Living will: Todays thoughts and actions.

Introduction: The word "Euthanasia" relates to two different words from the Greek language "Eu which indicates good and Thanatosis which indicates death", suggesting a "satisfactory Death" or "easy and painless Death" The phrase "mercy killing" has become associated with this meaning. It comprises inflicting painless death on a person suffering from an incurable and dreadful illness. It's the practice of terminating a person's life by administering a lethal injection or ceasing medical treatment. Informed and shared decision-making between the patient and the health professional caring for him or her is crucial for the quality of care and its outcomes. Living wills are nothing more than a tangible representation of this truth. As a result of their legal approval, patients' autonomy has been recognized. However, there are some differences in the regulations that have been adopted, and the health practice linked with these documents raises a number of practical and ethical questions that should be considered. Materials and Methods: PUBMED and COCHRANE databases were searched, with no language constraints, up to July 2021. Trial registration studies, hand searching, and bibliographic references of pertinent literature were also checked. Individual authors were responsible for data collection and analysis. The studies were evaluated independently by three review authors. Conclusion: A thorough assessment of the current accessible literature on living will be conducted, just to focus on the knowledge of euthanasia in detail. Most importantly, the social impact of the concept of euthanasia needs to be understood by the society. Moreover, it must be considered that euthanasia is different from suicide. Few communities may show the interference of their religion with euthanasia. So it is essential to enlighten the idea of euthanasia in legal ways for different countries.

Comparative Evaluation of the Effectiveness of Triphala and Chlorhexidine in Full-mouth Disinfection Treatment of Periodontitis in Type 2 Diabetes Patients.

AIM: To evaluate and compare the efficacy of triphala and chlorhexidine (CHX) in the treatment of stages II and III periodontitis with one-stage complete mouth disinfection in type 2 diabetes mellitus (DM) patients. MATERIALS AND METHODS: A total of 24 type 2 diabetic subjects with either stage II or stage III periodontitis were randomly divided into test and control groups with 12 patients in each group. For control group, full-mouth disinfection (FMD) was done using CHX and for test group, FMD was done using triphala. Clinical parameters were evaluated at baseline and at 6 months which comprised of probing pocket depth (PPD), plaque index (PI), clinical attachment level (CAL), papillary bleeding index (PBI). The primary outcomes considered were a reduction in PPD and a gain in CAL. The data were recorded, tabulated, and statistically analyzed. RESULTS: The PPD reduction for the test group was 3.38 ± 0.75 mm and for the control group was 3.39 ± 0.76 mm. The CAL gain for the test group was 3.39 ± 0.76 mm and for the control group was 3.18 ± 0.74 mm. Although there was a statistically significant PPD reduction, statistically not significant CAL gain was observed. CONCLUSION: Both the groups with the FMD protocol showed beneficial results in terms of PPD reduction and CAL gain but the test group showed slightly better results. CLINICAL RELEVANCE: Clinically, there is more PPD reduction and CAL gain from baseline to 6 months in the test group compared to the control group. Clinically, the test group has more favorable results compared to the control group.

Factors Influencing Parents' Decision in Choosing a Pediatric Dentist.

Introduction Pediatric dentists support children's dental health while also providing parents with health education and information. Parents are guardians of their children's oral health, as their knowledge, beliefs, also attitude about oral health can influence early childhood oral health directly or indirectly. Recognizing parenting practices on early childhood oral health is essential for developing effective prevention and treatment strategies for the child, because parents' health attitudes, behavior, and their children's dental health are usually influenced directly or indirectly by their practice. Objectives of this study were to find out what factors parents prefer while choosing a pediatric dentist for their kids, to assess parent attitudes towards management of a symptomatic primary tooth, to analyze parental understanding of the importance of deciduous teeth, and to assess parent knowledge and perception regarding their child. Methodology A cross-sectional study conducted at Sharad Pawar Dental College and Hospital was done, where 20 questions were posed to the parents who came with their children for dental treatment. Questions were divided into two parts, knowledge-based assessment scale and perception-based assessment scale. The questions were formulated to assess the knowledge of parents regarding dental care, their perception, and their attitude toward the decision-making while selecting a pediatric dentist for their kids. The questions also included information about the child's habits and associated problems with it. Three hundred parents of children under 14 years of age were chosen randomly where all parents were adequately informed beforehand, and their written consent was taken before proceeding with the questions. All the questions were formulated in the native language that they could easily understand. A convenient method was applied as per the respondent from an offline questionnaire survey.  Results By evaluating the parental knowledge as well as perception towards children's oral health and dental treatment we are able to determine which aspects parents prefer while selecting a pediatric dentist for their child. The study found that parents had limited knowledge about the causes, treatment, prevention, and consequences of oral health problems in children. Many parents neglect oral health problems and lack correct knowledge. Conclusion  Hence this study assesses the parental knowledge as well as perception towards children's oral health. This study concludes that it is crucial to raise awareness about oral health among parents and inform them about available treatments, consequences of negligence and future problems to aid them in decision-making.

Evaluation of PRF Membrane with Coronally Advanced Flap with and without Vertical Releasing Incisions for the Treatment of Gingival Recessions.

AIM: The aim of the current study was to compare the esthetic results for subjects with Miller Class I and II gingival recession (GR) abnormalities using platelet-rich fibrin (PRF) membrane with coronal advanced flaps (CAFs) with and without vertical releasing incisions (VRIs; the envelope-type flap and the flap with VRIs). MATERIALS AND METHODS: Seven defects from each of the test and control groups made up of fourteen defects total. In the test group, PRF + CAF was performed without VRI, while in the control group, VRI was used. Gain in root coverage was the main result, with secondary results including papillary bleeding index (PBI), plaque index (PI), relative gingival margin level, relative attachment level, probing pocket depth, recession depth, width of keratinized gingiva (WKG), and gingival thickness. After 3 months of therapy, a clinical evaluation was conducted. RESULTS: No significant difference was observed between the two groups in terms of recession reduction (2.08 ± 0.5 vs 1.91 ± 0.66 mm), clinical attachment level (CAL) gain (2.08 ± 0.5 vs 1.91 ± 0.66 mm), and increase in WKG (2.66 ± 0.88 vs 2.58 ± 0.51 mm) for test and control groups, respectively. CONCLUSION: For the treatment of GR, both groups are efficient. However, the CAF + PRF without VRI group showed higher patient compliance and lower postoperative morbidity. CLINICAL RELEVANCE: The PRF membrane with CAF with or without VRI provide effective treatment option for GR. CAF + PRF without VRI is easy to perform and has less postoperative complications.

A blind randomized controlled pilot trial on recombinant human bone morphogenetic protein-2 in combination with a bioresorbable membrane on periodontal regeneration in mandibular molar furcation defects.

OBJECTIVES: In preparation of a definitive randomized clinical trial (RCT), the current parallel-grouped triple-blind pilot RCT assessed the efficacy of recombinant human bone morphogenetic protein-2 (rhBMP-2) with polylactic acid/polyglycolic acid (PLA/PGA) membrane for improvement of periodontal tissue regeneration in Class II furcation type defects. METHOD AND MATERIALS: With the present single-center investigation, 24 patients/24 mandibular molars revealing Class II furcation lesions with involved buccal surfaces were randomly allocated and treated surgically, using either a PLA/PGA membrane alone (control, n = 12) or in combination with rhBMP-2 (n = 12). Assessors, participants, and the statistician were blinded to the treatment groups. Clinical parameters including Plaque Index (PI), Papillary Bleeding Index (PBI), clinical attachment level, vertical probing depth, horizontal probing depth, and gingival recession were assessed at baseline and 6 months postsurgery. RESULTS: Baseline values concerning the investigated parameters were comparable between both groups (P > .05). After 6 months, clinical attachment level gain was similar (P = .76), while greater reductions in vertical probing depth (P = .01) and horizontal probing depth (P = .05), along with less gingival recession (P = .03) were observed in the PLA/PGA + rhBMP-2 group (compared to the controls). An increased number of completely closed furcation type defects was observed in the PLA/PGA + rhBMP-2 group (with no adverse effects). CONCLUSIONS: When treating Class II furcation lesions, the use of rhBMP-2 (combined with PLA/PGA membranes) seems advantageous. The presented set-up seems feasible with regards to recruitment, randomization, acceptance, retention, and adherence to the study protocol. (Quintessence Int 2023;54:112-124; doi: 10.3290/j.qi.b3631815).

Implementation of Low-Level Laser Therapy in Dentistry: A Review.

A type of light therapy known as low-level laser therapy (LLLT) uses only one wavelength of light. Low-level lasers (LLL) do not have a warming effect on the tissues; instead, they have an effect called photobiostimulation. LLL do not evaporate the tissue. The use of LLL to manage a range of illnesses is known as LLLT. Helium-neon lasers are an illustration of an LLLT product. Gallium arsenide, the infrared semiconductor made of gallium aluminum arsenide, is also an example. The performance powers range from 50 to 500 mW with electromagnetic spectrum wavelengths in the red and near-infrared region spanning from 630 to 980 nm and pulsed or continuous-wave emission. In periodontics, LLLT has gained prominence for several applications, including wound healing and pain relief after non-surgical and surgical procedures.