Comparative Assessment of Crestal Bone Levels in Immediate Versus Delayed Implant Placement With and Without Bone Graft.

Background Presently, modern regenerative and surgical techniques for immediate implant placement in prepared sockets with soft tissue grafts and bone substitutes have helped eliminate concerns about bone deficiency. This also allowed the placement of dental implants based on prosthodontic needs. Aim  The present study aimed to comparatively assess dental implant healing following immediate implant placement with or without bone graft and dental implant healing after delayed implant placement with or without bone graft. Methods The study included 120 study subjects that were divided into two groups. Group I for immediate implant placement with or without bone graft (n=60) and Group II for delayed implant placement with or without bone graft (n=60). These two groups were further divided into subgroups. Group I subjects were further divided into two subgroups, where Group A (n=30) subjects underwent immediate implant placement with bone graft and Group B (n=30) subjects were given immediate implant placement without bone graft. Group II participants were further divided into two subgroups, where Group C (n=30) subjects underwent delayed implant placement with bone graft and Group D (n=30) subjects underwent delayed implant placement without bone graft. In the two groups, crestal bone levels were compared radiographically preoperatively and postoperatively at the immediate postoperative time, three months, and six months. Results More reduction in the crestal bone level was seen in the immediate implant placement group at three and six months postoperatively compared to the delayed implant placement group. A non-significant reduction in crestal bone levels was seen in the immediate implant placement with bone graft group with p>0.05 at three and six months compared to immediate implant placement without bone graft. Similar, non-significant crestal bone loss was seen in the delayed implant placement with bone graft group at three and six months compared to delayed implant placement with bone graft. Conclusions  This study concluded that healing of crestal bone in the delayed implant placement group with or without bone graft is better in comparison to the immediate implant placement group with or without bone graft.

Evaluation of the Periodontal Inflammatory Effect on Erythrocyte Sedimentation Rate: A Clinical Study.

Context: The link between oral infections and systemic disease is a well-proven hypothesis in the current literature. This relationship is the result of interaction between periodontal microbe that triggers inflammatory processes leading to the secretion of cytokines and other mediators of inflammation resulting in the systemic effects of pathogenesis. Materials and Methods: In this study, erythrocyte sedimentation rate (ESR), probing pocket depth, plaque index, gingival index, and the parameters were assessed initially and 1 month after scaling and root planing (SRP). Statistical Analysis Used: The paired t-test and the Pearson correlation were needed to examine and compare measured data. Results: The data from the study reveal that all the clinical parameters like the plaque index, the gingival index, and the probing pocket depth were statistically significantly reduced after 1 month of SRP with respect to baseline. While ESR mean value was also reduced, that is, 3.27 ± 1.24 mm/hr which was also considered statistically significant. Conclusions: The findings from the study showed a positive correlation between periodontal inflammation and ESR.

Platelet-Rich Plasma in the Management of Temporomandibular Joint Pain in Young Adults With Temporomandibular Disorder.

BACKGROUND: Temporomandibular disorder (TMD) encompasses a range of conditions affecting the temporomandibular joint (TMJ) and associated structures, with TMJ pain being a prevalent symptom. Conventional management strategies have limitations, which require the exploration of innovative interventions. Platelet-rich plasma (PRP), known for its regenerative properties, presents a potential therapeutic avenue. This study aims to investigate the effectiveness of PRP in reducing the pain associated with mild TMJ in young adults. METHODOLOGY: Participants (n = 128) aged 18 to 35 years with mild TMD were evenly randomized into PRP treatment and placebo control groups. PRP was prepared using a standardized protocol, and intra-articular injections were administered. Placebo injections mimic PRP. Follow-up evaluations were carried out at four and eight weeks after the intervention. RESULTS: The study successfully randomized comparable groups, and the PRP treatment group experienced a significant reduction in TMJ pain (visual analog scale [VAS] score: 6.8 ± 1.2 to 2.1 ± 1.0 at eight weeks, P < 0.001). The PRP treatment also increased the largest opening of the mouth (from 38.2 ± 2.5 to 43.5 ± 3.1, P < 0.001) and the number of lateral movements (12.3 ± 1.5 to 14.9 ± 2.0, P < 0.001), while the placebo group had very few changes. Positive patient-reported outcomes on daily activities were observed, with no serious complications reported in either group. CONCLUSIONS: This study provides evidence supporting the efficacy of PRP in reducing TMJ pain, improving jaw function, and improving quality of life in young adults with mild TMD. The results underscore the potential of PRP as a minimally invasive intervention for TMJ disorders.

Dramatic increase in antimicrobial resistance in ESKAPE clinical isolates over the 2010-2020 decade in India.

RATIONALE AND OBJECTIVES: ESKAPE pathogens (Enterococcus faecium, Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, Pseudomonas aeruginosa, and Enterobacter species) constitute a threat to humans worldwide. India is now the most populous country. The goal was to investigate the evolution of the rates of antimicrobial resistance in ESKAPE pathogens across India over the 2010-20 decade. METHODS: The data (89 studies) were retrieved from the Medline PubMed repository using specific keywords. RESULTS: The study of 20 177 ESKAPE isolates showed that A. baumannii isolates were the most represented (35.9%, n = 7238), followed by P. aeruginosa (25.3%, n = 5113), K. pneumoniae (19.5%, n = 3934), S. aureus (16.3%, n = 3286), E. faecium (2.6%, n = 517) and Enterobacter spp. (0.4%, n = 89). A notable increase in the resistance rates to antimicrobial agents occurred over the 2010-20 decade. The most important levels of resistance were observed in 2016-20 for A. baumannii (90% of resistance to the amoxicillin-clavulanate combination) and K. pneumoniae (81.6% of resistance to gentamycin). The rise in ß-lactamase activities was correlated with an increase in the positivity of Gram-negative isolates for ß-lactamase genes. CONCLUSIONS: This review highlighted that, in contrast to developed countries that kept resistance levels under control, a considerable increase in resistance to various classes of antibiotics occurred in ESKAPE pathogens in India over the 2010-2020 decade.

Clinicoradiographic Evaluation of Long-term Efficacy and Risk Factors Associated with Dental Implants used for Full Mouth Rehabilitation.

Background: Despite various complications and failure factors, newer implants are designed that allow placement in sub-optimal conditions to allow the operator to place implants at sites with low bone quality. These newer designs also allow improved stability with higher survival rates in the short term. Aims: The present study was undertaken to evaluate long-term efficacy and risk factors associated with dental implant placement for full mouth rehabilitation. Materials and Methods: In 24 subjects, 438 implants were placed. The data collected were surgical and were retrospectively analyzed. The data collected included medical history, local, patient satisfaction, marginal bone loss, and systemic risk factors affecting implant survival. Outcome variables assessed were peri-implantitis, implant success, and survival at the follow-up visit. The data were expressed in terms of percentage and number, and the results were derived. Results: Peri-implantitis was seen in 31.05% (n = 136) of implants. 76.02% (n = 333) of implants were considered successful at recall. Concerning survival, compromised and satisfactory survival was shown by 10.04% (n = 44) and 2.96% (n = 13) of implants, respectively. 10.95% (n = 48) of implants were considered as failures. Conclusion: The present study concludes that good, long-term survival rates are associated with full mouth rehabilitation using dental implants.

Clinical Assessment of the Bone Width Following Lateral Ridge Expansion in Augmentation of Narrow Alveolar Ridges for Placing Immediate Dental Implants.

Background: Less residual alveolar bone at extraction site at esthetic and functional tooth position is the main limitation in placing a dental implant, especially at long-span edentulous ridges. This needs ridge augmentation. Aims: To assess bone width gain and implant stability following narrow ridge augmentation using the vertical ridge split technique. Materials and Methods: In 22 subjects within the age group of 20-60 years and the mean age of 38.46 years. The vertical ridge split technique was done in all subjects for horizontal ridge augmentation. Paraesthesia, pain/discomfort, mobility, and radiographic crestal bone width were assessed 6 months postoperatively. The data were described as mean and standard deviation along with number and percentage. Paired t-test was also used keeping the level of significance at P < 0.05. Results: Implant stability was seen in 86.36% (n = 19) study subjects and were not stable in 13.63% (n = 3) subjects. Bone width preoperatively was in the range of 3.1-4.4 mm with the mean value of 3.64 ± 0.41. Postoperatively, the bone width increased and was in the range of 5.2-6.3 mm with the mean value of 5.62 ± 0.45 mm. This increase postoperatively was statistically significant with a P value of <0.001. Conclusion: The present study concludes that acceptable success results are seen using the ridge split technique with simultaneous dental implants placement in both atrophic maxilla and mandible.

Fever of Unknown Origin in Older Adults: A Prospective Observational Study from North India.

OBJECTIVES: Fever of unknown origin (FUO) has different etiology in different age groups. We aimed to determine the spectrum of FUO in older patients and to establish the underlying etiology. METHODS: This was a hospital-based prospective observational study conducted between January 2018 to June 2019 at Postgraduate Institute of Medical Education and Research, Chandigarh, India. Fifty-one consecutive patients aged 60 years and above met the qualitative criteria of FUO. RESULTS: The etiological distribution was infections in 21 patients (41.2%), malignancies in 16 (31.4%) and noninfectious inflammatory disorders in 8 (15.7%). Six patients (11.8%) remained undiagnosed. Among infections, 15 patients (29.4%) had tuberculosis, and 10 had an extrapulmonary disease. Twelve out of 16 cases with malignancies had a hematological cause, and eight had lymphoma. ;Regarding decisive methods of diagnosis, 18F-fluorodeoxyglucose positron emission tomography was diagnostic in 17 out of 27 patients (63%) and computed tomography in 21 out of 42 cases (50%). Imaging or endoscopy-guided procedures provided a diagnostic clue in 12 out of 14 patients (85.7%), and bone marrow examination results were useful in 9 out of 19 (47.4%). CONCLUSIONS: Infections and malignancies contributed to about three-fourths of cases, with tuberculosis and lymphoma being the commonest etiologies.

The effect of mouthwashes on fluoride dentifrices in preventing dental abrasion or erosion.

Erosive tooth wear (ETW) refers to the chemical dissolution of mineralized tissues by acids of non-bacterial origin. It occurs in the primary as well as the permanent dentition. In this study, our objectives were to investigate and compare the impact of chlorhexidine gluconate (CHX), essential oils (EO), and cetylpyridinium chloride (CPC) on ETW protection produced by conventional fluoride kinds of toothpaste. A clinically relevant in-vitro erosion/abrasion pH cycling model was employed to test the effect of the aforementioned mouthwashes on modulating the ability of NaF and SnF2 types of toothpaste. The mean dentin surface loss associated with NaF toothpaste was significantly lower than for the SnF2 toothpaste. On the other hand, enamel surface loss with SnF2 toothpaste was significantly lower than for the NaF toothpaste. Also, the surface loss of erosion was significantly higher when associated with abrasion than without brushing and for both enamel and dentin. There was no significant difference in the surface loss among all types of mouthwash. Commonly used types of mouthwash containing antimicrobial agents or additional fluoride do not impact fluoride toothpaste action on erosion/abrasion. Also, considering erosion only, the tested SnF2 dentifrice provided better protection against surface loss of enamel than the other.

Influence of Periodontal Infection as a Possible Risk Factor for Preterm Low Birth Weight.

BACKGROUND: There is emerging interest and increasing amount of evidence that support the interrelationship between periodontitis and systemic conditions. Epidemiological and microbiological-immunological studies have lent credence to the concept that periodontal disease may be a separate risk factor for cardiovascular disease, cerebrovascular disease, and respiratory disease, as well as preterm delivery of low-birth-weight infants. AIM: The aim of this study was to evaluate the influence of periodontal infection as a possible risk factor for preterm low birth weight (LBW) based on age, literacy, and hemoglobin level of mother. MATERIALS AND METHODS: The observational study was conducted on 200 subjects, which were selected from the free labor ward, District Hospital, Saifai, Etawah, UP, India. Periodontal examinations were performed using the World Health Organization criteria. The periodontal status of the mother was recorded using Community Periodontal Index. RESULTS: For this study, chi-square test was performed to know the effect of variables and to find out the statistical significance of the study. Age of mother shows statistical insignificant association with periodontal disease, whereas literacy of mothers showed statistical significant association with periodontal disease, and periodontal status and hemoglobin levels of the mothers also showed a significant association. CONCLUSION: The prevalence of LBW infants was considerably less in mothers with a healthy periodontium and increased with progressive periodontal disease.

Molecular characterization of a multidrug-resistant/pandrug-resistant nosocomial polymicrobial infection with Klebsiella pneumoniae, Providencia rettgeri, and Acinetobacter baumannii from Rural Maharashtra, India.

The emergence of resistance against commonly used antibiotics has become a serious global concern. The rapid development of antibiotic resistance exhibited by Enterobacteriaceae has caused an increasing concern regarding untreatable bacterial infections. Here, we isolated four pathogens from a geriatric female patient who was hospitalized for a month with ventilator-associated pneumonia (VAP) and fever. The organisms isolated from the tracheal aspirates and urine included Klebsiella pneumoniae, pandrug-resistant Providencia rettgeri, and Acinetobacter baumannii. Resistome analysis indicated that the bacterial isolates from the polymicrobial infection were multiple-drug resitnat and pandrug resistant clones. Molecular characterization revealed presence of blaTEM-1 in K. pneumonaie, P. rettgeri and A. baumannii. The blaTEM-1 and blaNDM-1 genes were present in P. rettgeri and A. baumannii, whereas the blaTEM-1, blaNDM-1 and blaOXA-23 traits were present in A. baumannii isolates. The patient has died due to the unavailability of effective antimicrobial treatment for this drug-resistant polymicrobial infection.

Efficacy of xanthan based chlorhexidine gel as an adjunct to scaling and root planing in treatment of the chronic periodontitis.

AIM: The aim of this study was to evaluate the clinical effectiveness of locally delivered xanthan-based Chlosite(®) gel as an adjunctive therapy to scaling and root planing in treatment of chronic periodontitis. MATERIALS AND METHODS: In a randomized controlled clinical study, 30 patients were selected. Pocket depth between 5 and 7 mm was selected and each patient had two sites on the same side of the mouth. A total of 30 control sites were scaled and root planed and 30 test sites were scaled and root planed and Chlosite(®) gel was added. The clinical parameters, probing depth (PD), clinical attachment level (CAL), plaque index (PI) and bleeding on probing (BOP), gingival index were recorded at baseline, 6 weeks, 3 months and 6 months. STATISTICAL ANALYSIS: Paired/unpaired t-test was used, significance was placed at 5% level of significance, i.e., P < 0.05 was considered as a significant. RESULTS: From baseline to a period of 6 months, significant difference was found between test and control group for PD, CAL, PI and BOP, P value being PD (P = 0.002), CAL index (P = 0.014), respectively. CONCLUSION: Subgingival injection of xanthan-based Chlosite(®) gel adjunct with scaling and root planing appeared to cause significant improvement compared with scaling and root planing alone in persons with chronic periodontitis.