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ORO FACIAL CHRONICLE A NEWSPAPER WITH GLOBAL VISION OF MEDICINE AND DENTISTRY

23rd OCTOBER 2013 VOL- 06 ISSUE-01, 12 PAGES ISSN (PRINT) 2278-9286

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DME conspires -MCI proposes -OFC opposes- GOI disposes Government of India does not accept and returns MCI's proposal for Amendments in Minimum Qualification for Teachers in Medical Institutions Regulations, 1998 for appointments in Dentistry Departments of Medical Colleges of the country.

CMYK

DCI shows Concern on Self Styled Academies/Institutes

T

he Dental Council of India expressed grave concern that some self styled training academies, Institutes, Organisations & Universities are imparting training to dental Dr. T.N. Tilakraj K-DCI President graduates, professionals, dental technicians and hygienists in various aspects of dentistry and are issuing certificates, degrees, diplomas & fellowship for the same. It also observed that individuals and organizations are promising to help dental professionals to acquire qualifications from universities abroad. Karnataka Cont d PAGE -04 State Dental Council

WHATSAPP, THE E-AGE STETHOSCOPE OF DOCTORS THIRUVANANTHAPURAM: WhatsApp, the trending free chat app in mobile phones, is turning out to be a hit among doctors.Orthopaedic surgeons both from the government and private hospitals have formed a group, Orthopods, on WhatsApp for sharing live images of surgery, X-rays and scanning results so that members could exchange their views, help in diagnosis, and Cont d PAGE -04

Indore & Gwalior in anticipation of amendment by GOI. Vested interests prompted Dr. Sharad Tiwari, former Director of Medical Education, MP Govt. to request MCI, without proper Government sanction, for amendment in the Minimum Qualification criteria for appointments in Dentistry

Departments of Medical Colleges. BUT he received a jolt when Government of India taking cognizance of OFC representation elaborating demerits of BOG MCI proposal returned it to MCI without acceptance vide GOI Letter dated 29th May, 2013. The DME had requested for waiver of the statutory provision of

Docs peek at Surgery through Google glass Chennai Surgeon Becomes First In Country To Live-stream A Procedure Using Latest Gadget Chennai: When the surgeon’s scalpel drew a red line on the patient’s abdomen, two blocks away a group of medical students leaned toward their screens. The procedure was a simple hernia repair, but the surgical team was upbeat as they looked at the latest gadget in the operation theater

MEDICAL USES n Doctors can stream an operation live and consult colleagues far away. n It can be used as a tool for medical education with operations being recorded on camera or livestreamed for students. the Google Glasses n Doctor can pull up X-rays, MRI worn by their chief images, reference material and other medical information as they Cont d PAGE -04 conduct surgeries. n Can be used as instant documentation tool, saving health records of patients. n Can support apps to assist doctors.

Three years of

Cont d PAGE -04

Half-baked doctors churned out from Colleges: Madras HC CMYK

Bhopal: M.P Govt. is in a fix for reply to Lokayukta for calling ineligible applicants to interview for posts at Bhopal & Jabalpur as well as Dr. Sharad Tiwari selections done for

CHENNAI: As reported by a national English daily touching upon issues such as the auctioning of medical seats, unfettered autonomy to medical colleges, rampant corruption in academic affairs and illequipped institutions, the Madras high court has refused to interfere with the ongoing Medical Council of India (MCI) proceedings against a private college. Justice K K Sasidharan, dismissed the petition of M K Rajagopalan of Sri Sathya Sai Medical College in Kancheepuram, and quoted that "Ill-equipped medical institutions often produce half-baked medical professionals. Medical seats are reported to be auctioned for crores... It is said that even for awarding more marks or to make a failed candidate pass in MBBS courses, some of the deemed universities are charging a hefty sum. If this trend continues, a time would come when patients would verify the Cont d PAGE -04

Dr.Rohit thanks to OFC in his Letter to the Editor First of all I would like to extend my regards to your one and only chronicle, which is very popular among the dentists. It was your chronicle only where me and my friend Dr. Rohit Mishra Dr. Anurag saw the ACFAI, Periodontist & Implantologist,Jabalpur Goa conference information

and decided to go. Overall it was excellent experience for all the knowledge seeking people. In Head and Neck region specially the pain which is diagnosed to be migraine can be caused by improper occlusion was a

very new concept for me and with the knowledge of great Dr. Noshir Mehta from Tufts University, U.S.A, we came to know about different appliances to cure such type of pain. Email:drrohitmishra7@gmail.com Dr. Noshir Mehta (R)


NATIONAL

OFC-02

OCTOBER 2013

MyDentist opens its 50th clinic in Kharghar MyDentist, India's largest dental clinic chain inaugurated its 50th dental clinic in Kharghar. MyDentist also announced the introduction of new initiatives that will help the dentists at the clinic, detect and manage oral cancer at an early stage.

T

hey have Introduced the low cost oral cancer detection tests. While speaking to a local daily they reported that "Their focus will continue to be on providing best quality dental care techniques." MyDentist treats over 10,000 patients every month. It has been observed that a number of patients develop oral/dental problems because of the habit of chewing or

smoking tobacco. A recent report prepared by experts of National Institute of Health and Family Welfare (NIHFW) had indicated that India alone accounted for 86% of the total oral cancer figure across the world. Chewing tobacco and gutka contributes to 90% of oral cancer cases in the country.

The doctors at MyDentist have been instrumental in spreading awareness about

the impact of usage of tobacco. MyDentist, the operative brand name for the company Total Dental Care Pvt Ltd (TDCPL), was incorporated by Vikram Vora in 2009 and was incubated by Seedfund in 2010. It received its first round of funding from Seedfund in 2011.MyDentist raised Rs50 crore as Series B

in April from Seedfund and Asian Healthcare Fund. MyDentist used this fund to establish itself in the market and grow its chain to 50 clinics across Mumbai and Pune. In less than 3 years time, it has served over 1,20,000 patients making it the largest dental care chains in India. As of May, it had a team of 400 employees inclusive of 200 doctors.

MCIeases norms forMBBS studies abroad Hyderabad: Students who want to study MBBS abroad will no longer need to obtain eligibility certificates from the Medical Council of India. Due to severe shortage of MBBS seats in the state, nearly 10,000 students from AP opt for medical colleges in China, Russia, Central America, the Philippines among others every year. There are only 6,200 MBBS seats in the state for which over 1 lakh candidates compete in amcet. Getting the degree in these countries is relatively cheaper. A student can complete MBBS

abroad in less than Rs 30 lakh. In the state, the student has to pay, apart from the fee, a donation of up to Rs 80 lakh to get a seat in management quota. All this totals to Rs 1.5 crore reported the daily. But students wanting to study in these countries had to obtain an EC from the MCI, which was an ordeal taking several months. The MCI had to obtain data from the Board of Intermediate Education and the SSC Board to verify the students’ age and educational qualifications for doing their MBBS abroad. Most students turned to brokers to get the work done quickly. Those who took admissions directly

without obtaining the EC were barred from appearing for the MCI’s "screening test". which these students have to mandatorily clear to be eligible to practice in India. The daily also published a public notice issued by the MCI which states: "Indian citizens who intend to acquire primary medical qualification from any foreign country on or after 15 May, 2013, are not required to obtain the Eligibility Certificate from the Medical Council of India. However, they are required to fulfill the eligibility criteria for admission to MBBS course as laid down in the Graduate Medical Education Regulation, 1997."

Dental and Medical Admission Test: Scamsters operated in Cyber Cafes BHOPAL: As per the published news in a leading English daily which exposed a dozen gangs that were busted for duping medical aspirants of crores of rupees in exchange of getting them seats in private medical and dental colleges of the state through the Dental and Medical Admission Test

(DMAT) operated from internet cafes to college premises. The accused used to introduce themselves to aspirants as personal assistants of college directors, doctors and claimed to have influence in DMAT office - the body which conducts exam for private medical colleges in M.P. One of the Accussed

arrested after the first FIR of forgery was registered at the Kolar police station on September 7, used to lure victims claiming that he is the personal assistant of the director of LN medical college reported the daily. Similarly,

the incident wherein a Nainitalbased person, who was duped of Rs 16 lakh for a medical seat for his nephew, claimed that he was approached by an imposter, through internet who claimed

ORO FACIAL CHRONICLE

that he is handicapped and is based at Guwahati. The newspaper reported that the Police said the busted gangs would claim to have influence in DMAT office. It has even come to light that students would get the exact numbers in DMAT exam they needed to get medical seats in the private colleges

where they wanted to take admissions.Police officials are in the process to ascertain how the marks of a student were managed through the DMAT exam. In total six interstate gangs involved in forgery of medical seats worth around Rs 3 crore have been busted by the police so far.


CAREERS

OFC-03

Solutions to Control Diabetes and Thyroid Essential: Governor

n Suresh Vijaywargiya, Chancellor Peoples University,Bhopal welcomed the Governor of M.P on 43rd International Conference of Endocrine Society of India. n More than 800 medical specialist from around the world participated in the 3 days Conference Bhopal: "There is a rapid increase in the number of patients of diabetes and thyroid in the country, it is a serious matter to ponder over" said M.P Governor, Ramnaresh Yadav. He addressed the 43rd International Conference ISICON 2013. Dr. Shubankar Chaudhary, ESI chairman expressed his views on the importance of such conference. Dr. Rakesh Sahay, Dr.

V . K Pandya also expressed their views. 800 doctors from all around the globe, some of which from USA, Britain, Switzerland, Germany, Tunesia, Belgium, Srilanka and Pakisthan participated in

the conference. Around 250 doctors presented their paper in the scientific session on diabetes, obesity & hormones and other diseases. Dr. NP Mishra, Dr .S .S Yesikar also expressed their thought in the conference. Eminent Practitioner of the city Dr. C. C Chaubal,Dr. Sushil jindal were also present in the inaugural ceremony.

ORO FACIAL CHRONICLE

OCTOBER 2013


STATE

OFC-04

DME Conspires... Teaching & Research Experience of a recognized medical college for recruitments in dentistry department.There are more than dozen Non-MBBS faculties in medical institutions & all require 3 years teaching & research experience in a recognized medical college to be eligible for the post of Assistant. Prof. but Dr. Sharad Tiwari singled out dentistry and misled the Secretary, MCI who in turn got approved from BOGMCI a proposal for amendment which caught the eye of OFC. OFC brought it to the notice of Government of India for maintaining quality medical education as well as for justice to those pursuing residency in medical colleges and also discourage level jumpings.

Docs peek at... reported a leading English daily. As the medical fraternity in the west debates the usefulness of the newest device produced by software giant Google Inc, doctors in India have joined the chorus with bouquets and brickbats, even as a surgeon became the first in the country to live-stream a surgery using Google Glass published a daily.

Orientation Programme on Dental Implants held at Bhopal

Bhopal: Dental Implant Orientation Programme was held on 20th October at Courtyard Marriot, Bhopal. Professor Dr. Kamal Kiswani, MDS and M.Sc (Implantology) from Gothe University, Frankfurt,

Germany expressed his thoughts and shared his vast clinical experience in the field of Implantology. He is a well renowned speaker at various conferences held nationally.Dr. Kiswani is a famous Implantologist from Pune. Dr.

Sumit Khare, MDS from GDC, Bangalore deliberated on basic idea on Implants. Dr.Anuj Bhargava, MDS and trained at University of Besancon, France talked about the need of structured programme on Oral Implants

CMYK

FIRST LOOK This month Lifeline Hospitals, Chennai livestreamed an upper gastro intestinal laparoscopy procedure on a 45- year-old man and a hernia repair on a 42-year-old woman to medical students seated two blocks away using Google Glass.

BLS Workshop at Indore

Google Glass is a wearable computer that has a frame similar to traditional eyeglasses. It follows voice commands to take photos and videos from the viewpoint of the user. The surgeries were live streamed on Google Hangout. It can be used for mapping taking photos and videos (with ability to livestream what you are looking at) and internet search Besides being an educational tool, doctors say it could be used to view X-rays, MRI images and other medical information as they operate. It could be used to connect with doctors in far-flung places, provided their internet connectivity is good. The gadget could help professionals access data and communicate with colleagues far away, while getting feedback to improve quality of patient care.

Hospital Spoke on Management of Medical Emergencies in Dental Practice. Dean, Aurobindo Dental College, Indore Spoke on Interlink between systemic diseases and gum problems. Dr. Sunil M Jain, D.M (Endocrinology) and Dr. Idris Khan,D.M (Cardiology), Bombay Hospital also expressed their views on the subject.A Live demonstration of Cardio Pulmonary Resucitation (CPR) was also done.

Half-baked doctors... degree certificates of medical professionals before taking treatment.",reported the English daily.The CBI had raided the institution in July 2010 and charged it with falsifying and forging documents. Simultaneously, the MCI too started proceedings against the college and withheld its recognition.

DCI Shows Concern... has taken a step in this direction as it released a circular on its official website.The circular says " That academies should refrain from conducting out any Dental Education Course without the recommendation from DCI and without prior approval of central Govt. As per section 10-A the Dentists (Amendment) Act, 1993, no institute or organization or person or university can start a dental course or training course or impart dental education leading to a certificate, diploma, a degree, fellowships without the prior recommendation of the Dental Council of India and without the prior approval of the Central Government in accordance with the provisions of section 10-A of the Dentists (Amendment) Act, 1993.

WhatsApp, the e-age... suggest the best treatment options.The doctors are using this tool for getting opinions on diagnosis and exchanging their views on the treatment options.

Indore:A One day Workshop on Basic Life Support and CPR was organized by IDA, Indore Branch on 29th September in association with Total Diabetes

Hormone Institute, Indore. The program was convenyed by Dr.Kamlesh Badonia and his Team. Dr. Sanjay Dhanuka, Intensivist, Synergy

Chirayu College Workshop on Cardio Surgery Bhopal : Chirayu Medical College and hospital organized a CME and live surgical workshop on minimally invasive cardiac surgery this month. The department of cardio thoracic and vascular surgery organized the workshop on heart surgery. Senior faculty Dr. Gopal Krish Gokhle from Secundrabad and Dr. Satyaki Nambala from Bangalore graced the occasion.

for general dental practioners. A 6 months basic implantology programme under the mentorship of the speakers was also launched. The course was attended by leading Practitioners and post graduate students of the city.

Dr.Ajay Speaks on CBCT CMYK

C ontinued From Page-01

OCTOBER 2013

Jabalpur: A CDE Program on CBCT ( Cone Beam Computed Tomography) :A paradigm shift in dentistry was organized by IDA, Jabalpur under the able mentorship of Dr.Anurag Sahu and Dr. Ashish Dixit. Dr. Ajay Parihar, MDS and Head Dept.of Oral Medicine & Radiology, Government College of Dentistry, Indore, was the guest speaker. A hands on session was also Organized for both IDA and Non-IDA Members.The program was a great success and was graced by many senior, junior faculties and students.

Cops sensitized on importance of 'golden hour' Bhopal: Aimed at sensitizing police towards accident victim s ,a three day long workshop on "Sensitization of police officers for ensuring safety of victims of road accident" was inaugurated by Bhopal range inspector general of police(IGP), Sanjay Kumar Jha at the police training and research this month. Immediate medical assistance after the accident could help in saving a number of lives. In several instances, accident victim dies because he does not get timely medical attention. Since a policeman first reaches on accident spots, his

ORO FACIAL CHRONICLE

timely decision and swift action could help in bringing down the death toll.OFC appreciates Bhopal Police for their effort in saving patient lives in Road Traffic Accidents.


OFC-05

INTERNATIONAL

Fully Functional Bioengineered Salivary Gland The research group led by Professor Takashi Tsuji of Tokyo University of Science and Organ Technologies Inc. has provided a proof-of-concept for bioengineered mature organ replacement as a regenerative therapy. Current advances in regenerative therapies have been influenced by the study of embryonic development, stem cell biology, and tissue engineering technologies. The ultimate goal of regenerative therapy is to develop fully functional bioengineered tissues that can replace lost or damaged organs following disease, injury or aging. A research group led by Professor Takashi Tsuji (Professor in the Research Institute for Science and Technology, Tokyo University of Science, and Director of Organ Technologies Inc.) has provided a proof-ofconcept for bioengineered mature organ replacement as a regenerative therapy. Dr. Tsuji’s research group (M. Ogawa et al.) reports the fully functional regeneration of a salivary gland that reproduces the morphogenesis induced by reciprocal epithelial and mesenchymal interactions through the orthotopic transplantation of a bioengineered salivary gland germ as a regenerative organ replacement therapy. The bioengineered germ developed into a mature gland through acinar formations with the myoepithelium and innervation. The bioengineered submandibular gland produced saliva in response to the administration of pilocarpine and gustatory stimulation by citrate, protected against oral bacterial infection and restored normal swallowing in a salivary gland defect mouse model. Thus, this study provides a proof-of-concept for bioengineered salivary gland regeneration as a potential treatment for xerostomia. This research was performed in collaboration with Professor Tetsuhiko Tachikawa (Department of Oral Pathology, Showa University School of Dentistry, Shinagawaku, Tokyo, JAPAN). Salivary glands play essential roles in normal upper gastrointestinal tract function and oral health, including the digestion of starch by salivary amylase, swallowing and the maintenance of tooth hard tissues through the production of saliva. There are three major salivary glands -- the parotid, submandibular and sublingual glands -- as well as minor salivary glands. Salivary glands are composedof duct, acinar, and myoepithelial cells.

The disease of salivary gland. One concept that may be applicable for restoring salivary glands is regenerative therapy, which involves tissue stem-cell transplantation to restore damaged tissues and organs in a variety of diseases. Furthermore, organ replacement regenerative therapy, which can replace lost or dam-

aged organs with a fully functional bioengineered organ, is also expected to provide a novel therapeutic strategy for organ transplantation. The study demonstrated that each bioengineered salivary gland germ, including the submandibular and sublingual glands, had the potential to regenerate into mature glands using researchers previously developed organ germ method. After three days in organ culture, all of the bioengineered salivary gland germs underwent branching morphogenesis, followed by stalk elongation and cleft formation.

Engraftment of a bioengineered salivary gland Saliva, which is produced from serous- and mucous-type acinar cells, plays essential roles in oral function. Histological analysis using haematoxylin and eosin (HE) staining and periodic acid and Schiff (PAS) staining revealed a distinctive acinar structure, including serous acinar cells, in the bioengineered submandibular gland and mucous acinar cells in the bioengineered sublingual gland. E-cadherin and calponin proteins were detected in the acinar and duct cells as well as in myoepithelial cells, which enveloped acinar cells in these bioengineered glands. Innervations were also detected in the interstitial tissue among acinar cells, and neurofilament H (NF-H)expressing nerve fibres connected to calponin-positive myoepithelial cells. The research demonstrates that engrafted bioengineered salivary gland germ cells successfully formed correct tissue structures and could secrete saliva in response to neural stimulation.

Functional analysis of bioengineered saliva secretion Saliva secretion is essential to the maintenance of oral health, and xerostomia causes various health problems, including dental caries, periodontal disease, bacterial infection and swallowing dysfunction. To semiquantitatively analyse saliva secretion,

the researchers performed fluorescein diffusion analysis. Briefly, fluorescent sodium test paper, which contains a fluorescent dye that dissolves in saliva drippings, was placed on the tongue. Dye diffusion was not observed during the observation period in the salivary gland defect mice. Gradual diffusion and disappearance of the fluorescein dye in the oral cavity was observed in mice transplanted with the bioengineered submandibular gland. The number of oral bacteria was drastically increased in salivary gland defect mice compared to normal mice. The number of bacterial colonies that formed in the mice engrafted with the bioengineered submandibular gland germ was significantly reduced compared to the number in salivary gland defect mice. These results indicate that the bioengineered submandibular gland has a cleansing function that prevents dryness and inhibits bacterial growth by secreting saliva into the oral cavity.

Functional recovery of swallowing and survival

CONCLUSION The research demonstrates the regeneration of fully functional salivary glands through the orthotopic transplantation of a bioengineered salivary gland germ in adult mice. The bioengineered submandibular gland, which was transplanted using an inter-epithelial tissueconnecting plastic method, produced saliva in response to the administration of gustatory stimulation by citrate, protected against oral bacterial infection and restored swallowing in a mouse model of a salivary gland defect. Thus, this study provides a proof-of-concept for bioengineered salivary gland regeneration as a potential treatment of xerostomia. Further studies on the identification of stem cells as a source for the reconstitution of bioengineered salivary gland germs are warranted.

Journal Reference Miho Ogawa, Masamitsu Oshima, Aya Imamura, Yurie Sekine, Kentaro Ishida, Kentaro Yamashita, Kei Nakajima, Masatoshi Hirayama, Tetsuhiko Tachikawa, Takashi Tsuji.Functional salivary gland regeneration by transplantation of a bioengineered organ germ. Nature Communications, 2013; 4 DOI: 10.1038/ncomms3498

ORO FACIAL CHRONICLE

OCTOBER 2013

High-Dose Statins Reduce Gum Inflammation in Heart Disease Patients

Statins, commonly prescribed medications for lowering cholesterol, also reduced inflammation associated with gum disease in a new study published in the Journal of the American College of Cardiology. The study suggests that steps taken to reduce gum disease may also reduce inflammation in the arteries and vice versa. "Periodontal disease is characterized by chronic gum inflammation and affects approximately 50 percent of the U.S. adult population," explains Ahmed Tawkol, MD, co-director of the Cardiac Imaging Trials Program at Massachusetts General Hospital and Harvard Medical School and co-author of the study. Periodontitis and atherosclerosis are both primarily driven by inflammation. These inflammatory conditions tend to co-exist within individuals and their biologies may be intertwined. In the double-blind, randomized study, patients with heart disease or a high heart disease risk were assigned to take either an 80 mg statin or a 10 mg statin daily for 12 weeks. PET/CT scans were collected after four and 12 weeks and compared to scans taken before treatment began. The 59 patients included in the final analysis showed a significant reduction in gum inflammation after as few as four weeks of treatment with the high-dose statin. Interestingly, the improvement in gum inflammation tracked closely with improvement in atherosclerotic disease. The study authors Cont d PAGE -11

Journal Reference Ahmed Tawakol, Zahi A. Fayad, Robin Mogg, Achilles Alon, Michael T. Klimas, Hayes Dansky, Sharath S. Subramanian, Amr Abdelbaky, James H.F. Rudd, Michael E. Farkouh, Irene O. Nunes, Chan R. Beals, Sudha S. Shankar.Intensification of Statin Therapy Results in a Rapid Reduction in Atherosclerotic Inflammation. Journal of the American College of Cardiology, 2013; 62 (10): 909 DOI:10.1016/j.jacc.2013.04.066


INTERNATIONAL

OFC-06

OCTOBER 2013

Are Nanodiamond-Encrusted Teeth the Future of Dental Implants? UCLA researchers discover: Diamonds on a much, much smaller scale than those used in jewelry could be used to promote bone growth and the durability of dental implants. Nanodiamonds, which are created as byproducts of conventional mining and refining operations, are approximately four to five nanometers in diameter

next to implants such as prosthetic joints or teeth, which leads to the implants becoming loose -- or failing. Implant failures necessitate additional pro-

taneously delivered using one vehicle. The unique surface of the diamonds allows the proteins to be delivered more slowly, which may allow the

cal models were effective at treating multiple forms of cancer. Because osteonecrosis can be a side effect of chemotherapy, the group

and are shaped like tiny soccer balls. Scientists from the UCLA School of Dentistry, the UCLA Department of Bioengineering and Northwestern University, along with collaborators at the NanoCarbon Research

cedures, which can be painful and expensive, and can jeopardize the function the patient had gained with an implant. These challenges are exacerbated when the disease occurs in the mouth, where there is a

affected area to be treated for a longer period of time. Furthermore, the nanodiamonds can be administered non-invasively, such as by an injection or an oral rinse. As per the Initial studies indi-

decided to examine whether nanodiamonds might help treat the bone loss as well. Results from the new study could open the door for this versatile material to be used to address multiple challenges in

Institute in Japan, may have found a way to use them to improve bone growth and combat osteonecrosis, a potentially debilitating disease in which bones break down due to

limited supply of local bone that can be used to secure the prosthetic tooth, a key consideration for both functional and aesthetic reasons. The study, led by Dr. Dean Ho,

Journal of Dental Research. During bone repair operations, which are typically costly and

monds to deliver these proteins has the potential to be more effective than the conventional

cate that they are well tolerated, which further increases their potential in dental and bone repair applications elaborates one of the study author. Ho’s team previously showed

drug delivery, regenerative medicine and other fields. This discovery might serve as a foundation for the future of nanotechnology in dentistry, orthopedics and other

reduced blood flow. When osteonecrosis affects the jaw, it can prevent people from eating and speaking;

professor of oral biology and medicine and co-director of the Jane and Jerry Weintraub Center for Reconstructive

time-consuming, doctors insert a sponge through invasive surgery to locally administer proteins that promote bone

approaches. The study found that nanodiamonds, which are invisible to the human eye, bind rapidly to both bone morpho-

that nanodiamonds in preclini-

domains in medicine.

when it occurs near joints, it can restrict or preclude movement. Bone loss also occurs

Biotechnology at the UCLA School of Dentistry, appears online in the peer-reviewed

growth, such as bone morphogenic protein. Ho’s team discovered that using nanodia-

genetic protein and fibroblast growth factor, demonstrating that the proteins can be simul-

L. Moore, M. Gatica, H. Kim, E. Osawa, D. Ho. Multi-protein Delivery by Nanodiamonds Promotes Bone Formation. Journal of Dental Research, 2013; DOI:10.1177/0022034513504952

Journal Reference

Smile! New Nanotube Surface Promises Dental New nose grown by surgeons to replace original one Implants that Heal Faster and Fight Infection A brighter, better, longer-lasting dental implant may soon be on its way to your office. Dental implants are posts, usually made of titanium, that are surgically placed into the jawbone and topped with artificial teeth. More than den-

sodium naproxen and demonstrated that it could be released gradually after implant surgery. That assures that the medicine gets where it’s needed,

tures or bridges, implants mimic the look and feel of natural teeth. While most dental implants are successful, a small percentage fail and either fall out or must be removed. A scientist at Michigan Technological University wants to lower that rate

and it reduces the chances of unpleasant side effects that arise when a drug is injected or taken orally. To fight infection, the TiO2 nanotubes can also be laced with silver nanoparticles. Shokuhfar and Craig Friedrich, who holds the Richard and

to zero using nanotechnology. "Dental implants can greatly improve the lives of

Bonnie Robbins Chair of Sustainable Design and Manufacturing at Michigan Tech, are conducting

people who need them," said Tolou Shokuhfar, an assistant professor of mechanical engineering in his study. "But there are two main issues that concern dentists: infection and separation from the bone." The mouth is a dirty place, so bacterial infections are a risk after implant surgery, and sometimes bone fails to heal securely around the

University of Illinois at Chicago (UIC) College of Dentistry on a dental implant with a surface made from TiO2 nanotubes, but she has been making and testing them for several years. "They have done toxicity tests on the nanotubes, and not only did they not kill cells, they encouraged growth,"

research, as yet unpublished, which is focused on orthopedic implants, such as artificial hips, but which also applies to dental implants. Silver has antimicrobial properties.In Cont d PAGE -11

device. Because jawbones are somewhat thin and delicate, replacing a failed implant can be difficult, not to mention expensive. Generally, dentists charge between $2,000 and $4,000 to install a single implant, and the procedure is rarely covered by insurance.Enter a nano-material that can battle infection, improve healing, and help dental

as per the study. The study demonstrated that bone cells grow more vigorously and adhere better to titanium coated with TiO2 nanotubes than to conventional titanium surfaces. That could keep more dental implants in place. The nanotubes can also be a drug delivery system. Shokuhfar’s team, in collaboration with

1.Tolou Shokuhfar, Suman Sinha-Ray, Cortino Sukotjo, Alexander L. Yarin. Intercalation of antiinflammatory drug molecules within TiO2 nanotubes. RSC Advances, 2013; 3 (38): 17380 DOI: 10.1039/C3RA42173B 2.T. Shokuhfar, J.Y. Chang, C.K. Choi, C. Friedrich.Biophysical Evaluation of Osteoblasts

province, China.It was grown by placing a skin tissue expander onto Xiaolian’s forehead, cutting it into the shape of a nose and planting cartilage taken from his ribs. Mr Shehan Hettiaratchy is Chief of Plastic and Reconstructive Surgery at the Imperial College Healthcare NHS Trust and a member of the

implants last a lifetime: titanium dioxide nanotubes. Shokuhfar is now working with Cortino Sukotjo, a clinical assistant professor at the

Alexander Yarin, a professor in UIC’s Department of Mechanical and Industrial Engineering, loaded TiO2 nanotubes with the anti-inflammatory drug

on TiO2 Nanotubes. Nanomedicine: Nanotechnology, Biology, and Medicine, Dec 2011, Under Revision.

British Association of Plastic, Reconstructive and Aesthetic Surgeons (BAPRAS) who performed the surgery.

Journal Reference

ORO FACIAL CHRONICLE

China:Xiaolian, 22, didn’t look in the mirror after his badly damaged nose following a traffic accident in August 2012.The infection corroded the cartilage of his nose, making it impossible for surgeons to fix it.They then decided to grow him a new one at a hospital in Fuzhou in Fujian


DOOOX.DE

OFC-07

OCTOBER 2013

Light corrective device for increased predictability of tooth shade-matching Kelvin I. Afrashtehfar, DDS, FADI; George A. Freedman, DDS, FADFE. Dr. Afrashtehfar is a post-graduate research trainee in the field of Oral and Craniofacial Sciences. His training is focused on multidisciplinary research including Health Technology Assessment and Evidence-based Dentistry. He is a reviewer for the European Journal of Oral Implantology. His first textbook entitled ’Computerized Dental Occlusal

Dr. Freedmanis a founder & past president of the American Academy of Cosmetic Dentistry & a founder of the Canadian Academy for Esthetic Dentistry. His publications include more than 700 dental articles and a dozen texts. His most recent textbook, "Contemporary Esthetic Dentistry" is published by Elsevier. He is

Analysis for Temporomandibular Disorders’ will be released this year. Dr. Kelvin Ian has collaborated with the Children’s General Hospital and UniversitØ de MontrØal,among other institutionsin Montreal, Canada. He can be reached at kelvin.afrashtehfar@mail.mcgill.ca

an Editorial Board member with Oral Health (Dental Materials and Technology), is a REALITY Team Member and lectures internationally on dental esthetics & technology.Dr. Freedman maintains a private practice in Toronto, Canada.

ABSTRACT Dental professionals such as general den-

light source while performing the procedure.

quantification of color which provides generally more accurate color matching

index (CRI)greater than 93, for dental professionals.The CRI measures the equal balance

tists, prosthodontists and dental technicians regularly perform shade-matching procedures during restorative procedures. Matching an artificial restoration with natural teeth can be one of the most challenging procedures in restorative dentistry.This article will give the

KEYWORDS: tooth shade matching,tooth color selection, light-corrective device, correcting light source, esthetic dentistry. Light corrective device for increased predictability of tooth shade-matching ’It is not the form that dictates the color,

outcomes.However, since 35 years ago these spectrophotometers and colorimeters devicesare primarily used in research rather in dental offices due to high cost.

OPERATOR'S FACTORS AFFECTING SHADE MATCHING

of all the visible wavelengths.And viewing teeth under diffuse illumination will minimize the distortion of the reflected light. A low intensity of light will make the clinician miss fine details and complicate perceiving hue. The value guide should be used firstprefer-

reader a better understanding of what are the factors to consider for shade-matching and the importance of consideringa correcting

but the color that brings out the form.’ - Hans Hofmann (1880-1966) Abstract expressionist painter

It has been stated that shade marching varies due to experience, age and individual degree of color perception due to decline in functional ganglion cell density

ably with low light levels, even if the operator has to squint, since is the best for value evaluation. There is strong and reliable evidence that

Cosmetic and esthetic outcomes in dentistry are essential to dental treatment,especially to meet patients’ high expectations and impact

ed light). Therefore, the clinician who discusses the primary tooth shade characteristics of hue, chroma, and value, provide the essential informa-

and abnormalities in eyes’ rod and cone photoreceptor morphology.For example, images are perceived more yellowish and brownish as our eyes age with us.

supports the use of a lighting correcting source during tooth shade matching and there is no evidence in the literature contradicting this fact.

their self-esteem positively.Shape and color determine aesthetic appearance of natural teeth and restorative materials. Attractive restorative and prosthodontic outcomes begin

tion to at echnician who produces restorations that correspond with the remaining dental structure.Hueis the quality of sensation according to which an observer is aware of the

Therefore, human physiology mostly determines color perception along with individual variations. - Gender.In dental convention symposiums we

In the United Kingdom, clinician scientists combined the use of color correcting device at the same time with a digital recording device showing an improved

with a consistent shape and silhouette of the buccal surface as it determinesthe amount of the light reflected back.The color we perceive of natural teeth depends on the nature of the

varying wavelengths of radiant energy (red, yellow, green, blue, purple, etc).Approximately an 80% of natural dentition belong to the A hue range.Chromais the purity of a color, or its

have commonly heard that men are less likely than women to get the color right. However, there are at least seven studies in Dentistry showing no gender differences

ability to match dental shades when compared to the digital device alone under normal light condition.Other study showed that in order to standardize light

light source illuminating them, which is crucial to appreciate their translucency, opalescence and fluorescence. Selection of the appropriate color in the shade-

departure from white or gray, and describes the strength or saturation of the hue.Value, as well known as lightness or brightness, is the quality by which a light color is distinguished

in shade matching. - Experience.It is still controversial whether the accuracy of shade matching can be attributed as an innate or, acquired or learnt skill.

conditions, an aid of a daylight lamp significantly improve the ability to match colors when compared to natural daylight.There was also a significant bet-

matching has many clinical applications: tooth whitening, restoring a tooth with porcelain or composite, acrylic teeth of a denture and even gingival prosthetic components. For determining a precise shade matching, the criteria den-

from a dark color.Value is the most important dimension of shade rendering. Natural teeth exhibit translucency, fluorescence and opalescence, which should be mimicked by restorative materials to succeed clini-

However, there is also plenty of evidence that contradicts that experience is influential in shade matching. - Eye color. Brown eyes absorb wavelengths better due to greater presence of

ter shade matching performance under correcting light source when compared to natural or clinical light.Even when light conditions are improved by using a low temperature illuminant, there is a notable

tal professionals use is dependent on their own skill, type of shade guide system used

cally.Translucency is the gradient between transparent and opaque, the quality of allowing

melanin,which may influence sightbut not color perception.

improvement in color vision deficient individuals.In another Irish study, the overall

and lighting conditions. The scope of this paper is to review some of the influential factors in the process of tooth shade matching and reported benefits of modern methods such as the light correcting devices.

light to pass diffusely. Fluorescence is the absorption of light of short wavelength by a material and the spontaneous emission of light in a longer wavelength.Opalescence is when a material seems to be one color when you observe the light reflected from it and looks another color when you see light transmitted

-Astigmatism, hypermetropia and myopia.An insignificant influence effect may be expected on shade-matching ability even when these refractive errors are corrected with eyeglasses or contact lenses. Therefore, corrected refractive error cannot be associated with a poorer shade-match-

results indicated that the most beneficial factor on shade taking was the light correcting source. The closer the spectral reflectance curves (optical properties) of the two materials to be matched, the more successful the color matches will be, minimizing metamerism.

BASES OF ESTHETIC DENTISTRY

ESSENTIALS OFCOLOR CONCEPTS According to the Glossary of Prosthodontic terms,10 color can be defined as the quality of an object or substance with respect to light refected or transmitted by it. Color is usually determined visually by measurement of hue, saturation, and luminous refectance of the refected light. The three components of color are light source

through it.

ing skill.

The most commonly used technique is performed by visually matching the shade of the natural teeth with the tabs of a shade guide system. The shade guides available in the

is the light source to get it right the first time and avoid remakes and extra appointments which will increase the direct cost to the clinician.Since natural light conditions vary,

Ideally, the clinician and the technician should have balanced full spectrum lighting conditions. The superiority of acorrecting light is a fact and could also be seen as convenient since it is portable and wireless, and readily available since it is often found in the dental market industry, and this

(illuminates the object), object (reflects, absorbs or transmits the incident light to theobserver) and the observer (perceives the reflect-

market are the standard instrument to be compared with the patients’ tooth shades.The computerized shade determination devices use

recommendations for the shade matching procedure include proper color temperature that come up to 5500k and a color-rendering

instrument which appeared at prices as much as $5,000dlls, now it can be acquired for as little as $300dlls. Cont d PAGE 08

TOOLS FOR TRANSMISSION OF LIGHT SOURCE EVOLUTION TOOTH SHADE COLOR The most important factor in shade matching

ORO FACIAL CHRONICLE


WWW.DOOOX.DE

OFC-08 RITE 2 SHADE MATCHING INSTRUMENT - A PROPER CORRECTING LIGHT SOURCE

metamerism, which is when a restoration will match in one light but then display a different color in other light conditions.Without having

should be done prior to turning on the dental unit light.Eye fatigue can also be reduced by the having a correcting daylight lamp around

the patient leave the chair, efficient shade-taking can take place (Figure B). For the ceramist. During build-up, the fired ceramic can be verified. The restorations can be verified in the model, as a quality control measurement, before sending the case to the clinician. Without leaving the work station, efficient shade check can take place.

while shade match selection is conducted.Duringshade selection,the operator should not stare at the teeth for more than five seconds to prevent hue accommodation, therefore first impressions are better. To rest the shade-taker eyes, they can also look at a blue plaque.It has also been recommended to have the walls of room, where the shade

ENVIRONMENT CONDITIONS

matching takes place, painted in grey and two correcting day light lamps , with.

Image.A

PHOTHOGRAPHIC ADVICE

This portable and wireless correcting light device has been designed to aid in shade matching in any dental clinic by its particular characteristics.This device is a clad in satinfinished aluminum. Its top contains 12 LEDs and it has an external round 5.3cm diameter, while the inner window-hole to view patient’s teeth has a diameter of 3cm. The patient’s side of this top section illuminates the denti-

OCTOBER 2013

the optical properties of the tooth.

ADDITIONAL RECOMMENDATIONS

Image.F While proceeding on the delicate step of shade matching, it is advised to use a standard light source with full spectrum and provide appropriate conditions. The shade tabs shades should be preserved on shade guide rather than out of the shade guide while performing the shade matching procedure since accuracy significantly increases.(NEW IMAGE F) By holding the shade tab incisal edge to the

Image.C

tion from all directions to avoid glare or distortions by direct reflections (Figure A).The bottom section is a cylindrical handle 9.6cm long by 2cm diameter. Any shade matching staff

It is recommended that participants who perform the shade-matching test should use the ideal background color which is neutral

member can use this 184.3g weight device. The device even notifies the user when its two conventional AA batteries lose power and need to be replaced, in order to maintain con-

gray,since it has no complimentary color and is restful to the retinal cones in our eyes.(NEW IMAGE C) It is suggested to remove or cover the lipstick.

It is suggested to take photos of the following: a full face, a natural smile, the lips and cheeks retracted, and the selected shade tab adja-

shade tab, the mid-buccal of the tooth should be looked at.

stant the light intensity emitted.It has three choices as settings of color temperature: " 5500k (color rendering index of 92.2): is the closest to the natural daylight, and is

For example, if the patient has a red lipstick next to the tooth to evaluate, the red receptors in the clinician eyes become fatigued while the blue and green receptors remain fresh with

cent to the remaining natural teeth. If not possible, at least the last photo described must be sent. The only moment teeth should be dry is when

Shades should Image.G be evaluated looking at the tooth at different angles (vectoring) due to the curved translucent surfaces

considered a standard in shade measurements. It is produced by 6 LEDsactivated while pushing the activation button once. The importance of the other light settings

fullpotential to be stimulated. This leadsto a tooth perception that is more blue-green than in reality is. It is also recommended to use a gray bib to cover the patient’s

evaluating value, translucency, surface, its texture, and its degree of luster. The teeth can be wet for hue and chroma evaluation to limit the influence of surface morphology. The

found on teeth, the anisotrophic properties of enamel, and the complex layering of the tooth structure. Shade matching should be delayed for at least one month after bleaching due to

relies on being the indoor ambient to which the patients are mostly exposed. 3200k: simulates incandescent light. It is produced by the other 6 LEDs while push-

clothes.Contrastaids to our visual system, when exceeded causes glare. A brilliant object against a dark background or differently colored itemscause can affectthe shade-taker’s

shade matching with photography is a great communication tool, however proper shade tabs still need to be selected and a need for special lighting is still recommended. (NEW

the enamel rehydration and color stability. With the weight of the literature available, it seems safe enough to state that it is strongly recommended that standard light sources with

ing the activation button twice. 3900k: it a combination of incandescent with fluorescent indoor lighting. This light is produced when the 12 LEDs are activated LEDs while pushing the activation button

perception.

IMAGE D)

Ideal time of the day for shade matching

DENTAL LABORATORY PRESCRIPTION

full spectrum be used and an appropriate environment be present in the clinic for shade selection.

"

"

three times.

Benefits of Tri-Spectra LED technology

Image.D

The proper time of the day recommendations

CONCLUSION

are not reliable since there is a high degree of variation such as our daylight conditions differ

Regardless of gender, training and experi-

according to the ray of lights direction, amount of and size of windows, months and seasons of the year, weather conditions, geographical region, etc.

ence, the shade matching ability significantly improves when a light-correcting device is used in our clinical practice or dental laboratory instead of the conventional light conditions. When the shade selection between the natural teeth and the restorative material is accurate, it positively influences the

Ideal moment of the appointment for shade matching Shade selection should be done before treatment since the value increases and the chroma and translucency decrease as the teeth dry out during treatment.Shade selection is contraindicated after using a dental unit light.

Image.B For the clinician. Daylight mode for initial shade determination. Room light and ambient light modes to verify the shade to avoid

incisal edges of the teeth, reflecting onto each other should be avoided to reduce afterimages.(NEW IMAGE G) When choosing the hue with a

Image.E

Eye fatigue awareness

This prescription should be a three-dimensional drawing of the shade-map, ideally from several views (vectoring). The labial face of the crown can be divided into nine to 16

The high intensity (brightness) of the dental chair light can cause glare and result in fatigue to the eyes. Shade guide selection

zones. (NEW IMAGE E) The surface texture and luster as heavy, moderate, and light should be described since have an impact on

ORO FACIAL CHRONICLE

patient’s aesthetic appearance and selfesteem. ’The most important factor inshade matching is the lighting condition.’ - Afrashtehfar and Freedman, July 2013 For References contact Author for further Details or log on to www.oralhealthgroup.com. Printed with Prior Permission from Author.


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VOLUME I / ISSUE II 2013 Archives of CraniOrofacial Sciences, ACOFS is a Semi Annual Peer Reviewed Online Journal with monthly supplemental issues on topics of CraniOrofacial Region printed in association and support of Oro Facial Chronicle, a Medical & Dental media newspaper. The journal is published by Bharat Paper House (BPH) which is one of the oldest Printers and Publishers in Central India [Bhopal]. The journal full text is available online on this website. The journal allows free access (Open Access) to its contents and permits authors to self-archive final accepted version of the articles on any OAI compliant institutional / subject-based reposi-

tory. The journal does not charge for submission, processing or publication of manuscripts and even for color reproduction of photographs. Author can submit manuscript with cover page at acofseditor@gmail.com any time. The journal covers technical and clinical studies related to health, ethical and social issues in field of CraniOrofacial Sciences.Articles with clinical interest and implications are given preference. Students, Researchers, Clinicians and other Healthcare Professionals can worldwide access this journal to help them fuel new discoveries and improve patient care.

Bibliographic Listings/Indexing

OCTOBER 2013

Craniofacial Gunshot Trauma: A Case Study Approach

CRANIOROFACIALAND HEAD INJURY MANAGEMENT - RESIDENT'S PERSPECTIVE

ABSTRACT

ABSTRACT

Ideal management of patients who have underwent craniofacial trauma requires a collaborative interdisciplinary approach that involves the clinical expertise of a number of related specialties. This case study reveals the efforts and the contributions to an example of such type of trauma from eminent practitioners closely involved in the challenging care and management of patients who have required reconstruction of both acute and established injuries to the craniofacial hard and soft tissue. Craniofacial trauma due to Gunshot injuries is a challenging surgical emergency. In this case report we are discussing the whole aspects of managing a case with a compound orbitocraniofacial trauma due to gunshot injury. We are describing here the presentation, investigations and treatment, as well as the aim in managing such emergencies.

Everyday, men, women and children suffer head injuries. A car accident, a fall from height or sports injuries can range in severity from concussion to coma. Traumatic Brain Injury (TBI) can be fatal,dangerous and survivors, can show persistent problems that significantly affect their livelihood and well-being. India has the rather unenviable distinction of having the highest rate of head injury in the world. In India, more than 100,000 lives are lost every year with over 1 million suffering from serious head injuries, to be addressed by a handful number of craniofacial and neurosurgeons , as craniofacial neurosciences in India is new and rapidly expanding discipline and one has to be competent and razor sharp in applying its cognitive base and principles, and residency as is always described as an island in shades of grey, and in India it means higher pressure, higher stress loads, lesser patience, and longer quantum of time spent at work with sleepless nights and merciless bosses. For More Articles & Abstracts Log on to www.acofs.com

Editor-in-Chief Jenny

Carolina Ruiz, Venezuela

Executive Editor Lilian Roman, Mexico, Aharshi Banerjee, France K R David Tharkan, India

Board of Editors Atif Malik, NJ, Mayte Pinilla, Spain Yasser Fouad Elsawaf. Egypt, Venkataraman Sundar, India Mohammad Omar, Egypt, Mohammed Salah Abdel-hadi, France

International Advisory Board Suresh K Gupta, Washingto DC, Jagdeep Singh Nandhawan, India Chet Trivedy, UK, Ziad N-AI-Dwairi, Jordan, Maher Almasari, U.K. Mahmoud AI-Omiri, Jordan, Shamsul Alam, Bangladesh Magomed Lepshokov, Russia,Y.HYau, Australia

Submit Manuscript at :acofseditor@gmail.com

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MEDICOZZ

SYNDROMES

OCTOBER 2013

Frontal (or Coronal) Plane

Posterior

Sagittal (Median) Plane

Superaior

Anterior

Transverse (or Horizontal) Plane In feraor

Uses of Chloroquine

Factors Causing Low Cardiac Output

*Inadequate left Ventricular Filling

*Inadequate Left Ventricular Ejection

- Tachycardia - Rhythm distubance - Hypovolemia - Mitral or Tricuspid Stenosis - Pulmonic Stenosis - Constrictive peri carditis or tampo nande - Restrictive car diomyopathy

- Coronary artery disease causing LV ischemia or infarc tion - Cardiomyopathy - Hypertension - Aortic Stenosis - Mitral Regurgitation - Drugs that are neg ative inotropes

ORO FACIAL CHRONICLE


TECHNOMANIA

OFC-11 C ontinued from Page 5-6

OCTOBER 2013

High-Dose Statins ...

DePuy Synthes CMF TRUMATCH Solutions for Facial Reconstruction

concluded that the research provides further evidence of a link between periodontal disease and atherosclerosis and demonstrates that treatments aimed at reducing inflammation in one of these conditions may produce improvements for the other. The authors also raise the possibility that improved oral hygiene to reduce inflammation of the gums may lead to reduced inflamma-

ePuy Synthes (part of J&J) is now offering a complete package solution for creating customized ortho implants for maxillofacial reconstruction surgery. TRUMATCH CMF allows creation of computer simulations of the implants and discus-

tion of the arteries. "Statins have beneficial effects beyond their lipid lowering properties," explained one of the author of the study. "Physicians should take this into consideration when discussing antihyperlipidemic treatment options with their patients." Tawakol, the co-author of the study added that

sion with the design team before the implants are created. Additionally, surgical guides and occlusal splints are provided specifically for each patient’s unique anatomy and surgical need. TRUMATCH

tify potential surgical challenges, and simulates various approaches to skeletal osteotomies for harvest and relocation sites and reconstruction. Clinical engineers work with surgeons in live interactive sessions to assist in the development of a comprehensive pre-operative plan with objectives to optimize surgical time, reduce the

CMF Trumatch uses 3D printing, a type of additive manufacturing by which a digital file is translated into a physical object by a 3D printer to create patient-specific surgical guides and occlusal splints. This enables transfer of the preoperative plan to the operating room, potentially reducing OR time and assisting in the placement of implants.

patients with heart disease and stroke should inform their physicians about any significant gum disease and should be particularly careful to follow existing guidelines for tending to gum disease.

CMF offers:

number of procedural steps and achieve desired results. Anatomic bone models may be created from original patient CT scans or to the planned outcome, to provide tactile representation and to enhance patient communication.

Customized Implants

Smile! New Nanotube... particular, it can help prevent biofilms, vast colonies of bacteria that can cover implants and be very difficult to eradicate. A nanotextured

D

Pre-Operative Planning Services The company’s ProPlan CMFfi, a virtual surgical planning service, provides 3D visualization of individual patient anatomy, helps surgeons iden-

Intraoperative Tools

Customized craniofacial implants are derived from patient CT data to enable a better anatomic fit when compared to conventional reconstruction methods that require extensive contouring.

Device Preps Biologic Drugs for Injection

implant surface embedded with silver nanoparticles could prevent infection for the life of the implant. The TiO2 nanotubes also have a cosmetic advantage: transparency. That’s a plus for

ira reusable auto-injector for biologic drugs that require to be warmed up from the refrigerator to body tem-

A

selves or a caretaker not used to working with syringes.

medicines prior to use - offering the extra confidence and reassurance

fridge to body temperature in less than one minute and then reducing the injection duration by up to 30 per cent.As well as being faster and

any dental implant, but especially for a new type made from zirconia, which some patients choose because it is totally white. Shokuhfar and Friedrich have received a provi-

perature before each injection. The syringe is loaded directly into the injector, which is then warmed within the base unit. Once ready, a

Patients are increasingly able to manage arthritis and other con-

that is needed to ensure greater patient compliance for vital treatments.

easier to use, the new technology helps reduce the amount of discomfort associated with injecting drugs below body temperature - and could

sional patent and are working with two hospitals to further develop the technology,and eventually license it. Shokuhfar expects that implants with the new nanotubular surface will be easily assim-

button on top of the injector will deliver the drug, revealing the needle only at the last minute. The injector has a large grip handle and

ditions by injecting themselves with modern biological therapies.This technology will reduce the preparation and delivery

The technology guides the patient through the injection process - with audible, visual and tactile signals at each stage and

also help drugs disperse more rapidly into the body. Future applications of the technology could include cancer treatments, where there is

ilated into the market, since titanium implants, both dental and orthopedic, have a long history.

an intuitive mechanism for easier drug delivery by the patients them-

time of injections, as well as the associated pain, by heating the

the needle hidden from view - allowing the drug to be warmed from

an increasing trend towards selfadministration.

Color MRI Automatic Segmentation for Identification of Intracranial Hemorrhages and Masses

R

evolutions Medical out of Charleston, South

The resulting color images can be quickly viewed indi-

Blizzident Custom Chew-On Toothbrush

A

persistent problem with brushing one’s teeth is

as your brushing technique and discipline is. And even

the very act of brushing, which takes time, effort,

with a good technique, there are always regions you can-

Carolina has developed an image processing technology that brings a bit of color to MRI images. Color MRI uses proprietary algorithms to segment and colorize regions of the scan to hopefully make the images more readable, and

vidually or all together as a "riffle stack". A riffle stack consists of the individual MRI images assembled to create a single composite image that contains the data from the individual images. The riffle stack allows a radiologist,

and attention to detail to do it properly. But an upcoming product called Blizzident may change completely the way we brush our teeth. Looking like a dental guard, the device has thousands of bristles

All Blizzident-bristles are tailored to your own teeth. They are placed on the surface of

not reach, because of the geometry of your manual/ eletric toothbrush and bristles. Blizzident eliminates all those user errors completely. Just by biting a couple of times, you clean everywhere, and with per-

the firm is collaborating with H. Keith Brown, PhD, Professor of Anatomy at the Philadelphia College of Osteopathic Medicine to apply the technology to differentiation and characterization of intracranial hemorrhages and characterization of intracranial masses. The technology consists of software, which

using a computer mouse, to page through the images, creating a 3-D appreciation of the colorized MRI output even though the images themselves are not 3-D.The software program can also segment the data and create a true 3-D image of the area to be examined. For instance, bone, fluid and other tissue displayed in an MRI

positioned so that when the wearer chews on it, the bristles work to clean the teeth and massage the gums, all in about six seconds. Each Blizzident is created uniquely from a patient’s dental impressions so

your teeth in a 45 degree angle. They are also aligned exactly along your gumline in a 45 degree angle. Additionally there are interdental bristles between all your teeth. For tailoring, a 3D model of teeth is required.

fect technique. Blizzident bristle pressure is always the same, and within the correct limits. Whereas, when you brush by hand, often too much pressure is applied, and gums and teeth are harmed. And if not enough

uses various color masks to produce full-color composite images from gray-scale MRI output.

scan of the head can be electronically eliminated to allow a 3-D rendering of just the brain.

that the bristles are positioned most effectively to work on the

Traditional manual and electric toothbrushes clean only as well

pressure is applied, the cleaning effect is reduced.

ORO FACIAL CHRONICLE

user’s teeth.

Technical Note:


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OCTOBER 2013

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