Context: The incidence of third molar impaction is very frequent in the dental arch; however, the etiology remains unclear. Assessment of ramal parameters might aid in deducing the chance of the lower third molar being impacted. Aims: To investigate the mandibular ramus features that could contribute to the etiology of mandibular third molar impaction. Settings and Design: A prospective study. Methods and Materials: In total 1,125 patients (568 males and 557 females) who satisfied the inclusion and exclusion criteria were included in the study. Six linear and four angular measurements such as ramal height, ramal width, mandibular body length, third molar width, the body of mandible width, retromolar space, angle of the impacted tooth, the angle between condyle and coronoid process, gonial angle, and inclination of the lower posterior teeth were made using digital panoramic radiographs and recorded. Also, the occurrence of impacted lower third molar was noted. Statistical Analysis Used: Comparisons between groups were done using Student's t -test. Pearson correlation was used to assess the degree of relationship between retromolar space and mandibular measurements. Results: Control group showed significantly greater measurements in most of the variables, whereas the impacted group showed no significant difference. A significant correlation of retromolar space is found with body height, third molar width, and angle of impaction. Conclusions: The present study found that the configuration of the mandibular ramus appears to be discrete in many aspects in the erupted other than impacted lower third molars subjects, which might be a possible cause for the impaction.
Introduction Shoulder disorders are frequently encountered by clinicians and are a common cause of musculoskeletal pain in the general population. Clinical tests specific to each shoulder pathology, MRI, and arthroscopy are the most relied upon modalities of diagnosis used by many clinicians. The aim of this study was to correlate clinical tests and MRI with arthroscopy as the gold standard and whether a negative MRI with a positive clinical test could justify an arthroscopy. Materials and methods A total of 120 consecutive patients who had a history of shoulder pain or instability were evaluated by clinical tests and MRI, and underwent arthroscopy. Based on the confirmatory findings of arthroscopy, they were classified as True Positive (TP), True Negative (TN), False Positive (FP) and False Negative (FN) for each modality i.e., clinical tests and MRI. Results Clinical assessment of rotator cuff tears in comparison to arthroscopy yielded a sensitivity of 96.88%, specificity of 92.86% and diagnostic accuracy of 95%, whilst MRI had a sensitivity of 90.62%, specificity of 92.86% and diagnostic accuracy of 91.67%. In anterior labral lesions, clinical assessment had a sensitivity of 94.44%, specificity of 97.62 % and diagnostic accuracy of 96.67%, whilst MRI had a sensitivity of 83.33%, specificity of 92.86%, with diagnostic accuracy of 90%. Interestingly, in the clinical assessment of superior labral tear from anterior to posterior (SLAP) lesions, a sensitivity of 90%, specificity of 95%, and diagnostic accuracy of 93.33% were observed while MRI had a sensitivity of 60%, specificity of 92.50%, and diagnostic accuracy of 81.67%. Conclusion On the basis of these results, clinical assessment appears to be an effective tool in diagnosing shoulder pathologies, whereas MRI, though reliable in the identification of rotator cuff tears and instability, does not identify patients with SLAP lesions effectively. This study reinforces the importance of a good clinical examination of the shoulder, especially in chronic pain and an uncertain MRI, therefore improving patient management.
Total knee arthroplasty (TKA) is one of the commonly performed procedure for osteoarthritis knee, rheumatoid arthritis, post traumatic arthritis etc. with a main goal of providing a pain free, stable and functional joint. Assessment of clinical outcomes should be done by both objective findings and by taking into account the patients point of view and his/her own evaluation of the functional trends of the treated joint. Forgotten Joint Score (FJS) is one such recently developed patient reported outcome measure (PRO), with better discriminatory power. The main aim of our study was to evaluate the patient reported outcomes in our patients who underwent TKA for osteoarthritis knee using FJS system and to analyse the temporal relationship of the outcomes of the time since surgery. Though there are various scoring systems, the "forgotten joint score" system is a disease specific and joint specific scoring system . We concluded that the best scores among our patients was obtained in patients operated 12months and 24months before the conduct of study. Therefore we can conclude that the maximum improvement in functional status of patients can be expected between 6months to 12months after sugery. Age, gender had no affects on the outcomes and the FJS score. Patients with unilateral TKR as well as bilateral TKR both had equally better functional outcomes and FJS scores.
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