Tag: pubmed

J Am Acad Orthop Surg. 2024 May 10. doi: 10.5435/JAAOS-D-23-01172. Online ahead of print.

ABSTRACT

INTRODUCTION: Firearms are the leading cause of death in the pediatric population, and the incidence of firearm injury is on the rise in the United States. The purpose of this study was to examine the incidence of pediatric gunshot wounds (GSWs) in New Orleans from 2012 to 2023 and evaluate factors that contribute to mortality.

METHODS: A retrospective analysis of pediatric GSWs was conducted using the trauma database at a Level I trauma center in New Orleans, Louisiana. All patients aged 0 to 18 years with a GSW between January 1, 2012, and January 1, 2023, were evaluated. Demographic data, Injury Severity Score (ISS), hospital length of stay (LOS), discharge disposition, intent of injury, mortality, firearm type, orthopaedic injuries, and related surgical procedures were extracted from the database. Linear regression was used to assess the trend of GSWs over time, and logistic regression was used to identify variables that predicted mortality. Statistical significance was defined as α = 0.05. Geographic information system (GIS) mapping was conducted using the ZIP code location of injury to identify geographic areas with the greatest number of GSWs.

RESULTS: A significant increasing trend was observed in the number of pediatric GSWs when adjusted for changes in population (P = 0.014), and the number of GSWs increased 43.2% over the duration of the study. Higher ISS, shorter length of stay, and self-inflicted intent of injury were notable predictors of mortality. Three hundred fifty-four patients (31.4%) had at least one orthopaedic injury, and of the survivors, 365 patients (35.6%) required at least one surgical procedure in the operating room during their admission.

DISCUSSION: The number of GSWs in the pediatric population in New Orleans presenting at a large level 1 trauma center demonstrated a statistically significant increasing trend over the past 11 years. ISS and self-inflicted intent were predictive of mortality within this pediatric patient population.

PMID:38739866 | DOI:10.5435/JAAOS-D-23-01172

J Am Acad Orthop Surg. 2024 May 10. doi: 10.5435/JAAOS-D-23-01147. Online ahead of print.

ABSTRACT

INTRODUCTION: A pronounced gender imbalance is evident among orthopaedic surgeons. In the field of arthroplasty, there exists a dearth of comprehensive data regarding gender representation. This study aimed to analyze the gender diversity, or lack thereof, within the field of total hip arthroplasty (THA). In addition, this study used literature review to identify possible reasons for the gender disparity among THA surgeons and identify the best next steps to promote gender equity within orthopaedics.

METHODS: A retrospective analysis was conducted using the Medicare Provider Utilization and Payment Data: Physician and Other Practitioners data set to quantify orthopaedic surgeons who performed primary THA procedures from 2013 to 2020. To assess trends in the number of hip surgeons by sex and the evolving female-to-male ratio, two-sided correlated Mann-Kendall tests were conducted.

RESULTS: Overall, 3,853 to 4,550 surgeons billed for primary THA annually. Of this number, an average of 1.7% was female. The mean number of services billed for by male surgeons was 31.62 ± 24.78 per year and by female surgeons was 26.43 ± 19.49 per year. Trend analysis of female-to-male ratio demonstrated an increasing trend of statistical significance (P = 0.009). The average number of procedures by female surgeons annually remained stable throughout the study, whereas there was a steady increase in that for male surgeons.

CONCLUSION: Results showed a notable and sustained upward trajectory from 2013 to 2020 in the number of female surgeons billing for THA along with the female-to-male ratio. However, female surgeons constitute a mere 2% of surgeons engaging in primary THA billing. Furthermore, the annual average number of THAs conducted by female surgeons exhibited constancy, whereas there was a gradual increase in the median number of annual procedures performed by their male counterparts. Future studies should aim to identify and resolve specific barriers prohibiting female medical students from pursuing and obtaining a career as an orthopaedic THA surgeon.

STUDY DESCRIPTION: Retrospective analysis using the Medicare Provider Utilization and Payment Data: Physician and Other Practitioners data set.

PMID:38739863 | DOI:10.5435/JAAOS-D-23-01147

Indian J Dent Res. 2023 Oct 1;34(4):438-442. doi: 10.4103/ijdr.ijdr_5_23. Epub 2024 Apr 19.

ABSTRACT

AIM: The aim of the present study is to assess the microhardness of resin-based composites (RBCs) cured with ultrafast curing mode at two different exposure durations.

STUDY DESIGN: This is an experimental in-vitro study. Forty-five cylindrical composite specimens were prepared to a dimension of 5 mm height and 4 mm diameter. Curing was done using three different exposure modes and duration with dual mode LED curing light as follows: Group I: Ultrafast curing mode for 1 second at 2300 mW/cm2 (n = 15); Group II: Ultrafast curing mode for 3 second at 2300 mW/cm2 (n = 15) and Group III: Standard exposure mode for 20 second at 1000 mW/cm2 (n = 15). Vicker’s microhardness measurement was done on both the curing and non-curing sides of the specimen using a motorised diamond-faced micro-indenter (Wilson Wolpwert, Germany) using a load of 50 gram and a dwell time of 30 second.

STATISTICAL ANALYSIS: Kruskal Wallis ANOVA was used to test for difference between the three groups followed by Mann-Whitney U test for post-hoc analysis.

RESULTS: The microhardness values of the composite cured with a conventional curing unit were significantly higher than the ultrafast cured specimens.

CONCLUSION: Low-intensity conventional curing lights were found to perform better than the high-intensity ultrafast curing units.

PMID:38739828 | DOI:10.4103/ijdr.ijdr_5_23

Indian J Dent Res. 2023 Oct 1;34(4):427-432. doi: 10.4103/ijdr.ijdr_519_23. Epub 2023 Dec 27.

ABSTRACT

BACKGROUND: 3D printing technology is replacing manual fabrication in all fields. 3D-printed impression trays should be assessed as they could replace conventional impression trays in the future.

AIM: In-vitro comparison and evaluation of the dimensional stability and retention strength of impressions to custom impression trays fabricated using conventional method and additive technology.

MATERIALS AND METHODS: A maxillary edentulous auto-polymerizing acrylic resin model served as the master model. Two moulds were prepared from the master model in order to obtain 12 casts. One cast was scanned for 3D printing digital light processing (DLP) and fused deposition modelling (FDM) 24 impression trays using polylactic acid (PLA). Twelve casts were used to fabricate light cure impression trays. Polyvinyl-siloxane impressions were made on the master model using 36 impression trays and 18 trays each were used to assess dimensional stability and retention strength.

RESULTS: In dimensional stability analysis, one sample t-test revealed a statistically significant difference between each group and the master model followed by a one-way ANOVA. There were significant differences, but the difference was less with FDM trays (P < 0.05). In retention strength analysis, one-way Analysis of variance (ANOVA) revealed statistically significant difference between each group and post-hoc test revealed specific difference, the highest with FDM trays (P < 0.05).

CONCLUSION: Dimensional changes were observed at 30 minutes and 72 hours. Lesser dimensional changes were observed when impressions were made using FDM trays followed by DLP and light cure trays. The mean retention strength seen in descending order was FDM, followed by DLP and light cure trays. The best retention strength was noticed when impressions were made using FDM trays.

PMID:38739826 | DOI:10.4103/ijdr.ijdr_519_23

Indian J Dent Res. 2023 Oct 1;34(4):422-426. doi: 10.4103/ijdr.ijdr_708_22. Epub 2024 Feb 16.

ABSTRACT

BACKGROUND: The bond strength of an endodontic sealer to the root dentin is an important factor in maintaining the integrity of the root canal seal. The present study aimed to assess the push-out bond strength of three endodontic sealers used with the single-cone obturation technique.

MATERIALS AND METHODS: The root canals of 40 central maxillary incisors were instrumented using ProTaper Universal NiTi rotary files. The roots were divided into 4 groups (N = 10) according to the type of root canal sealers: Group 1 (control group): AH Plus/Gutta-percha lateral condensation technique (LC); Group 2: AH Plus/Gutta-percha single-cone technique (SC); Group 3: GuttaFlow 2/SC; Group 4: Realseal SE/SC. After obturation, each tooth was prepared for push-out assessment. The total and sectional push-out bond strengths were measured and statistically analysed. Furthermore, failure modes were identified microscopically.

RESULTS: The results indicated that samples in the first group showed the highest total and sectional bond strengths. Samples from other groups showed statistically similar total bond strengths. The highest sectional bond strength was found mainly in the apical root sections. Cohesive failure was predominant for the first group, whereas adhesive failure was predominant in the other groups.

CONCLUSIONS: It could be concluded that the dentin bond strengths of the tested sealers used with the single-cone technique were nearly similar but lower than those of AH Plus/LC. The highest sectional bond strength was observed in the apical thirds. The failure mode was mostly cohesive for AH Plus/LC and adhesive for sealers used with the single-cone obturation technique.

PMID:38739825 | DOI:10.4103/ijdr.ijdr_708_22

Indian J Dent Res. 2023 Oct 1;34(4):417-421. doi: 10.4103/ijdr.ijdr_538_23. Epub 2024 Apr 19.

ABSTRACT

CONTEXT: The role of platelet parameters as markers of inflammation in various diseases is now in limelight. The interaction between cancer cells and platelets is a well-established phenomenon. Oral submucous fibrosis (OSMF) is a premalignant disorder with a malignant transformation rate of 2-8%. This study aimed to evaluate platelet parameters in OSMF and oral squamous cell carcinoma (OSCC) in the background of OSMF. This cross-sectional study was performed using secondary data retrieved between January 2019 and December 2019 in the Department of Oral Pathology and the Hematology Laboratory.

METHODS AND MATERIALS: The data retrieved included 44 histopathologically proven OSCC in a background of OSMF (group III) and 36 OSMF (group II). The haematological parameters of these selected cases were retrieved from the Sysmex XN-1000 automated hematology analyser database. A control group (group I) comprises 50 subjects with normal (negative/unflagged) haematological parameters. All data were statistically analysed using SPSS 20.0. The significance level of tests was set at 5%.

RESULTS: The mean platelet volume (MPV) (9.60 [±0.95] P < 0.001), platelet distribution width (PDW) (10.45 [±1.9], P < 0.001), platelet large cell ratio (PLCR) (21.70 [±7.98], P < 0.001), and the ratio of mean platelet volume to total platelet count (MPV/PLT) (0.03 [0.01], P < 0.001) were lower in group III when compared to the other two groups.

CONCLUSIONS: Platelet parameters may be used as indices in the OSCC in the background of OSMF. However, large-scale prospective studies are necessary to evaluate the utility of these parameters during the malignant transformation of OSMF, thereby encouraging prompt treatment to prevent morbidity and mortality.

PMID:38739824 | DOI:10.4103/ijdr.ijdr_538_23

Indian J Dent Res. 2023 Oct 1;34(4):410-412. doi: 10.4103/ijdr.ijdr_1142_21. Epub 2024 Apr 19.

ABSTRACT

BACKGROUND: The rise in awareness programs with regard to the maintenance of oral hygiene in children with diabetes has led to a hypothetical question if children with juvenile diabetes are still under the risk of developing dental caries and having poor oral hygiene.

AIM: To compare the oral hygiene status of the children with and without juvenile diabetes.

MATERIALS AND METHOD: The study was conducted as age and sex matched case-control study. Sixty-six children diagnosed with juvenile diabetes were compared with the age and sex matched 66 healthy controls with respect to the oral hygiene index, gingival index and DMFT/def index. Mean of the obtained scores of the variables were compared between the groups using Mann-Whitney test with significance level set at 5%.

RESULTS AND CONCLUSION: No statistically significant differences were noted in the gingival condition and dental caries experience between the children with and without juvenile diabetes (P = 0.820; 0.504; 0.422). However, the overall oral hygiene status was found to be poor in children with juvenile diabetes (P = 0.003). No significant differences were observed in the gingival status and the dental caries prevalence between the two groups.

PMID:38739822 | DOI:10.4103/ijdr.ijdr_1142_21

Indian J Dent Res. 2023 Oct 1;34(4):401-404. doi: 10.4103/ijdr.ijdr_293_22. Epub 2024 Apr 19.

ABSTRACT

INTRODUCTION: Chlorhexidine (CHX) is a chemical mouthwash that has been considered the gold standard, but has its drawbacks. When used for a longer duration, it produces taste alteration and staining on the tooth surfaces. Nowadays, herbal extracts from plants have been widely used as they possess anti-inflammatory, antimicrobial and analgesic actions.

MATERIAL AND METHODS: A group of 45 healthy subjects in the age group of 19-35 years were selected and randomly divided into three groups, Group A – Himalaya complete care mouthwash, Group B – CHX mouthwash, Group C – Distilled water as a control group. Gingival index and plaque index, OHI-s index, and Ainamo and Bay index for bleeding were recorded. Subjects received complete supragingival scaling at baseline and were instructed to use 10 ml of mouthwashes twice a day in their group. Variables were again recorded on the seventh and 14th day after the use of mouthwashes, and data obtained was subjected to statistical analysis. Posthoc and ANOVA tests were used for statistical analysis.

RESULTS: It was found that both CHX and herbal mouthwash proved to be more effective than placebo in maintaining gingival health. There was no significant difference between the test group on gingival health.

CONCLUSION: Herbal mouthwash is an effective alternative to CHX mouthwash, in the light of the reported side effects of CHX mouthwash.

PMID:38739820 | DOI:10.4103/ijdr.ijdr_293_22

Indian J Dent Res. 2023 Oct 1;34(4):396-400. doi: 10.4103/ijdr.ijdr_191_23. Epub 2024 Feb 16.

ABSTRACT

OBJECTIVES: To compare and evaluate the occlusal variability/discrepancy recorded using qualitative (articulating paper) and quantitative (T-scan) techniques in partially edentulous implant-supported restorations.

MATERIALS AND METHODS: A total of 20 patients in the age group of 25-61 yrs participated in this study. All the patients had more than one tooth replaced with implant-supported prosthesis. After three months of restoration, occlusion reevaluated was carried out using qualitative (articulating paper) and quantitative (T-scan). T-scan data were used to measure implant occlusion time, occlusion time, and the relative occlusal force (ROFs) on implant prosthesis. And the data were statistically evaluated.

RESULTS: The T-scan values showed high points on the implants in most of the patients, which could not be evaluated by that of articulating paper outcomes.

CONCLUSION: The occlusal harmony achieved from using qualitative analysis of articulating paper was not supported by the finding of the quantitative analysis (T-scan). Also the T-scan provided the time interval of occlusion of the implant-supported restorations, which would help in better defining the implant-protected occlusal.

CLINICAL RELEVANCE: The T-scan occlusal analysis system provides ROF and time intervals of occlusal contact. This allows accurate occlusal equilibration of implant-supported restoration according to implant protected occlusal concept.

PMID:38739819 | DOI:10.4103/ijdr.ijdr_191_23

Indian J Dent Res. 2023 Oct 1;34(4):387-390. doi: 10.4103/ijdr.ijdr_731_22. Epub 2024 Apr 19.

ABSTRACT

INTRODUCTION: Maxillofacial skeleton is the most vulnerable site for trauma due to its prominence. The aim of our study was to analyse the cause and pattern of maxillofacial injuries & to correlate the aetiology and pattern of facial injury.

MATERIALS AND METHODS: This prospective study includes 304 patients with facial trauma, who reported to our institute within a time span of 2 years. Data were collected on basis of sociodemographic status plus additional data obtained on type of injury, aetiology, location and status of the victim.

RESULT: The most frequent cause of maxillofacial trauma (MFT) was fall (43.3%) followed by RTA (34.2%) and assault (15.1%). In upper 3rd face region frontal bone fracture was prevalent with 1.3%, while in the midface, zygomatic complex (ZMC) fracture (3.9%) and in lower 3rd part of face, mandible fracture (42.8%) and dentoalveolar fracture (30.2%). Mandible was the most prevalent site for trauma. Although fall was the main aetiological factor in our study, midfacial injuries were mainly due to assault and RTA. Combination of mandibular fracture and soft tissue injury were mainly seen in RTA and injury due to fall. Conservative management was mainly employed for treatment with 46.1% followed by ORIF with 36.2%.

CONCLUSION: Changing trend in aetiology of MFT was noted. Furthermore, study should be conducted for better understanding, and to carry out preventive measure for the same.

PMID:38739817 | DOI:10.4103/ijdr.ijdr_731_22