Effect of Acrylic Removable Partial Denture in Caries Prevalence Among Diabetic and Non-Diabetic Patients.

Background: Dental caries is the most prevalent dental disease affecting human race. The etiology and pathogenesis of dental caries are known to be multifactorial. Studies have shown that removable partial dentures in the oral cavity increases the biofilm formation and consequently an increase in the occurrence of caries and periodontal diseases. There is a complex relationship between diabetes mellitus and dental caries. Patients with diabetes are more susceptible to oral sensory, periodontal, and salivary disorders which could increase the risk of developing new and recurrent dental caries. Therefore, the aim of the study was to assess the prevalence of dental caries among diabetic and non-diabetic acrylic removable partial denture wearers. Materials and Methods: Individuals participating in the study were partially edentulous and aged between 18 and 64 years. Patients were screened at Out patient department (OPD) in the Department of Prosthodontics JSSDCH, among which 60 patients were diabetic based on the random blood sugar level more than 160 mg/dl-30 patients were wearing RPD and 30 were without RPD. And 60 non-diabetic patients were selected among which 30 were wearing RPD and 30 without RPD. A total 120 patients were screened. Dental caries prevalence was assessed using Decayed, Missing, Filled (DMFT) index. Results: Diabetic group unrehabilitated with removable partial prosthesis showed significant difference in the number of missing teeth when compared to non-diabetic patients without removable prosthesis (P < 0.05). Conclusion: Removable partial denture prosthesis had less impact on prevalence of dental caries with good oral hygiene, following post insertion RPD instructions and regular dental visits irrespective of diabetes.

Evaluation of dentinal crack propagation, amount of gutta percha remaining and time required during removal of gutta percha using two different rotary instruments and hand instruments - An In vitro study.

Background: One of the most important goal of non surgical endodontic retreatment is the successful removal of gutta percha and sealers from the root canal system. A variety of techniques have been recommended for retreatment procedures for the removal of gutta-percha and sealers with or without the help of adjunctive chemical solvents, by using stainless steel hand files or nickel-titanium rotary files, gate glidden burs, heated instruments, ultrasonic instruments, and lasers 1,3. The current advancements in the design of NiTi instruments have proved efficacious in the removal of filling materials from the root canal wall and various studies have also confirmed their cleaning ability and efficacy 4,5. Nevertheless, the use of rotary instrumentation can lead to the formation of dentinal cracks in the root canal dentin. Many researchers have reported the incidence of crack formation and propagation after the procedure with manual, rotary and reciprocating instruments. The behavior of rotary instruments in the generation of defects have been the point of greatest interest during many years 6. These dentinal cracks can be defined as defects with a complete crack line extending from inner root canal space up to the outer surface of the root when the tensile stress in the root canal wall exceeds the tensile stress of dentin 7. Aim: This study was conducted to investigate and to compare the amount of dentinal microcracks formation with various new instrumentation methods and conventional hand filing method. It also looks into amount of gutta-percha removed after retreatment from the canal and the time required for all the instrumentation technique. Methodology: Sixty extracted human maxillary first molars with curved roots were mounted on addition silicone impression material incorporated in an aluminium hollow block, then instrumented using step-back preparation with 35 size K files. Obturation was done using gutta-percha with AH plus sealer. These were stored for 14 days and divided into three groups Mani GPR, Endostar Re Endo and H file and were subjected to retreatment procedures. Retreatment was considered complete when no filling material was observed on the canal wall and the canal was smooth and free of visible debris. The samples were examined under scanning electron microscope and the number of cracks were calculated. The percentage of root canal filling material and time taken was recorded. Statistical Analysis: The data obtained were analyzed by using descriptive statistics, ANOVA (Analysis of Variance), chi-square test and Scheffe's post hoc test through SPSS for window (version 22.0). Result: All the techniques showed similar amount of crack propagation, with no statistical difference between the group. Retreatment done using H Files required more time and removed less material. The coronal third showed less amount of gutta-percha remnants than the apical third in all groups. Conclusion: All the groups showed a similar amount of crack propagation. Less number of cracks were observed in the coronal one third and more amount of cracks were found at the apical third. Endostar RE Endo rotary instrument proved to be most effective and least time-consuming. Hedstrom Files required more time and removed less material.

Treatment guidelines and prognosis of immune reconstitution inflammatory syndrome patients: a review.

Immune reconstitution inflammatory syndrome (IRIS) is an "unmasking" or paradoxical worsening of a pre-existing infection after commencement of highly active antiretroviral therapy (HAART) in human immunodeficiency virus (HIV) - infected patients. The use of HAART in the management of HIV patients restores immune responses against pathogens however in few patients, the reconstituted immune system leads to IRIS. As the treatment protocols are not standardized for IRIS, this leads to short-term morbidity or in some cases also mortality. Therefore, treatment in these patients is a huge challenge and further more research regarding the immunopathogenesis, diagnosis and management of IRIS should be well thought-out. To understand the immunopathogenesis of IRIS it will be difficult to elucidate the intrinsic dynamics of immune cells after initiation of HAART but, there are few biomarkers which help to predict or diagnose IRIS and develop specific treatment, following initiation of HIV therapy. This review is an attempt to put light on those patients with IRIS with treatment guidelines for the management of the progression of it.