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Dental implants offer a predictable solution for the replacement of missing dentition. This report describes the case of a patient who underwent dental implant surgery several years ago but due to negligence on the part of previous dentist, her implant pushed into the maxillary sinus. The patient presented with vague pain and swelling in the right maxillary region. Orthopantomogram (OPG) showed that the implant was lying in the right maxillary sinus which the patient had no clue of. It was decided to retrieve the implant and later restore the missing teeth for definitive function and aesthetics. However, at the time of surgery, the implant in question was missing from the anticipated position as it had migrated to the most posterior-superior compartment of the antrum making its retrieval difficult in the first attempt. Later, a maxillofacial surgeon carried out the retrieval. ---Continue

Objective: To evaluate the position of the root apices of posterior teeth of mandible with inferior alveolar nerve canal and the cortical bone on cone beam computed tomography. Method: The retrospective study was conducted from September to October 2021 at the Aga Khan University Hospital, and comprised cone beam computed tomography scans between November 2017 and October 2021 scans of healthy individuals of either gender aged 18-71 years with healthy, untreated, mandibular posterior teeth bilaterally. Shortest distance from apices of the mandibular posterior teeth to the border of inferior alveolar nerve canal, and to the mandibular buccal cortex were measured on the scans. Data was analysed using SPSS 23. Result: Of the 106 scans, 55(52%) were males and 51(48%) were females. Of the 746 33teeth in the scans, 385(51.6%) were present in the scans of males and 361(48.4%) in those of the females. For all mandibular posterior teeth, the distances in females were shorter than males, but for the distance from root apices to the IAN canal, the difference between genders was significant for the roots of second premolar and second molar only on the left side (p0.05). Regarding the distance from the root apices to the buccal cortex, no significant difference was found between the genders, for each type of tooth, (p>0.05). Correlations between the distance from apex to inferior alveolar nerve (r

Objective: To determine the difference in the marginal accuracy at buccal, lingual, mesial and distal margins of temporary crowns fabricated with bisacryl-based temporary crown material. Method: The in-vitro, experimental, laboratory-based study was conducted at the Aga Khan University, Karachi, from September to December 2019, and comprised two bisacryl-based temporary crown material, Integrity and Protemp 4, which were used to fabricate a sample of 24 temporary crowns. A pre-operative polyvinyl siloxane impression served as a template for temporary crown fabrication. A right mandibular molar tooth on a typodont was prepared to receive a crown. The provisional crown material was syringed onto the template and was allowed to cure. All four surfaces of the crown were observed under a stereomicroscope equipped with digital single-lens reflex camera at 25.6x magnification. An image of each surface was captured and a photographic record was maintained. An image processing software was used for the measurement of marginal discrepancy. Marginal accuracy among the four surfaces was assessed. Data was analysed using SPSS 23. Results: Mean marginal discrepancy for provisional crowns fabricated with Protemp 4 and Integrity was 410±222um and 319±176um, respectively. The marginal discrepancy between the two groups was statistically significant (p=0.027), with buccal margin exhibiting the most discrepancy (p

Objectives: To evaluate the vertical relationship of the roots of maxillary posterior teeth with maxillary sinus floorand its association with age, gender and bilateral jaw symmetry. Method: The cross-sectional study was conducted at a tertiary care hospital in Karachi from June to December 2018, and comprised patients who visited the dental clinics and underwent cone-beam computed tomography scans. The scans were evaluated in the axial, coronal and sagittal planes and roots were classified using Jungs classification for proximity to maxillary sinus floor. The distance between the sinus floor and the apices of maxillary posterior teeth was measured. Data was analysed using SPSS 23. Results: There were 60 scans with 1066 roots. The most common maxillary tooth root in Type III group of Jung classification was the mesio-buccal root of the 2nd molar with the shortest mean distance of 0.44±3.05mm, followed by palatal roots of the 1st molar with the shortest mean distance of 1.58±4.01mm. The maxillary tooth root most frequent in Type I group was buccal root of 1st premolar with a mean distance of 8.15±6.65mm, and the 2nd premolar with a mean distance of 7.38±6.60mm. No significant difference was found in terms of gender and sides (p ?0.05). Conclusion: The most common root protruding in the sinus was found to be the mesio-buccal root of the 2nd molar, followed by palatal roots of the 1st molar. The most distant maxillary tooth root from the sinus was the buccal root of 1st and 2nd premolars. Continuous...

As per the Centers for Disease Control and Prevention (CDC) guidelines, dentists must avoid the aerosol-generating procedures during the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic.This study aimed to compare the rate of bracket bond failure with the aerosol-generating and non-aerosol generating bonding techniques.A retrospective cohort study was conducted during the SARS-CoV-2 pandemic on a sample of 44 patients (880 teeth), equally divided into 2 groups: the conventional aerosol-generating bonding technique (ABT); and the novel non-aerosol-generating bonding technique (NABT). The rate of bracket survival and total number of bracket breakages in the 2 groups were assessed by means of the survival regression analysis. The influence of pre-treatment factors, such as the sagittal jaw relationship (ANB), the Frankfort-mandibular plane angle (FMA), overjet, overbite, and upper and lower crowding, on the rate of bracket survival was also evaluated.There was a statistically significant difference between ABT and NABT in terms of bracket survival. The mean bracket survival with ABT was 176.21 ±77.89 days and with NABT it was 162.53 ±83.34 days. The novel technique showed a hazard ratio of bracket survival of 2.99 as compared to the conventional method. There was a statistically significant influence of overjet on the rate of bracket survival (p = 0.010). The posterior segment had a higher rate of bracket failure as compared to the anterior segment in NABT, which was statistically significant (p0.001). However, this difference was statistically non-significant in the case of ABT.There was an increased rate of bracket failure with NABT as compared to ABT. The rate of bracket breakages in the anterior quadrants was comparable for both bonding techniques.

Abiotic stresses, particularly heavy metals, are a threat to living organisms, including plants. Heavy metals activate ethylene biosynthesis and ultimately stimulate reactive oxygen species (ROS)-related gene expression to enhance stress tolerance. The identification and functional analysis of such stress-related genes is very important to increase the stress tolerance of valuable plants to heavy metals. Ethylene responsive factor ERF061 belongs to the ERF transcription factor family, controls plant growth and ontogenesis and regulates abiotic stress in model plant species. Therefore, in this study, we examined the tolerance function of LrERF061 via an overexpression vector in the growth and physiology of G. uralensis hairy roots under cadmium (Cd) stress. The effect of different Cd concentrations (0, 25, 50, 75, 100 mg/L) on the growth and physiology of LrERF061-OE hairy roots (LrE-HR) and control hairy roots (LrC-HR) of G. uralensis was measured. Initially, at low cadmium concentrations, there was a stimulating effect of Cd on G. uralensis LrE-HR and LrC-HR. However, at high cadmium doses, the growth of LrC-HR was retarded compared to that of LrE-HR. Intriguingly, a significant increase was observed in the relative expression level of LrERF061-OE in LrE-HR at 100 mg/L Cd. According to the results, compared to LrC-HR (11 mg/g), LrE-HR showed maximum Cd uptake (81 mg/g) at high Cd concentrations. The antioxidant enzyme activities (SOD, CAT and POD) in LrE-HR were enhanced at high Cd concentrations compared to those in LrC-HR. This work first highlighted the effect of LrERF061-OE, which is upregulated under Cd stress in G. uralensis hairy root clones, on heavy metal tolerance. Current study for the first time aimed to evaluate effect of ethylene responsive transcription factor (LrERF061) under Cd stress on growth and physiological properties of Glycyrrhiza uralensis hairy root clones.

Dentistry is a profession that requires coordinated motor skills in addition to acquired knowledge for ideal execution of any treatment plan for patients. Learning experiences have been modified over a period of time for students as well as for the healthcare providers. Conventional pre-clinical training employed the use of cadavers, but financial, ethical and supervisory constraints have become a major shortcoming. With the adaptation of technology in dentistry, pre-clinical training has now employed simulation. It provides the opportunity for students to develop psychomotor skills for procedures by practising pre-clinical, standardised learning competencies before they engage in patient-management. Simulation involves computer-aided learning, augmented reality and virtual reality, which are largely taking over pre-clinical teaching. Augmented reality is commonly being employed in maxillofacial, restorative, tooth morphology learning and mastering technique for administering local anaesthesia in dentistry. Virtual reality is being employed particularly in pre-treatment implant planning and dental education for students. Use of haptic technology, like robotics, is also gaining popularity, and facilitates a two-way communication between the user and the environment to better simulate the clinical setting for learning purposes.

Introduction: Aerosol-generating procedures (AGPs) put the dental health care professionals (DHCPs) at a greater risk for acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. In late June 2020, the Centers for Disease Control and Prevention advised elective dental procedures provision to asymptomatic patients while mandating strict infection control protocol and suggested the use of preprocedural testing as an adjunct. A cost-effective method for mass preprocedural testing is pool testing, which has specificity and sensitivity similar to polymerase chain reaction. This article aims to assess the outcomes and utility of incorporating preprocedural testing protocol for SARS-CoV-2 in dental clinics before providing AGPs. Method: The patients who were recommended AGPs where rubber dam placement was not possible were advised to undergo preprocedural testing for SARS-CoV-2. Pool testing strategy was employed, and patients were asked to get tested 48 h before the day of the procedure. Results: Out of a total of 1,000 patients, who presented from June 2020 to late July 2020, 464 were recommended dental procedures. In 194 of 464, AGPs could not be performed under rubber dam isolation; therefore, the patients were advised to get a preprocedural pool test. In total, 111 patients deferred the procedure and testing. Out of 83 who got tested, 7 were positive for SARS-CoV-2, 5 of whom were tested in early June 2020 and 2 in late July 2020. Conclusion: Pool testing within its limitations can be a useful preprocedure test in asymptomatic low-risk patients for AGP in dentistry, especially when the disease prevalence is low or moderate (Knowledge Transfer Statement: The results of this study can be used by clinicians when deciding which preprocedure testing approach they wish to use when performing aerosol-generating procedures in asymptomatic patients with consideration of cost sensitivity and specificity values.

Introduction: Cigarette smoking is a well-established risk factor for all forms of stroke. While both the general public and the global healthcare system are aware of the vascular risks associated with smoking. Aim: The goal of the present large-scale pooled analysis, called Evidence for Cardiovascular Prevention from Observational Cohorts, is to provide reliable information on smoking and the risk of mortality from each subtype of cardiovascular disease. Method: A total of 27,385 male and 39,207 female participants aged 40–89 years were enrolled from 10 well-qualified cohort studies with a mean follow-up of 10.1 years. Hazard ratios and their corresponding 95% confidence intervals in smokers who had hypertension or high serum cholesterol were estimated for men and women separately using a Cox proportional hazards regression model that included age, body mass index, cohort and either serum total cholesterol or systolic blood pressure as covariates. Fractions of deaths attributable to the coexistence of these risk factors were also calculated. Conclusion: Smoking is definitely an undesirable habit that can lead to an increased risk of mortality from both coronary heart disease and cerebral infarction. Furthermore, smoking increases the burden of cardiovascular disease due to its high popularity. Particular attention should be given to smokers who have another cardiovascular risk factor, such as hypertension or high serum cholesterol, because the combination of these risk factors substantially increases the mortality risk from coronary heart disease and cerebral infarction. Therefore, smokers with a concomitant risk factor should have rigorous counselling for smoking cessation and other lifestyle modifications.

Obesity is a major health problem globally. It is directly linked with with an increased cardiovascular risk and obesity and also brings up other medical conditions (hypertension, diabetes, insulin resistance, and sleep apnoea syndrome). Obesity has major role in atherosclerosis and coronary artery disease. It leads to structural and functional changes of the heart, which directly or indirectly causes heart failure. The change in myocardial structure enhances the possible chance of atrial fibrillation and sudden cardiac death. However, obesity also has a protective effect on the clinical outcome of underlying cardiovascular disease, the phenomenon called obesity paradox. In this review, we attempt to summarize the relationship between obesity and cardiovascular diseases and outline the underlying mechanisms.

A study of the extraction of polymeric material and dyes from the pharmaceutical plastic containers using various organic solvents was conducted to evaluate the effect of polarity on the extraction process. The plastic containers used included semi-opaque, opaque, transparent and amber colored and the solvent used were acetonitrile, methanol, ethanol, acetone, dichloroethane, chloroform and water. The determination of extractable material was carried out by gravimetric and spectrometric methods. The yield of extractable materials from containers in 60 h was 0.10-1.29% (w/w) and the first-order rate constant (kobs) for the extraction of polymeric material ranged from 0.52-1.50 × 10-3 min