[DrAnil]

 

Edmonton institute aids foreign-trained professionals

Manilall eventually heard about the Bredin Institute in Edmonton.

Funded by the federal and provincial governments, the institute helps foreign-trained professionals navigate the Canadian licensure system.

Executive director Debbie MacDonald says professionals trained in other countries are often lost when they arrive in Canada.

“Very much in the health professions feedback is not available,” she said.

“So they get advice from one another on where they think they went wrong, which often puts them in the wrong direction. They start studying the wrong things again …and fall short again.”

Manilall says the pressure to get 80% to 90% on exams, covering academic material he last studied 20 years ago, was intense.

By the time he reached his clinical skills exam he hadn’t practiced for six years and his confidence had been shattered.

“It’s been a nightmare in the sense you are something, but you feel as though it’s been taken away,” he said.

“You feel humiliated. You question who you are. You go through bouts of depression. But you always feel that you can make it, and you strive and you strive.”

The Bredin Institute’s Debbie MacDonald says it’s a story she’s heard hundreds of times.

“For them it’s very depressing, very discouraging," she said.

MacDonald says there should be more support for those trying to qualify in Canada, and better screening overseas, so potential immigrants will know the challenges they face when they arrive.

Alberta Dental College satisfied with approval process

“When it comes to getting registered in Canada we absolutely…bias on the side of public protection,” said Dr Randall Crutze, spokesman for the Alberta Dental Association and College.

Crutze says applicants fail or drop out of the process for a number of reasons, including being completely unqualified.

“I think that 100% of those people who are successful are going to do very well in private practice in Canada.”

Meanwhile, Jayanth Manilall has one last chance to pass his clinical skills exam.

Before he takes it, he wants to get back the confidence he says he’s lost during the past six years.

He’s returning to South Africa to work as a dentist for three months.

“So I can pay for the exam fees, and also send some money for the family. It’s going to give me two things, some finance and getting back my skills and confidence."

If that doesn’t work, he says he’ll close his family’s chapter on Canada, and move to a country that will accept his credentials.

        

[DrAnil]

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

        

[DrAnil]

 

Dental council member held for taking bribe

 

A dental surgeon, who is a member of the Dental Council of India, and three others were arrested by the CBI for taking a bribe of Rs 25 lakh from a self-financing medical college on Tuesday.

CBI officers said the college had paid the surgeon to get the council’s permission to start post-graduate dental courses this year. The other arrested include an administrative officer of the college that had sought permission, a former AIADMK legislator and a mediator.

 

The officers said the management of Adi Parasakthi Dental College in Melmaruvathur had given Rs 25 lakh to Dr S Murukesan at his clinic, Cranio Facial Clinic, on Llyods Road in Royapettah in the heart of the city to start MDS courses. On Tuesday, the CBI officers raided his clinic and seized Rs 25 lakh cash.

"During inquiry he confessed that the money was given to him by officials of Adhi Parasakthi Dental College to get approval for MDS," a senior officer said.

The Dental Council of India is the regulatory authority for dental education in the country.

The Melmaruvathur college admits 100 students for the BDS course. Dr S Murukesan, who is also the dean (in-charge) of SRM Dental College, was nominated to the Dental Council of India by the Annamalai University, Chidambaram.

The CBI also arrested Adi Parasakthi Dental College administrative officer K Ramabadhran, former AIADMK MLA of Arcot constituency T Palani and a mediator, R Karunanidhi of Chromepet. They were produced before the CBI court in Egmore and remanded in judicial custody for 15 days. The CBI slapped a corruption case against Adhi Parasakthi Dental College managing director S Srilekha.

It’s not the first time Dr Murukesan has faced corruption charges. The Dental Council of India has put him under the scanner after it received a complaint from a senate member of the state medical university in September last year. The council received a letter from Dr Yashwanth Venkaraman, a senate member of the TN Dr MGR Medical University, stating that Dr Murukesan and another dentist had demanded Rs 450 crore from 16 dental colleges to circumvent the common entrance examination proposed by the Centre.

Two months later, Dental Council of India secretary Dr SK Ojha wrote to the 16 colleges asking them for a report on the complaint. "Only three colleges replied. We are still inquiring into the complaint," Ojha told TOI. There were also cases filed against Dr Murukesan’s nomination from the Annamalai University, he said.

        

[DrAnil]

 I have come across many clinics who employ fresh dental graduates. In fact some of them are not even full graduates; they are still into their internship. At least these clinic chains have a proper and formal procedure of recruiting dentists, which eventually results in better quality personnel than in the private set ups. I am not against private clinics, but the way these private practitioners malign the clinic chains is not correct.

        

[DrAnil]

 

 

 

The holidays are fast approaching, and while many may stamp the coming months as “slow,” a dental practice can do a number of things to boost revenue during this time. Think of the next few months as a built in marketing plan to use to your advantage. This is a great time to bolster patient loyalty and, likewise, show your loyalty to them.

1. Plan to promote. The first thing you will want to do to gear up for the holiday season is to create a schedule. Sit down with your staff and make note of which holidays are coming up (i.e. Thanksgiving, Christmas, Hanukah, New Year’s, Valentine’s Day), and which procedures or products you are most concerned with promoting. After you have solidified a working schedule, you are ready for the creative part.
2. Make it relevant. Now it’s time to find interesting and relevant ways to engage your patients. Brainstorm newsletter ideas that tie into the holiday season. You can be as creative or as straightforward as you like.  For instance, a December newsletter titled “Candy Cane Cleanup” —designed to educate dental patients on the top five most worrisome holiday treats for teeth — can be informative and relevant to patients.  At the bottom of the newsletter, you can add a call-to-action button that allows patients to request an appointment. Contrarily, a more straightforward newsletter or social media post may include a New Year’s discount on teeth whitening when you refer a friend. 
3. Be festive. If you use a patient engagement service, such as Smile Reminder, then you have access to a full suite of predesigned newsletters perfect for the holidays. As I alluded to above, it is okay to get spirited in your approach. Try a Holiday Card Smile Brightening Treatment or a Valentine’s Day BOGO special on facial aesthetic treatments.
4. Use social media. It isn’t only newsletters that can help boost activity during the holidays, but social media can also be a big player. Use the holidays to create interactive posts to keep your office in the thoughts of your patients. For example, do a countdown to a bright and healthy New Year’s smile, where for the weeks leading up to the holiday your office posts a daily tip for a bright smile. This is sure to be a fun and an engaging way to draw patient attention during the holidays.
5. Target effectively. Just as targeted outreach is effective all year, it is also doubly effective during the holidays. Choosing particular groups of patients to receive specific newsletters makes them feel special and shows you care. Consider a holiday “use It or loose It” reminder to those patients who take advantage of flex spending insurance dollars. Include a call-to-action to schedule appointments before the year ends. The more specific and targeted you can be, the more likely you are to bolster your bottom line.

By following these quick and easy steps, your office is sure to be well on its way to a happy (and lucrative) holiday season!

        

[DrAnil]

 

 

Fig. 1 — Premolar tooth with minimal tooth structure remaining requires a post and pins to ensure connection of the coronal build-up to the remaining root structure.

Fig. 2 — A fiber-reinforced resin-based composite post and two pure titanium pins (Filpins) have been placed in the premolar shown in Fig. 1 to ensure retention of the build-up material.

Fig. 3 — Radiograph from endodontist showing well done endodontic treatment, but minimal tooth structure remaining.

Fig. 4 — Tooth shown in Fig. 3 was built up with two fiber-reinforced resin-based composite posts and bonded composite.

Fig. 5 — Often, endodontically treated teeth with minimal tooth structure remaining, such as the second molar shown, can be built up adequately to provide long-term service.

Fig. 6 — Preoperative view of patient with gross caries in both maxillary and mandibular anterior teeth. Several of the teeth were treated endodontically and posts, build-ups, and tooth-colored crowns were placed on the teeth. Assuming adequate oral hygiene is practiced, teeth restored in such manner will serve for many years.

No tooth structure remaining coronal to the gingival tissue

There are clinical situations in which these teeth should be retained, including if the practitioner plans to extrude the tooth orthodontically. However, when considering the clinical success of dental root-form implants compared to questionable teeth, it is often better to extract the teeth and place implants. In the debatable event that a decision is made to restore such teeth, a post in single-rooted teeth or more than one post in multirooted teeth should be placed. Even with adequately placed posts present, the long-term success of such teeth is very questionable.

No tooth structure coronal to the bone

These teeth should usually be extracted. The only procedure, infrequently accomplished, that may allow teeth with long roots to be retained is orthodontic extrusion of the tooth. However, the cost of orthodontic extrusion and the time involved in waiting for the tooth to extrude and stabilize make the procedure questionable unless there is some major reason to retain the tooth.

Quality of remaining tooth structure

Assuming that there is a significant amount of coronal tooth structure remaining, the quality of the remaining tooth structure should be considered. Often, remaining tooth structure has discolored areas, slightly demineralized areas, cracks, undermined areas, or other negative characteristics. Removal of tooth structure with these characteristics allows a realistic and necessary appraisal of the amount of viable tooth structure remaining. After removing the affected areas, the same suggestions stated in the previous section on quantity of tooth structure remaining apply. Posts are often indicated.

Remaining adjacent teeth

If an endodontically treated tooth stands alone without adjacent teeth present, it will receive significantly more occlusal forces on it when compared to a tooth that has sound adjacent teeth. When restoring a tooth that has no or few surrounding teeth, it is appropriate to use a post or posts to augment the strength of the endodontically treated tooth, and to ensure that the remaining coronal tooth structure is strongly connected to the root portion.

Occlusion

One of the most important factors relative to the question of post placement in an endodontically treated tooth is the nature of the patient’s occlusion. Patients with bruxing or clenching habits place far more stress on teeth than those patients with normal occlusion. Usually, bruxers move their mandibles in left-right and forward-back movements, grinding off canine rise and incisal guidance. Enormous lateral stresses are placed on the teeth of these patients. Clenchers place forces in an apical direction with intense load and frequency. A logical decision is to place posts in bruxing and clenching patients.

Planned restoration to be placed on the tooth

An endodontically treated tooth planned to receive a single crown has minimal stress when compared to a tooth that is planned to be an abutment for a fixed prosthesis or an abutment for a removable partial denture. If an endodontically treated tooth is expected to have significant load placed on it in service, posts should be placed.

In summary — YES, posts are often needed, and there are many clinical factors related to whether or not they should be used, in addition to just how much tooth structure is remaining. Clinical judgment is still critical in deciding whether or not to use posts.

        

[DrAnil]

 I dont think this is enough. These guys know how to get away with the rules. I understand these pharma companies route the gifts and cash through the distributors who will claim them as reimbursement of marketing expenses. Our country needs to have tough regulations.

        

[DrAnil]

 

Researchers intend to supplement their microtribological analyses of the interaction between toothbrush, toothpaste and tooth surface with practical tests, using a tooth cleaning machine they have developed themselves. Bottom right: Friction and wear tests with individual bristles. (Credit: Copyright Fraunhofer IWM)

 

Determining abrasion rates with microtribological tests

The researchers at the IWM have chosen an alternative method to this radiotracer system. "Our new approach enables us to determine realistic abrasion rates and characterize the interaction between brush, enamel and toothpaste. What’s more, our tests are less laborious than the time-intensive radiotracer procedures carried out by only a handful of laboratories worldwide," says Dr. Andreas Kiesow, team leader at the IWM. The scientist and his team have successfully managed to determine the abrasion of various toothpastes on a microscopic scale and to measure the friction values using microtribological experiments. "Until now, tribological values such as friction coefficient, did not exist" says Kiesow.

The researchers use human teeth as well as different toothpastes made by industrial partners for their experiments. These toothpastes were diluted with water and saliva in order to create a solution whose consistency corresponds to the mixture of toothpaste and saliva that is present when people brush their teeth. The friction and wear tests were each carried out with a single bristle — referred to as a monofilament. This is mounted in specialized tribological instruments, a microtribometer and a nanoindenter, and moved over the sample in both straight and circular motions, in the latter case up to 8000 times. Highly sensitive instruments then measure the depth of the resultant marks left on the surface of the tooth.

"Our findings reveal that the RDA value of toothpastes correlates with the depth of abrasion; the higher the value, the greater the abrasion. By analyzing the friction value we also identified a clear relationship between the friction behaviors of the bristle on the dental enamel and the abrasiveness of the toothpaste," sums up Kiesow. The new process allows the researchers to not only characterize the abrasion more quickly and simply, but also to describe how different geometries of toothbrush filaments act upon the surface of the tooth and how the bristle shape should ideally be designed. The experts at IWM can use their know how to support manufacturers of dental hygiene with product development. At the end of the day it is the consumer who benefits most.

        

[DrAnil]

 Well said Sir..

        

[DrAnil]

 

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[DrAnil]

 

Laboratory Technique

Provisional Restoration

A provisional bridge can also be fabricated in the laboratory using hybrid resin. The previously developed patient/clinician-approved diagnostic wax-up was first matrixed with silicone putty. A duplicate cast was minimally prepared and lubricated with petroleum jelly. An initial application of enamel shade hybrid resin material was placed into the matrix from the heated syringe, distributed appropriately with the electric spatula, and allowed to cool. The dentin shade was then syringed into the matrix and seated on the cast while it was ensured that the matrix was completely seated. After the material was allowed to cool for four minutes, the matrix was carefully removed by first carving carefully where significant undercuts existed, to prevent damaging the uncured wax-like material. (Voids from trapped air can be repaired, if necessary, using the electric spatula.) After the hybrid resin had cooled, it was carved to develop the desired final contours and anatomy, after which the occlusal and interproximal contacts were thoroughly checked. The glaze was then applied with a disposable brush and cured. Figure 10 shows the excellent results that can be achieved using this method for a provisional for the same case.

Fabricating the Definitive FPD

All ceramic materials and technologies have exhibited an exponential development over the previous 20 years for ceramic indirect restorative advancements. The workhorse porcelain-fused-to-metal restoration is slowly being replaced with high-strength CAD/CAM-developed ceramic materials. Development has moved through leucite-reinforced pressed ceramics to pressed or machined lithium disilicate ceramics. The use of YZ zirconium oxide as a substrate veneered with stacked ceramics has evolved into monolithic CAD/CAM-produced restorative systems. In this case, the FPD was created with full-contour zirconia, utilizing a digitally optimized fabrication technique. Upon completion of the master cast fabrication, the casts were articulated in a centric relation utilizing the provided occlusal registration.

The working cast was scanned and, utilizing the design software, the margins were identified at 100 times the actual size, thereby providing a level of accuracy that is impossible to achieve with traditional die trimming (Figs. 11-12). The virtual cement gap was determined specifically for each area of the restoration by establishing independent parameters for margins, axial walls, the occlusal surface, and line angles. The desired external contours were transferred from a scan of the approved diagnostic wax-up (Fig. 13-16). The .stl file was then e-mailed to the central manufacturing facility for milling of the restoration. Upon receipt of the file, the restoration was milled from a pre-sintered zirconium oxide disk. Next, the restoration was dipped in the appropriate stain to achieve the desired dentine shade of the completed restoration. Finally, the restoration was sintered in an oven at 1600 degrees Celsius, fusing the zirconia particles and shrinking them by approximately 30%. The sintering process transforms the zirconia into a more dense material with high strength. The restoration was then returned to the laboratory for confirmation of internal, occlusal, and interproximal adaptation. After minimal adjustments were accomplished, external characterization was applied for appropriate intra-oral esthetic matching. For optimal results, A-3 Dentine was applied to the areas of wear illustrated on the buccal cusp tips of teeth #29 and 30 (Fig. 17).

Placement of the FPD

The definitive restoration was tried in to assess marginal fit, adequate interproximal contact with the distal of tooth #28, and occlusion. A bitewing radiograph confirmed the visual inspection that marginal fit had been achieved (Fig. 18). Occlusal and interproximal contacts required no adjustment owing to an accurate impression, bite registration, and meticulous laboratory work. A dual-cure resin cement was used to retain the FPD. A resin cement will adhere to the abutment tooth structure for added retention. The patient was pleased with the improved function and high esthetics of the final result (Fig. 19). The selected shade was successful in blending the opposing dentition (shade A2) with the adjacent dentition (more A3).

Summary

Dentists today have a variety of materials at their disposal for each step in the fabrication of an FPD. The successful recording of preparations, manufacture of multi-unit restorations, and their delivery intraorally is aided by astute attention to material properties at each of these critical stages.

Case Study Introduction

Restoring teeth in the anterior region routinely presents with esthetic challenges. In this case, the patient, a 42-year-old female, was unhappy with her smile. Several composite restorations had been placed a number of years earlier due to decalcification of the facial surfaces of her anterior teeth and had discolored over time. In addition, the patient’s high lip line and significant gingival display presented a challenge that mandated meticulous planning. (Figure 1) The spacing and position of the teeth were otherwise ideal, allowing minimal preparation for 6 porcelain veneers. As increasing the length of the central incisors would result in more harmonious proportions, gingival recontouring prior to veneer preparation was recommended to the patient. Probing and sounding was completed to ensure that there was adequate room to perform soft tissue recontouring (Figure 2), and a CBCT scan was captured and studied.

 

At the first treatment appointment, a laser gingivectomy was performed to remove the gingival excess.  Proper, consistent, and adequate reduction of the facial surfaces was facilitated through depth cuts on the facial surfaces of the anterior teeth. (Figure 3) After the depth cuts had been created, the preparations were completed and carried over the incisal edges. Preparation of the teeth on the centric stops was avoided by checking the occlusion before initiating the preparations and by recording the centric stops (in blue). (Figure 4)

Gingival retraction paste was used to achieve adequate retraction and hemostasis for optimal impression conditions. B4^® pre-impression surface optimizer (DENTSPLY Caulk) provided ideal wetness of the preparations for consistent coating with VPS impression material. An impression material with extended working time (Aquasil Ultra Xtra Smart Wetting^®, DENTSPLY Caulk) was used as there were several preparations in this case. Porcelain veneers were laboratory fabricated.

At the seat appointment, a total-etch bonding agent (XP Bond^®, DENTSPLY Caulk) was applied to ensure high bond strengths. The veneers were next cemented using the base portion, without catalyst, of an esthetic resin cement (Calibra^®, DENTSPLY Caulk), giving an extended working time during seating. Each restoration was placed, the margins cleaned, and the teeth flossed before an initial tack cure. Excess cement was then removed and a full cure was initiated. The central incisors were seated first, followed by the right and left lateral incisors and canines, and a final cure of 40 seconds on each restoration was accomplished (20 seconds on the facial surface and 20 seconds on the palatal surface). (Figures 5-8)

The veneers demonstrated a precise fit and smooth transition to natural tooth structure. The patient was very pleased with the esthetic results achieved. At 6-month recall, gingival health adjacent to the veneers, and esthetics, were excellent. 
As demonstrated, proper planning of preparation style, material selection and patient communication are key to the success of anterior veneers.

        

[DrAnil]

Irish dentists have welcomed new EU regulations which control the use of a chemical used in tooth whitening products.

The directive from the European Council regulates the use of hydrogen peroxide. Specifically, it bans the use of tooth whitening products which contain over 6% of the chemical. It also states that tooth whitening can only be carried out on a patient if the procedure is being supervised by a dentist.

Meanwhile, people under the age of 18 will not be allowed use these products at all.

Last month, the Irish Dental Association (IDA) expressed serious concern about some tooth whitening products. It claimed that many of these products ranged from ‘useless to dangerous’.

It also expressed concerned about unsupervised tooth whitening and insisted that only fully-qualified dentists should be allowed to provide such services.

Under this new directive, products that contain up to 0.1% of hydrogen peroxide will still be available to consumers. However, when it comes to products that contain between 0.1% and 6% of the chemical, a dentist must carry out a full clinical examination and the first treatment. After that, patients can continue the treatment themselves.

Commenting on the new directive, Dublin-based dentist and IDA member, Tom Feeney, said that patient safety ‘is the number one priority’ and this move will enhance that.

"The new regulations ensure that properly qualified dentists are carrying out what is a dental procedure, that safe products are being used and that the treatment is restricted to those over 18," he said.

He pointed out that tooth whitening is a safe procedure ‘if carried out by a dentist’. However, he warned that it should not be carried out too often.

"As a rough guide once a year should be sufficient. We don’t recommend it for pregnant women or heavy smokers or drinkers as it can cause particular problems for each of these groups," he added.

Each EU member state will have 12 months to incorporate the directive into national legislation following its publication in the Official Journal of the EU.

 

        

[DrAnil]

From today, those under the age of 18 will not be allowed to have their teeth whitened, following the introduction of strict new EU regulations.

The new EU directive regulates the use of the chemical used in tooth whitening products – hydrogen peroxide.

It states that from today, consumers can only be sold whitening products that contain no more than 0.1% hydrogen peroxide. Products that contain more than that will have to be administered by a dentist in the first instance.

However, products with more than 6% hydrogen peroxide are now illegal.

This means that anyone who wants to undergo tooth whitening must be examined by a dentist and have their first treatment carried out by that dentist. Any further treatments must be undertaken on the prescription of the dentist.

According to Tom Feeney of the Irish Dental Association (IDA), these new regulations will enhance patient safety.

"The dentist must examine the patient to determine whether tooth whitening is a suitable treatment option and to ensure the absence of risk factors in the mouth.

"The new regulations ensure that qualified dentists are carrying out what is a dental procedure, that safe products are being used and that the treatment is restricted to those over 18," he explained.

Dr Feeney also emphasised that tooth whitening should only be carried out, at most, once a year. Furthermore, the procedure is not recommended for heavy smokers, heavy drinkers or pregnant women.

Meanwhile, the IDA has again warned people not to purchase tooth whitening products over the internet, as some contain dangerously high levels of hydrogen peroxide, while others contain so little of the chemical, they are ineffective.

 

        

[DrAnil]

For the past several decades, CT has enabled researchers to examine mummies without damaging the remains and study ancient mummification processes, as well as the humans’ health status — including dental condition — at the time of death.

Now researchers have used multidetector-row CT to image the mummies from the Redpath Museum at McGill University in Montreal. The dental findings of one male mummy in particular piqued the researchers’ interest for further study as the CT images show a unique example of early dental intervention in ancient Egypt (International Journal of Paleopathology, October 3, 2012).

The mummy had "dental packing of a large interproximal carious lesion with a protective linen barrier," the researchers reported. "The dental packing … is unique among ancient Egyptian mummies studied to date, and represents one of only a few recorded dental interventions in ancient Egypt," lead author Andrew D. Wade, PhD, and colleagues wrote. "Such a finding lends further support for the existence of a group of dental specialists practicing interventional medicine in ancient Egypt."
Ancient dentistry 101

Ancient and classical texts indicate the existence of a dental profession that attempted to ease the pain and discomfort of dental disease, according to the study authors. Ancient toothache remedies included bitumen, cedar oil, wild olive gum, and fig juice on wool inserted into the cavity — and, of course, extraction. Egyptian medical texts mention other dental remedies, including preventing tooth loss and how to "fasten a tooth" with ochre, honey, frankincense, and malachite.

Later the Greeks and Romans described filling materials and methods that included shredded alum wrapped in wool and inserted into the cavity, or filling with lint or lead and extracting the tooth.

There are examples of prostheses, but the authors stated that there is "serious doubt over their use in the lifetime of the individual, and these may represent embalming prostheses intended to restore the natural form of the mummy for its use in the afterlife," just as other body parts were repaired or replaced by embalmers.

While dental remedies are described in ancient texts, little physical evidence exists of interventional dental practices, making the Redpath Museum mummy with dental packing an interesting case study, the authors noted.

Imaging and radiocarbon dating

The mummy, known as the Theban Male (RM2718), is a young adult male that was acquired by Montreal politician James Ferrier during a trip to Egypt in 1859, according to co-author Barbara Lawson, curator of world cultures at the Redpath Museum.

In 1995, the mummy was imaged using plain film radiographs and CT with 3-mm slice thickness. His teeth were later examined by Odin Langsjoen, DDS, of the University of Minnesota-Duluth. "A dense rounded mass was noted in the largest of the carious lesions, which indicated that the individual may have received medical treatment during life," the authors reported.

In April 2011, the museum’s mummy collection, which included two other female human mummies, was reimaged with higher-resolution CT as part of the IMPACT project. Wade and colleagues reported their findings of all three mummies earlier this year (RadioGraphics, July-August 2012, Vol. 32:4, pp. 1235-1250). They estimated the male mummy’s age at death to be 20 to 30 years based on dental eruption and skeletal features.
The whole-body CT scans were performed at the Montreal Neurological Institute and Hospital using an Aquilion One 320-slice scanner (Toshiba America Medical Systems) with 0.5-mm-thick slices, offering much greater detail than the CT imaging performed in 1995 and also the ability to create 3D reconstructions, using Vital Images’ Vitrea software and OsiriX software.

"We wanted to look closer at the dental packing because it is unique, so far, in published accounts of mummified human remains from Egypt," Wade wrote in an email to DrBicuspid.com. "We wanted to showcase the power of the recent scanning technology, too, in the hopes that more rescanning is done on mummies. CT scans from the ’90s were great at the time, but we’ve come a long way in terms of spatial resolution."

In addition, in the fall of 2011, the mummy’s outer linen wrapping underwent radiocarbon analysis, which dated the mummy as being from the Ptolemaic Period at approximately 350-360 before the common era (BCE) — much younger than the New Kingdom Period (1550-1069 BCE) previously thought based on the museum’s records.

Overall, the dental condition of the mummy is poor, the researchers reported. The maxillary and mandibular teeth show occlusal attrition and abrasion, while the maxillary teeth also have numerous periapical abscesses and large interproximal carious lesions.

"Abscesses were found at the apices of the maxillary right first molar and second incisor and of the left first incisor and molars," they wrote. "The abscesses of the left maxillary molars communicate with the maxillary sinus and inferior meatus. Interproximal caries are noted in the maxillary right second premolar."

In fact, the dental condition of the young man may have caused his death. "An infection, such as that seen here extending into the sinuses, was likely accompanied by substantial pain and swelling during the life of this individual, and may have ultimately led to his death," Wade and colleagues wrote.

The researchers also identified the mass previously found by Dr. Langsjoen in the carious lesions of the left first and second molars, and described it as a low-density, homogeneous ball of material, such as linen. It measures 7.7 x 7.1 x 3.7 mm, larger than the lesion’s opening of 5.5 x 6.8 mm, but it remains loose within the cavity, they noted.

The mass is evidence of "therapeutic dental packing" that was used before death, according to the authors. No antemortem dental packing has been identified before, and this wasn’t done postmortem, as the mass was not formed to the tooth’s shape for a lifelike appearance and function in the afterlife, and not all of the cavities are filled, they explained. Also, the material wouldn’t have been able to restore strength or stability to the tooth. But it may have delivered a medicine such as cedar oil or fig juice to treat the pain, prevented food particles from entering the cavity, and protected the nerve from contact with the tongue or foreign bodies, they noted.

The researchers also pointed out the unusual appearance of the maxillary left first and right second incisors, which are smooth and flat with the same chiseled shape. The pulp chambers of both are exposed anteriorly, but the incisor in between doesn’t have the same damage.

Sweet tooth?

Heavy attrition and abrasion are the most common dental conditions of the ancient Egyptians, often resulting in periapical abscesses from the exposure of the pulp to bacteria, according to the researchers. The cause is due to the Egyptian diet, which consisted in large part of coarse-milled flour that was often mixed with millstone debris and sand from the desert, they noted.

"The heavy occlusal wear resulting from chewing these components is evident in both noble and commoner mummies throughout Egyptian history and even in modern Egyptian farmers," Wade and colleagues wrote. "While the high level of attrition serves to wear smooth the pits and grooves where cariogenic bacteria adhere, the high-carbohydrate component of the ancient Egyptian diet, including bread and a weak porridge-like beer, was still a cariogenic risk for nonocclusal surfaces."
"Only the upper teeth have cavities or abscesses, and lots of them; the lower teeth are in fine shape for an ancient Egyptian," Wade wrote on his blog. "Given what we know about the effect of soft, sticky food on the teeth, our thought was that this man was eating something that he could keep isolated on the roof of his mouth. This would keep it off the lower teeth until it was swallowed and leave them in good shape." His theory was perhaps honey or some other soft, sticky, sugary food may have been eaten.

And what about the unusual wear pattern of the incisors? From the 1995 CT scans, it was believed that these teeth had been broken, but the condition of the incisors is consistent with antemortem slow wear of the surface, according to the authors. Since the ancient Egyptians weren’t known for modifying the shape of their teeth and the attrition and abrasion wear pattern of ancient Egypt is occlusal in nature, the wear pattern of these incisors is not from mastication, but may be from using the teeth as tools of some sort, they noted.

What’s next for the Redpath mummies?

With the cranial and mandibular skeletal data from the recent CT scans, 3D printing was used to make solid, three-dimensional models, and forensic artist Victoria Lywood is creating facial reconstructions of the Redpath mummies to be displayed at the museum.

More research on the mummies will be published soon, according to Wade. "RM2718 and all of the Redpath mummies are a fascinating bunch," he told DrBicuspid.com. "And all of them are part of the IMPACT Radiological Mummy Database at Western, designed to make primary imaging datasets available online to researchers around the world."

 

        

[DrAnil]

 Three strong political opponents of the ruling UPA coalition have torpedoed the government’s plan to do away with scam-tainted Medical Council of India (MCI) and Dental Council of India (DCI).

Though as many as 10 states backed the National Commission for Human Resources for Health Bill, 2011, stiff opposition from Mamata Banerjee, Narendra Modi and Jayalalitha sealed the bill’s fate in the Parliamentary Standing Committee which was examining the legislation.

Officials representing West Bengal, Gujarat and Tamil Nadu raised several questions on the rationale of forming the over-arching regulatory commission for medical education, loaded with “experts” picked by the Centre.

Barely two months before Trinamool Congress severed ties with the Congress-led UPA government, the principal secretary of West Bengal informed the Parliamentary panel that the state was not in favour of passing the bill in its present form as it proposed shifting self-regulation of professional bodies to a central and technocratic regulator.
“A properly strengthened individual council with a term limit and definition of the office bearers as public servants in terms of Indian Penal Code, besides an accountability mechanism in place would suit the need better than having an over-arching body with gigantic mandate,” he said in his deposition on July 31.

Besides MCI and DCI, the proposed NCHRH sought to replace Indian Nursing Council and Pharmacy Council of India with an umbrella organisation.
Three separate bodies

The apex council would have three constituent bodies to look after educational standards, enforcement and ethical medical practice.

“The bill attempts to create a mechanism so overwhelming that it is likely to breed delays. The three constituent bodies are purely nominative in character and there is no democratic element. Since medical education is a concurrent subject, some representation to the states is a must in the proposed commission,” said principal secretary to Gujarat government, in his statement, which is a part of the Parliament panel’s report, a copy of which is available with Deccan Herald.

This would undermine the powers of the state governments and leave them with no role to play in policy issues, said Tamil Nadu in its deposition.

While the Central government sought to eradicate corruption from professional medical education bodies, the states insisted that determining term limits and definition of office bearers and a provision to remove them in case of blatant corruption or misuse of official power would have sufficed to cleanse the existing councils.

Rejection of the NCHRH Bill by the House panel and possible revival of the MCI may figure at the state health ministers’ conference here on Friday to discuss issues concerning medical education and human resources versus health.

        

[Author]

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