Publications by authors named "Anupama Ramachandran"

21 Publications

  • Page 1 of 1

Basic Principles AI Simplified For A Medical Practitioner: Pearls And Pitfalls In Evaluating AI Algorithms.

Curr Probl Diagn Radiol 2022 Apr 22. Epub 2022 Apr 22.

Indian Institute of Technology, New Delhi, India.

With the rapid integration of artificial intelligence into medical practice, there has been an exponential increase in the number of scientific papers and industry players offering models designed for various tasks. Understanding these, however, is difficult for a radiologist in practice, given the core mathematical principles and complicated terminology involved. This review aims to elucidate the core mathematical concepts of both machine learning and deep learning models, explaining the various steps and common terminology in common layman language. Thus, by the end of this article, the reader should be able to understand the basics of how prediction models are built and trained, including challenges faced and how to avoid them. The reader would also be equipped to adequately evaluate various models, and take a decision on whether a model is likely to perform adequately in the real-world setting.
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http://dx.doi.org/10.1067/j.cpradiol.2022.04.003DOI Listing
April 2022

An Interdisciplinary Management of Avulsed Maxillary Incisors: A Case Report.

Cureus 2022 Apr 6;14(4):e23891. Epub 2022 Apr 6.

Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND.

The current case report presents a case of a road traffic accident comprising dental avulsion of maxillary incisors. A 30-year-old male reported missing teeth following trauma in his upper front tooth region. The avulsion of maxillary right central and lateral incisors along with laceration in upper and lower lips was evident. The avulsed teeth were stored in milk after a brief extra-oral dry time of one hour and were carried to the department with a one-hour delay. After clinical and radiographic investigations, no mobility or fractures were apparently noticed. The avulsed 11 and 12 had closed apices with intact crown and root surfaces. Following an extra-oral endodontic therapy, immediate replantation was scheduled. Subsequently, the alveolar sockets were irrigated with saline to dislodge the clot and any gross debris that was present. Teeth were reimplanted into the socket after placement of PRF membrane around the root surface. A semi-rigid wire and composite splinting were done for a span of two weeks and antibiotics were prescribed. An exploratory CBCT taken revealed a cortical bone loss in the buccal region of 12 and 11. An interdisciplinary approach to regenerate the osseous defect was then carried out. A follow-up of two weeks, four weeks, three months, six months, and a year was done. Evaluation performed after a year revealed the absence of clinical symptoms and satisfactory healing with no signs of resorption radiographically.
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http://dx.doi.org/10.7759/cureus.23891DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9075823PMC
April 2022

Finishing and Polishing of Composite Restoration: Assessment of Knowledge, Attitude and Practice Among Various Dental Professionals in India.

Cureus 2022 Jan 3;14(1):e20887. Epub 2022 Jan 3.

Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND.

Aim The key to the success of a composite restoration lies in the important final step of finishing and polishing. This survey aims to assess the knowledge, attitude, and practice about finishing and polishing in composite restoration among various dental professionals in India. Materials and methods A cross-sectional questionnaire survey was conducted among various dental professionals in India. The participation of dentists was voluntary. A total of 350 responses were received, and the data were converted to Microsoft Excel 2019 program and descriptive statistics were analyzed using SPSS Version 21.0 software. Results Almost 99% of respondents know the importance of finishing and polishing procedures of composite restoration. Overall, 71% of respondents felt it is necessary to remove the surface layer to improve the surface characteristics of the composite restoration, 59.8% of professionals follow the sequential order of abrasives for finishing and polishing of composites, 74.2% use interproximal strips to finish interproximal areas of restoration, and 55.8% of professionals use polishing paste for the final polishing of composite restoration. Only 44.2% are aware of liquid polish/composite glaze, among which 12.4% of practitioners use liquid polish often. Conclusion Most of the respondents were aware of the benefits of proper finishing and polishing of composite restorations. However, still they need to follow proper sequential series of burs, abrasive points, disks, strips, and polishing pastes. The usage of surface sealants should be emphasized for enhanced results.
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http://dx.doi.org/10.7759/cureus.20887DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8808663PMC
January 2022

An Immature Traumatic Teeth Management With Apical Pathology Using the Novel Biodentine™ Obturation: A Case Report.

Cureus 2021 Dec 29;13(12):e20818. Epub 2021 Dec 29.

Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Chennai, IND.

Pulpal and periapical pathosis in an immature anterior tooth following traumatic injury is a frequent occurrence, and management of open apices in such cases poses a constant challenge to endodontists. This is due to the absence of apical constriction that would result in poor three-dimensional seal/adaptation of the obturated material within the canal system. Treatment of immature pulpless teeth with long-term calcium hydroxide may consequently weaken the dentin and increase the fracture susceptibility. Obturating the root canals completely with bioactive agents like Biodentine/mineral trioxide aggregate (MTA) has benefits like increased fracture resistance when compared to apexification. When used for obturation, Biodentine™, a new calcium silicate-based cement, performs superior to other Portland cement derivatives. This case report demonstrates a six-month follow-up result of an open apex and a periapical lesion involving maxillary right central incisor #11 with the Biodentine obturation that was previously subjected to triple antibiotic paste as an intra-canal medicament for three weeks. The satisfactory healing rate of tooth 11 with the reduction in the size of periapical radiolucency at the end of the six-month follow-up in this current article is highly considerable.
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http://dx.doi.org/10.7759/cureus.20818DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8799935PMC
December 2021

Neurotic personality trait as a predictor in the prognosis of composite restorations: A 24-month clinical follow up study.

Sci Rep 2021 08 25;11(1):17179. Epub 2021 Aug 25.

Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, Jabriya, Kuwait.

The role of personality traits in modulating the incidence and progression of medical disease conditions are well documented, however, there is a paucity of information for its effects on dental health conditions and specifically on the prognosis of restorative dental materials. This study aims to evaluate the clinical performance of Micro-hybrid and Nano-ceramic composite restorations among patients with different personality traits. A total of 323 patients, indicated to receive operative treatment at a University Dental College Hospital, were invited to participate in this study. Consenting patients were requested to complete the Big Five Inventory (BFI-44 Item) personality questionnaire and were evaluated by a psychiatrist for categorizing the participants based on their personality traits. Out of the recruited patients, 124 patients falling in to the dominant trait of Agreeableness (n = 62) and Neuroticism (n = 62) were included in the study for further investigation. Next, patients from the Agreeableness (Group A) and the Neuroticism personality trait group (Group N) were randomly divided into two subgroups each-sub group Am (n = 44) and Nm (n = 48) for Micro-hybrid composite restorations and Sub group An (n = 42) and Nn (n = 47) for Nano-ceramic composite restorations. Two trained and calibrated dentists prepared the cavities according to previously published methodology. The restorations were evaluated at baseline (immediately after restoration), 6-months, 12-months and 24-months intervals by two blinded independent dental professionals for anatomical form, secondary caries, color match, retention, marginal adaptation, surface texture, marginal discoloration and post-operative sensitivity. There is no statistically significant difference noted in various parameters of restoration performance between Micro-hybrid composite and Nano-ceramic composite compared among 'agreeableness' personality group and among 'neuroticism' personality group after controlling the personality trait factor. Higher 'Neuroticism' individuals had higher restoration deterioration in color matching and surface texture when compared to higher 'Agreeableness' trait individuals. Regression analysis showed no effect of gender or cavity size on the outcome of results. Assessment of personality traits may serve as a useful tool during treatment planning which would aid clinicians in choosing suitable restorative dental material and prosthesis design according to individual patient's physiological and functional needs, thereby overall improving the quality of treatment provided.
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http://dx.doi.org/10.1038/s41598-021-96229-3DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8387411PMC
August 2021

Pattern of Traumatic Dental Injuries Among Adults.

Open Access Emerg Med 2021 21;13:201-206. Epub 2021 May 21.

Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, Safat, Kuwait.

Background: The etiology, presentation and management of traumatic dental injuries (TDIs) vary significantly between the adult and the younger population. Most epidemiological studies on TDIs have focused on the pediatric age group. This study aims to report and compare the distributions of TDIs among adults in a sub-population in India.

Methods: This prospective observational study was performed on 1562 consecutively selected patients (1218 males and 344 females) from a university dental hospital in India, between July 2014 and June 2018. The clinical examinations were performed by a single trained and calibrated endodontist. Only TDIs to anterior teeth were recorded (canine to canine in the maxilla and mandible) and classified using a modified version of the World Health Organization's (WHO's) classification. Periapical and panoramic radiographs were taken for all the subjects.

Results: A total of 1562 patients aged between 20 and 73 years, with a mean age of 36 years, were examined during the study period. The total number of teeth with TDIs was 3044. Males (78%) clearly outnumbered the females (22%) in all the age groups. The most common type of injury occurring in both the genders is uncomplicated crown fractures (male=31.0% and female=36.6%). Avulsion injuries are more likely to be seen by a dentist within 1 hour post-trauma. About two-third of the TDIs were caused by road traffic accidents (RTAs) followed by falls in about 20% of the patients.

Conclusion: Uncomplicated crown fracture was the most commonly observed type of TDI, and RTAs were the primary cause of TDI.
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http://dx.doi.org/10.2147/OAEM.S311113DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8149273PMC
May 2021

Comparative evaluation of pulp tissue dissolution ability of sodium hypochlorite by various activation techniques: An study.

J Conserv Dent 2020 May-Jun;23(3):304-308. Epub 2020 Dec 4.

Department of Conservative Dentistry and Endodontics, Chettinad Dental College and Research Institute, Kanchipuram, Tamil Nadu, India.

Background: The success in endodontic therapy is dependent largely on the absolute elimination of pulp tissue remnants and the maximum reduction of pathologic microbial load present within the root canal system.

Aim: The aim of this study was to compare and evaluate the ability of pulp tissue dissolution with and without activation of 5.25% sodium hypochlorite (NaOCl).

Materials And Methods: Pulp tissue samples collected from intact, noncarious extracted third molars were standardized to 8 mg in each group. These samples were placed in conical Eppendorf tubes of 15 ml with 10 ml 5.25% NaOCl for 4 min and were activated suitably according to the group specifications. All the procedures in this study were carried out at room temperature. The preweighed pulp tissue samples were further weighed again after the dissolution phase, and residual weight loss in each group along with its percentage was obtained. The results were then statistically analyzed using one-way analysis of variance and Tukey test.

Results: The maximum amount of pulp tissue dissolution was found in the laser-assisted irrigation group, i.e., NaOCl with Er, Cr: YSGG ( < 0.05) and showed a statistically significant result in comparison with other groups.

Conclusion: Within the limitations of the study, laser-assisted irrigation with a radial firing tip (NaOCl activated by Er, Cr: YSGG) was the most effective in dissolving the pulp tissue in comparison with other groups. The ultrasonic activation also showed a considerable amount of pulp tissue dissolution comparable to laser-activated irrigation in this study.
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http://dx.doi.org/10.4103/JCD.JCD_425_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7861078PMC
December 2020

Influence of personality traits on the intensity of maximum voluntary bite force in adults.

Indian J Dent Res 2020 Sep-Oct;31(5):706-711

Department of Conservative Dentistry and Endodontics, Ragas Dental College and Hospital, Uthandi, Tamil Nadu, India.

Purpose: To determine the Maximum voluntary bite force among patients having different personality traits.

Methods: In total, 323 patients were given the big-five inventory (BFI) questionnaire to fill and allotted to the various personality traits. The patients in the Agreeableness (n = 62) and Neuroticism traits (n = 62) were included in the study. They were categorized into groups as Group 1a - Neuroticism male (41 patients) and Group 1b - Neuroticism Female (21 patients) and Group 2a - Agreeableness male (26 patients) and Group 2b - Agreeableness female (36 patients). Highest value of the maximal voluntary bite force (MVBF) was recorded using FlexiForce sensor (B 201) (Tekscan, USA). The statistical data were analyzed by independent t-test (P < 0.05).

Results: The mean bite force values for Neuroticism male was 778.66 N, Agreeableness male was 699 N, Neuroticism female was 686.24 N, and for Agreeableness female was 565.47 N. Statistically significant differences in the bite forces between the male and female groups of both the groups with the males showing significantly higher bite force values in both groups was seen. Also, the bite force in Neuroticism male was significantly higher than Agreeableness male and bite force in Neuroticism female was higher than Agreeableness female.

Conclusion: In this study, the highest bite force was seen in Neuroticism males. Additionally, this study infers that personality has significant influence on the quantum of bite force. Thus, personality assessment of the patient can assist the clinician in planning the appropriate treatment.
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http://dx.doi.org/10.4103/ijdr.IJDR_517_19DOI Listing
January 2021

Influence of Neuroticism on the Prognosis of Nanoceramic and Microhybrid Composite Restoration: A Comparative 1-year Clinical Study.

J Int Soc Prev Community Dent 2020 Sep-Oct;10(5):613-621. Epub 2020 Sep 28.

Department of Restorative and Prosthetic Dental Sciences, College of Dentistry, King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.

Aim: This study aimed to compare the clinical performance of nanoceramic and microhybrid-based composite restorations in adult patients with different personality traits.

Materials And Methods: Patients in accordance with the inclusion and exclusion criteria were asked to complete the BFI (Big Five Inventory) questionnaire. Of a total of 323 patients, 124 (67 males and 57 females) patients were categorized into agreeableness and neuroticism traits and were included in the study. The patients were randomly divided into two subgroups: SG I A ( = 31) and II A ( = 31) for microhybrid composite (Spectrum TPH 3, Dentsply/DeTrey, Konstanz, Germany), SG I B ( = 31) and II B ( = 32) for nanoceramic composite restorations (Ceram X mono, Dentsply/DeTrey, Germany). At baseline, 6 and 12 months, the restorations were evaluated using the Modified USPHS (United States Public Health Service) evaluation criteria. The Pearson chi-square and the Fisher's exact test were used to assess the difference between the personality traits and restorative material groups where a probability value of < 0.05 was considered to be statistically significant.

Result: Most of the restorations scored alfa (A), whereas very few scored bravo (B) in all the subgroups. However, there were no charlie (C) or delta (D) scores. Overall, Spectrum TPH and Ceram x mono displayed superior performances in retention and postoperative sensitivity than all the other clinical parameters. Furthermore, Ceram x mono restorations showed more surface roughness than Spectrum TPH. No statistical differences in the restoration performance were found between both personalities and restorative material types.

Conclusion: Although neuroticism has an effect on various health outcomes, its impact on the clinical performance of composite restorations during the follow-up period was not observed. In addition, there was no difference between the performance of nanohybrid and microhybrid composite.
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http://dx.doi.org/10.4103/jispcd.JISPCD_274_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7685270PMC
September 2020

Gallbladder cancer revisited: the evolving role of a radiologist.

Br J Radiol 2021 Jan 23;94(1117):20200726. Epub 2020 Oct 23.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.

Gallbladder cancer is the most common malignancy of the biliary tract. It is also the most aggressive biliary tumor with the shortest median survival duration. Complete surgical resection, the only potentially curative treatment, can be accomplished only in those patients who are diagnosed at an early stage of the disease. Majority (90%) of the patients present at an advanced stage and the management involves a multidisciplinary approach. The role of imaging in gallbladder cancer cannot be overemphasized. Imaging is crucial not only in detecting, staging, and planning management but also in guiding radiological interventions. This article discusses the role of a radiologist in the diagnosis and management of gallbladder cancer.
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http://dx.doi.org/10.1259/bjr.20200726DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774702PMC
January 2021

Male genital tract tuberculosis: A comprehensive review of imaging findings and differential diagnosis.

Abdom Radiol (NY) 2021 04 12;46(4):1677-1686. Epub 2020 Oct 12.

Department of Radiology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Urogenital tuberculosis is the most common form of extrapulmonary tuberculosis. Genital organ involvement occurs as a continuum of urinary tract tuberculosis and often presents a diagnostic challenge due to the non-specific nature of the symptoms. Delay in diagnosis may lead to complications such as infertility and perineoscrotal sinuses. Imaging plays an important role in raising timely suspicion of tuberculosis. In this article, we describe the imaging findings of male genital tuberculosis and the differential diagnosis. High-resolution ultrasonography (HRUS) is the best modality for assessing the epididymis, testis, scrotum and vas deferens, whereas MRI is optimal for evaluating the prostate, seminal vesicles and ejaculatory ducts. Epididymis is the most common site of genital tuberculosis, and presents as a nodular lesion limited to the tail or as diffuse enlargement. The proximal vas deferens is also frequently involved due to anatomical contiguity and shows diffuse or nodular thickening. Advanced cases may show pyocele formation and scrotal wall sinuses. Testicular involvement is almost always secondary to epididymal tuberculosis and presents as single or multiple nodules, diffuse enlargement, or the 'miliary' pattern. Isolated testicular involvement should raise suspicion of malignancy. Tuberculosis of the prostate is often asymptomatic. The most common imaging manifestations are nodules and the diffuse forms, which may later evolve into abscesses. Fibrosis and calcification occur with healing. Seminal vesicle and ejaculatory duct involvement with fibrosis may cause infertility. Awareness of the imaging findings would enable the radiologist to raise timely suspicion, so that prompt treatment is initiated and complications are prevented.
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http://dx.doi.org/10.1007/s00261-020-02811-0DOI Listing
April 2021

Ultrasound Imaging of Renal Cysts in Children.

J Ultrasound Med 2021 Mar 14;40(3):621-635. Epub 2020 Aug 14.

Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India.

Renal cysts can be focal or diffuse and unilateral or bilateral. In childhood, most renal cysts are due to hereditary diseases rather than simple cysts or acquired cystic diseases, unlike adults. Inherited cystic diseases can be ciliopathies due to a primary ciliary defect (as in polycystic kidney diseases and nephronophthisis). Acquired causes include obstructive cystic dysplasia, dyselectrolytemia, and acquired cysts in renal replacement therapy. The final diagnosis requires a multispecialty approach, including radiology, pathology, and genetics. Imaging is a very important component in treating patients with cystic renal diseases. This article discusses the ultrasound findings of cystic renal diseases in children, along with a brief discussion of other imaging modalities and a suggested ultrasound reporting format.
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http://dx.doi.org/10.1002/jum.15435DOI Listing
March 2021

Comparison of bite force on the dominant and nondominant sides of patients with habitual unilateral chewing: a pilot study.

Gen Dent 2020 Mar-Apr;68(2):60-63

Occlusion and chewing-side preference (CSP) are complex aspects of the stomatognathic system. The present study aimed to record the difference in bite force between the dominant and nondominant chewing sides of patients with a CSP. A sample of 95 subjects (aged 20-35 years) with established CSPs was selected. Measurements of bite force on both sides of the jaw were recorded while the subjects were seated in an upright, forward-looking, unsupported natural position. The recordings of each subject were accomplished in a single session with a portable customized bite recording sensor, and the maximal voluntary bite force (MVBF) value was recorded in newtons. The MVBF data were compared in pairs (dominant vs nondominant side; men vs women; and age < 30 vs ≥ 30 years) with independent-samples t tests. The combined mean (SD) MVBF for men and women was 694.73 (110.47) N on the dominant chewing side and 507.20 (86.76) N on the nondominant chewing side. In the male group, the mean MVBF was significantly greater (P < 0.0001) on the dominant chewing side (755.73 N) than on the nondominant chewing side (548.10 N). Similarly, in the female group, the mean MVBF was significantly greater (P < 0.0001) on the dominant chewing side (620.95 N) than on the nondominant chewing side (457.74 N). Furthermore, the differences between the male and female dominant sides and between the male and female nondominant sides were statistically significant (P < 0.0001). However, there was no statistically significant difference in bite force between the age groups (P > 0.05).
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September 2020

The Double Trouble: A Case of Duplicated Extrahepatic Bile Duct with Choledochal Cyst.

Indian J Pediatr 2019 Feb 12;86(2):186-188. Epub 2018 Sep 12.

Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

Biliary tract shows a large number of anatomic variations and duplication of the bile duct is an extremely rare anomaly. It has been reported to be associated with other congenital conditions like Abnormal Pancreato Biliary Junction (APBJ), biliary atresia and choledochal cyst and may lead to complications like cholangitis, choledocholithiasis and malignancy. The clinical presentation may be with one of the above complications and the condition usually reveals itself only on imaging investigations, as a surprise to the radiologist and the surgeon. Its detection is important prior to any biliary tract surgery to prevent inadvertent bile duct injury. The authors report a case of a rare subtype of extrahepatic bile duct duplication with coexisting choledochal cyst.
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http://dx.doi.org/10.1007/s12098-018-2790-1DOI Listing
February 2019

Ex vivo fracture resistance of teeth restored with glass and fiber reinforced composite resin.

J Mech Behav Biomed Mater 2018 06 29;82:235-238. Epub 2018 Mar 29.

Department of Developmental and Preventive Sciences, Faculty of Dentistry, Kuwait University, Kuwait. Electronic address:

Objectives: This study aims to compare the ex vivo fracture resistance of root canal treated (RCT) teeth restored with four different types of fibers under composite resin.

Subjects And Methods: One hundred and forty extracted mandibular first molar teeth were assigned to seven groups (n = 20/group). Group 1 was the control group. In groups 2-7, endodontic access and standard Mesio-occluso-distal (MOD) cavities were prepared. Following RCT, group 2 was left unrestored. In group 3, flowable composite resin (FCR) was used to line the cavities and restored with composite resin. In groups 4,5,6 and 7, Ribbond, Everstick, Dentapreg and Bioctris fibers were inserted in flowable resin and restored respectively.

Results: All the groups restored with fiber reinforced composite displayed higher fracture resistance than the group restored with only composite resin (p < 0.001). In addition, Groups restored with Everstick and Bioctris (Groups 5 and 7) showed higher fracture resistance when compared to Ribbond and Dentapreg (Groups 4 and 6).

Conclusion: E glass fibers demonstrated highest fracture resistance and hence can be preferred over other fiber types to reinforce RCT teeth with weakened crown structures.
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http://dx.doi.org/10.1016/j.jmbbm.2018.03.030DOI Listing
June 2018

Pancreatic Walled-Off Necrosis Eroding into the Inferior Vena Cava.

Curr Probl Diagn Radiol 2019 Sep - Oct;48(5):519-521. Epub 2018 Feb 2.

Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India. Electronic address:

Walled-off necrosis (WON) is a well-known delayed local complication of acute necrotizing pancreatitis. Occasionally, WON may spontaneously rupture into the gastrointestinal tract or peritoneal cavity. However, erosion of a WON to a systemic vein has not been reported in literature so far. We report an unusual case of a 63-year-old male with acute necrotizing pancreatitis in whom WON was eroding into the inferior vena cava resulting in its thrombosis. Our patient also had a bunch of other well-described complications of pancreatitis including splanchnic venous thrombosis.
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http://dx.doi.org/10.1067/j.cpradiol.2018.01.007DOI Listing
January 2020

Incidence and Pattern of Dental Erosion in Gastroesophageal Reflux Disease Patients.

J Pharm Bioallied Sci 2017 Nov;9(Suppl 1):S138-S141

Chettinad Dental College and Research Institute, Kanchipuram, Tamil Nadu, India.

Aim: Gastroesophageal reflux disease (GERD) is a very common condition whose consequences of are localized not only in the esophagus; extra-esophageal involvement has frequently been reported. The aim of the study is to examine the incidence and pattern of dental erosion in GERD patients.

Methodology: A total of 50 patients were recruited in this study (control -25 and GERD -25). All participants diagnosed having GERD by the endoscopic examination by their gastroenterologist are included. The patients were examined for dental erosion and will be quantified using Basic erosive wear examination index.

Results: The results showed that the incidence of dental erosion was 88% as compared to 32% in the control group which was found to be statistically significant.
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http://dx.doi.org/10.4103/jpbs.JPBS_125_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5731001PMC
November 2017

The mandibular first molar with three canals in the mesial root- a case report.

J Clin Diagn Res 2013 Mar 1;7(3):601-3. Epub 2013 Mar 1.

Senior Lecturer, Department of Conservative Dentistry & Endodontics.

The dynamic concept of the root canal system, which describes a variable morphology of the multiple root canals which are inter-connected by anastomoses, has been established as the prevailing state in the mandibular molars. The aim of this case report was to describe the unusual root canal anatomy that was detected in the mandibular first molar during the routine endodontic treatment. The clinical and the radiographic examinations allowed the detection of the middle mesial root canal between the mesiobuccal and the mesiolingual root canals. This report highlights the importance of such examinations and the need to find and treat the additional canals, to achieve a successful endodontic treatment.
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http://dx.doi.org/10.7860/JCDR/2013/4234.2835DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3616593PMC
March 2013

Effect of two different types of fibers on the fracture resistance of endodontically treated molars restored with composite resin.

J Adhes Dent 2013 Apr;15(2):167-71

Department of Conservative Dentistry and Endodontics, Chettinad Dental College, Kelambakkkam, India.

Purpose: To compare the in vitro fracture resistance of endodontically treated molars with mesio-occluso-distal (MOD) cavities restored with two different types of fibers.

Materials And Methods: Sixty extracted human mandibular first molars were selected for the study and randomly assigned to six groups (n = 10). Group 1 served as the control. In groups 2 through 6, endodontic access and standard MOD cavities were prepared. Following root canal treatment, group 2 was left unrestored. In group 3, the teeth were restored with composite resin (Venus, Heraeus Kulzer). In group 4, flowable composite resin (Venus, Heraeus Kulzer) was used before restoring the teeth with composite resin. In group 5, leno-woven ultrahigh molecular weight polyethylene ribbon fiber (Ribbond) was inserted in the flowable resin in a buccal to lingual direction, and the teeth were then restored with composite resin. In group 6, translucent glass fiber (Vectris, Ivoclar) was adapted over the flowable resin in the bucco-lingual direction and restored with composite resin. The specimens were stored in 100% humidity at 37°C for 1 day. Compressive loading of the teeth was performed using a universal testing machine at a crosshead speed of 0.5 mm/min. The mean load necessary to fracture the samples was recorded in Newtons (N). Data were subjected to analysis of variance (ANOVA) and Duncan's post-hoc test, where significance was set at p < 0.001.

Results: The highest and the lowest mean fracture strengths were found in sound teeth (1598.8 N) and unrestored teeth (393.7 N), respectively. The mean load necessary to fracture the samples was 958.6 N in the polyethylene ribbon group (group 5), 913.2 N in the glass-fiber group (group 6), 699.7 N in teeth restored with flowable resin and composite (group 4), and 729.3 N in group 3 with composite resin alone. Statistical analysis showed significantly higher fracture resistance of both the fiber groups compared to composite resin alone (p < 0.001).

Conclusion: Both polyethylene ribbon and glass fiber under MOD composite restorations significantly increased fracture strength with no statistical difference between the two groups. Therefore, both polyethylene- and glassfiber- reinforced composites can be used for access cavity restorations in teeth with weakened cusps.
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http://dx.doi.org/10.3290/j.jad.a28731DOI Listing
April 2013

The efficacy of pre-operative oral medication of paracetamol, ibuprofen, and aceclofenac on the success of maxillary infiltration anesthesia in patients with irreversible pulpitis: A double-blind, randomized controlled clinical trial.

J Conserv Dent 2012 Oct;15(4):310-4

Department of Conservative Dentistry and Endodontics, Chettinad Dental College, Rajiv Gandhi Salai, Kelambakkkam, Kanchipuram District, 603103, India.

Aim: To determine the effect of preoperative administration of paracetamol (PARA), ibuprofen (IBUP), or aceclofenac (ACEC) on the success of maxillary infiltration anesthesia in patients with irreversible pulpitis in a double-blinded randomized controlled trial.

Materials And Methods: One hundred and twenty patients with irreversible pulpitis of a maxillary first molar participated. Patients indicated their pain scores on a Heft Parker visual analog scale, after which they were randomly divided into four groups (n = 30). The subjects received identical capsules containing 1000 mg PARA, 800 mg IBUP, 100 mg ACEC or cellulose powder (placebo, PLAC), 1 h before administration of maxillary infiltration anesthesia with 2% lidocaine containing 1:200,000 epinephrine. Access cavities were then prepared and success of anesthesia was defined as the absence of pain during access preparation and root canal instrumentation. The data were analyzed using chi-squared tests.

Results: The success rates in descending order were 93.3% (IBUP), 90% (ACEC), 73.3% (PARA), and 26.5 % (PLAC). A significant (P < 0.001) difference was found between the drug groups and the PLAC group.

Conclusions: Pre-operative administration of PARA, IBUP, and ACEC significantly improved the efficacy of maxillary infiltration anesthesia in patients with irreversible pulpitis.
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http://dx.doi.org/10.4103/0972-0707.101881DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3482740PMC
October 2012

Endometrial stromal sarcoma mimicking a myoma.

Fertil Steril 2009 Nov 19;92(5):1744-6. Epub 2008 Oct 19.

KJK Hospital, Fertility Research and Gynaec Centre, Trivandrum, Kerala, India.

Uterine malignancies are not uncommonly misdiagnosed for the more ubiquitous leiomyoma. A case of endometrial stromal sarcoma with ultrasound and color Doppler imaging is described.
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http://dx.doi.org/10.1016/j.fertnstert.2008.08.124DOI Listing
November 2009
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