Notes

Emesis of an enteral round: An infrequent the event of bullet embolism towards the thoracic esophagus.
Indian J Crit Care Med 2020;24(11)1010-1011.How to cite this article Kothekar AT. Combined Cardiopulmonary Ultrasound A Treatment Changing Modality in Acute Respiratory Failure. Indian J Crit Care Med 2020;24(11)1008-1009.Reduction in the maternal mortality ratio (MMR) continues to be a worldwide challenge. With repeated analytical studies done over decades, it has become possible to identify the significant contributors to this challenge. Right from low socioeconomic status to the availability of recent technological advances, many factors need attention and prioritization. Obstetric hemorrhage remains an important cause followed by hypertensive disorders of pregnancy and sepsis. In this issue of IJCCM, Miglani et al. have highlighted the various levels of the delays, which are significant contributors to the high MMR. In other preventive strategies, efforts will be needed to improve patient education, infrastructure, availability of trained manpower, blood storage facilities, timely referrals, transport facilities, etc., at peripheral levels. In the tertiary care centers, there is an increased need for trained manpower in critical care, the obstetric medical emergency team as a new concept, aggressive teamwork in intensive care unit (ICU) and operation theaters, the use of advanced technologies and newer drugs, etc. It will remain a tough challenge to reduce global MMR to 70 per 100,000 live births, as per plans by the United Nations, by the year 2030.
Bande BD. Critically Ill Obstetric Patients and Fetomaternal Outcome. Indian J Crit Care Med 2020;24(11)1005-1007.
Bande BD. Critically Ill Obstetric Patients and Fetomaternal Outcome. Indian J Crit Care Med 2020;24(11)1005-1007.Developmental anomalies are marked deviations from normal size, shape, contour, and various other parameters. An understanding of these anomalies and its application has been a clinical challenge. With the advances in diagnostic technology, the field of endodontics has been evolving with new treatment protocols, which gives promising results. The aim of this article is to present a case report on tooth anomaly that is taurodontism and its management in a patient with multiple taurodont teeth. This article brings discussion on anatomical variations of the taurodont teeth and the techniques related to the endodontic treatment of the same and how it differs from normal teeth.Autogenous transplantation is a fast and economical option when a suitable donor tooth is available for the replacement of nonsalvageable teeth. The preservation of the periodontal ligament (PDL) cells is considered to be critical for the success of a transplanted tooth. This article presents a successful case report of autotransplantation of a mandibular third molar using a novel technique to store the donor tooth extraorally during the surgical procedure and preserve the viability of PDL cells. One year of clinical and radiographic examination revealed no signs or symptoms suggestive of any pathology and the marginal adaptation of gingiva around the donor tooth appeared to be satisfactory. Inappropriate cases, this treatment approach may be considered as an alternative to conventional prosthetic rehabilitation or implant treatment.
This study aims to compare the efficacy of a combination of an inferior alveolar nerve block (IANB) plus buccal infiltration using 4% articaine versus 2% lignocaine in achieving anesthesia of lower first molar teeth with irreversible pulpitis.

Seventy adult patients were selected. A random sequence list was employed to administer IANB plus buccal infiltration. After the onset of lip numbness, cold test and electric pulp testing were performed. Five patients, four missed blocks and one no bleeding, were excluded. Heft Parker Visual Analog Scale scores during pulp extirpation were recorded. The data of sixty-five patients were statistically analyzed using Chi-square and Mann-Whitney U-test.

The success rate after lip-numbness for articaine is 91.42% and for lignocaine is 94.28%. The difference is statistically, not significant (
= 0.6425). EGFR activation During access, the success rate for lignocaine is 96.87%, whereas 96.96% for articaine. This difference is also not significant (
= 0.982366).

IANB plus buccal infiltration using articaine or lignocaine is equally effective in anesthetizing mandibular first molar with irreversible pulpitis.
IANB plus buccal infiltration using articaine or lignocaine is equally effective in anesthetizing mandibular first molar with irreversible pulpitis.
This study determined the corrosion rate by mass loss caused by oral strains of sulphate-reducing bacteria (SRB) in Kerr endodontic files (KF), aiming the development of a biopharmaceutical that facilitates the removal of endodontic limb fragments from root canals.

Nine new KF were analyzed after immersion in the modified Postgate E culture medium inoculated with
oral (84 days),
in the consortium (84 days) and environmental
(119 days).

Optical microscopy revealed corrosion suggestive areas in all files submitted to immersion in SRB cultures, presenting a statistical difference (
< 0.05) between the samples environmental
and KF control and between oral
and KF control. Epifluorescence microscopy revealed an active SRB biofilm over the entire metal surface of the KF, as evidenced by the SYTO
9 fluorophore.

SRB were capable of promoting biocorrosion in Kerr type endodontic files, but with low rate.
SRB were capable of promoting biocorrosion in Kerr type endodontic files, but with low rate.
The growing demands for esthetic restorations have stimulated intensive research in the field of adhesive dentistry. Dental adhesive systems are used to promote adhesion between composite resins and dental structure. In the fundamental principles of adhesion, the primary mechanism contributing to the formation of adhesion is micromechanical bonding between the restoration and the tooth. The bond strength of self-etching adhesives to dentin was found to be almost equal to that of total-etch adhesives. The aim of the present prospective, double-blind, randomized controlled clinical trial was to evaluate and compare the clinical performance of two self-etch adhesive systems with total-etch adhesive system in noncarious cervical lesions (NCCLs).

In each patient, three teeth were randomly assigned according to the adhesive system used to Group A (total-etch adhesive system), Group B (two-bottle self-etch adhesive system), and Group C (one-bottle self-etch adhesive system). The clinical efficacy of these adhesive systems was determined by evaluating the retention rate, marginal integrity, and postoperative sensitivity at the following three levels baseline, 6 months, and 18 months by following the Modified USPHS criteria introduced by Vanherle


In the present study, the retention rate at 18 month in Group A, Group B, and Group C of 96%, 92%, and 92% was observed, respectively. A marginal integrity at 18 months was 88%, 80%, and 84% for Group A, Group B, and Group C, respectively. Postoperative sensitivity at 18 months was 16%, 12%, and 12% for Group A, Group B, and Group C, respectively.

The clinical performance of total-etch and self-etch adhesive systems in NCCLs did not differ significantly with regard to the evaluated parameters - retention, marginal integrity, and postoperative sensitivity.
The clinical performance of total-etch and self-etch adhesive systems in NCCLs did not differ significantly with regard to the evaluated parameters - retention, marginal integrity, and postoperative sensitivity.
Thorough cleaning of the pulp space is a challenging task. The mechanical instrumentation alone is usually not sufficient to completely debride the canals, and therefore, it requires the chemical action of irrigants also to disinfect the difficult to reach areas.

The purpose of this study was to determine apical extrusion and assess irrigant penetration through cone-beam computed tomography (CBCT) for EndoActivator (EA) and XP Endo Finisher (XP).

Sixty single-rooted mandibular premolars with oval-shaped canals were equally divided into three groups after instrumentation, based on the final irrigation Group-1 syringe needle (30G Max-I-probe), Group-2 EA, and Group-3 XP. After the final irrigation, the weight of the extruded sodium hypochlorite was calculated. The prepared canals were then irrigated with a radiopaque contrast medium, which was activated according to the group of the sample (Group-1, 2, or 3). The volume of irrigant filled in the canal, especially in the apical third was determined through special tools in CBCT imaging.

One-way ANOVA test was used to compare the different groups.

Significantly more apical extrusion was seen in XP (
< 0.001). Both XP and EA have shown complete penetration of irrigant in the canal (100%).
Significantly more apical extrusion was seen in XP (P less then 0.001). Both XP and EA have shown complete penetration of irrigant in the canal (100%).
The aim of this study is to compare the microleakage of bulkfill composite activated by modulated photoactivation between fluorosed and nonfluorosed teeth using the confocal laser scanning microscope.

One hundred and twenty intact human premolar teeth with Thylstrup and Fejerskov index fluorosis index 0-4 were stored in 0.5% thymol at the room temperature until further use. Standardized Class V preparations of 2 mm depth, 3 mm width, and 2 mm height were prepared on the buccal surface. The cavities were etched with 37% phosphoric acid, rinsed and primed with Tetric
bond, cured for 20 s with Quartz Tungsten Halogen (QTH) variable intensity light-curing unit spectrum-800 operating at 450 mW/cm
. Later, bulk fill composite was placed in the cavity and cured. Depending on the curing mode used, all the fluorosed and nonfluorosed teeth were divided into three subgroups each (
= 20) - Conventional light curing, stepped curing, and pulse delayed curing. All samples were stored in distilled water at the room temperature for 24 h and subjected to 500 thermocycles. The prepared teeth were placed in 0.6% rhodamine solution for 48 h; sectioned longitudinally using a hard-tissue microtome and scanned under a confocal laser scanning electron microscope. Data were analyzed using the one-way ANNOVA, Wilcoxson signed-rank test, and Kruskal-Wallis test.

Significant differences were observed between fluorosed and nonfluorosed groups. Intragroup comparisons showed significant differences between fluorosed step and conventional subgroups.

Fluorosed teeth had higher microleakage values than nonfluorosed teeth. Pulse-delayed subgroup had the least microleakage to that of conventional and stepped curing subgroups, in both fluorosed and nonfluorosed groups.
Fluorosed teeth had higher microleakage values than nonfluorosed teeth. Pulse-delayed subgroup had the least microleakage to that of conventional and stepped curing subgroups, in both fluorosed and nonfluorosed groups.
The aim of the study was to compare the fracture resistance of endodontically treated teeth with simulated invasive cervical resorption cavities, restored with different restorative materials, namely, conventional glass-ionomer cement (CGIC), resin-modified glass-ionomer cement (RMGIC), flowable composite (FC), and giomer.

Sixty extracted human permanent maxillary central incisor teeth were assigned to six groups,which were, Group 1 (intact teeth, control), Group 2 (teeth with biomechanical preparation and resorption cavity), Group 3 (CGIC), Group 4 (RMGIC), Group 5 (FC), and Group 6 (giomer). Except for Group 1, other groups were subjected to endodontic treatment. Teeth of Group 2 were left unobturated and teeth of Groups 3-6 were obturated. A simulated resorption cavity was prepared labially in the specimens belonging to Groups 2-6 and restored with respective restorative materials. The specimens were subjected to compressive load until failure in an Instron testing machine and the load at failure was recorded in Newtons.
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