Convalescing Mandibular Anterior Crowding through Piezocision and the Micro-Osteoperforation Surgical Procedure-A Clinical Comparative Study.

BACKGROUND: Minimally invasive periodontic (perio) surgical procedures, piezocision, and micro-osteoperforation are useful techniques for accelerating tooth movement. These techniques also offer advantages in the orthodontic (ortho) and aesthetic domains. This study aimed to evaluate and compare the rates of lower anterior decrowding with piezocision and micro-osteoperforation. METHODS: This clinical study included 24 patients requiring fixed orthodontic treatments. Two periodontic techniques (piezocision (PZ) and micro-osteoperforation (MOP)) were considered for the orthodontic treatments. Each patient was randomly allocated to either the piezocision (PZ) group or the micro-osteoperforation (MOP) group. The piezocision group received five radiographically guided incisions on the labial surface of the alveolar bone, whereas the micro-osteoperforation group received one to three MOPs each using a mini-implant drill between the six lower anterior teeth, and later, an initial arch wire was ligated to each bracket. Little's irregularity index (LII) was calculated using a digital vernier caliper on study models every four weeks until decrowding was achieved. The difference in the rates of lower anterior crowding between the piezocision and micro-osteoperforation groups was analyzed to determine the statistical significance. RESULTS: The rates of irregularity index change during decrowding were 4.38 ± 0.61 in the piezocision group and 3.82 ± 0.47 in the micro-osteoperforation group. Piezocision was found to be 1.2 times faster than micro-osteoperforation in terms of the rate of decrowding. CONCLUSION: The advanced perio-ortho combination technique was advantageous in accelerated decrowding. In comparison to MOP, there was an increase in the rate of decrowding with PZ. Decrowding can be completed quickly with PZ, and it can thus be used to treat crowding effectively in a limited time frame.

Evaluation of Propolis Hydrogel for the Treatment of Dentinal Sensitivity: A Clinical Study.

BACKGROUND: Propolis is a natural resinous substance collected by honeybees, chiefly from buds and the leaves, branches, and bark of trees. Its role as a wound-healing gel has been studied, but the use of a propolis hydrogel in the treatment of dentinal hypersensitivity has not been evaluated. Dentin hypersensitivity (DH) is commonly treated via iontophoresis using fluoridated desensitizers. The aim of the present study was to compare and evaluate the effects of a 10% propolis hydrogel, 2% sodium fluoride (NaF), and 1.23% acidulated phosphate fluoride (APF) when used in conjunction with iontophoresis for the treatment of cervical dentin hypersensitivity (DH). METHODS: Systemically healthy patients complaining of DH were selected for this single-centre, parallel, double-blind randomized clinical trial. Three substances were selected as desensitizers for study in the present trial: a 10% propolis hydrogel, 2% sodium fluoride, and 1.23% acidulated phosphate fluoride, all in conjunction with iontophoresis. Any decrease in DH following the application of specific stimuli was assessed at baseline, before and after application, on the 14th day following use, and on the 28th day following the intervention. RESULTS: Intra-group comparisons show diminished values of DH at maximum post-op follow-up intervals which were significantly trimmed down from the baseline (p < 0.05). The 2% NaF demonstrated a significant reduction in DH over 1.23% APF and the 10% propolis hydrogel (p < 0.05). However, there was no statistically significant difference in the mean difference between the APF and propolis hydrogel groups assessed via tactile, cold, and air tests (p > 0.05). CONCLUSION: All three desensitizers have proved to be useful when used in conjugation with iontophoresis. Within the limitations of this study, a 10% propolis hydrogel can be used as a naturally occurring alternative to commercially available fluoridated desensitizers.

Variations of Serum CRP Levels in Periodontal Health and Diseases: A Clinico-Biochemical Study.

This study aimed to quantify serum C-reactive protein (CRP) values in periodontally healthy people and explore the relationship between serum CRP levels and chronic periodontitis, and the influence of scaling as well as root planing (SRP) on serum CRP levels. The study included 100 systemically healthy adults (n = 100; 50 males and 50 females) who were separated into two groups: Group A (control) n = 50; periodontally healthy subjects and Group B (test) n = 50; subjects with chronic periodontitis. The test group (group B) was further separated randomly into two groups: B1 (n = 25) and B2 (n = 25). The clinical parameters and serum CRP levels were measured only once in Group A and before SRP in Group B1 subjects. In Group B2 subjects the clinical parameters and serum CRP levels were measured only after two months following SRP. For group A, B1, and B2 (the readings recorded after SRP) the mean gingival index scores were 0.146, 2.437, and 1.052, respectively, while the plaque index was 0.414, 2.499, and 0.954, respectively. Probing pocket depth (PPD) and clinical attachment loss (CAL) showed statistically significant differences between three groups, with higher values in patients with periodontitis before intervention (2.196 ± 0.49; 1.490 ± 0.23), respectively. Healthy controls (Group A) had a C-reactive protein level of 0.04820 mg/dL, while group B1 (test) had 1.678 mg/dL and 0.8892 mg/dL (group B2). C-reactive protein levels were observed to be greater in the test group (groups B1 and B2), and these differences were statistically significant (p < 0.001). Chronic periodontitis enhances blood levels of systemic inflammatory markers like CRP, which has been reduced by periodontal treatment with SRP.

Psychometric Properties and Validation of the Arabic Maslach Burnout Inventory-Student Survey in Saudi Dental Students.

Background: Few studies have studied burnout among dental students worldwide, and no such study is available from Saudi Arabia. In addition, an Arabic version of the Maslach Burnout Inventory-Student Survey (MBI-SS) has not yet been validated for use among students. Objectives: This study aimed to translate and validate an Arabic version of the MBI-SS questionnaire and to examine the psychometric properties of burnout among dental college students at a university in Saudi Arabia. Materials and Methods: This cross-sectional questionnaire study included all dental students at King Khalid University, Saudi Arabia, and was conducted between December 2019 and January 2020. After the MBI-SS questionnaire was translated, its face validity was determined and the test-retest reliability was assessed. Confirmatory factor analysis and reliability analysis were performed following the full-scale study to validate the Arabic MBI-SS. Results: A total of 433 dental students responded in the full-scale study (mean age: 21.9 ± 1.6 years). Emotional exhaustion was present in 32.3% (95% confidence interval: 28%-36.9%), cynicism in 33.7% (29.3%-38.4%), and poor academic efficacy in 34.2% (29.8%-38.9%) of the dental students. Emotional exhaustion and cynicism were significantly associated with academic level, a history of medication due to academic stress, and thoughts of quitting the course (for all, P < 0.05). The reliability of MBI-SS was found to be adequate for all three subscales: Emotional exhaustion, Cronbach's α = 0.827; cynicism, α = 0.855; academic efficacy, α = 0.704. Conclusions: All three subscales of burnout were highly prevalent in the study cohort. The Arabic version of the MBI-SS inventory was shown to be a valid and reliable tool for assessing the psychometric properties of burnout among dental students, and its use may aid in identifying burnout in the early stages.

Comparative Evaluation of Locally Administered 2% Gel Fabricated from Lemongrass Polymer and 10% Doxycycline Hyclate Gel as an Adjunct to Scaling and Root Planing in the Treatment of Chronic Periodontitis-A Randomized Controlled Trial.

Background: Extracts of medicinal plant like lemongrass offer a new choice for optional antimicrobial therapy against various oral microorganisms. The objective of this study was to assess, verify, and compare the antimicrobial effectiveness of locally administered 2% lemongrass gel and 10% doxycycline hyclate gel as an adjunct to scaling and root planing (SRP) in treating chronic periodontitis. Method: This is a double-blind parallel arm randomized controlled study. Forty subjects were randomly divided into Group A and B for 2% lemongrass gel and 10% doxycycline hyclate gel, respectively. The clinical assessments of Gingival Index (GI), Plaque Index (PI), Probing Pocket Depth (PPD), and Clinical Attachment Level (CAL) together with microbial colony counts for Porphyromonas gingivalis, Actinomyces naeslundii, and Prevotella intermedia were done at baseline, 1st month, and 3rd month follow-ups. Results: The results showed there was a significant reduction in the mean scores of GI, PPD, and CAL clinical indices from baseline to the 1st and 3rd month follow-ups in both the 2% lemongrass gel and 10% doxycycline gel groups (p < 0.05). Similarly, there was significant reduction in mean CFU scores for all periodontal pathogens from baseline to 1st and 3rd month follow-ups in both the 2% lemongrass gel and 10% doxycycline gel groups (p < 0.05). Conclusions: It could be concluded that the local delivery of 2% lemongrass gel as an adjunct to scaling and root planing is effective and comparable to 10% doxycycline gel in the treatment of chronic periodontitis.

Effect of Injectable Platelet-Rich Fibrin with a Nano-Hydroxyapatite Bone Graft on the Treatment of a Grade II Furcation Defect.

Background: Periodontal diseases lead to bone loss, crestal defects and even loss of the tooth, which also further makes it difficult to replace the tooth. Autogenous bone grafts are considered the gold standard in bone regenerative procedures. This study aimed to compare and evaluate the bone regenerative effects of i-PRF (Injectable- Platelet-rich fibrin) with a bone graft and a bone graft alone in mandibular grade II furcation defects over a period of 9 months. Method: This was a comparative study of 12 participants, who were randomly selected and grouped into two groups: test and control. Following phase I therapy, both groups were subjected to open flap debridement. In the test group, after debridement, a nano-hydroxyapatite bone graft mixed with i-PRF was inserted, whereas in the control group only a nano-hydroxyapatite bone graft was inserted. The clinical parameters such as plaque index (PI), gingival index (GI), pocket probing depth (PPD), clinical attachment level (CAL), horizontal probing depth (HPD) and vertical probing depth (VPD) were recorded at baseline, 3 months, 6 months and 9 months following the surgery. The bone area fill (BAF) was assessed using intraoral periapical radiographs (IOPARs) taken at baseline and 9 months after surgery. Results: At the baseline, there was no statistically significant difference between the tested parameters. After 9 months all the clinical parameters, PI, GI, PPD, CAL, HPD and VPD as well as radiographic bone fill showed a significant increase in both the groups (p < 0.05) (PI-TGr; CGr−VPD­3.5 ± 0.54 to 0.66 ± 0.51; 3.3 ± 0.81 to 2 ± 0.63/BAF­2.9 ± 0.88 to 5.6 ± 1.10; 3.4 ± 1.39 to 3.9 ± 1.4). On comparison the test group showed better results for each clinical parameter. Conclusion: The results showed increased improvement in clinical conditions in both groups, although better results were seen in the group where i-PRF with a nano-HA bone graft was used in the furcation defect.

Comparison of the effect of sodium bicarbonate and glycine air polishing systems on tooth surface roughness: An atomic force microscopic analysis.

BACKGROUND: A variety of prophylactic materials are used in the dental office for the removal of stains and calculus. OBJECTIVE: To evaluate tooth surface changes caused by the application of air abrasive powders (sodium bicarbonate, SBAP and glycine air powder, GPAP) along with scaling and root planing (SRP), under atomic force microscope (AFM) and to analyze the histological soft tissue changes caused by these agents, using light microscopy. METHODS: This study was conducted in two phases: in vitro and in vivo. In the in vitro phase, hard tissue analysis was done under AFM following air powder polishing. Eighteen extracted teeth were chosen. SRP and tooth sectioning were carried out. Subsequently, each section of the tooth was mounted on a glass plate with self-cure acrylic resin and air polished using SBAP and GPAP. In the vivo phase, the soft tissue was analyzed under a light microscope for surface roughness. A biopsy specimen was taken from patients who had received phase I therapy, and flap surgery was planned using a modified Widman flap technique. RESULTS: This study compared surface changes in enamel and cementum, under AFM, as indicated by RA after SRP, SRP and SBAP, and SRP and GPAP; comparisons were then drawn across the three groups. The mean AFM values were 108.5 and 144.7, 102.7 and 81.7, and 95.6 and 7.4, at the crown and root, for SRP, SRP and SBAP, and SRP and GPAP interventions, respectively. GPAP was the least rough on soft tissues. CONCLUSION: SBAP and GPAP were better than hand instrumentation as indicated by AFM and histological section analysis.

Age estimation by measurement of open apices in tooth roots: Study using Saudi Arabian samples.

The aim of this study was to verify Cameriere's regression formula to predict chronologic age in Saudi Population and if proven to be inaccurate, develop a new algorithm specific for Saudi children. A total of 788 Orthopantamographs(495 boys and 293 girls) were analyzed. The tooth measurement parameters were: number of teeth with closed apex (N0), open apex width (a), crown length (l), A/L ratio for each tooth (x1to x7) and summation of all open apex width (s). The radiographic measurements were substituted in the formula: Age = 8.971 + 0.375g + 1.631 x5 + 0.674 N0 - 1.034s-0.176s * N0 The mean dental age assessed by Cameriere's method was significantly lower than chronologic age in Saudi population and with both genders and total study population (p < 0.05). A stepwise linear regression showed all parameters gender, N0, x1 to x7 except x2significantly associated with age (R2 = 0.6334, F (6,779) = 168.28, p < 0.05). There was no statistically significant difference between predicted and actual chronologic age for 788 children using regression equation for Saudi population (p = 1). Cameriere's formula verified in Saudi children was found to underestimate the chronologic age in both genders. A prediction formula based on Cameriere's method specific to Saudi children has been developed for estimating chronologic age. The new regression formula developed will be more accurate for age assessment in Saudi children.

Prevalence of dental caries among male students aged 15-17 years in southern Asir, Saudi Arabia.

BACKGROUND: Dental caries had been studied by several studies in Saudi Arabia among different age groups and at various places. According to World Health Organization (WHO), assessment of caries at 15 years of age is more meaningful. The objective of this survey was to assess the prevalence of dental caries among 15-17-year teenage students in Abha, Saudi Arabia. Results of the present study can be used as baseline data for future oral health interventions for the population. METHODS: A stratified cluster random sampling was followed in selecting the students. The clinical data was collected using dentition status component of WHO oral health assessment form 2013. Five investigators were trained and calibrated with 20 subjects for two successive days (Cronbach's Alpha = 0.91). Data was analyzed for descriptive statistics and Mann-Whitney U test was applied to compare the DMFT scores. RESULTS: Prevalence of dental caries among the study population was found to be 72.9%. The DMFT scores were found to be highest in the posteriors (90.7%). First permanent molar was the most common tooth affected by dental caries in all quadrants. CONCLUSION: The present study revealed that there is a high prevalence of dental caries among students aged 15-17 years in Abha, Saudi Arabia. Caries prevalence was highest in mandibular posterior segments, however, it was lowest in mandibular anterior segments. There is an urgent need for both preventive and curative dental health services in the region. It is recommended that a coordinated school dental program may be initiated in the area.

Knowledge and attitude regarding management of tooth avulsion injuries among school teachers in rural India.

OBJECTIVES: Traumatic dento-alveolar injuries are frequent in children and adolescents, affecting teeth, their supporting structures, and adjacent soft tissues. Because school teachers are likely to be in contact with the child soon after injury, it is important to ascertain their knowledge and attitude about this. AIM: The study aimed to assess the knowledge and attitude of school teachers in Coorg with regard to immediate management of avulsed teeth. MATERIALS AND METHODS: This cross-sectional study was conducted among school teachers in Coorg district. A self-administered questionnaire containing 16 questions was given to a sample of 600 school teachers. RESULTS: Descriptive statistics and independent sample t-test were used for analysis. Only 24.7% teachers thought the tooth was important and wanted to search for the avulsed tooth. Regarding the knowledge about replantation of tooth, 25.7% teachers knew that a fallen tooth can be placed back in the socket. Extraoral time for replantation of the tooth that was opted by 44 teachers (30.3%) was ≤30 min. CONCLUSION: This survey reflected the lack of experience and inadequate knowledge regarding dental trauma management among school teachers in Coorg. The implications of this study are directed toward education of these school teachers who are involved in the supervision of children in schools.

Oral Health Literacy and Oral Health Status among Adults Attending Dental College Hospital in India.

BACKGROUND: Low health literacy is one among many reasons why preventable diseases remain so common and why people often do not adopt healthy practices. It is important to detect patients with inadequate oral health literacy (OHL) and to improve the level of communication between the provider and the patient. This study was aimed to determine the relationship between OHL with selected socio-demographic variables and oral health status among adults in Virajpet, Karnataka, India. MATERIALS AND METHODS: A convenience sample of 187 subjects from the out-patient department of Coorg-Institute of Dental Sciences Hospital administered the Rapid Estimate of Adult Literacy in Dentistry (REALD-30). The demographic variables and the oral health status were recorded for every participant using World Health Organization oral health survey proforma (1997). Data were analyzed using t-tests, analysis of variance, correlations and Kruskal-Wallis test. RESULTS: The associations between REALD-30 scores and gender, age, and ethnicity were not statistically significant. Significant associations were found between REALD scores and the following oral-health related variables: Temperomandibular joint problems, prevalence of prosthetic need, CPI (Community Periodontal Index) and loss of attachment scores. REALD-30 scores were negatively correlated with DMFT (Decayed, Missing and Filled Teeth) scores and DAI (Dental Aesthetic Index) scores. CONCLUSION: OHL was not associated with sex, age, or ethnicity in this sample of the Virajpet population. OHL was associated with oral health status. Lower OHL was associated with poorer oral health status. OHL instruments can be considered to be included as screening tools to identifying individuals or groups with poor oral health outcomes.

Effect of aqueous and alcoholic Stevia (Stevia rebaudiana) extracts against Streptococcus mutans and Lactobacillus acidophilus in comparison to chlorhexidine: An in vitro study.

INTRODUCTION: Stevia (S. rebaudiana) a herb which has medicinal value and was used in ancient times as a remedy for a great diversity of ailments and sweetener. Leaves of Stevia contain a high concentration of Stevioside and Rebaudioside which are supposed to be sweetening agents. AIM: To compare the efficacy of aqueous and alcoholic S. rebaudiana extract against Streptococcus mutans and Lactobacillus acidophilus in comparison to chlorhexidine. MATERIALS AND METHODS: In the first part of the study, various concentrations of aqueous and ethanolic Stevia extract were prepared in the laboratory of Pharmacy College. It was then subjected to microbiological assay to determine its zone of inhibition using Agar disk diffusion test and minimum inhibitory concentration (MIC) using serial broth dilution method against Streptococcus mutans and Lactobacillus acidophilus. Chlorhexidine was used as a positive control. One way Analysis of Variance (ANOVA) test was used for multiple group comparisons followed by Tukey post hoc for group wise comparisons. RESULTS: Minimum inhibitory concentration (MIC) of aqueous and ethnolic Stevia extract against Streptococcus mutans and Lactobacillus acidophilus were 25% and 12.5% respectively. Mean zone of inhibition of the aqueous and alcoholic Stevia extracts against Streptococcus mutans at 48 hours were 22.8 mm and 26.7 mm respectively. Mean zone of inhibition of the aqueous and alcoholic Stevia extracts against Lactobacillus acidophilus at 48 hours were 14.4 mm and 15.1 mm respectively. Mean zone of inhibition of the chlorhexidine against Streptococcus mutans and Lactobacillus acidophilus at 48 hours was 20.5 and 13.2 respectively. CONCLUSION: The inhibitory effect shown by alcoholic Stevia extract against Streptococcus mutans and Lactobacillus acidophilus was superior when compared with that of aqueous form and was inferior when compared with Chlorhexidine.

Effect of virgin olive oil pulling and chlorhexidine mouth washon plaque and gingivitis: a randomized controlled trial

Aim: The objective of this study is to compare the efficacy of oil pulling with virgin olive oil and chlorhexidine mouthwash in reducing plaque and gingivitis. Material and Methods: A total of sixty subjects satisfying the inclusion criteria were selected. The subjects were then randomly divided into two groups of thirty each. Group I used oil pulling with olive oil and Group II used 0.2% chlorhexidine as mouthwash. The plaque index and modified gingival index scores were measured at baseline, first week and second week. Results: The results showed that there was statistically significant reduction of mean plaque and gingivitis scores from baseline to first week and second week in both olive oil (p<0.05) and chlorhexidine group (p<0.05). There was significant difference in mean plaque scores between olive oil group and chlorhexidine group at second week (p<0.05). There was no significant difference in mean gingivitis scores between olive oil group and chlorhexidine group at second week (p<0.05). Conclusions: Oil pulling with virgin olive oil was found to be effective in reducing plaque and gingivitis. Regular and proper oil pulling with virgin olive oil can therefore be recommended as a routine home-based practice in promoting oral health.