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Karnam S.,Rajarajeswari Dental College and Hospital | Raghavendra P.,CloudMunch
Journal of Clinical and Diagnostic Research | Year: 2017

In the last decade, we have seen a significant surge in the number of patients whom we can term as “Informed patients”. Informed patients are well read on the medical condition that they are looking to resolve. They may have often over researched and may be paranoid about what they may be going through; they may also know all potential medications that may be used for treatment and also potential side effects of these. However, they may not be in a position to judge what is actually right and what is actually applicable for what they are going through. This causes patients to go through, what we define as hyper information, where they have a lot of information but are unaware what applies to them. In this paper, we classify patients driven by this hyper-information, and discuss how this may lead to different patient states. We also discuss the need for doctors to adapt themselves to become what we call Hybrid Doctors. We briefly discuss how Hybrid Doctors can handle informed patients of various types and states. © 2017, Journal of Clinical and Diagnostic Research. All rights reserved.


Arali V.,Rajarajeswari Dental College and Hospital | Mytri P.,Bapuji Dental College and Hospital
Journal of Clinical and Diagnostic Research | Year: 2015

Background: Lidocaine is the gold standard anaesthetic solution that has been used since its inception into dentistry till date. Around 80% of failures have been reported when lignocaine has been used for inferior alveolar nerve block in children and adults with irreversible pulpitis. There is a need to use newer drugs which are available which have been reported to be effective like lignocaine, such as articaine. Although articaine has been used in adults, literature supporting its use in children is sparse. Aim: The purpose of this study is to compare the anaesthetic efficacy of 4% articaine buccal infiltration and 2% lignocaine inferior alveolar nerve block in children with irreversible pulpitis. It also aims to assess the need for supplemental intrapulpal injections. Materials and Methods: This study was designed as a randomized double-blind cross over trial comparing the anaesthetic effectiveness of 4% articaine with 1:100,000 epinephrine in buccal infiltration and 2% lignocaine IAN block anaesthesia. The study subject and the pediatric dentist performing the pulpectomy procedures were blinded to the study. A sample size of 40 subjects in the age group of 5-8 y was included in the study. Results: The onset of anaesthesia with 4% articaine was faster as compared to 2% lignocaine. The duration of anaesthesia with articaine infiltration was shorter. The need for supplemental injection in the articaine group was less. Conclusion: Four percent articaine infiltration can be used in children with irreversible pulpitis. It can be used to replace the IAN block in children thereby reducing the post anaesthetic complications like lip biting. © 2015, Journal of Clinical and Diagnostic Research. All rights reserved.


Rohit S.,Rajarajeswari Dental College and Hospital | Praveen Reddy B.,Government Dental College | Sreedevi B.,Hitkarini Dental College and Hospital | Prakash S.,Triveni Institute of Dental science
Journal of Clinical and Diagnostic Research | Year: 2015

Pycnodysostosis is a rare craniofacial syndrome characterized by dwarfism, cranial anomalies, diffuse osteosclerosis where multiple fracture of long bones and osteomyelitis of jaw are frequent complications. This clinical entity was first described in 1962 by Maroteaux and Lamy. This article presents two clinical cases of pycnodysostosis with their clinical and radiological characteristics. © 2015, Journal of Clinical and Diagnostic Research. All right reserved.


Subbaiah R.,Rajarajeswari Dental College and Hospital | Thomas B.,Memorial Institute of Dental science
Medicina Oral, Patologia Oral y Cirugia Bucal | Year: 2011

Presently, bone replacement grafts are one of the modalities of therapy for which there is histologic evidence of regeneration coronal to the base of the previous osseous defect. Bioactive glasses are used extensively in medicine and dentistry. This study evaluated the additional efficacy of a bioactive alloplast, PerioGlas, in comparison with open flap debridement only. 8 systemically healthy volunteers were chosen, each having 2 collateral sites with ≥6 mm clinical probing depth and radiographic evidence of an intrabony defect. Randomly, one defect was treated with open flap debridement plus bioactive glass (test) and the other with open flap debridement alone (control). At baseline, 3, 6, 9 months measurements were recorded which included plaque index, gingival index, pocket probing depth, clinical attachment level, and increase in gingival recession. Standardized radiographs were used to measure defect fill and alveolar crest resorption. The data were subjected to statistical analysis. Both treatments showed no significant differences between the two groups at any point of time. However, radiographically, bioactive glass group showed significant improvement in bone fill over the sites treated with open flap debridement alone. The alloplastic bone graft material, PerioGlas, demonstrated clinical advantages beyond that achieved by debridement alone. © Medicina Oral S. L.


Varsha V.K.,Rajarajeswari Dental College and Hospital | Hallikeri K.,Sri Dharmasthala Manjunatheshwara Dental College | Girish H.C.,Rajarajeswari Dental College and Hospital | Murgod S.,Rajarajeswari Dental College and Hospital
Journal of Oral and Maxillofacial Pathology | Year: 2014

Background: Central and Peripheral giant cell granulomas of jaws are uncommon, benign, reactive disorders that are characterized by the presence of numerous multinucleated giant cells and mononuclear cells within a stroma. The origin of the multinucleated giant cells is controversial; probably originating from fusion of histiocytes, endothelial cells and fibroblasts. Objective: To assess the expression of CD34 and CD68 in central and peripheral giant cell granulomas to understand the origin of these multinucleated giant cells. Materials and Methods: Twenty cases of Central and Peripheral giant cell granulomas were evaluated immunohistochemically for CD34 and CD68 proteins expression. Results: Immunopositivity for CD34 was seen only in cytoplasm of endothelial cells of blood vessels; whereas, consistent cytoplasmic immunopositivity for CD68 was seen in few stromal cells. Statistical significance was seen in mean number of multinucleated giant cells, mean number of nuclei in multinucleated giant cells, CD68 expression and ratio of macrophages to multinucleated giant cells among two lesions. Conclusion: Although the central giant cell granulomas share some clinical and histopathological similarities with peripheral giant cell granulomas, differences in mean number of nuclei in multinucleated giant cells and CD68 immunoreactivity may underlie the distinct clinical behavior. © 2014, Medknow. All rights reserved.


Govindraju P.,Rajarajeswari Dental College and Hospital | Chandra P.,Rajarajeswari Dental College and Hospital
Journal of Clinical and Diagnostic Research | Year: 2014

Introduction: Osteoporosis is a regressive change Which occurs in the bone and it is seldom diagnosed before the occurrence of fractures. Hence, determination of mandibular bone density is of paramount importance for the detection of this silent disease. Aims and Objectives: The purpose of this study was to evaluate the influences of gender and age on the radiomorphometric indices and to assess the differences in the various indices, if any, between digital and analog radiographs. Materials and methods: Two hundred and fifty six panoramic radiographs (128 digital and 128 analog) were obtained and they were grouped into 8 age groups which were between 21 to 60 years with 5 year intervals between them, with equal sex distributions. The mandibular cortical index (MCI), mental index (MI) and panoramic mandibular index (PMI) were analyzed. Results: C2 and C3 categories of MCI increased as age advanced in females. MI showed a significant difference in genders and MI Values decreased from younger to older females. PMI (p<0.05) was significant for both the genders. Conclusion: This study showed that MCI, MI and PMI indices were useful for identifying patients with low skeletal bone mineral densities (BMD) or osteoporosis and that digital panoramic radiographs were better than analog radiographs for measuring the indices.


Viral P.M.,RajaRajeswari Dental College and Hospital
Journal of Clinical Pediatric Dentistry | Year: 2013

Objectives : To evaluate and compare the efficiency, marginal leakage and shear bond strength of Carisolv and Papacarie in primary molars. Method: Freshly extracted 60 human carious primary molars were randomly divided into two experimental groups - Group I [ caries removal by Carisolv ] and Group II [ caries removal by Papacarie ]. The amount of time taken for complete caries removal was recorded using a stopwatch. After bonded restorations, both the experimental groups were further randomly subdivided into four experimental groups and subjected to marginal leakage and shear bond strength evaluation. Results : Papacarie [ 337.67 ± 18.13 ] was clinically more efficient than Carisolv [461.33 ± 27.76 ] in removing caries with respect to time in seconds. 66.7% of teeth treated with Carisolv did not show any marginal leakage as compared to 20% with Papacarie. The mean [ ± SD ] shear bond strength of Carisolv [ 9.67 ± 3.80 ] treated teeth was slightly more when compared to Papacarie [ 8.36 ± 4.51]. Conclusion :Papacarie was clinically more efficient in caries removal but showed significantly more marginal leakage than Carisolv.


Rohit S.,Rajarajeswari Dental College and Hospital | Praveen R.B.,Hitkarini Dental College and Hospital
Journal of Clinical and Diagnostic Research | Year: 2014

Introduction: Surgical extraction of mandibular third molar is the most frequently performed procedure in oral surgery. This procedure is associated with significant postoperative sequelae such as trismus, swelling, pain and infection. The need of antibiotic therapy during the removal of mandibular third molar has been a contentious issue. Method: This study investigated a regimen by using amoxycillin and metronidazole in one group and without using antibiotics in the other. Both the groups were assessed postoperatively on the 1st, 2nd, 5th, 7th and 10th days by the same observer for post operative mouth opening (interincisal distance), presence of a purulent discharge at the site of surgery, pain and swelling. Result: Overall, no statistically significant difference was seen between both the treatment groups when interincisal distance, pain, swelling and purulent discharge were considered. Conclusion: The results of this study failed to show any advantage which was associated with the routine postoperative use of antibiotics in asymptomatic third molar surgeries.


Vinaya Kumar R.,Rajarajeswari Dental College and Hospital | Shubhashini N.,Rajarajeswari Dental College and Hospital
Cell and Tissue Banking | Year: 2013

Among the great challenges facing clinical research is the development of bioactive surgical additives regulating inflammation and increasing healing. Although the use of fibrin adhesives and platelet-rich plasma (PRP) is well documented, they have their own limitations. Hence, reconstructive dental surgeons are looking for an "edge" that jump starts the healing process to maximize predictability as well as the volume of regenerated bone. Overcoming the restrictions related to the reimplantation of blood-derived products, a new family of platelet concentrate, which is neither a fibrin glue nor a classical platelet concentrate, was developed in France. This second generation platelet concentrate called platelet-rich fibrin (PRF), has been widely used to accelerate soft and hard tissue healing. Its advantages over the better known PRP include ease of preparation/application, minimal expense, and lack of biochemical modification (no bovine thrombin or anticoagulant is required). This article serves as an introduction to the PRF "concept" and its potential clinical applications with emphasis on periodontal regeneration. © 2012 Springer Science+Business Media Dordrecht.


Tulsani S.G.,Rajarajeswari Dental College and Hospital | Chikkanarasaiah N.,Rajarajeswari Dental College and Hospital | Bethur S.,Rajarajeswari Dental College and Hospital
Journal of Clinical Pediatric Dentistry | Year: 2014

Objectives: Biopure MTAD™, a new root canal irrigant has shown promising results against the most common resistant microorganism, E. Faecalis, in permanent teeth. However, there is lack of studies comparing its antimicrobial effectiveness with NaOCl in primary teeth. The purpose of this study was to compare the in vivo antimicrobial efficacy of NaOCl 2.5% and Biopure MTAD™ against E. Faecalis in primary teeth. Study design: Forty non vital single rooted primary maxillary anterior teeth of children aged 4-8 years, were irrigated either with NaOCl 2.5% (n=15), Biopure MTAD™(n=15) and 0.9% Saline (n=10, control group). Paper point samples were collected at baseline (S1) and after chemomechanical preparation (S2) during the pulpectomy procedure. The presence of E. Faecalis in S1 & S2 was evaluated using Real time Polymerase Chain Reaction. Results: Statistical significant difference was found in the antimicrobial efficacy of NaOCl 2.5% and BioPure MTAD™ when compared to saline (p<0.05). However, no statistical significant difference was found between the efficacies of both the irrigants. Conclusions: NaOCl 2.5% and BioPure MTAD™, both irrigants are equally efficient against E. Faecalis in necrotic primary anterior teeth. MTAD is a promising irrigant, however clinical studies are required to establish it as ideal root canal irrigant in clinical practice.

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