The Efficiency of Three Irrigating Solutions after Surgical Removal of Impacted Mandibular Third Molars: A Cross-sectional Study.

AIM: The present study was conducted to assess the effect of irrigation with three different irrigants, namely normal saline, chlorhexidine, and povidone iodine on pain, alveolar osteitis, swelling, trismus, infection, and food impaction during surgical removal of impacted mandibular third molar. MATERIALS AND METHODS: Forty-eight patients, including 26 males and 22 females, fulfilling criteria for inclusion in this study were divided into three groups: group I where irrigant used was normal saline, group II as chlorhexidine, and group III as povidone iodine group. RESULTS: The pain was significantly more in groups I and III in 24 hours and 7th day as well. Alveolar osteitis was noted in groups III and I, nil in group II. The facial swelling measured in millimeters on 24 hours and on 7th day was significantly higher in 24 hours in groups I and III than in group II. Trismus was significantly more in group I and group III than in group II (with p < 0.01) on 7th day. CONCLUSION: It is concluded that chlorhexidine is effective in reducing pain, alveolar osteitis, swelling, and trismus when used as an irrigant following surgical removal of impacted third molar. CLINICAL SIGNIFICANCE: Chlorhexidine as irrigating solution helps in reducing the postoperative consequences after third molar surgery. Further studies are required using large sample size.

Effect of Periodontal Therapy on Crevicular Fluid Interleukin-18 Level in Periodontal Health and Disease in Central Maharashtra (India) Population.

AIM: The incidence and progression of the periodontal disease depend on periodontal microflora and the multifaceted response of the host, and these interactions are mediated by cytokines and chemokines. Interleukin-18 (IL-18) is a proinflammatory cytokine of the IL-1 superfamily. The aim of the present study was the assessment of the periodontal therapy in IL-18 level in periodontal disease and health. MATERIALS AND METHODS: Based on clinical attachment loss (CAL), probing pocket depth (PPD), gingival index (GI), and plaque index (PI) patients were divided into three groups: Group I with healthy patients, group II with chronic periodontitis, and group III with posttreatment patients having periodontitis. RESULTS: Mean PI, PPD, CAL, and gingival crevicular fluid (GCF) volume were significantly higher in groups II and III compared with group I. However, there were no significant differences between GI in groups I, II, and III. The total amount of IL-18 in GCF was significantly higher in group II when compared with groups I and III (p < 0.05). CONCLUSION: The present study confirmed that the IL-18 level in GCF was lower in healthy patients, higher in periodontally involved patients, and reduced at baseline, 3 and 6 weeks after nonsurgical periodontal therapy. CLINICAL SIGNIFICANCE: The IL-18 might be hypothetically beneficial in distinguishing health from disease and monitoring periodontal disease activity.

Comparison of the Impact of Two Interdental Cleaning Devices on the Reduction of Bleeding Around Implants.

Objective: Purpose: To evaluate the efficacy of water flossing to traditional flossing in lowering the bleeding on probing (BOP) index around dental implants. Methods and Materials: This single-center, examiner-masked research enrolled patients with implants and randomly allocated them to one of two groups. The research analyzed the effectiveness of manual toothbrushes when used with either string floss or a water flosser. Results: After 30 days, the main result was a decrease in BOP occurrence. At the outset, neither group had noticeably higher rates of bleeding than the other. While only six of 20 implants in the floss group demonstrated a decrease in BOP after 30 days, 18 of 20 implants in the water flosser group did. Conclusions: These results demonstrate that the use of water flossers was associated with much less bleeding than that of string floss. The researchers think that water flossing might be a useful addition to the maintenance of dental implants.

Efficacy of 1.5% Metformin Gel as an Adjuvant to Scaling, Root Planing, and Curettage for the Treatment of Infrabony Defects in Chronic Periodontitis Patients.

Context: To compare and evaluate clinically and radiographically the efficacy of 1.5% metformin (MF) gel and placebo gel as an adjunct to scaling and root planing (SRP) and Curettage for the treatment of infrabony defects (IBDs) in chronic periodontitis patients. Subjects and Methods: The study was conducted randomly on 15 patients of both the genders. Each patient contributed two sites (total 30 sites - Split mouth design) which was randomly assigned to one of the two treatments: (i) Site A (Control Site) in which SRP was done along with curettage and intrapocket application of Placebo Gel and (ii) Site B (Test Site) in which SRP was done along with curettage and intrapocket application of 1.5% MF Gel. The Periodontal status {which included plaque index (PI), sulcus bleeding index (SBI), probing pocket depth (PPD), clinical attachment level (CAL), IBD Depth} was assessed both clinically and radiographically at baseline, 3 months, and 6 months after treatment. Results: It was found that there was statistically significant difference in the periodontal status (PI, SBI, PPD, CAL, IBD depth) of the two sites when compared from baseline to 6 months. Conclusions: Local delivery of 1.5% MF improves the clinical outcomes of traditional treatment (SRP) and curettage and should be considered particularly as an adjunct to it.

A Two-Year Follow-Up Assessment of Decreasing Crestal Bone Levels Around Dental Implants in Patients Rehabilitated With Mandibular Implant Overdentures.

AIM: This two-year follow-up study was aimed to evaluate declining crestal bone levels around dental implants in patients rehabilitated with mandibular implant-supported overdentures. A three-dimensional advanced radiographic tool, cone beam computed tomography (CBCT), was utilized as radiographic aid in this study. MATERIALS & METHODS: A total of 15 patients wearing mandibular implants supported overdentures were studied for two years. Randomization and strict inclusion/exclusion criteria were followed during study execution. Complete dentures were fabricated with standard methods, which were later anchored by a bilateral implant in the mandibular jaw. Bone loss at all four surfaces in all studied implants was estimated by the cone beam computed tomography (CBCT) technique. These assessments were done at postoperative follow-up periods of six, 12, 18, and 24 months. Duly signed and informed consent was obtained from all participating patients. STATISTICAL ANALYSIS AND RESULTS: The statistical analysis was completed by the software IBM Corp. Released 2013. IBM SPSS Statistics for Windows, Version 22.0. Armonk, NY: IBM Corp. All relevant data was entered into it to be analyzed with suitable statistical tests. Out of all 15 studied patients, 11 were male, and four were female. P-value was very significant for the age range 35-40 years (0.01). In all instances, the lingual surface showed minimum, while the distal surface showed maximum bone loss when seen at all postoperative phases. Grossly, the mean bone loss ranged between 0.14-0.45. P-value was highly significant for the measurements made at the lingual and distal sides of implants (for both B and D positions). A comparison of both study groups by one-way ANOVA confirmed a highly significant p-value for estimations done between the groups (0.001). CONCLUSION: Within the limitations of the study, the authors confirmed that crestal bone levels showed a clear decreasing pattern in the postoperative phases. Since these deleterious processes can compromise long-term prosthesis success, operators should consider all these facts while planning to implant an overdenture prosthesis in the lower jaw.

Evaluating the Need of Continuing the Antiplatelet Drug Therapy in Patients Undergoing Minor Oral Surgical Procedures.

BACKGROUND: Dental treatment in patients on antiplatelet drug therapy is a long standing debate. Discontinuation of medication increases the risk of thrombotic complications, whereas continuation leads to increased postoperative bleeding. AIM: We conducted this prospective cross-sectional study to assess risk of bleeding in patients continuing antiplatelet medication while performing minor oral surgical procedures such as single or multiple teeth extraction, transalveolar extraction of third molar, biopsy, and alveoloplasty. MATERIALS AND METHODS: We calibrated the steps taken to achieve hemostasis, time taken to arrest bleeding, and correlated time taken to achieve hemostasis in patients under antiplatelet drug therapy (Group A [n = 64] - aspirin, Group B [n = 36] - aspirin and clopidogrel) and in patients without any drug therapy (Group C [n = 100] healthy patients). RESULTS: Out of 200 patients, Level 1 hemostatic measures were required for 129 (64.5%) patients, Level 2 hemostatic measures were taken for 68 (34.0%) patients, and Level 3 hemostatic measures were taken for 3 (1.5%) patients. Chi-square test conducted to compare the local hemostatic measures taken for minor oral surgical procedure for all groups was statistically significant (P ≤ 0.001). CONCLUSION: Overall, there was no postoperative bleeding within 24 h of extraction in any patient group. In conclusion, surgical procedures can be safely accomplished in patients receiving single or dual antiplatelet therapy when appropriate local hemostatic measures are taken.

Assessment of Titanium Level in Submucosal Plaque Around Healthy Implants and Implants with Peri-implantitis: A Clinical Study.

BACKGROUND: The present study focused on assessing the level of titanium in submucosal plaque in the peri-implant area with peri-implantitis in comparison to healthy implants. METHODOLOGY: Sixty patients with titanium dental implants were recruited. The degree of titanium in submucosal plaque around peri-implantitis and healthy implants was estimated using inductively coupled plasma mass spectrometry. RESULTS: The mean ± standard deviation probing depth in Group I was 3.12 ± 1.1 and in Group II was 7.2 ± 2.5; gingival index was 0.64 ± 0.3 and 1.64 ± 0.8 in Group I and Group II, respectively. The plaque index was 0.82 ± 0.2 in Group I and 1.5 ± 0.6 in Group II. The mean plaque mass in Group I was 24.1 ± 3.8 ng/ul and 49.3 ± 6.4 ng/ul in Group II. The mean titanium level in Group I was 0.08 ± 0.02 µg and in Group II was 0.91 ± 0.04 µg. A highly significant difference between both groups was found (P < 0.05). CONCLUSION: There was a significantly higher titanium level in submucosal plaque around dental implants with signs of peri-implantitis as compared to healthy dental implants.

Awareness Regarding Impact of Tobacco on Oral Health: An Original Study.

INTRODUCTION: The use of tobacco in all forms is increasing day by day globally causing its ill effects on oral as well as overall health of the people and affecting their sense of well-being and quality of life. AIM AND OBJECTIVES: The present study was done to investigate among patients the awareness of tobacco use and its ill effects on oral health. MATERIALS AND METHODS: This descriptive, cross-sectional study was conducted at Dr. RRK Dental College and Hospital, Akola. A total of 297 patients were asked using a self-structured questionnaire. RESULTS: Out of a total of 297 patients participating in the study, 48 (16.2%) were female and 248 (83.8%) were male. About 81.7% of the patients were aware that heart problems can be one of the ill effects of tobacco chewing, while 3.7% were still not sure about it. CONCLUSIONS: We found that patients had a knowledge about the impact of tobacco on oral health.

Incidence of grinspan syndrome among tribal and suburban population of Maharashtra - A cross sectional study.

BACKGROUND: Grinspan syndrome is characterised by presence of the triad: hypertension, diabetes mellitus (DM) and oral lichen planus (OLP). OLP, seen in hypertension and diabetes mellitus, is caused by drugs used to treat these diseases according to literature, however the incidence of this syndrome in India has not yet been reported anywhere. Hence the present study was conducted with the following objectives: (i) To determine the incidence of Grinspan syndrome amongst tribal and suburban study population of Maharashtra in different gender and age groups (ii) To correlate occurrence of OLP with DM type 2 and hypertension (iii) To find out the number of patients with OLP, DM type 2 and hypertension either alone or in combination. METHODS AND MATERIAL: The present study was conducted on 4681 new patients attending the routine outpatient department (O.P.D.) of the dental hospital between January 2017 and December 2018. Patients with OLP or DM (type-2) or hypertension or any combination of these diseases were included in the present study. Brief case history of each patient was recorded. Data thus collected were analysed using SPSS version 20 for Chi-square test. RESULTS: Grinspan syndrome was found in 1.62% of the study population. Syndrome was seen in 1.02% of female and 0.59% of male. Maximum patient affected by syndrome were in 35-50 years of age group. CONCLUSIONS: Incidence of Grinspan syndrome was 1.62%, mainly seen in sub-urban females of 35-50 years and OLP seen in hypertension and diabetes mellitus has different etiology and is not caused by drugs used to treat these diseases.

Management of radicular cyst in deciduous molar: A case report.

Radicular cysts associated with deciduous teeth are very rare. They constitute 0.5-3.3% of the total number of cysts in primary dentition. Radicular cysts involving deciduous teeth occur mostly in 3-19 years of age and has a male predominance. Enucleation with extensive removal of bone and vital teeth is preferred treatment for large radicular cysts and marsupialization can be preferred as a conservative approach to reduce morbidity. This paper presents a case report of a radicular cyst associated with a mandibular left deciduous first molar of a 7-year-old male child. The first premolar was displaced and the path of eruption was disturbed, horizontally placed below the first primary molar. The management comprised enucleation of the cystic sac and extraction of the involved permanent and primary teeth under general anesthesia.