PURPOSE: Recently TF-adaptive movement is developed in order to increase the durability of TF files. The purpose of this study was to assess the effects of adaptive movement on durability and performance of twisted files. MATERIALS AND METHODS: Resin blocks simulating artificial J-shape canals were used for this study. In TFC group, TF-adaptive ML-1 (25/.08 size) files were used to prepare the canals under continuous rotation 500 rpm/4.0 Ncm. In TFA group, TF-adaptive ML-1 (25/.08 size) files were used to prepare the canals under adaptive movement. After preparing each artificial canal, TF files were observed under dental microscope for assessing existence of unwinding, distortion, and fracture. If unwinding of flute was observed, the number of artificial canals until unwinding of flute occurs was recorded. Required time until instruments reach working length and distance of unwinded portion of files from D0 were measured. All test results were conducted by Mann-Whitney U test at a 0.05 level of significance. RESULTS: No NiTi instrument's separation was observed. Number of resin blocks until file unwinding happens and working time was significantly high in TFA group compared to TF group. Distance of distortion from D0 didn't show significant difference between TFA, TF groups. CONCLUSION: The number of resin blocks prepared until unwinding happens and working time were significantly high in TFA group. The location of unwinding showed no significant difference between 2 groups. Adaptive movement increased the number of canals prepared until unwinding occurs and working time of twisted files.
Filing ; Movement ; Root Canal Preparation

Aesthetic dentistry in the manner of tooth modification or ornamentation existed in the Philippines long before the Spaniards first arrived. Tooth filing, gold pegging and staining were the popular methods used then. For beauty, style and not to have features similar to that of animals, have been cited as reasons for its practice.

Beauty ; Gold ; Filing ; Philippines ; Tooth ; Esthetics ; Odontogenesis ; Tooth Diseases ; Dentistry ; Staining And Labeling

BACKGROUND: Underutilization of PhilHealth benefits undermines the effective distribution of public resources. To formulate effective strategies, the factors affecting the utilization of members must be studied.

OBJECTIVES: To (1) assess the rate of underutilization of inpatient benefits and (2) determine the association of chosen factors with PhilHealth underutilization of selected member groups in three barangays in Manila.

METHODS: The study was done in selected Barangays in Manila. Using the Expanded Program on Immunization (EPI) method of sampling, a sample size of 147 households were obtained and interviewed  for the study. An interview guide was used to gather the data needed for analysis. Chi-square test was then used to determine existing associations between underutilization and the chosen factors.

RESULTS AND CONCLUSION: The chi-square test of association revealed that gender (p-value=0.034), income (p-value=0.026), and type of membership (p-value=0.027) are significantly associated with underutilization. Females and paying members were found to be more frequent users. Gap between the utilization and underutilization rates was found to be greatest in the lowest income groups. 'Lack of knowledge on filing claims' (p-value<0.001) and on benefits (p-value<0.001) were also identified as significant predictors of underutilization. Results showing a significant proportion of household experiencing insurance underutilization highlight the need for NHIC to create new and/or improved mechanisms that will enable it to extend its reach to the people.

Human ; Male ; Female ; Middle Aged ; Adult ; Chi-square Distribution ; Filing ; Sample Size ; Inpatients ; Poverty ; Income ; Family Characteristics ; Insurance ; Immunization

INTRODUCTION: Posterior Inferior Cerebellar Artery aneurysms are rare and constitute 0.5 to 2% of total aneurysms in the brain. The majority of cases involve aneurysms in the proximal area of the vertebral artery from which the PICA arise (1). Distal PICA aneurysms are even rarer and account for approximately 0.3% of all PICA aneurysms. In a study done by Park et al, only five cases of distal PICA aneurysms were reported among 386 brain aneurysms making it a rare entity. They present typical computed tomography (CT) scan findings, but it can easily be overlooked on initial diagnosis.

CASE PRESENTATION: A 56-year-old female presented with a subarachnoid hemorrhage in the basal cisterns and CP angles associated with compression of the pons and intraventricular extension of the hemorrhage. CT angiography showed saccular, lobulated aneurysm measuring 5.9 x 4.7 x 4.6 cm with a narrow 2mm neck along the right PICA medullary-cranial loop junction accompanied by minimal focal vasospasm of the proximal medullary segment. Patient underwent coiling of the aneurysm. achieving subtotal filing of the aneurysm and there was complete preservation of parent arteries. The patient recovered without neurological sequelae.

DISCUSSION: PICA aneurysms commonly occur in patients in their 5th and 6th decades without gender predilection. The age and sex distribution of PICA aneurysms are similar to those of general aneurysms (1). Our case was in the 5th decade. Symptoms of PICA aneurysms are similar to those of subarachnoid hemorrhage. These symptoms include sudden onset of severe headache, sensorial changes, syncope and meningeal irritation. As in our case, the patient presented with severe headache followed by unresponsiveness. Non-invasive vascular imaging techniques are useful in detecting presence of aneurysm like 3D CT angiography and Magnetic Resonance Angiography. As in our case, a CT angiography became very useful in finding out the exact cause of the subarachnoid hemorrhage and in discovering the exact location of the aneurysm. Outcome of patients with ruptured distal PICA aneurysms is generally favorable; the incidence of rebleeding after rupture of a distal PICA aneurysm is higher than the rebleeding rate of Il intracranial aneurysms (78% vs 34%) (7).

CONCLUSION: When we are confronted with a case of subarachnoid hemorrhage in the fourth ventricle of unknown origin, particular attention should also be made to the distal PICA due to the rare occurrence of aneurysm in the said location.

Human ; Humans ; Female ; Middle Aged ; Intracranial Aneurysm ; Subarachnoid Hemorrhage ; Vertebral Artery ; Magnetic Resonance Angiography ; Computed Tomography Angiography ; Fourth Ventricle ; Incidence ; Filing ; Pica ; Aneurysm, Ruptured ; Pons ; Syncope ; Sex Distribution ; Attention ; Headache