Orofacial Features and Their Correlation in Cardiovascular Diseases.

Background: The association between cardiovascular diseases and periodontitis had different pathophysiological mechanisms involved. These mechanisms are both inflammatory and microbial. Furthermore, the possible association between two diseases can be explained by common risk factors. Aims: The present trial was carried out to establish a relation between coronary artery disease and periodontitis. Materials and Methods: One hundred and twenty-six participants advised for the angiography were included. Periodontists determined the presence of periodontitis in all participants followed by lipid profile, C-reactive protein (CRP) levels, and blood coronary angiography was then performed. The collected data were subjected to the statistical analysis, and the results were formulated. Results: The level of CRP in participants with and without coronary artery disease was 0.66 ± 1.52 and 0.53 ± 1.01, respectively, which was nonsignificant with a P = 0.63. Nonstatistically significant difference was seen in values of cholesterol and blood glucose in participants with and without coronary artery disease (P = 0.28 and P = 0.53). The mean tooth loss in participants with coronary artery disease was 14.2 ± 6.4 and in participants with no coronary artery disease was 11.8 ± 6.5, and such difference was statistically significant (P = 0.05). Conclusion: The present study establishes an association between poor oral health, periodontitis, and coronary artery disease. This study demonstrates that tooth loss which is an important feature of periodontitis is significantly associated with coronary artery disease.

Success of Dental Implant Influenced by Abutment Types and Loading Protocol.

Background: Dental implants are considered better, latest, and most advanced technique of teeth replacement in present times with more teeth loss and increased related concerns. Aims: The present clinical trial was carried out to assess marginal bone loss and implant failure in immediate and delayed loading implants. The study also evaluated healing using Polymerase Chain Reaction (PCR) and the effect of risk factors on marginal bone loss. Materials and Methods: The 44 subjects were randomly divided into two groups with immediate loading and delayed loading protocols. Various soft-tissue parameters were seen clinically. Quantitative PCR was done to detect biomarkers. The collected data were subjected to statistical evaluation with a level of significance at P < 0.05 and the results were formulated. Results: Concerning marginal bone loss, it was seen that for delayed loading, the bone loss at the implant level was 1.52 ± 0.14, 0.19 ± 0.11, and 0.40 ± 0.12, respectively, at placement, 1 and 2 years. Plaque and mucosal bleeding scores were low at the time of placement with respective values of 0.96 ± 0.12 and 28.42 ± 3.15 for the delayed loading group and 0.98 ± 0.11 and 30.24 ± 3.15 for the immediate loading group. Tartrate-resistant acid phosphatase (TRAP) showing remodeling was high at 3 months in delayed loading (13.3 ± 8.5). Alkaline Phosphatase (ALP) was highest in delayed loading at 3 months (25.2 ± 7.7) and immediate loading at 2 days (32.6 ± 13). Conclusion: Both immediate loading and delayed loading implants show similar results in terms of bone loss, soft-tissue parameters, and biomarkers in sulcular fluids with relatively few and manageable complications.

Efficacy of Locking Miniplates in Managing Mandibular Fractures without Intermaxillary Fixation.

Background: In maxillofacial trauma, the most commonly encountered are mandibular fractures requiring treatment. Managing these fractures with rigid fixation abolish the intermaxillary fixation (IMF) requirement with reduction and early return to function. Aims: The present trial was carried out to assess clinically the effectiveness of new locking bone plate screw system postsurgically in mandibular fracture cases without IMF. Materials and Methods: In 18 subjects, the fracture site was exposed, fracture segments were reduced and approximated keeping the occlusal relationship is desirable using locking 2 mm mini plates and screws without IMF. The subjects were followed every week for initial 4 weeks followed by evaluation for up to 6 months every month to assess clinical and radiographic healing and the results were formulated. Results: Road traffic accident was the cause in 10 subjects (55.5%), followed by assault in 22.2% (n = 4) subjects, and fall from height in 16.6% (n = 3) subjects. Parasymphysis was involved in 44.4% (n = 8), followed by symphysis in 11.1% (n = 2) subjects. A minor complication of wound dehiscence was seen in 5.5% (n = 1) subjects that were managed conservatively and a major complication of infection was also seen in 1 subject that required removal of the plate at 4 weeks of follow-up. Following plate removal, IMF was done for that subject. All other sites were healed uneventfully. Primary healing in bone was seen in 94.4% (n = 17) subjects and it was not seen in the case with infection. Conclusion: Within the limitations, the present study concluded that the locking miniplate system is highly effective and reliable in treating mandibular fractures with acceptable results and a very low postoperative complications rate.

Analysis of Risk Factors Associated with Squamous Cell Carcinoma in the Indian Population.

BACKGROUND: Squamous cell carcinoma (SCC) describes the carcinomatous growth in the oral cavity. Recently, various authors have described increased SCC incidence in the young population. The distribution of SCC shows varied geographic spread, with the highest distribution in Asian countries. AIMS: The present trial was carried out to assess the associated factors that could lead to increased risk of developing oral cancer. MATERIALS AND METHODS: Oral examination was carried out for 21 participants by a dentist and any significant oral lesion or deleterious habit if present, was recorded. The data collected were analyzed. RESULTS: Areca nut was chewed by 47.61% participants (n = 10), smoking tobacco by 76.19% (n = 16), chewing tobacco by 38.09% (n = 8), and consuming alcohol in 9 participants (42.85%). No significant difference was seen concerning age for any factor except alcohol which showed higher intake in the older group where six participants depicted alcohol intake as compared to three participants in the younger group. In participants who chewed areca nuts, 6 participants also smoked tobacco and 1 consumed alcohol. For tobacco chewing, 5 consumed alcohol and 6 also took tobacco as smoke. CONCLUSION: The present study showed that areca nut and tobacco chewing along with alcohol consumption and tobacco smoking increase the risk of developing SCC in the Indian population.

Skills, Knowledge, and Implementation of Techniques for Behavioral Guidance in Adults with a Fear of Dentistry.

BACKGROUND: Dental fear and anxiety (DFA) is considered the main reason of dental negligence which can lead to detrimental oral health as well as overall health including psychological well-being and quality of life in an individual. AIMS: The present trial was aimed to assess the skill and knowledge of dentists in managing DFA in adult subjects, to evaluate the available strategies used in treating such subjects, and to find the need for further education. MATERIALS AND METHODS: The present study was an original survey and questionnaire trial, which was distributed to the 82 dentists. The collected data were subjected to statistical evaluation and the results were formulated. RESULTS: Educating and motivating subjects was found to be effective by 62.19% (n = 51) of dentists followed by successive approximation, and muscle relaxation was considered highly ineffective by one responder (1.21%). Music and reduced waiting time in the clinic appeared to be the most effective strategy as responded by 56.09% (n = 46) of dentists. Attempting treatment in various visits than a single seems to be a highly ineffective technique by 4 dentists (4.87%). CONCLUSION: Within its limitation, the study showed that the application of various behavior modification techniques can be effective in alleviating DFA in adult patients.

Assessment of Oral Health and Prevalence of oral Conditions in Human Immunodeficiency Virus-infected Subjects Visiting Antiretroviral Therapy Centers.

BACKGROUND: Weakened immune system from acquired immunodeficiency syndrome (AIDS) makes the individual prone to various opportunistic infections which are life-threatening including various carcinomas and disorders affecting the neurological system. AIMS: The present trial was done to assess the prevalence of oral presentations and treatment needs in AIDS/human immunodeficiency virus (HIV)-infected subjects visiting antiretroviral therapy centers. MATERIALS AND METHODS: The study included 126 subjects. Oral cavity was assessed and dentition, periodontal condition, and lesions and conditions affecting the oral mucosa were identified along with their treatment needs. The collected data were subjected to statistical evaluation and the results were formulated. RESULTS: Candidiasis was seen in 25.39% (n = 32) of total subjects. Concerning the periodontal status of HIV-infected study population, it was seen that maximum attachment loss both in males and females was within the range of 0-3 mm. Regarding decayed, missing, and filled teeth scores, these were statistically significantly higher in males (P = 0.001). CONCLUSION: The present study concluded that the majority of subjects infected with HIV present one or more oral presentation and lesion, with candidiasis being the most common condition.

Alterations in Integumental Facial Dimensions after Orthodontic Treatment.

BACKGROUND: It is documented that the facial profile changes, morphology changes, and continued facial growth in early adults and late adolescents. AIMS: The present trial was aimed to quantitatively assess the changes in facial growth from adolescents to adults. MATERIALS AND METHODS: In the present study, 16 facial distances (transverse) and craniocaudal facial distances were measured, and growth changes were assessed. The collected data were subjected to statistical evaluation, and the results were formulated. RESULTS: Upper face width was statistically significantly increased in males than females from posttreatment to recall with the P < 0.0001. The decrease in outer canthus was seen in females as compared to males, which was statistically significant with the P < 0.0001. An increase in mouth width was seen in both males and females with higher in females. CONCLUSION: The present study showed an increase in facial dimensions in both genders with age where transverse changes were higher than the craniocaudal alterations.

Antibiotic Prescribing Knowledge, Awareness, and Attitude of Dental Surgeons Practicing in the Urban Indian Population.

BACKGROUND: Studies have reported that dental procedures may serve as a portal of entry for bacteria into the blood circulation, commonly termed as bacteremia which may inhabitate the heart and joints subjected to repair and replacement by prosthesis and may lead to complications in immunocompromised patients. Dental procedure may play a pivotal role in the development of infective endocarditis and infection around the prosthetic joint. Antibiotic use is suggested for all dental procedures requiring gingival manipulation or of the periapical region of teeth or mucosal incision in these patients. OBJECTIVE: The present study has been conducted to inspect the antibiotic prescribing practices of general dentists among 250 dental practitioners. METHODS: The study was conducted on 250 dental surgeons practicing in the urban Indian population of various parts of the country. A validated questionnaire was developed by a multidisciplinary dental and medical team and was circulated on the subject of the basic knowledge and awareness about antibiotic prophylaxis in susceptible patients. The data from the participants were collected, collated, and statistically analyzed. RESULTS: The present study comprised 250 dental surgeons; 178 out of 250 were male, whereas 72 were female. Antibiotic prophylaxis guidelines were followed by 169 practitioners (67.60%), whereas 81 (32.40%) dentists did not follow any guidelines. Out of 169, 67 followed the American Academy of Orthopaedic Surgeons (AAOS) guidelines (39.64%), 58 followed American Heart Association (AHA) guidelines (34.30%), whereas 44 followed general physician's guidelines (26.03%). On screening the underlying conditions for which antibiotic cover was prescribed, it was shown that majority of the dental surgeons did the same for patients with cardiac valve repair or replacement (230; 92%), followed by infective endocarditis (212; 84.80%); organ transplant (212; 84.405); diabetes (189; 75.60%); prosthetic joint replacement (150; 60%); and congenital heart defect (110; 44%). CONCLUSION: Patients should then be trained to perform meticulous oral hygiene and advised to schedule regular dental checkups to maintain optimal dental health. Dentists should use antibiotic prophylaxis in only conditions associated with a valid scientific basis and should follow the standard protocols recommended by the American Dental Association, AHA, or AAOS.