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The fracture of endodontic instruments and canal blockage is a procedural problem creating a major obstacle to normal routine endodontic therapy. The separated instrument, particularly a broken file, leads to metallic obstruction in the root canal while canal blockage,caused by packing dentin chips and/or tissue debris, impedes efficient cleaning and shaping. Negotiating the canal and achieving patency is a must but when attempts fail to bypass such a fragment or gaining patency becomes difficult, it should be achieved by newer techniques and equipments. Dental operating microscope and ultrasonics have found indispensable applications in a number of dental procedures. This clinical casedemonstrates the usage of anultrasonic device under operative microscope in the removal of separated NiTi instrument and achieving patency in symptomatic premolars.

Introduction: Patient satisfaction is regarded as an important outcome of health care that contributes to better patient compliance and consequently offers improved clinical outcomes Dental school clinics must regulate both the clinical and academic classes in balance without hampering the needs of both the patient and students. Objectives: To develop a reliable and valid Nepali version of Dental Satisfaction Questionnaire (DSQ-N). Methodology: The English version of the dental satisfaction questionnaire (DSQ) was translated into Nepali following a standard translation process. Content validity followed by pre-testing were evaluated to obtain the final version of DSQ-N. Two hundred patients attending the Department of Conservative Dentistry and Endodontics completed the DSQ-N in the waiting room, at their convenience. Internal consistency of the questionnaire was determined by Cronbach's alpha and Principal component analysis was used to determine the construct of the scale. Result: Content Validity Index of the scale was 0.9 (S-CVI/ Avg) and alpha (Cronbach's) coefficient for the overall construct of DSQ was ≈0.83. Principal Component Analysis confirmed the internal structure of the scale and four components emerged from it. Conclusion: The translated nepali version of DSQ is a reliable and valid tool to determine patients’ satisfaction of dental care services based on the excellent content validation result together with robust internal reliability.

Introduction: Dentin hypersensitivity (DH) is a commonly encountered dental complaint, management of which is often challenging to dentists. It occurs when dentinal tubules are patent both at the pulpal and the oral surface. It is widely accepted that DH affects function and quality of life. Thus, it is necessary for dentists to manage it properly. Objective: The objective of this study was to assess the efficacy of VivaSens and Propolis in comparison to Gluma in reducing cervical dentin hypersensitivity. Methods: A randomized clinical trial, double-blinded, parallel-group study was conducted among forty-five patients. They were randomly allocated into three different groups (n=15): Gluma (positive control), VivaSens, and Propolis. Tactile and evaporative methods were used to assess pain using the Numeric Pain Rating Scale (NPRS) in patients with cervical abrasion, with a complaint of dentin hypersensitivity. Pain score was recorded preoperatively, immediately after application, at one week and one month postoperatively. Data were analyzed using SPSS version 11.5 and Microsoft Excel version 2010. Mean NPRS scores were calculated. Results: All three desensitizing agents significantly reduced DH scores from baseline to all subsequent follow-ups (p

Corona virus disease 2019 (COVID-19) caused by severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) has rapidly evolved as a pandemic with a challenge to the entire world for its management. Various modalities of treatment have been tried till date and when all the modalities failed then the only option that has been shown to be successful in some cases is lung transplantation. Decision for Solid-organ transplantation is not only made based upon its therapeutic requirement but also need to be supported by the law of land. In this regard, current Nepalese law is not with the provision for lung transplantation. Thus, in order to make the concerned authorities aware of it and also as a step toward the preparedness for COVID-19 pandemic, this research has been conducted with an aim to see the perception of health care professionals of tertiary care centre of eastern Nepal regarding the legal aspects of lung transplantation. Conclusion Outcome of this research has supported the therapeutic aspect of transplantation over its legal issue in the emergency conditions like COVID-19 Pandemic.

DOI: https://doi.org/10.3126/jcmsn.v15i1.22238 Inflammatory external root resorption is one of the major complications after traumatic dental injury. It is characterized by the loss of mineralized dental tissue which may, ultimately, result in loss of the tooth. However, with appropriate treatment, prognosis for these teeth may be greatly improved, by preventing or arresting resorption. This is a case report of an 18-year-old male patient presented with root canal treated maxillary central incisors associated with pain; with history of trauma. Radiographic examination revealed periradicular lesion and associated pathologic resorption of the apical region of the root with respect to 11 and calcification of the root canal with inadequate obturation with respect to 21. After removal of the root canal filling, 11 was disinfected with intracanal double antibiotic paste. After 2 weeks, antibiotic dressing was removed, and apical third was sealed with mineral trioxide aggregate (MTA). Canal was obturated with custom-fit gutta-percha and accessory cones with AH plus sealer and restoration was done with composite resin. Retreatment was also done with respect to 21 and obturated with custom-fit gutta-percha. Both teeth were restored with E-max crown. No clinical symptoms were apparent, significant osseous healing of the periradicular region was observed with arrest of external root resorption with respect to 11 and no periapical changes were apparent with respect to 21 on subsequent follow-up. Key words: double antibiotic paste; external root resorption; mineral trioxide aggregate.

Objective : This study was designed to compare the level of apical microleakage of root canal sealers; Acroseal, AH Plus, Endoflas FS and Endomethasone N, with laterally condensed gutta percha by level of apical dye penetration. Materials and Methods : Freshly extracted sixty permanent maxillary anterior teeth were divided randomly into four groups. Shaping and cleaning of teeth was done followed by obturation with gutta percha and four different root canal sealers. Samples were immersed in 2% methylene blue dye solution in individual dappen dish and stored in the solution for 30 days. The roots were split longitudinally with a chisel in two halves and observed under stereomicroscope. Apical microleakage measured from the apex to the most coronal extent of dye penetration. Results : Minimum microleakage was observed with AH Plus with mean value 2.140 mm, standard deviation 0.817. The maximum microleakage was observed with Endomethasone N with mean value 3.858 mm, standard deviation 1.840. There was no statistically significant difference in microleakage between Acroseal, AH Plus, and Endoflas FS. Endomethasone N showed highest level of microleakage than other three groups under the test condition, which was statistically significant. Conclusion : The microleakage was the lowest for the AH Plus and increased in the following order, Endoflas FS, Acroseal, Endomethasone N. Bangladesh Journal of Medical Science Vol.16(2) 2017 p.219-224

Dens evaginatus is an uncommon developmental anomaly of human dentition characterized by the presence of tubercle on the occlusal surface of mandibular premolars and lingual surface of anterior teeth. Due to occlusal trauma this tubercle tends to fracture thus exposing the pathway to the pulp chamber of teeth. This case report is about the presentation of dens evaginatus in mandibular premolars bilaterally; among them tooth 44 was associated with chronic apical periodontitis. Fractured tubercle of three premolars was sealed with composite resin. Root canal treatment was performed with tooth 44. Routine endodontic treatment did not result in remission of infection. Therefore, culture and sensitivity tests were performed to identify the cause and modify treatment plan accordingly. Triple antibiotic paste was used as an intracanal medicament to disinfect the root canal that resulted in remission of infection.

This report describes the cases autopsied at B. P. Koirala Institute of Health Sciences- Nepal, during the period of two years in which the treatment provided falls below the accepted standard practice causing the death of the patient. Postmortem examination provides an opportunity to find out the actual cause of death in which the cause of death is suspicious. Sometimes the cause of death found through postmortem examination is different from the clinical cause of death. The autopsy finding on the cause of death will help doctors even to think about unusual conditions that lead to death and hence apply preventive measures for those unusual conditions. The cause of medical error is not always due to the doctor’s mistake, but sometimes also due to the obsolete hospital protocol. The autopsy reporting of medical errors can be used to identify lacunae in hospital protocols, problem-prone clinical processes and suggest interventions that may reduce negligence.

The formation of craniofacial structures during embryonic development involves various complex molecular pathways. Disturbances in these pathways either due to genetic or environmental factors may lead to orofacial clefts. Approximately two thirds of the cases are not accompanied by other anomalies and are called non syndromic. The etiology seems complex, but genetics plays a major role. With the advances in molecular biology and genetics such studies are more refined than ever before and various candidate genes have been associated with Non Syndromal cleft lip/palate in different populations. There are various techniques and models used by different investigators across the globe. In this review we intend to describe most common approaches towards genetic analysis of Non syndromic cleft and try to evaluate the merits and demerits of a particular approach.

Background: Currently, the Nepalese law permits organ donation by an individual who falls into the category of a “close relative” of the recipient. There is a need for expansion of the live organ donor pool beside close relatives. Different systems of organ transplantation are followed by several countries and the professional opinions that underpin these systems need to be studied. Objective: To generate a questionnaire related to different organ transplant systems and validate it so that it can be used to collect mass professional opinions. Methods: Item generation, item reduction, item scaling, and pretesting were used to develop a questionnaire. The final version of the questionnaire was reviewed by experts for its content validity and then was used twice for participants at a 20-day interval to calculate Cronbach’s alpha for testing its internal consistency and Intra-class correlation for testing its test and retest reliability. Results: The questionnaire was found to be valid and reliable with an overall Cronbach’s alpha of 0.701. Intra-class correlation scores for each question in both test and retest were correlated. Conclusion: A valid and reliable questionnaire was developed that can be used to collect mass professional opinions to assist policy makers to establish a better organ transplant system.