A Survey on Alveolar Bone Grafting in Indian Cleft Centers.

OBJECTIVE: To assess the factors influencing the type and timing of Alveolar Bone Grafting (ABG) among cleft centers throughout India. To examine the decision-making criteria for orthodontic treatment and the timing of ABG. DESIGN: Cross sectional survey. METHOD: This survey was based on a convenience-based sample selected from cleft teams across India. The survey was formulated using the SurveyMonkey platform and emailed to 40 cleft teams. The survey included questions on demographics, timing, surgical protocol, orthodontic protocol, radiograph prescription rate, assessment methods for the success of ABG and three scenarios for evaluating the timing of the bone graft. The Chi-squared test was performed to evaluate the difference in opinion between specialists. The inter-examiner reliability was assessed using Kappa statistics. RESULTS: Thirty-five units completed the questionnaire. Most units operate with 1-2 surgeons, with 42.9% of them treating cleft patients for under 5 years. Only 11.4% of centres routinely advised oblique occlusal radiographs for post-surgery evaluation, and 31.4% prescribed CBCT. However, 40% of cleft teams did not perform audits to evaluate the success of ABG, and less than 50% advised radiographs six months post-surgery. Around 26% of centres do not routinely provide orthodontic treatment pre-ABG. The inter-examiner reliability for case scenarios showed poor agreement between the clinicians. CONCLUSION: The survey showed a serious lack of consensus in the ABG treatment among cleft teams in India and emphasises the need for standardised protocols for the treatment of children with cleft palate. There is an urgent need to develop core outcome set in cleft.

Microneedles and Nanopatches-Based Delivery Devices in Dentistry.

Needle-based devices are evolving as a promising diagnostic and therapeutic tool in the field of medicine. They can be used for drug delivery, as well as extraction of fluids, for systemic and local effects. The conventional methods of drug delivery require repeated dosing in the oral cavity due to the presence of saliva. Hence delivery systems, such as needle-based devices that could provide sustained release of the drug in the oral cavity, are required. These devices could also be a useful adjunct in diagnosis and therapy of oral cancers, delivering anti-cariogenic and antiplaque agents, for remote monitoring of oral health, and for administering painless and fearless local anesthesia. Since they offer many advantages, such as increased compliance, absence of needle phobia, they are painless, safe, self-applicable and are minimally invasive, they will have a major impact in the field of dentistry. This paper summarizes the various types of needle-based devices and their manufacturing technologies. The manuscript aims to serve as a foundational review that highlights and proposes several current and prospective impactful applications of these devices in various fields of dentistry.

Oral health concerns in India.

Oral health is an integral part of general health. There are many oral health issues which are of concern to India, despite having the maximum number of dental schools in the world. Dental caries, oral cancers and periodontal diseases are areas of national oral health concern. India lacks baseline data to know the exact prevalence of oral diseases, which is the first requirement to frame any national policies or manpower allocation. India is a vast country, nations within a nation, with great diversity in eating and behavioural practices. With a population of 1.21 billion and 68.84% of population residing in villages, the strategies need to be customised based on the population subgroup. Low level of awareness, strained and skewed infrastructure and resources, lack of motivation and research and oral health policies are some major factors that need to be tackled. This paper would attempt to highlight the oral health concerns of India, lacunae in the current system and possible strategies to address these issues.

Treatment of a patient with a bilateral cleft lip and palate with implants and surgery of the maxillary anterior region.

Caring for patients with bilateral cleft lips and palates requires an interdisciplinary approach. The treatment of such a patient is described. Therapy comprised maxillary expansion, mini-implant insertion, premaxillary osteotomy, and vomeroplasty, which led to a drastic improvement of the occlusion and facial appearance.