Apical radiolucency was observed most commonly in the first molars.

Indoor Air Quality Evaluation Using Mechanical Ventilation and Portable Air Purifiers in an Academic Dentistry Clinic during the COVID-19 Pandemic in Greece.

The coronavirus disease 2019 (COVID-19), which is mainly transmitted through droplets without overlooking other sources of transmission, rendered attention on the air quality in indoor areas and more specifically in healthcare settings. The improvement of indoor air quality (IAQ) is ensured by frequent changes of the air that must be carried out in healthcare areas and with assistance from special devices that undertake the filtration of the air and its purification through special filters and lamps. In this research, the performance of air purifiers is assessed in terms of the limitation of PM2.5, PM10, VOCs and CO2 in a postgraduate clinic of the Dentistry School of the National and Kapodistrian University of Athens in parallel with mechanical ventilation. Our findings indicate that the use of mechanical ventilation plays a key role on the results, retaining good IAQ levels within the clinic and that air purifiers show a positive impact on IAQ by mainly reducing the levels of PM2.5 and secondly of TVOC.

Understanding the Lived Experience of North American Dental Patients With a Single-Tooth Implant in the Upper Front Region of the Mouth: Protocol for a Qualitative Study.

BackgroundAssessment of the subjective experiences of individuals with maxillary anterior (ie, the upper front region of the mouth) single-tooth implants is limited mainly to quantitative measurements of satisfaction with appearance. Interestingly, there is unexplained variability in the relationship between satisfaction and appearance.ObjectiveThis qualitative study protocol aims to explore and better understand the satisfaction with appearance and function in a Canadian population with maxillary anterior single-tooth implants treated at a postgraduate university clinic. Thus, we aim to obtain diversity among participants relating to the identification of esthetically pleasing and displeasing cases from a clinician perspective.MethodsA qualitative research design using interpretative phenomenology analysis (IPA) will provide an adaptable inductive research approach. The participants will be recruited, and consent documents, photographs, digital intraoral scans, and self-administered questionnaire responses will be obtained from them. The transcribed verbatim data from audio-recorded, in-depth, semistructured, one-to-one interviews of the participants will be managed, coded, and analyzed thematically with computer-assisted qualitative data analysis software. The IPA will consider the COnsolidated criteria for REporting Qualitative (COREQ) guidelines when applicable.ResultsFor the qualitative interview, we plan to include at least eight patients to conduct up to 1.5 hours of open-ended interviews with each participant aided by an interview guide. Ethical approval was granted by the University of British Columbia Behavioral Research Ethics Board (H19-00107) in May 2019. Two American dental foundations funded this study.ConclusionsThe analysis in this study will elucidate the aspects (including their value) that influence participant satisfaction at different dental implant treatment stages. This will be the first qualitative study on this group of the population to explore and obtain a better understanding of their satisfaction with appearance and function, as well as any other patient-reported outcome measures that could be identified.International Registered Report Identifier (IRRID)DERR1-10.2196/25767

Endodontic Treatment in a single session in a patient with Chronic Non-Progressive Encephalopathy: Case report

This study aims to report a one-session endodontic treatment of a patient with chronic Non-progressive encephalopathy (CNPE). A patient with CNPE attended our postgraduate clinic for patients with special needs. During the anamnesis, the patient's brother, who is his legal representative, reported discomfort with the esthetics of the patient's anterior tooth and that the patient felt discomfort when touching the same dental element. After detailed anamnesis and elaboration of the treatment plan, endodontic treatment of element 11 (upper right central incisor) and coronary reconstruction were performed. Taking care of patients with cerebral palsy is still a challenge in dentistry. This is because care has to be taken when carrying out necessary interventions in these patients. This treatment aims at the positive resolution of their pathological condition and well-being. The possibility of endodontic treatment in a single session makes treatment more humane and less mutilating.

Sustainability of Improvement in Oral Health-Related Quality of Life in Children After Dental Treatment.

PurposeDental treatment has been associated with improvement in the oral health-related quality of life (OHRQoL) in children. There is little evidence of whether the effect of treatment is sustainable over time or not. The aim of this study was to determine whether the effect of dental treatment on OHRQoL is maintained or diminishes over time.Materials and MethodsA consecutive sample of parents of 47 children between 2 and 6 years who received comprehensive dental treatment at a postgraduate dental clinic were recruited. Parents completed the Early Childhood Oral Health Impact Scale (ECOHIS) prior to treatment and at 1 and 4 months after treatment. Parents were also asked three global questions. Score changes (overall and for each section) between time points were analyzed by a repeated-measures analysis of variance and Bonferroni tests.ResultsThe children’s mean age was 4.7 ± 1.1, and 60% were females. ECOHIS scores were significantly improved from baseline (22.2 ± 6.9) to 1 month after treatment (8.7 ± 6.8) and were further improved at 4 months after treatment (1.9 ± 2.7), P < 0.001, with large effect sizes (2.8 for the child impact section and 2.2 for the family impact section). Parents’ perception of changes in the OHRQoL of their children obtained from a global question indicated an improvement in OHRQoL that was sustained over the follow-up period; at 1-month and 4-month follow-up, 89% and 94% of mothers reported that their child’s oral health improved a lot after dental treatment, respectively.ConclusionThe impact of dental treatment on OHRQoL continued to remarkably improve during the 4 months following dental treatment.

Pulpal blood flow changes and pain scores related to using Superelastic 0.018-inch Nickel Titanium as the first orthodontic alignment archwire: a prospective clinical trial.

Background Optimal orthodontic force results in maximum rate of tooth movement without tissue damage. Even though starting orthodontic treatment with a thicker archwire may shorten treatment duration, the evidence on the effect of using 0.018-inch NiTi as the first alignment archwire on pulpal blood flow (PBF) status is still scarce.Objectives to record PBF changes and pain scores associated with using 0.018-inch NiTi as the first alignment archwire during fixed orthodontic treatment.Methodology Patients were selected from subjects attending postgraduate orthodontic teaching clinics at Jordan University of Science and Technology. In total, forty healthy patients who exhibited mild lower arch crowding were included. A split-mouth trial design was used. Each patient received two archwire sizes at one time joined in the midline by crimpable hook and applied in the lower arch. Patients were assigned into one of two groups based on archwire sizes used. Group 1: 0.014-inch and 0.018-inch NiTi (Six males, 14 females aged 19.4±1.33 years) and Group 2: 0.016-inch and 0.018-inch NiTi (Seven males, 13 females aged 19.6±1.45 years). The archwire size group was randomly allocated with a 1:1 allocation ratio. A Laser Doppler Flowmeter was used to measure PBF at different time intervals (T0-T5). Pain scores were recorded using a visual analogue scale (VAS). A repeated measures ANOVA and a post-hoc Bonferroni comparison tests were conducted to examine differences at the different time points before and during orthodontic alignment.Results For all studied archwire sizes, PBF decreased 20 minutes after their placement. Most PBF changes occurred within 24hours and continued to decrease until 72 hours after archwire placement where the maximum reduction was reached. Eventually, normal values were reverted within 1 month. PBF changes were similar between all alignment – groups.Conclusions Initial orthodontic alignment with 0.018-inch NiTi does not cause irreversible changes to pulpal vasculature or produces higher pain scores.

Effectiveness of Lavender (Lavandula angustifolia) and Jasmine (Jasminum officinale) Aromatherapy on the Intensity of Dysmenorrhea in Student of Faculty of Public Health, Universitas Nusa Cendana, Kupang

Background: Dysmenorrhea is a menstrual cramp that in general occurs in adolescents. In In­do­nesia the figure of dysmenorrhea is es­timat­ed at 64.25%. Students who experience dys­me­nor­­rhea will greatly disrupt learning activities and ab­sen­ce on campus. Lavender and jasmine aro­ma­the­ra­py has benefits for reducing dys­me­nor­rhea be­cause it contains li­na­nool. One of the met­hods to de­c­rease the dys­menorrhea is namely la­vender aro­­ma­the­ra­py and jasmine aroma­the­ra­py. The pur­­pose of this study was to deter­mi­ne dif­fe­ren­ces of the effectiveness of lavender aro­mat­he­ra­py and jas­mine­ arom­ath­erapy to­wards the in­ten­­sity of dys­menorrhea. Subjects and Method: This was a a qua­si-experiment without control group. The study was con­duct­ed at the Postgraduate Clinic of Univer­sitas Nusa Cendana, from Mar­ch to Ap­r­il 2020. The study population was the stu­dents of the Faculty of Public Health, Universitas Nusa Cendana year 20­19. A sample of 40 stu­dents was selected by pur­posive samp­ling. The dep­­en­dent va­riable was dys­meno­­r­rhea. The independent va­­riables were la­vend­er and jasmine aroma­the­ra­py. Dys­meno­r­rhea was measured by Nu­me­ri­cal Pain Rating Sca­le. The data were analyzed by t test. Results: After receiving lave­nder and jasmine aro­mat­he­ra­py, intensity of dysmenorrhea in lavender aromatherapy (Mean=19,50 ; SD­=­0,­48 ) was lower than jasmine aro­ma­the­rapy (Me­an­=­21.­50 ; SD=0.51 ), but it was sta­tis­ticall­y non-sig­ni­fi­cant (p= 0.­5­24). Conclusion: Lavender and jasmine aroma­therapy have similarly effect in in­­ten­­­­sity of dysmenorrhea. Keywords: lavender aromatherapy, jasmine aro­­­matherapy, dysmenorrhea. Correspondence: Maria Antonia Nurak. Masters Program in Public Health Sciences, Universitas Nusa Cen­­dana, East Nusa Tenggara, Indonesia. Jl. Adi Sucipto Penfui La­si­ana, Klp. Lima, Kota Kupang, Nusa Tenggara Tim 85­001. Email: anurmaria10@gmail.com Mo­bile: 08­13­53242041 Journal of Maternal and Child Health (2020), 05(03): 429-435 https://doi.org/10.26911/thejmch.2020.05.04.10

Interdental papilla reconstruction using injectable hyaluronic acid: A 6 month prospective longitudinal clinical study.

The objective of this study was to assess the efficacy of Hyaluronic Acid (HA) on interdental papilla (IDP) loss in the esthetic zone. Twenty one subjects (14 females and 7 males) from those referred for treatment of IDP loss at Periodontics postgraduate clinics at the Jordan University of Science and Technology. A total of 86 interdental sites (58 sites in the maxillary jaw and 28 sites in the mandibular jaw) were treated and followed up. A 0.2 ml of Hyaluronic acid was injected in each receded IDP site and injections were repeated after 21 days. Papilla sites were evaluated and statistically analyzed. At the 3 week interval the mean reduction of black triangle (BT) height was 0.17 mm (8% reduction) (P-value <0.001), at the 3 month interval there was a mean reduction of BT height of 0.83 mm (39% reduction) (P-value <0.001). At 6 months however, the reduction in BT height was 0.62 mm (29% reduction) (P-value <0.001). Within the limitations of this study, it can be concluded that the use of commercially available HA gel for the treatment of interdental papillae loss may have promising results over the first 6 months after injection. The maximum improvement in black triangles was at 3 months after injection with a reduction of improvement between 3 and 6 months. Clinical Relevance Helping clinician to take evidence based decision while considering Hyaluronic acid injection as a short term nonsurgical treatment modality for interdental papilla loss.

Association of patients with fluorosis who underwent vital bleaching - A hospital-based study

Fluorosis staining is an esthetic problem, especially when in anterior. Numerous treatment approaches include Conservative approaches such as vital tooth bleaching, which is the most sought option to eliminate fluorosis staining as it is simple, low cost, noninvasive. Further, it is relatively rapid, no distortion of enamel and can be safely used for permanent teeth. This research emphasizes the association of patients with fluorosis who underwent vital bleaching to correct the staining and to obtain esthetically pleasing teeth. This is a comparative and descriptive study for which the data was obtained from DIAS (dental information archiving software). The data collection was from the Undergraduate and postgraduate clinics, Saveetha dental college, SIMATS. The data was collected and compiled, followed by its statistical analysis by using the SPSS software by IBM. Results revealed the incidence of Vital bleaching for fluorosis was 76.7%, and vital bleaching for other reasons was 23.3%; Out of the patients who underwent vital bleaching for fluorosis, males were 86.7%, and females were 13.3% with P-value &lt; 0.05 statistically significant; patients from 1-34 years were 83.3%, 35-55 years were 10.0% and above 55 years were 6.7% with P-value &lt; 0.05 statistically significant. The overall results show a Male predilection in vital bleaching for fluorosis and 1-34 years as the most predominant population for undergoing vital bleaching among fluorosis patients.

Development and validation of an instrument to assess adherence to occupational health protocols in dentistry.

The purpose of this study was the creation and validation of an instrument to evaluate adherence to occupational health protocols used in dentistry that arise from official regulations and international recommendations on infection control, biosafety, and occupational health in dentistry. Additionally, in May 2017 the effectiveness of the instrument was documented within the dental care clinics in the postgraduate area. The instrument was developed based on constructs of occupational health, infection control, and biosafety in dentistry, made up of 21 indicators of 5 dimensions called protocols. Using direct observation through 35 measurements during 1 week, adherence to occupational health protocols was evaluated in postgraduate residents within the clinical sections of endodontics/pediatric dentistry, periodontics, prosthodontics, and orthodontics. The instrument presents an index of 0.88 in Cronbach's alpha analysis. There is a 34.4% adherence within the postgraduate dental clinic to the proposed occupational health protocols. The protocol with the highest adherence at 41.1% was the personal protection protocol. The periodontics section had a 52.9% observance of the proposed protocols and had the highest adherence to occupational health protocols. The proposed instrument is valid and reliable to evaluate adherence to the proposed occupational health protocols within dental care clinics. Dental clinics must be inspected and evaluated to ensure adherence to infection control, biosafety, and occupational health protocols within routine dental practice.

Guided Endodontic Access in a Maxillary Molar Using a Dynamic Navigation System

The treatment of calcified root canals is challenging in endodontic practice. A 63-year-old man was referred to the postgraduate endodontic clinic at the University of Maryland School of Dentistry, Baltimore, MD, for the treatment of tooth #3. Because of the patient’s history of head and neck radiation and the high risk of developing osteoradionecrosis, a nonsurgical endodontic approach was found to be the most reasonable treatment option despite the questionable prognosis of the tooth. During the endodontic treatment, the distobuccal canal appeared to be partially calcified and was not possible to be located freehand even with use of the dental operating microscope and cone-beam computed tomographic approximated approach. Therefore, the dynamic navigation system using the X-Guide system (X-Nav technologies, LLC, Lansdale, PA) was used, which allowed for the successful location of the canal. Conventional endodontic treatment was completed following standardized instrumentation, irrigation, and obturation. Details on how to use the dynamic navigation system are described including its advantages, disadvantages, and limitations.

Hemoglobin Levels and the Associated Factors in the Patients Visiting A University Hospital in Chennai, India

Hemoglobin is a protein molecule present in the red blood cells that carries oxygen from the lungs to thebody’s tissues and returns carbon dioxide from the body tissues to the lungs. The normal Hemoglobin levelfor males is 13.5 - 17.5 -grams per deciliter and for females is 12.0 - 15.5 - grams per deciliter. However,Adult men and women have different haemoglobin levels, which are independent of iron status. Estimationof Hemoglobin levels is essential due to several reasons and this research is unique in the aspect of itsimportance in dentistry. This study aims at the assessment of Hemoglobin levels of patients, based ontheir gender visiting Saveetha dental college outpatient department. This is a comparative and descriptivestudy for which the data was obtained from reviewing the patient records. The data collection was fromthe Undergraduate,postgraduate clinics, Saveetha dental college, SIMATS. The data was collected andcompiled followed by its statistical analysis by using the SPSS software by IBM. Out of the total samplesize (1825 cases), various hemoglobin result values obtained were, 5-8 g/dl - 5.2%; 8-12 g/dl - 38.0%;12-16 g/dl -52.3%; and 16-20 g/dl - 4.5%. Where 12-16 g/dl was considered as normal level Hemoglobinlevels among males showed 65.0% under normal range; 27.12% anaemic ; 7.88% above normal level andHemoglobin levels among females showed 35.54 % under normal range ; 64.33 % anaemic ; 0.13% abovenormal level. Chi square test between gender and Hemoglobin result values resulted in a P value &lt; 0.05statistically significant. Hemoglobin levels among the age group 1-31 years were 38.4%; 32-55 years were45.2%; and above 55 years were 16.4%; Chi square tests between various age groups and Hemoglobinresult values resulted in a P value &lt; 0.05 statistically significant. Our study assessed the association ofHemoglobin levels of patients with various parameters such as age, gender and result values. The overallresults show a Male predilection in hemoglobin levels and females having lesser hemoglobin levels thantheir normal range. The study also reveals that Anemia is strongly associated with females when comparedto males and both males and females attain the peak in hemoglobin levels during their young and MiddleAge and gradually come down during old age.