Comparison of the Efficacy of Different Oral Hygiene Aids in Maintaining Periodontal Health in Patients With Gingivitis.

Background Gingivitis is a common oral health condition characterized by inflammation of the gingiva, which, if left untreated, can progress to more severe forms of periodontal disease. Effective oral hygiene practices play a crucial role in managing gingivitis, but the comparative efficacy of different oral hygiene aids remains unclear. This study aimed to evaluate and compare the efficacy of various oral hygiene aids in maintaining periodontal health in patients with gingivitis, considering gender and the degree of gingivitis as potential influencing factors. Methods A total of 120 participants with gingivitis were enrolled in this study. The participants were randomly assigned to one of four groups, each utilizing a different oral hygiene aid: Group A (toothbrush), Group B (electric toothbrush), Group C (brushing along with the use of an interdental brush), and Group D (brushing along with the use of a water flosser). All participants received toothpaste for use with their respective oral hygiene aids. Periodontal health parameters, including plaque index (PI), gingival index (GI), and bleeding on probing (BOP) score, were assessed at baseline and after a specified duration of oral hygiene intervention. Also, the microbial count for Streptococcus, Actinomyces, Porphyromonas, Fusobacterium, and Veillonella species was evaluated. Results No significant differences in periodontal health outcomes were observed between males and females in any of the oral hygiene aid groups. Similarly, no significant differences were found among the mild, moderate, and severe gingivitis groups within each oral hygiene aid group. The microbial count also has no statistical significance except for streptococcus species. These findings indicate that the efficacy of the tested oral hygiene aids was comparable across genders and different degrees of gingivitis. Conclusion The findings of this study suggest that the tested oral hygiene aids were effective in maintaining periodontal health in patients with gingivitis, irrespective of gender and the degree of gingivitis. These results have implications for oral healthcare professionals in their recommendations to patients regarding oral hygiene practices. However, it is important to consider the limitations of this study, including the relatively small sample size and the specific oral hygiene aids tested.

Implant abutment using hand drivers versus torque wrench.

The most frequent instrument used to begin tightening screws is a manually regulated screwdriver. Regarding manually regulated screwdrivers, predicted margins of error vary between fifteen percent to forty eight percent. Mechanical Torque restricting devices can consistently produce the requisite torques. As a result, devices like wrenches are needed to achieve the desirable values of torque. Hence, the present study was designed to evaluate the torque difference between handheld drivers and torque wrench and thereby its effect on the internal threads of implant surface.120 blocks was prepared from an autopolymerizing type of acrylic material each with a dimension of 1 inch. The centre of each block was affixed with analogue of dental impalnts with dimensions of 3.5 mm width and 13 mm length. With 60 specimens each, these models were split into two categories: hand torque specimens category and torque wrench specimens category. A stereomicroscope was used to look at the implant analog's internal threading architecture at a magnification of 100. At the bottom and top, four threads were spaced apart by a certain amount. Biowizard software was used for the assessment, and the results were recorded. Threads on the internal surface of dental implants were produced once more following torquing the implant's impression, and the stereomicroscope was used to quantify the separation between the 4 threads. Statistics were used to correlate the readings. All study participants' hand torque as well as torque wrench measurements were documented and statistical analysis was performed on them. When there was statistical analysis of the measurements then it was observed that mean values of torque in specimens included category of manual torque application was found out to be 33.6 ± 6.510 Ncm. On the other hand the mean values of torque in specimens included in category of torque application by torque wrench were found out to be 33.57 ± 3.472 Ncm. The outcome showed operator heterogeneity for both categories and operator variance when using a manual driver to generate torque. One independent - sample t test was used to contrast the mean data between the two categories, and P< 0.05 was chosen to determine whether the intergroup difference was meaningful. Because the torque values obtained with hand tightening were uneven, it may be concluded that different levels of hand torquing skill caused the torque to fluctuate. The torque wrench device displayed the desired torque data in the range that the manufacturer had advised. However, utilising manual drivers and a mechanical torque instrument did not cause any modifications to thread on the internal surface, and it rarely underwent significant deformation during the preliminary tightening torque readings. Thus, given that manually hand regulated drivers create a range of torques, it may be inferred that the employment of mechanical torque restricting instruments should be required.

Maxillofacial Surgery and Hair Transplantation: Ethics with Expertise.

Background: The hair transplantation has become widely popular aesthetic procedure. Hair transplantation being a relatively new field in maxillofacial surgery, several aspects raise issues and controversies. Follicular unit transplantation (FUT) and follicular unit extraction (FUE) are two commonly used and accepted techniques. Further, hair transplantation has been successfully used in correction of alopecia, cleft lip scars, post-burn or surgical scars, vitiligo and as an adjuvant to other maxillofacial procedures. Several maxillofacial surgeons have incorporated hair transplantation procedure into their aesthetic practice successfully. Sound knowledge of surgical technique, armamentarium and proper surgical planning are important for good results. A lot of debate has been there on minimum qualification for performing hair transplantation. Purpose: The aim of this review is to highlight that an oral and maxillofacial surgeon can perform hair transplant surgery with perfection and can manage all associated complications with expertise.

A comparative study between conventional and the Bethesda System for Reporting Thyroid Cytology of 240 cases.

Introduction: Thyroid nodule is a common disorder of thyroid. Despite their benign nature, they can be associated with multiple pathologic conditions including thyroid cancer. Fine-needle aspiration plays an essential role in evaluating thyroid nodules. The Bethesda System for Reporting Thyroid Cytology (TBSRTC) has attempted to standardize reporting and cytological criteria in aspiration smears. Aim: The aim of this study is to compare the conventional and TBSRTC and to compare and correlate the cases with histological findings wherever available. Materials and Methods: The present study was a retrospective study undertaken in the department of pathology from January 2018 to December 2018 to access the validity of TBSRTC considering histopathology as the gold standard. May Grünwald Giemsa and Papanicolaou stained thyroid FNA smears of 240 patients were collected which were reported by the conventional system for reporting thyroid cytology and also categorized as per current Bethesda nomenclature for thyroid cytology. Diagnosis of both the reporting systems was then compared and correlated with the histological diagnosis wherever possible. Results: A total of 240 cases were examined on cytology, out of which histopathological correlation was possible in 110 cases. For benign thyroid lesions, sensitivity and specificity with conventional system were 69.91% and 40.25%, respectively, while with TBSRTC, sensitivity and specificity were 84.04% and 29.94%, respectively. Sensitivity and specificity of conventional system for malignant thyroid lesions were 58.56% and 69.91%, respectively, while with TBSRTC, sensitivity and specificity were 73.69% and 95.12%, respectively. The Bethesda system found to be highly sensitive for benign thyroid lesions and highly specific for malignant thyroid lesions as compared to the conventional method of reporting of thyroid cytology. Conclusion: Bethesda system was found to be superior for reporting thyroid cytology over the conventional system of reporting for thyroid cytology.

Assessment of immunohistochemical expression of p16 in head and neck squamous cell carcinoma and their correlation with clinicopathological parameters.

INTRODUCTION: Oral squamous cell carcinoma is a major cause of death throughout the developed world. It is associated with tobacco chewing, paan chewing and alcohol consumption. Human papillomavirus (HPV) type 16 has also been suggested to play a role in the etiology of head-and-neck squamous cell carcinoma (HNSCC). p16 expression is now being used as a surrogate marker of HPV infection in squamous cell carcinoma. MATERIALS AND METHODS: In this cross-sectional observational study, a total of 100 cases of HNSCC were taken. p16 expression was determined by immunohistochemical (IHC) staining and correlated with clinicopathological parameters. The obtained results were analyzed and evaluated using Chi-square test, value of P < 0.05 was taken significant. RESULTS: P16 was positive in 60% of cases. A statistically significant direct association was observed between p16 with age, site of the tumor, abnormal sexual habits and lymph node involvement. CONCLUSION: IHC expression of p16 can be used as a surrogate marker of HPV. Study of p16 expression may provide clinicians with more exact information in order to evaluate tumor aggressiveness, treatment modalities and can provide support for vaccination program in a high-risk group.

Clinical and Radiologic Evaluation of Regenerative Potential of NHA Paste and DBM in the Treatment of Periodontal Intra-bony Defects -A Randomized Control Trial.

INTRODUCTION: Previous studies have shown that Hydroxyapatite (HA) has shown good results in the treatment of intra-osseous periodontal defects. A newer variety of HA has been designed over a period of research which has nano-sized particles and is availed in a paste consistency called Nanocrystalline Hydroxyapatite paste (NHA paste). This variation in size and surface area of NHA paste can provide better results when used in intra-bony defects. AIM: The purpose of this study was to compare the clinical and radiographic outcomes obtained with usage of NHA paste to those obtained with Demineralized Bone Matrix (DBM) in the treatment of periodontal intra-bony defects. MATERIAL AND METHODS: A clinical trial was carried out for a period of 12 months. A total of 26 intra-bony defects in 10 patients were divided into experimental and control sites. The experimental sites were debrided and grafted with NHA paste. The control sites were debrided and grafted with DBM-Xenograft. Probing Depth, Clinical Attachment Level (DCAL) and Gingival Margin (GM) position were recorded at baseline 3, 6, 9 and 12 months. Standardized radiographs were also documented at these recalls. The results were averaged (mean± standard deviation) for each parameter and Student t-test was used to determine intra-group statistical difference and One way analyses of variance (ANOVA) to test the difference between groups using Excel and SPSS (SPSS Inc, Chicago) software packages. RESULTS: On completion of 12 months, the mean percentage of PD reduction achieved in the experimental and control sites was 67.45% and 69.03% respectively (p<0.05). The mean percentage of gain achieved in CAL was 63.58% and 61.42% in the experimental and control sites respectively (p<0.05). Gingival recession was seen to be non-significant in the experimental and control sites. The mean percentage of bone fill in the control group obtained was 48.16% where as the percentage of bone fill obtained in the experimental group was 48.64% (p<0.05). CONCLUSION: Overall, both therapies led to significant improvements of the investigated parameters. The NHA paste was as effective in terms of improving clinical and radiographic parameters as DBM-Xenograft, which is an already established bone graft. There is a need for further long term controlled studies evaluating the adjunctive benefits of usage of NHA paste in the treatment of periodontal intra-bony defects.

Effect of Surgical Periodontal Therapy on Serum C-reactive Protein Levels Using ELISA in Both Chronic and Aggressive Periodontitis Patient.

BACKGROUND: Periodontitis can be defined as a local inflammatory process which mediates destruction of periodontal tissues & is triggered by bacterial insult. In periodontal infections, the levels of C reactive proteins are elevated as compared to the levels in a periodontally healthy individual. The study was done to determine the relative levels of serum CRP in aggressive, chronic and periodontally healthy subjects and to evaluate the effect of surgical periodontal therapy on serum C-reactive protein levels. MATERIALS AND METHODS: Serum samples were collected from 150 participants (50 healthy control patients (non-periodontitis), 50 patients with chronic periodontitis and aggressive periodontitis. Serum C- reactive protein levels were assessed by means of immunoturbidimetric assay at baseline for subjects in all the 3 groups and 3 months after completion of surgical therapy. RESULTS: The mean baseline C-reactive protein (CRP) concentrations in the Groups I, II and III were 1.65±0.57 mg/L, 3.03±2.14 mg/L and 3.09±2.27 mg/L respectively. After treatment, the mean C-reactive protein (CRP) levels in Groups II and III reduced from 3.03±1.67 mg/L to 1.46±1.67 mg/L and from 3.09±1.21 to 1.43±1.21 mg/L respectively. Similar results were found for probing depth and all indexes in Group II and III after treatment. Also, the mean attachment loss in Groups II and III reduced, so the results were highly significant. CONCLUSION: Successful periodontal treatment results in significant decrease in serum C-reactive protein (CRP) levels in otherwise healthy subjects.

Evaluation of Microleakage of Dental Composites Using Bonding Agents with Different Placement Techniques: An Invitro Study.

BACKGROUND: The rapid progress of adhesive dentistry over the past decade has been attributed to the significant advances in dentin bonding technology. Requirements of an ideal bonding agent are quite similar to those indicated by Buonocore despite of many improvements. As we enter the new millennium, it is important for us to examine the past. OBJECTIVE: To evaluate the microleakage of three bonding agents namely Single Bond, Prime & Bond NT and Excite using different composite materials namely Z100, Spectrum TPH, Tetric with three different placement techniques. MATERIALS AND METHODS: Fifty four extracted human premolars were taken & divided into 9 groups depending upon application of bonding agents followed by composite restorations. Specimens were subjected to thermal cycling at 6(0)C, 37(0)C, 54(0)C and again at 37(0)C & then placed in 10 ml each of freshly prepared 50% silver nitrate solution for 2 hour in darkness, washed & placed under sun light for 24 hours. The sectioned specimens were then observed under stereomicroscope to detect microleakage. RESULTS: On comparing the mean microleakage scores among the three groups, maximum microleakage scores have been obtained when no bonding agent was used, while least microleakage scores were obtained with double coat of bonding agent. CONCLUSION: The present study suggests that the placement of bonding agent technique before composite restoration can be effective to limit the microleakage at the tooth restoration interface.

Class II Division 1 in New Dimension: Role of Posterior Transverse Interarch Discrepancy in Class II Division 1 Malocclusion During the Mixed Dentition Period.

INTRODUCTION: Posterior transverse discrepancy as seen in some cases of Class II Division 1 malocclusion in mixed dentition period can be related to typical skeletofacial characteristics. These features when studied early in the mixed dentition period give a clear view of the desired appropriate treatment plan in a particular case. AIM: The purpose of this study was to establish a simple method to determine the posterior (intermolar) transverse discrepancy and craniofacial skeletal features between the dental arches during the mixed dentition in a sample of Class II Division 1 patients to provide diagnostic and therapeutic guidance in the early approach. MATERIALS AND METHODS: A sample of 60 Class II Division 1 patients in mixed dention that were divided into 30 Class II Division 1 patients with posterior transverse interarch discrepancy {Class II (I) PTID group} and 30 Class II Division 1 patients without posterior transverse interarch discrepancy {Class II (I) NPTID group}. Thirty Class I subjects in mixed dentition were included as control. RESULTS: The skeletal features of the Class II group without PTID are those of the skeletal Class II associated with 'anatomic' mandibular retrusion (due to a micrognathic mandible) and those of the Class II group with PTID as skeletal Class II associated with only a 'functional' mandibular retrusion (due to a posteriorly displaced mandible of normal size). CONCLUSION: This study confirmed the role of occlusion in the control of maxillomandibular skeletal relationships.The treatment strategies could be planned on the basis of the transverse component of Class II Division 1 groups in the mixed dentition period.

Aerosols how dangerous they are in clinical practice.

BACKGROUND AND OBJECTIVES: The purpose of the present study was to determine the microbial atmospheric contamination during initial periodontal treatment using a modern piezoelectric scaler and to evaluate the efficacy of two commercially available mouth rinses (0.2% Chlorhexidine mouth rinse and Listerine) in reducing bacterial contamination when used as a pre-procedural rinse, with and without high volume evacuation (Aerosol reduction device). MATERIALS AND METHODS: Subjects for the study were selected from the outpatient Department of Periodontics, Sri Siddhartha Dental College and Hospital, Tumkur, India. Total 60 patients were taken for the study and on the basis of inclusion and exclusion criteria's they were divided into three groups. The sampling was carried out in two stages before and after implementing a set protocol. Total duration of study was four months. MICROBIOLOGICAL EVALUATION: The samples (blood agar plates) were transported immediately to the Department of Microbiology, Sri Siddhartha Medical College, Tumkur for: Identification of microorganisms as per standard procedures (Gram stain, Biochemical Test, Species Identification).Counting the number of colonies formed on blood agar plates using colony counter unit. RESULTS: Out of all the three pre-procedural rinses 0.2% w/v Chlorhexidine is the best in reducing aerobic bacteria (CFU) followed by Listerine and then Water. CONCLUSION: The following conclusion was drawn that the use of pre-procedural rinses along with the use of high volume suction apparatus significantly reduced the aerosol contamination and hence chances of cross-infection in the dental units.

Central odontogenic fibroma.

Central odontogenic fibroma (COF), which has been categorized under the subheading of odontogenic tumors of ectomesenchyme, is such an uncommon neoplasm that much of its nature is left uncharted. COF is a rare tumor that accounts for 0.1% of all odontogenic tumors. Clinically, the lesion grows slowly and leads to cortical expansion. Radiologically, the lesion may be unilocular or multilocular. In some cases, it may be associated with root resorption or displacement. Histopathologically, the lesion is characterized by mature collagen fibers and numerous fibroblasts. A case of COF of the mandible in a male patient aged 49 years is described in this report. The patient showed no symptoms, no history of swelling discomfort or pain, and was unaware of the presence of the lesion. Orthopantomogram (OPG) showed generalized bone loss along with a unilocular radiolucent area, with a clear sclerotic lining and angular bone loss. Surgical enucleation of the lesion along with placement of osseo-graft, which is a bioresorbable demineralized bone matrix (DMBM), and platelet-rich fibrin was carried out in the defect site. Following surgery, patient was recalled for revaluation of the lesion; the surgical site showed good healing and an increase in bone height was seen.