Early Implant Placement with Immediate Loading in the Mandibular Anterior Region: A Rapid Solution to Edentulism.

The aim of this article is to present the case of an early implant placement with immediate loading in the mandibular anterior region as a rapid solution to edentulism. A 40-year-old healthy male patient reported with a chief complaint of loosening of tooth in the lower front region of the jaw. On intraoral examination, there was a mobile tooth with respect to 41. The mobile tooth was extracted, and early implant placement was done along with Bio-Oss bone grafts to fill the jumping distance with no barrier membrane. Immediate provisionalisation was done on early-placed dental implants. After 5 months of the healing period, the final implant-level impressions were made, and the provisional crown was replaced with the final zirconia crown. This case report demonstrates satisfactory esthetic and functional outcomes along with various other advantages.

Combined Periodontal and Endodontic Management of Palatal Radicular Groove with Platelet-Rich Fibrin and Biodentine®.

Palatal radicular groove (PRG) is developmental anomaly of root, which when present is associated with periodontal and endodontic problems. Different treatment modalities are available for its management, such as periodontal flap surgery, endodontic management, sealing of PRG with various cements, bone graft procedure for intrabony defect, extraction with intentional replantation after sealing or removal of a PRG, and endodontic treatment as well as the use of various growth factors. Success of the therapy depends on the type, depth, and extent of PRG, presence or absence of intrabony defect, vitality of involved tooth, and types of materials used to seal PRG. This study reports management of PRG with Biodentine® and platelet-rich fibrin in a 44-year-old systemically healthy female patient.

Periodontal Disease in Patients Visiting a Tertiary Care Dental Hospital: A Descriptive Cross-sectional Study.

INTRODUCTION: Periodontitis is chronic disease leading to tooth loss. Oral hygiene practices combined with regular dental examinations keep oral cavity disease free and maintain periodontal health. The primary objective was to find out the prevalence of periodontal disease of patients measured by the Simplified Oral Hygiene Index and Community Periodontal Index. METHODS: This descriptive cross-sectional study was conducted in department of Periodontics of a tertiary care dental hospital from April to June 2019 after obtaining ethical clearance and informed consent. Participants were recruited by convenience sampling and 183 sample size was calculated. Proforma included demographics, Simplified Oral Hygiene Index, Community Periodontal Index, body mass index, and smoking status. Data were entered in Statistical Package for Social Sciences version 23 and descriptive statistics were presented as frequency, percentage, mean, and standard deviation. RESULTS: Prevalence of periodontal disease corresponding to loss of attachment 1, 2, 3, and 4 was found to in 104 (56.83%) participants. Simplified Oral Hygiene Index score was 1.67±0.89 with "fair" status in majority 114 (62.30%). Gingivitis (Community Periodontal Index 1, 2) was seen in 136 (74.32%). The mean age was 36.37±14.43 years of which 92 (50.27%) were female but smoking was more in males. CONCLUSIONS: This study suggests deteriorating periodontal health related to age, sex, oral hygiene, smoking, and BMI. As updated information on oral and periodontal health in Nepal is limited, this assessment would help the national policy makers on oral health intervention measures to prevent periodontitis and develop future programs to improve oral health.

Dental Floss Prescription Pattern among the Dental Interns of Nepal.

INTRODUCTION: Periodontal disease is regarded as one of the preventable diseases. It can be prevented through effective plaque control measures that require mechanical instrumentation with various surgical or non-surgical periodontal therapies as well as daily oral hygiene measures. Dental professionals must be competent enough to promote good oral health by educating patients with daily oral hygiene practice measures. In this regard, the study was designed to assess the knowledge, attitude, and practice behaviour for using as well as prescribing dental floss among the dental interns of Nepal. METHODS: An online questionnaire consisting of two sections; the first comprised of the socio- demographic and professional aspects and the second consisted of questions related to knowledge, attitude, and practice regarding the use of dental floss, and its prescription was prepared using Google forms and the link was shared. The data were analysed in Statistical Package for Social Sciences (SPSS) version 20 software. RESULTS: In this study, the participants were familiar with the dental floss, but many lacked awareness regarding its proper use. Ninety-nine (64.3%) of the participants personally used dental floss. Only six (3.9%) never prescribed it to their patients. Among those who prescribed, only 37 (25%) always demonstrated the techniques. CONCLUSIONS: The study indicated that many participants used dental floss, however, educating and recommending the patient about it was comparatively low. This emphasizes the need to increase the awareness and use of interdental aids among dental interns to provide good oral self-care practices for the patient.

Sub Sinus Ridge Height at First Molar Region- A Panoramic Radiograph Based Study.

BACKGROUND: Among various replacement options available for maxillary molars, implants necessitate the need to examine available ridge height and width. Panoramic radiographs (orthopantomograms) are routinely used for preliminary determination of ridge height which is helpful in communicating with patients regarding treatment needs and options. This study was designed with the aim to assess the sub sinus ridge height at dentulous and edentulous first molar sites. METHODS: A cross-sectional study was conducted from March to November 2019 among patients visiting the dental college. The orthopantomograms of 455 patients were prospectively collected and analysed using Carestream imaging software (version 7.0.0). Distance from alveolar crest to maxillary sinus was measured in first molar region. RESULTS: Mean minimal sub sinus ridge height at non-missing maxillary first molar site was 8.16 ± 2.6 mm, whereas for missing maxillary first molar site it was 5.25 ± 2.28 mm and the difference was statistically significant (p<0.001). Statistically significant difference among the age groups and minimum subsinus ridge height (p<0.001) was observed. CONCLUSIONS: Missing maxillary first molar sites may often require vertical bone augmentation with direct sinus lifting procedures if it has to undergo replacement with dental implants in the representative Nepalese population.

Periodontal Health Status and Pregnancy Outcomes: A Survey in Medical Doctors.

INTRODUCTION: Periodontal disease and caries are the most common causes of tooth loss worldwide. Studies have demonstrated strong association between periodontitis and adverse pregnancy outcomes. Medical doctors, who are the primary healthcare providers, seldom advise women to seek dental care during pregnancy. This study was undertaken to explore the knowledge, attitudes and behaviours of medical doctors towards oral health and to identify the barriers of prenatal periodontal healthcare in their practices and its possible implications on pregnancy outcomes. METHODS: Total 377 doctors filled the questionnaire. The data collected through personal contacts, social networking, emails, online forms and networking at conferences were analysed using Statistical Package for the Social Sciences 20 software program and presented in tables, charts and diagrams. RESULTS: Out of 263 (69.8%) male and 114 (30.2%) female doctors enrolled in the study, only 52 (13.8%) had received education or training on oral care during pregnancy. Among them 299 (79.3%) agreed that there is possible link between health of teeth-gums and pregnancy. Approximately 105 (27.9%) encountered patients with oral/periodontal problem every week but only 108 (28.6%) "always" advised their patient for regular dental check-ups. Similarly, 358 (95%) agreed that there is need for universal guidelines however, 133 (35.3%) thought there was insufficient time to advise patients on oral health during check-ups. CONCLUSIONS: There is need for training on 'oral healthcare during pregnancy' for medical doctors. Developing universal guidelines for oral healthcare in pregnant women for all health professionals would be another important step. An adequate referral system to oral healthcare providers and biannual check-ups is recommended for both general patient as well as pregnant women for preventing adverse situations related to oral and specifically periodontal diseases.

Status of Tobacco Smoking and Diabetes with Periodontal Disease.

INTRODUCTION: Periodontitis is multifactorial disease that along with dental caries remains one of the commonest cause of tooth loss worldwide. Effective management requires clear understanding of risk factors. Smoking has a dose-dependent effect on periodontium. Similarly, individuals with diabetes have severe forms of periodontal diseases. We aim to assess the prevalence of periodontal disease in dental patients in relation to smoking and diabetes. METHODS: The study was conducted among 522 patients visiting the Periodontics Department, Kantipur Dental College. Individuals willing to participate had to sign an informed consent and undergo interview and clinical examination. Data collection, done on a structured proforma, was analysed using SPSS 20.0. RESULTS: Prevalence of periodontitis was 372 (71.3%), diabetes 33 (6.3%) and smoking as 138 (26.4%). Hypertension was observed in 64 (12.3%) patients and family history of diabetes among 94 (18%). Among the 372 periodontitis patients, smoking behaviour was present in 120 (32.3%), diabetes in 32 (8.6%), family history of diabetes in 72 (19.4%) and hypertension in 62 (16.7%). Conversely, 120 (87%) smokers, 33 (97%) diabetics, 72 (76.6%) with family history of diabetes, 62 (96.9%) hypertensive, 216 (41.4%) male and 156 (29.9%) female participants had periodontitis. Smoking behaviour was more in males: 115 (39.4%) compared to 23 (10%) females. CONCLUSIONS: Periodontitis was significantly associated with smoking, diabetes, hypertension and age. It is recommended that tobacco cessation and diabetes control be promoted as an integral component of periodontal therapy and oral health be included as an essential element of general health when conducting national health surveys.