Background Aggressive periodontitis is a specific type of periodontitis with clearly identifiable clinical characteristics such as “rapid attachment loss, bone destruction” and “familial aggregation”. Regeneration of mineralized tissues affected by aggressive periodontitis comprises a major scientific and clinical challenge. In recent years some evidence has been provided that bioactive glass is also capable of supporting the regenerative healing of periodontal lesions. Objective The aim of this clinical and radiological prospective study was to evaluate the efficacy of bioactive glass in the treatment of intra-bony defects in patients with localized aggressive periodontitis. Methods Twelve localized aggressive periodontitis patients with bilaterally located three-walled intra-bony defect depth ? 2 mm, preoperative probing depths ? 5 mm were randomly treated either with the bioactive glass or without the bioactive glass. The clinical parameters plaque index, gingival index, probing depth, gingival recession, clinical attachment level, and mobility were recorded prior to surgery as well as 12 months after surgery. Intraoral radiographs were digitized to evaluate the bone defect depth at baseline and 12 months after the surgery. Results After 12 months, a reduction in probing depth of 3.92 + 0.313 mm (P <0.001) and a gain in clinical attachment level of 4.42+0358mm (P <0.001) were registered in the test group. In the control group, a reduction in probing depth of 2.5 +0.230mm (P <0.001) and a gain in clinical attachment level of 2.58 + 0.149 mm (P<0.001) was recorded. Radiographically, the defects were found to be filled by 2.587 + 0.218 mm (P <0.001) in the test group and by 0.1792 + 0.031mm (P <0.001) in the control group. Changes in gingival recession showed no significant differences. . Conclusion Highly significant improvements in the parameters Probing depth, Clinical attachment level, and Bone defect depth were recorded after 12 months, with regenerative material. KATHMANDU UNIVERSITY MEDICAL JOURNAL  VOL.10 | NO. 1 | ISSUE 37 | JAN - MAR 2012 | 11-15 DOI: http://dx.doi.org/10.3126/kumj.v10i1.6906

Introduction: Total Knee Arthroplasty (TKA) surgeries are associated with moderate to severe postoperative pain. Inadequate analgesia leads to patient distress, suboptimal knee mobilisation and complications due to delayed rehabilitation. Peripheral nerve blocks and central neuraxial techniques are in the vanguard of various analgesic strategies to minimise pain after TKA. Aim: To compare the effects of Continuous Epidural Analgesia (CEA) and Continuous Femoral Nerve Block (CFNB) on postoperative analgesia, knee rehabilitation and adverse effects after TKA surgeries. Materials and Methods: A prospective cohort study was conducted among 90 patients undergoing unilateral TKA at the Government Medical College, Kozhikode, Kerala, India. They were divided into two groups of 45 each. CEA (Group E) and CFNB (Group F) were given for postoperative pain management. Effectiveness of postoperative analgesia was measured by Numerical Rating Scale (NRS) scores at 6, 12, 24, 48 and 72 hours and also by need for rescue analgesics during the first 48 hours. Postoperative knee rehabilitation indices were measured on 1st, 2nd and 3rd Postoperative Days (POD). Incidence of adverse effects in each group was also noted. Continuous variables were analysed using students t-test, categorical variables using Chi-square test and NRS scores using Mann Whitney U test. Results: NRS scores were similar in both CEA (E) and CFNB (F) groups. On POD 1, 75.6% of group E and 71.1% of group F (p=0.630), on POD 2, 71.1% of group E and 68.9% of group F (p=0.818) and on POD 3, 62.2% of group E and 66.7% of group F (p=0.66) achieved specific rehabilitation indices. There was no statistically significant difference in pain scores, rescue analgesic requirement and rehabilitation indices between the two groups. No significant adverse effects were noted in either group. Conclusion: CFNB is as effective as continuous epidural block for postoperative analgesia and knee rehabilitation after TKA without any significant side-effects.

PURPOSE: To compare the marginal fit of all metal, porcelain fused to metal and all ceramic crowns fabricated using different materials and techniques commercially available. MATERIALS AND METHODS: 80 freshly extracted human mandibular first premolars were divided into 8 groups of 10 each which received Nickel-Chromium (Ni-Cr) all metal (AM) crowns, Cobalt-Chromium (Co-Cr) AM crowns, Ni-Cr three-quarter crowns, Co-Cr three quarter crowns, porcelain fused to metal (PFM) crowns with Ni-Cr copings, PFM crowns with Co-Cr copings, pressed all ceramic (AC) crowns and CAD/CAM fabricated AC crowns respectively. Crowns were cemented and specimen were sectioned buccolingually. The marginal gap was evaluated under a stereomicroscope. Lesser marginal gap indicated a better marginal fit. RESULTS: The mean marginal gap was maximum for Group 8 (222.3 μm) and least for Group 1 (85.5 μm). The mean marginal gaps for ‘all metal crowns’ and ‘metal ceramic crowns’ showed significantly lesser marginal gaps (p<0.05) for Ni-Cr Groups than Co-Cr Groups. When only ‘all ceramic crowns’ were compared, significantly lesser marginal gap was found for pressed AC crowns (148.6 μm) than CAD/CAM fabricated AC crowns (222.3 μm). CONCLUSION: Marginal fit of AM crowns were significantly better than PFM crowns and AC crowns. Ni-Cr group always showed better marginal fit than Co-Cr group. A better marginal fit of pressed AC crowns was seen than CAD/CAM fabricated AC crowns. Chamfer finish line showed a significantly better marginal fit than shoulder finish line.