-
Journal of Family Medicine and Primary... May 2024(body constitution) is the essential fundamental of Ayurveda. In female physiology, it plays a crucial role in determining the age of menarche and menopause. Recent...
INTRODUCTION
(body constitution) is the essential fundamental of Ayurveda. In female physiology, it plays a crucial role in determining the age of menarche and menopause. Recent research has shown that early menopause occurs in tribal women. Vagbhata states that a female has a longer menstrual life [i.e., reproductive period] compared to the and females. This study was done to estimate in females who attain early and premature menopause in the tribal population to provide optimal care for tribal women through primary and whole health systems.
MATERIALS AND METHODS
This cross-sectional questionnaire survey study was carried out in four villages of Nagpur district territory of Eastern Maharashtra, the central zone of India after seeking permission from IEC. A multistage sampling technique was used to select the 80%, and above tribal people, 169 married women who attained early or premature menopause were included. Post-menopausal women were selected for the study, and females with hysterectomy, secondary amenorrhea, and other major illnesses were excluded from the study. Data were collected by survey method with the help of a pre-validated questionnaire.
OBSERVATION AND RESULT
Out of 169 females 57.98% of females were of , 24.85% of females were of , and 17.15% of females were of . The prevalence of early or premature menopause of females is 57.98.
DISCUSSION
characteristics such as , , , and in females lead to early or premature menopause. To avoid early or premature menopause in tribal females, ghee (ghrit) and milk can be included in dietary habits, lifestyle modification, and awareness counseling may prove beneficial.
CONCLUSION
Early or premature menopause is observed largely in females of Nagpur district, Eastern Maharashtra, tribal zone of Central Inda.
PubMed: 38948555
DOI: 10.4103/jfmpc.jfmpc_376_23 -
Bioactive Materials Oct 2024Composite biomaterials comprising polylactide (PLA) and hydroxyapatite (HA) are applied in bone, cartilage and dental regenerative medicine, where HA confers...
Composite biomaterials comprising polylactide (PLA) and hydroxyapatite (HA) are applied in bone, cartilage and dental regenerative medicine, where HA confers osteoconductive properties. However, after surgical implantation, adverse immune responses to these composites can occur, which have been attributed to size and morphology of HA particles. Approaches to effectively modulate these adverse immune responses have not been described. PLA degradation products have been shown to alter immune cell metabolism (immunometabolism), which drives the inflammatory response. Accordingly, to modulate the inflammatory response to composite biomaterials, inhibitors were incorporated into composites comprised of amorphous PLA (aPLA) and HA (aPLA + HA) to regulate glycolytic flux. Inhibition at specific steps in glycolysis reduced proinflammatory (CD86CD206) and increased pro-regenerative (CD206) immune cell populations around implanted aPLA + HA. Notably, neutrophil and dendritic cell (DC) numbers along with proinflammatory monocyte and macrophage populations were decreased, and Arginase 1 expression among DCs was increased. Targeting immunometabolism to control the proinflammatory response to biomaterial composites, thereby creating a pro-regenerative microenvironment, is a significant advance in tissue engineering where immunomodulation enhances osseointegration and angiogenesis, which could lead to improved bone regeneration.
PubMed: 38948254
DOI: 10.1016/j.bioactmat.2024.05.046 -
Imaging Science in Dentistry Jun 2024The aim of this study was to evaluate image artifacts in the vicinity of dental implants in cone-beam computed tomography (CBCT) scans obtained with different spatial...
Impact of the spatial orientation of the patient's head, metal artifact reduction, and tube current on cone-beam computed tomography artifact expression adjacent to a dental implant: A laboratory study using a simulated surgical guide.
PURPOSE
The aim of this study was to evaluate image artifacts in the vicinity of dental implants in cone-beam computed tomography (CBCT) scans obtained with different spatial orientations, tube current levels, and metal artifact reduction algorithm (MAR) conditions.
MATERIALS AND METHODS
One dental implant and 2 tubes filled with a radiopaque solution were placed in the posterior region of a mandible using a surgical guide to ensure parallel alignment. CBCT scans were acquired with the mandible in 2 spatial orientations in relation to the X-ray projection plane (standard and modified) at 3 tube current levels: 5, 8, and 11 mA. CBCT scans were repeated without the implant and were reconstructed with and without MAR. The mean voxel and noise values of each tube were obtained and compared using multi-way analysis of variance and the Tukey test (α=0.05).
RESULTS
Mean voxel values were significantly higher and noise values were significantly lower in the modified orientation than in the standard orientation (<0.05). MAR activation and tube current levels did not show significant differences in most cases of the modified spatial orientation and in the absence of the dental implant (>0.05).
CONCLUSION
Modifying the spatial orientation of the head increased brightness and reduced spatial orientation noise in adjacent regions of a dental implant, with no influence from the tube current level and MAR.
PubMed: 38948193
DOI: 10.5624/isd.20240016 -
Imaging Science in Dentistry Jun 2024Patients with head and neck cancer (HNC) who undergo dental procedures during radiotherapy (RT) face an increased risk of developing osteoradionecrosis (ORN)....
PURPOSE
Patients with head and neck cancer (HNC) who undergo dental procedures during radiotherapy (RT) face an increased risk of developing osteoradionecrosis (ORN). Accordingly, new tools must be developed to extract critical information regarding the dose delivered to the teeth and mandible. This article proposes a novel approach for visualizing 3-dimensional planned dose distributions on panoramic reconstruction computed tomography (pCT) images.
MATERIALS AND METHODS
Four patients with HNC who underwent volumetric modulated arc therapy were included. One patient experienced ORN and required the extraction of teeth after RT. In the study approach, the dental arch curve (DAC) was defined using an open-source platform. Subsequently, pCT images and dose distributions were generated based on the new coordinate system. All teeth and mandibles were delineated on both the original CT and pCT images. To evaluate the consistency of dose metrics, the Mann-Whitney test and Student -test were employed.
RESULTS
A total of 61 teeth and 4 mandibles were evaluated. The correlation coefficient between the 2 methods was 0.999, and no statistically significant difference was observed (>0.05). This method facilitated a straightforward and intuitive understanding of the delivered dose. In 1 patient, ORN corresponded to the region of the root and the gum receiving a high dosage (approximately 70 Gy).
CONCLUSION
The proposed method particularly benefits dentists involved in the management of patients with HNC. It enables the visualization of a 3-dimensional dose distribution in the teeth and mandible on pCT, enhancing the understanding of the dose delivered during RT.
PubMed: 38948189
DOI: 10.5624/isd.20230230 -
Imaging Science in Dentistry Jun 2024The aim of this study was to evaluate the influence of different cone-beam computed tomography (CBCT) acquisition protocols on reducing the effective radiation dose...
PURPOSE
The aim of this study was to evaluate the influence of different cone-beam computed tomography (CBCT) acquisition protocols on reducing the effective radiation dose while maintaining image quality.
MATERIALS AND METHODS
The effective dose emitted by a CBCT device was calculated using thermoluminescent dosimeters placed in a Rando Alderson phantom. Image quality was assessed by 3 experienced evaluators. The relationship between image quality and confidence was evaluated using the Fisher exact test, and the agreement among raters was assessed using the kappa test. Multiple linear regression analysis was performed to investigate whether the technical parameters could predict the effective dose. -values<0.05 were considered to indicate statistical significance.
RESULTS
The optimized protocol (3 mA, 99 kVp, and 450 projection images) demonstrated good image quality and a lower effective dose for radiation-sensitive organs. Image quality and confidence had consistent values for all structures (<0.05). Multiple linear regression analysis resulted in a statistically significant model. The milliamperage (b=0.504; t=3.406; =0.027), kilovoltage peak (b=0.589; t=3.979; =0.016) and number of projection images (b=0.557; t=3.762; =0.020) were predictors of the effective dose.
CONCLUSION
Optimized CBCT acquisition protocols can significantly reduce the effective radiation dose while maintaining acceptable image quality by adjusting the milliamperage and projection images.
PubMed: 38948188
DOI: 10.5624/isd.20230251 -
Imaging Science in Dentistry Jun 2024This study was conducted to identify the typical sites and patterns of peri-implant bone defects on cone-beam computed tomography (CBCT) images, as well as to evaluate...
PURPOSE
This study was conducted to identify the typical sites and patterns of peri-implant bone defects on cone-beam computed tomography (CBCT) images, as well as to evaluate the detectability of the identified bone defects on panoramic images.
MATERIALS AND METHODS
The study population included 114 patients with a total of 367 implant fixtures. CBCT images were used to assess the presence or absence of bone defects around each implant fixture at the mesial, distal, buccal, and lingual sites. Based on the number of defect sites, the presentations of the peri-implant bone defects were categorized into 3 patterns: 1 site, 2 or 3 sites, and circumferential bone defects. Two observers independently evaluated the presence or absence of bone defects on panoramic images. The bone defect detection rate on these images was evaluated using receiver operating characteristic analysis.
RESULTS
Of the 367 implants studied, 167 (45.5%) had at least 1 site with a confirmed bone defect. The most common type of defect was circumferential, affecting 107 of the 167 implants (64.1%). Implants were most frequently placed in the mandibular molar region. The prevalence of bone defects was greatest in the maxillary premolar and mandibular molar regions. The highest kappa value was associated with the mandibular premolar region.
CONCLUSION
The typical bone defect pattern observed was a circumferential defect surrounding the implant. The detection rate was generally higher in the molar region than in the anterior region. However, the capacity to detect partial bone defects using panoramic imaging was determined to be poor.
PubMed: 38948187
DOI: 10.5624/isd.20230258 -
Imaging Science in Dentistry Jun 2024The aim of this study was to explore the correlations of cone-beam computed tomographic findings with the apnea-hypopnea index in patients with obstructive sleep apnea.
PURPOSE
The aim of this study was to explore the correlations of cone-beam computed tomographic findings with the apnea-hypopnea index in patients with obstructive sleep apnea.
MATERIALS AND METHODS
Forty patients with obstructive sleep apnea were selected from the ear-nose-throat (ENT) outpatient clinic, Faculty of Medicine, Mansoura University. Cone-beam computed tomography was performed for each patient at the end of both inspiration and expiration. Polysomnography was carried out, and the apnea-hypopnea index was obtained. Linear measurements, including cross-sectional area and the SNA and SNB angles, were obtained. Four oral and maxillofacial radiologists categorized pharyngeal and retropalatal airway morphology and calculated the airway length and volume. Continuous data were tested for normality using the Kolmogorov-Smirnov test and reported as the mean and standard deviation or as the median and range. Categorical data were presented as numbers and percentages, and the significance level was set at <0.05.
RESULTS
The minimal value of the cross-sectional area, SNB angle, and airway morphology at the end of inspiration demonstrated a statistically significant association (<0.05) with the apnea-hypopnea index, with excellent agreement. No statistically significant difference was found in the airway volume, other linear measurements, or retropalatal airway morphology.
CONCLUSION
Cone-beam computed tomographic measurements in obstructive sleep apnea patients may be used as a supplement to a novel radiographic classification corresponding to the established clinical apnea-hypopnea index classification.
PubMed: 38948186
DOI: 10.5624/isd.20230249 -
Imaging Science in Dentistry Jun 2024This study examined the influence of a metal artifact reduction (MAR) tool, sharpening filters, and their combination on the diagnosis of vertical root fracture (VRF) in...
PURPOSE
This study examined the influence of a metal artifact reduction (MAR) tool, sharpening filters, and their combination on the diagnosis of vertical root fracture (VRF) in teeth with metallic posts using cone-beam computed tomography (CBCT).
MATERIALS AND METHODS
Twenty single-rooted human premolars - 9 with VRF and 11 without - were individually placed in a human mandible. A metallic post composed of a cobalt-chromium alloy was inserted into the root canal of each tooth. CBCT scans were then acquired under the following parameters: 8 mA, a 5×5 cm field of view, a voxel size of 0.085 mm, 90 kVp, and with MAR either enabled or disabled. Five oral and maxillofacial radiologists independently evaluated the CBCT exams under each MAR mode and across 3 sharpening filter conditions: no filter, Sharpen 1×, and Sharpen 2×. The diagnostic performance was quantified by the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. These metrics were compared using 2-way analysis of variance with a significance level of α=5%. Intra- and inter-examiner agreement were assessed using the weighted kappa test.
RESULTS
Neither MAR nor the application of sharpening filters significantly impacted AUC or specificity (>0.05). However, sensitivity increased when MAR was combined with Sharpen 1× and Sharpen 2× (=0.015). The intra-examiner agreement ranged from fair to substantial (0.34-0.66), while the inter-examiner agreement ranged from fair to moderate (0.27-0.41).
CONCLUSION
MAR in conjunction with sharpening filters improved VRF detection; therefore, their combined use is recommended in cases of suspected VRF.
PubMed: 38948185
DOI: 10.5624/isd.20230233 -
Imaging Science in Dentistry Jun 2024Preoperative identification of the intraosseous posterior superior alveolar artery (PSAA) is critical when planning sinus surgery. This study was conducted to determine...
PURPOSE
Preoperative identification of the intraosseous posterior superior alveolar artery (PSAA) is critical when planning sinus surgery. This study was conducted to determine the distance between the cementoenamel junction and the PSAA, as well as to identify factors influencing the detection of the PSAA on cone-beam computed tomography (CBCT).
MATERIALS AND METHODS
In total, 254 CBCT scans of maxillary sinuses, acquired with 2 different scanners, were examined to identify the PSAA. The distance from the cementoenamel junction (CEJ) to the PSAA was recorded at each maxillary posterior tooth position. Binomial logistic regression and multiple linear regression were employed to evaluate the effects of scanner type, CBCT parameters, sex, and age on PSAA detection and CEJ-PSAA distance, respectively. -values less than 0.05 were considered to indicate statistical significance.
RESULTS
The mean CEJ-PSAA distances at the second molar, first molar, second premolar, and first premolar positions were 17.0±4.0 mm, 21.8±4.1 mm, 19.5±4.7 mm, and 19.9±4.9 mm for scanner 1, respectively, and 17.3±3.5 mm, 16.9±4.3 mm, 18.5±4.1 mm, and 18.4±4.3 mm for scanner 2. No independent variable significantly influenced PSAA detection. However, tooth position (b=-0.67, <0.05) and scanner type (b=-1.3, <0.05) were significant predictors of CEJ-PSAA distance.
CONCLUSION
CBCT-based estimates of CEJ-PSAA distance were comparable to those obtained in previous studies involving cadavers, CT, and CBCT. The type of CBCT scanner may slightly influence this measurement. No independent variable significantly impacted PSAA detection.
PubMed: 38948184
DOI: 10.5624/isd.20230160 -
Frontiers in Oral Health 2024To determine which components in a new restorative material (Renewal MI) improve its ability to form resin tags within demineralized dentine.
OBJECTIVES
To determine which components in a new restorative material (Renewal MI) improve its ability to form resin tags within demineralized dentine.
METHODS
Varied components included polylysine (PLS), monocalcium phosphate (MCP), powder to liquid ratio (PLR), 4-methacryloyloxyethyl trimellitate anhydride (4META), and polypropylene glycol dimethacrylate (PPGDMA). Urethane dimethacrylate (UDMA), containing PPGDMA (24 wt%) and 4META (3 wt%), was mixed with glass filler with MCP (8 wt%) and PLS (5 wt%). PLR was 3:1 or 5:1. Reducing MCP and/or PLS to 4 and 2 wt% respectively or fully removing MCP, PLS, 4META or PPGDMA gave 16 formulations in total. Renewal MI, Z250 (with or without Scotchbond Universal adhesive) and Activa were used as commercial comparators. Collagen discs were obtained by totally demineralizing 2 mm thick, human, premolar, coronal dentine discs by immersion in formic acid (4M) for 48 h. The restorative materials were then applied on top ( = 3), before dissolving the collagen in sodium hypochlorite (15%). SEM/EDX was employed to determine resin tags length, composition, and surface coverage.
RESULTS
Tags were >400, 20 and 200 µm and covered 62, 55 and 39% of the adhesion interface for Renewal MI, Scotchbond and Activa, respectively. With experimental formulations, they were 200 and >400 µm long with high vs. low PLR and composed primarily of polymerized monomers. Percentages of the adhesion interface covered varied between 35 and 84%. Reducing PLS or MCP caused a decline in coverage that was linear with their concentrations. Reducing MCP had lesser effect when PLS or PLR were low. Removal of 4META caused a greater reduction in coverage than PPGDMA removal.
CONCLUSION
PLS, MCP, 4META, PPGDMA and low PLR together enhance Renewal MI tags formation in, and thereby sealing of, demineralized dentine.
PubMed: 38948090
DOI: 10.3389/froh.2024.1420541