Unusual objects in the root canal of deciduous teeth: a report of two cases

Accidental foreign body ingestion or aspiration is a common problem in children. Children often have a habit of inserting objects into their mouth. Some of these objects can be accidentally ingested or even aspirated which can be frightening and a stressful experience. But the presence of foreign objects in the teeth are rare. The foreign objects in the teeth may act as a potential source of infection and pain. In most of the cases, children avoid informing their parents due to fear of punishment. This paper presents two cases of foreign objects embedded in the deciduous teeth. In both the cases, parents were not aware of foreign body ingestion by their children.     

Assessment of changing patterns of Le fort fracture lines using computed tomography scan: an observational study

Objectives. To assess the changing mid-face fracture patterns using a computed tomography scan. Methodology: Fifty patients with mid-face trauma requiring open reduction and fixation were studied using 1.6 mm axial, sagittal, coronal and 3D images. Images were evaluated clinically, intra-operatively and finally were compared with standard Le Fort lines. Results. The male population dominated the female at a ratio of 11.5:1. The majority of the mid-face fractures were seen in the age group of 21–30 years. Road traffic accident (78%) was the major etiological factor followed by work-related accidents (12%) and assaults (10%). The CT scan analysis included categorizing the patients into three groups: (1) Fracture patterns resembling Le Fort lines (24%); (2) Fracture patterns partially resembling Le Fort lines (56%); and (3) Fracture patterns that do not resemble Le Fort lines (20%). Conclusion. With the change in the velocity of wounding object, there is a change in the mid-face fracture patterns. The majority of the cases present as a variant of classical Le Fort fractures. Computed tomography is a valuable diagnostic tool in assessing the fractures of the mid-face. 2D images are more sensitive than 3D images. However, both the images are required in delivery of an optimal treatment plan.     

Evaluation of Efficacy of Microwave Irradiation in Disinfecting Dental Gypsum Casts: An Ex Vivo Study

The aim of this study is to assess the efficacy of microwave irradiation in disinfecting gypsum casts and also to compare its efficacy with validated method of chemical disinfection. The present study is an ex vivo study conducted on a sample of five irreversible hydrocolloid impressions in vitro and on ten patients gypsum casts in vivo following standard impression techniques to check the efficacy of microwave oven irradiation and compare its efficacy with standard chemical method of disinfection. Results were analysed using Mann–Whitney test and Wilcoxon signed rank test. Untreated gypsum casts showed cfu/ml counts with a median log value of 6, while microwave-irradiated ones had median cfu/ml counts of 0. Casts poured from chemically disinfected impressions demonstrated cfu/ml counts with a median log value of 5. Microwave irradiation was found to be effective in disinfecting gypsum casts when compared to chemical disinfectant in disinfecting dental impressions.     

The Evaluation of Efficacy of Post-Operative Antibiotics in the Open Reduction of the Zygomatic and Mandibular Fracture: A Prospective Trial

Introduction

The administration of pre and post-operative antibiotics for open reduction and internal fixation of facial fracture is the usual norm followed. Although the benefit of antibiotic has been established in the literature, the value of post-operative administration has been questioned and yet not extensively studied or investigated. There are rising concerns over the duration and undesired effects of antibiotics. The purpose of the study was to evaluate necessity and/or efficacy of post-operative antibiotics in the open reduction of zygomatic and mandibular fracture.

Methods

Sixty patients who underwent open reduction and internal fixation were divided into two groups for the trial. Ab group (30 patients) received pre, intra and post-operative antibiotics. Non-Ab group (30 patients) did not receive post-operative antibiotics though pre and intra-operative antibiotics were administered. Patients were evaluated for post-op infection at the end of 1st and 3rd week after operation.

Results

Among 60 patients, 2 patients (1 from Ab group and 1 from non-Ab group) were infected; so statistically no significant difference in result was obtained (Fisher’s exact test, P value = 1).

Conclusion

In this trial, the use of post-operative antibiotics in the open reduction and internal fixation of facial fracture was shown to confer no benefit/efficacy in reducing the chances of infection.     

Bone Loss During Revision of Unicompartmental to Total Knee Arthroplasty : An Analysis of Implanted Polyethylene Thickness From the National Joint Registry Data

Using the National Joint Registry (UK) database, we compared the thickness of polyethylene (PE) and the level of constraint used during primary total knee arthroplasty (TKA) versus the revision of unicondylar knee arthroplasty (UKA) to TKA. A total of 251,803 TKA procedures and 374 revision UKA–TKA procedures between 2003 and 2009 were reviewed. The commonest PE size used in TKA was 10 mm, compared to 12.79 mm in the revision group. The use of constrained knee implant was required in 2.15% of primary TKA and 4.19% of UKA to TKA revisions. The revision of UKA to TKA is a more complex procedure compared to primary TKA, with a higher incidence of using constrained implants and thicker PE inserts. These findings may be useful for surgeons in their decision making.     

Successful Fixation of an Intertrochanteric Fracture After Hip Resurfacing Arthroplasty Using Cannulated Screws

We report a case of successful treatment of a high, stable intertrochanteric fracture (type 1) in a 59-year-old man. He sustained the injury 8 years after the resurfacing procedure. The fracture was fixed using three 6.5-mm cannulated screws, and he has returned to his normal level of activities 8 months after the fixation. We have shown that fixation with cannulated screws may be an acceptable option for treatment of high trochanteric fractures where a stable anatomical reduction can be obtained. We have also included a review of the literature for other reported surgical treatment options of this complication.