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Functional thoracic hyperkyphosis model for chronic subacromial impingement syndrome: an insight on evidence based "treat the cause" concept--a case study and literature review

Nagarajan M, Vijayakumar P

J Back Musculoskelet Rehabil, 2013;26(3):227-42.
PMID: 23893137 DOI: 10.3233/BMR-130373

Recent evidences suggest functional thoracic hyperkyphosis (FTH) could be a different approach in the management of subacromial impingement syndrome (SIS). This case study aims firstly with the development of evidence informed FTH model for SIS. Secondly this study aimed to develop well defined multimodal physical therapy intervention for FTH and its related mechanical consequences in elderly patient with chronic SIS. As a result, Level IV positive evidence was found in both the short and long-term pain and disability of chronic SIS, using FTH model with 26 months of follow-up.
Multimodal physiotherapeutic management for stage-IV osteitis pubis in a 15-year old soccer athlete: a case report

Vijayakumar P, Nagarajan M, Ramli A

J Back Musculoskelet Rehabil, 2012;25(4):225-30.
PMID: 23220803 DOI: 10.3233/BMR-2012-0337

Osteitis pubis among soccer athletes is a disabling painful condition and it is difficult to manage without integrating a multimodal treatment approach. There is limited scientific evidence on the effectiveness of exercise in treating Osteitis pubis especially when it progress to a chronic painful condition. The purpose of this case report is to discuss the successful multimodal physiotherapeutic management for a 15-year old soccer athlete diagnosed with stage-IV Osteitis pubis. Land and water based active core muscle strengthening exercises, Proprioceptive neuromuscular facilitation techniques (PNF) and Manual Therapy are some of the essential components incorporated in multimodal intervention approach with emphasis to water based strength and endurance training exercises. The athlete was able to make progress to a successful recovery from his chronic painful condition and accomplished the clearly established clinical outcomes during each phase of rehabilitation.
Fulltext Interceptive Correction of Anterior Crossbite Using Short-Span Wire-Fixed Orthodontic Appliance: A Report of Three Cases

Sockalingam SNMP, Khan KAM, Kuppusamy E

Case Rep Dent, 2018;2018:4323945.
PMID: 29854482 DOI: 10.1155/2018/4323945

Anterior crossbite is relatively a common presentation in the mixed dentition stage. If left untreated, it can lead to a host of problems and may complicate future orthodontic treatment. One of the major difficulties in performing anterior crossbite correction in young children is treatment compliance. In most cases, poor compliance is due to the unacceptability of the removable appliance used. This article describes three cases of successful correction of anterior crossbite of patients in mixed dentition using short-span wire-fixed orthodontic appliances. This sectional appliance provides an alternative method of correcting anterior crossbite of dental origin and offers many advantages compared to the use of removable appliances.
Fulltext Maturogenesis of an Immature Dens Evaginatus Nonvital Premolar with an Apically Placed Bioceramic Material (EndoSequence Root Repair Material®): An Unexpected Finding

Sockalingam SNMP, Awang Talip MSAA, Zakaria ASI

Case Rep Dent, 2018;2018:6535480.
PMID: 29977625 DOI: 10.1155/2018/6535480

Dens evaginatus is a dental developmental anomaly that arises due to the folding of the inner dental epithelium that leads to the formation of an additional cusp or tubercle on the occlusal surface of the affected tooth. This accessory tissue projection may carry with it a narrow and constricted pulp horn extension. Occasionally, the tubercle easily fractures, thus leading to microexposure of the pulp horn and eventual pulp necrosis. Often, the pulp necrosis occurs at a time the root development of the affected tooth is incomplete. Apexification with calcium hydroxide and mineral trioxide aggregates has been the mainstay of treatment options before root canal obturation in immature nonvital permanent teeth. Lately, regenerative endodontics (maturogenesis) is becoming one of the preferred treatment modalities to manage such teeth. The current case highlights the possibility of a bioceramic material (EndoSequence Root Repair Material, BC RRM-Fast Set Putty™, Brasseler, USA) which supposed to provide apical root closure (apexification) and could also induce continuation of root growth (maturogenesis).
Fulltext Preliminary in vitro cytotoxic evaluation of Uncaria gambier (Hunt) Roxb extract as a potential herbal-based pulpotomy medicament

Tan BC, Mahyuddin A, Sockalingam SNMP, Zakaria ASI

BMC Complement Med Ther, 2023 Sep 20;23(1):331.
PMID: 37730579 DOI: 10.1186/s12906-023-04163-w

BACKGROUND: The downfall of formocresol as a pulpotomy medicament highlights the importance of cytotoxic evaluation and the establishment of a safe concentration of dental material prior to its usage in the oral cavity. Uncaria gambir is an herbal plant that possesses antimicrobial, anti-inflammatory and antioxidant properties, suggesting its potential as an alternative medicament for pulpotomy. However, there are not many studies published on its cytotoxicity, with some using non-standardised techniques and reported variable outcomes. Here, we investigated the concentration and time-dependent toxicity of Uncaria gambir extract towards the M3CT3-E1 cell line and compared it with the gold standard pulpotomy medicament: mineral trioxide aggregate (MTA).
METHODS: Uncaria gambir extracts at concentrations ranging from 1000 to 7.8 µg/ml and MTA eluates at 4- and 48 h setting times were prepared. 10% dimethyl sulfoxide (DMSO) and culture media were used as positive and negative controls respectively. Cell viability on days 1, 2, 3 and 7 was analysed using Alamar Blue and Live and Dead Cell assay. Any morphological cellular changes were evaluated using transmission electron microscopes (TEM). Data were analysed using a two-way mixed Analysis of Variance (ANOVA).
RESULTS: The interaction between the concentration and exposure time on the fluorescence intensity of Uncaria gambir extract and MTA 48 h was found to be statistically significant (p < 0.001). No cytotoxic effects on the cells were exerted by both MTA 48 h and Uncaria gambir extract at a concentration below 500 µg/mL. TEM analysis and Live and Dead Cell assay for both materials were comparable to the negative control. No significant differences in fluorescent intensity were observed between Uncaria gambir extract at 500 µg/mL and MTA 48 h (p > 0.05).
CONCLUSION: Uncaria gambir extracts at a maximum concentration of 500 μg/mL are non-cytotoxic over time and are comparable to the MTA.
Fulltext Simple Orthodontic Correction of Rotated Malpositioned Teeth Using Sectional Wire and 2 × 4 Orthodontic Appliances in Mixed-Dentition: A Report of Two Cases

Sockalingam SNMP, Zakaria ASI, Khan KAM, Azmi FM, Noor NM

Case Rep Dent, 2020;2020:6972196.
PMID: 32695527 DOI: 10.1155/2020/6972196

The correction of rotated malpositioned tooth/teeth into the dental arch alignment in the mixed-dentition is often a challenging task for paediatric dentists. Failure in addressing this issue can bring about detrimental effect to the developing dentition and increases the probability of a complex orthodontic treatment in later years. Factors such as severity of the malpositioned teeth, patient's treatment compliance, limitation in specific functions of the selected appliance, availability of bone and space may dictate the success of the treatment. The combined use of a simple sectional orthodontic wire appliance and a 2 × 4 orthodontic appliance has been shown to produce a positive effect. The appliances resulted in derotation of the rotated malpositioned teeth and bringing them into arch alignment in two cases. This treatment option had eliminated the detrimental effects to the developing dentition and helped patients to enhance their smile and dental aesthetics.
Fulltext Patterns of Parental Information Seeking Behavior on Early Childhood Caries: A Qualitative Exploration

Kuppusamy E, Ratnasingam MD, Yazid F, Rosli TI, Ali AM, Sockalingam SNMP, et al.

J Int Soc Prev Community Dent, 2023;13(2):133-140.
PMID: 37223451 DOI: 10.4103/jispcd.JISPCD_213_22

OBJECTIVES: This study aims to explore the information-seeking behavior patterns of parents with children receiving treatment for early childhood caries (ECC).
MATERIALS AND METHODS: Semistructured in-depth interviews were conducted with 20 parents of children with ECC. A topic guide was developed, focusing on questions relating to (i) the timing of their seeking information on ECC, (ii) the types of EEC information they seek, and (iii) the resources used to seek information. The interviews were audio-recorded and transcribed verbatim. Thematic analysis was performed, whereby the data were coded and categorized into themes and subthemes.
RESULTS: Four main themes were identified: the immediacy of seeking information, perceived information need, use of resources, and barriers to seeking information. Parents either sought information immediately after detecting changes to the appearance of their child's teeth, with some being aware of the changes after signs and symptoms developed. The types of information parents usually sought covered the disease, its prevention, and management. Common sources of information were friends, family, the internet, and healthcare professionals. Barriers to seeking information discussed by parents were lack of time as well as insufficiency and inaccuracy of the information they received.
CONCLUSION: This study highlighted the need for comprehensive, tailored early education on ECC for parents using reliable information sources. There is also a need to empower other nondental healthcare professionals to provide oral healthcare education for parents.