International Journal of Medical Science and Dental Research

Volume 4 Issue 4 (July-August 2021)

    • Clinical study on the incidence of pain in Parkinson’s disease
      Abstract:
      this study focuses on the diagnosis and management of pain in parkinson’s disease. Separating PD related pain from pain of other origin is very difficult [1]. They all come under one umbrella among the different forms of PD related pain, musculoskeletal pain is the most common form accounting for 40% in PD. Pain occurs in about 60% of PD patients, two to three times more frequent in this population than in age matched healthy individuals. It is an early and potentially disabling symptom that can precede motor symptoms by several years. The lower back and lower extremities are the most commonly affected areas. The most used classification for pain in PD defines musculoskeletal, dystonic, central, or neuropathic/radicular forms [2]. Its different clinical characteristics, variable relationship with motor symptoms, and inconsistent response to dopaminergic drugs suggest that the mechanism underlying pain in PD is complex and multifaceted, involving the peripheral nervous system, generation and amplification of pain by motor symptoms, and neurodegeneration of areas related to pain The basal ganglia processes somatosensory information differently. Increased subjective pain sensitivity with lower electrical and heat pain threshold has been reported in PD patients. The mechanism is assumed to be diminished activity of the descending inhibitory system of the basal ganglia. Promising perspectives for this have come from studies using different pain scales in Parkinson’s disease. Selection criteria- “King’s Parkinson’s disease pain scale, ”[4] which was proposed by a multicenter group that included King’s College Hospital in London, is officially advocated by the “International Parkinson’s and Movement Disorder Society Non-Motor PD Study Group” for evaluating pain in Parkinson’s disease treatment prevalence.

      Keywords: Irreversible pulpitis, Mature, MTA, Pulpotomy



      • Child Perceptions Questionnaire 8-10: Validity and Reliability Of Turkish Version ABSTRACT:
        Evaluation of the oral health related quality of life(QoL) of children along with dental examination is critical to reveal the consequences of dental problems. The Child Perceptions Questionnaire(CPQ) is one of the scales used for evaluating the QoL of children. It was aimed to develop the Turkish version of CPQ8-10(T-CPQ8-10) and to evaluate the psychometric properties of this version. Methods: The CPQ8-10 was translated, a pilot-study assessed comprehensibility, and scale's adaptation was completed. The data was collected with T-CPQ8-10. Dental examination was performed. Confirmatory-factor-analysis for construct validity, item analysis, item-discrimination-index for discriminant validity, and Cronbach-Alpha-internal consistency-coefficient for reliability were calculated. Results: Totally 213 children (108 females,105 males) with a mean age of 9.38±0.75 participated. The mean CPQ8-10 was 15.31±10.82, Cronbach’s alpha for the total scale was 0.871. Items were statistically discriminant and significant. The total and sub-scales were statistically-significantly related. CPQ8–10 scores and global ratings were positively correlated (<0.001).

        Keywords: Irreversible pulpitis, Mature, MTA, Pulpotomy



      • Oil Extract of Jintan Hitam (Nigella sativa) Solution Gastric Ulcer Diseases ABSTRACT:
        Gastric ulcer is the destruction of the mucosal layer to the muscularis mucosa that is round or oval> 5 mm in shape due to the continuity of the integrity of the gastric mucosa being cut off. The occurrence of gastric ulcers is caused by an imbalance between aggressive and protective factors, Helicobacter pylori, Non-Steroid Anti-Inflammatory Drugs (NSAIDs), alcohol consumption, and stress. The content of active substances in Jintan Hitam such as thymoquinone (30% -48%), thymohidroquinone, dithymoquinone, p-cymene (7% -15%), calvacrol (6% -12%), 4-terpineol (2% -7%) , t-anethol (1% -4%). Thymoquinone as a component derived from black cumin oil extract has the main molecular target as anti-oxidant and anti-inflammatory. Antioxidant effect through scavenging action, induces anti-oxidant enzymes, and improves mitochondrial function. As for TQ as an anti-inflammatory by reducing IL-1β, and TNF-α, 5- LOX. Conclusion: Giving Jintan Hitam oil extract at the right dose is effective in reducing the incidence of gastric ulcers and there is no significant difference between giving Jintam Hitam oil extract and giving chemical treatment in the incidence of gastric ulcers. It is necessary to consider giving black cumin extract to patients with gastric ulcers who are allergic and resistant to chemical treatment.

        Keywords: Irreversible pulpitis, Mature, MTA, Pulpotomy



      • Adult Pulpotomy: the Last Resort to Save the Pulp. A Case Report. ABSTRACT:
        Most clinicians used to perform a total pulpectomy to the mature teeth exposed by caries as they believed that the pulp once inflamed, it must be extirpated. Adult pulpotomy has been introduced for the sake of removing only the degenerative and irreversibly inflamed part of the coronal pulp and leaving the healthy and vital pulp tissue. Methods: A 39-years old male patient with a carious lower right permanent molar with signs and symptoms of irreversible pulpitis was referred from the outpatient clinic of the Faculty of Dental Medicine, Al-Azhar University. After caries removal and access cavity preparation, excavation of all coronal pulp to the floor of the pulp chamber was done. Control of bleeding was achieved using pressure with a saline-soaked cotton pellet. MTA was prepared, applied to the floor of the pulp chamber with a wet cotton pellet was placed over it, and the tooth was temporized. Forty-eight hours later, the cotton pellet was removed, and the final filling was applied. The patient was followed up after 3,6,12, and 18 months and the tooth was still functioning and free of signs and symptoms.

        Keywords: Irreversible pulpitis, Mature, MTA, Pulpotomy



        • Analysis of the Effects of Double Straight Leg Raise and Abdominal Crunch Exercises on Core Stability ABSTRACT:
          Core training often involves engagement of the abdominals and plays an important role in rehabilitation, health promotion, and improvement of sports performance. Crunches and straight leg raises which are commonly employed in training the abdominal muscles. This study examined the effects of combining double straight leg raise and abdominal crunch exercises on core strength, endurance and flexibility.27 participants were recruited (13 males and 14 females)which comprised of three exercise groups [abdominal crunch group (ACG), double straight leg raise group (DSLG) and a combination group (ACG+DSLG)]for a period of six weeks. Pre and post-intervention parameters of core strength, endurance, and flexibility were measured. Paired sample t-test and ANOVA were used to test for differences within and between groups respectively.Within groups analysis showed significant improvements in all outcomes among the ACG+DSLG for core flexibility (0.004), endurance(0.021) and strength (0.004). Flexibility (0.046) improved within the ACG while the DSLG improved in flexibility (0.017) and strength (0.030).This study suggest that during core rehabilitation, abdominal exercise programs involving the recruitment of both the upper and lower abdominal muscle groups may be better in improving core stability.

          Keywords: Abdominal crunches, core, double, endurance, flexibility, stability, straight leg raise, strength.



          • Clinical Study on Dyskinesia in Parkinson’s Disease ABSTRACT:
            In this clinical obsevational study on dyskinesias and motor fluctuations which was conducted in a medical college hospital, about 100 patients with Parkinson’s disease were studied. Hoen and Yahr staging, AIMS Scale, Although several scales assess selected attributes of PD-dyskinesias, no comprehensive rating tool exists. Available rating scales were evaluated by the investigators and patient focus. Lateral segment [1] of the globus pallidus is overactive in dyskinesias in Parkinson’s disease. In the earlier stages of Parkinson’s disease before the emergence of motor symptoms when significant dopaminergic neuronal loss iscounterbalanced by endogenous compensatory mechanisms which are proposed. These are both dopaminergic focused on enhancing effects or exposure to existing dopamine and non dopaminergic being focused on reducing the activity of indirect striatal output pathway. Enhancement of compensatory mechanisms are responsible for the motor complications {Dyskinesias) [2] with levodopa. Novel and attractive disease modifying approach to PD would alleviate the symptoms.

            Keywords: DYSKINESIA, L-Dopa, Motor fluctuations.



            • Temporary Restorations for Resin-Bonded Fixed Partial Dentures ABSTRACT:
              Resin-bonded fixed partial dentures are an alternative to implant prosthesis and conventional fixed partial dentures when abutments are intact or exhibit only minimal carious lesion. However, a conventional provisional restoration is difficult to achieve. Some situations still require using a temporary treatment as when an anterior tooth is missing or for young patient in whom extrusion or migration of the teeth can quickly occur.This article presents and describes several clinical techniques and materials for implementing a provisional restoration for resin-bonded fixed partial denture.

              Keywords: Acrylic resin, resin-bonded fixed partial dentures, temporary restorations



              • Intra-Articular Injection of Platelet-Rich Plasma (Prp) In The Treatment of Temporomandibular Joint osteoarthritis ABSTRACT:
                Temporomandibular joint Osteoarthritis is a chronic painful degenerative pathology.First-line therapies such as mechanical rehabilitation and oral medication have failed. In view of this, researchers have studied new conservative treatments to delay recourse to arthroplastic surgery. If intra-articular injection of the platelet-Rich Plasma (PRP) in arthritic pathology has shown satisfactory results in humans, can this treatment, which has been studied mainly in gonarthrosis, be applied to the management of temporomandibular joint osteoarthritis? What would be the interest and place of intra-articular injection of PRP among the various therapies for this pathology?.

                Keywords: Temporomandibular joint- osteoarthritis - intra-articular injection – platelet-Rich Plasma (PRP)



                • Clinical Reasoning Process in the Management of Fixed Prosthesis Cases Among Senior Year Dental Students Part I: Treatment Plan ABSTRACT:
                  The aim of this study is to evaluate the clinical reasoning process among dental students at the Faculty of Dental Medicine in Casablanca. Materials and methods: A questionnaire including a clinical situation was distributed. 117 students in the last year of their training responded and the data were entered using a Microsoft Excel 2013 computer tool. Results: The majority of students were able to detect the objectives of the clinical case. 100% of them opted for pre-prosthetic care first and they placed prosthetic rehabilitation in the second step to replace the missing teeth. Each student proposed several prosthetic solutions for the clinical case, however the dental bridges was the most proposed treatment. Implant and removable solutions were also discussed. Conclusion: The students presented a difficulty to determine the treatment plan with a precise chronology. In order to develop an effective clinical reasoning strategy, educational strategies such as problem-based learning (PBL), learning clinical reasoning (LCR), community service learning and assessment methods need to be addressed. for rational decision-making in dentistry and more specifically in fixed prosthesis.

                  Keywords:Dental students. Clinical reasoning. Fixed prosthesis. Treatment plan.



                  • Decision-Making in the Management of Fixed Prosthesis Cases Among Senior Year Dental Students Part II: At-Risk and Specific Patients ABSTRACT:
                    To assess the ability of senior year dental students to adapt the treatment plan based on specific patient conditions. Materials and Methods: A cross-sectional study involved a sample of 150 senior year students at the Faculty of Dentistry in Casablanca. The survey used a questionnaire with different clinical situations. Results: The most proposed solution for a patient with low financial means was to replace the missing teeth with a removable prosthesis (67.5%). For the diabetic patient, 29.1% of the students felt that the treatment plan should not be changed if the diabetes was well balanced. 25.6% of the students felt that the treating physician should be contacted to find out if the diabetes was indeed balanced. For the patient with Parkinson's disease, 19.7% felt that care should be performed under deep sedation or general anesthesia. In the case of a patient undergoing radiotherapy for cavum cancer with alcoholism and smoking, 23.9% of the students thought that implants should not be used because of the healing delay, but also because of the risk of osteoradionecrosis and peri-implantitis. 20.4% thought that the treatment should be carried out before the radiotherapy. Conclusion: Our investigation revealed the weakness of students at the end of their training to undertake precautions for specific clinical situations. Learning methods and ongoing student evaluation must be implemented to ensure better preparation of students for their professional careers.

                    Keywords: Dental students, therapeutic decision, at-risk and specific patients