Caries Assessment Spectrum and Treatment: Would It direct Future Epidemiological Surveys?

AIM: To evaluate caries spectrum among 12- and 15-year-old Indian children using the Caries Assessment Spectrum and Treatment (CAST) index. MATERIALS AND METHODS: An epidemiological survey of the schoolchildren was carried out in a district in India. A stratified cluster random sampling method was used to select the sample. The caries prevalence of the surveyed population was obtained by using this CAST tool. Chi-square test was used to verify the association between dental fluorosis, socioeconomic status, and age and caries experience. Mann-Whitney U-test was used to compare the caries experience between the two age groups. RESULTS: A total of 2,610 children were examined. The majority of the schoolchildren (12 years: 74.2%, 15 years: 75.5%) were healthy concerning their caries experience and the prevalence of the other codes was minimal. The prevalence of dentin carious lesions and the percent of restorable teeth was greater among the 15-year-olds. The mean decayed, missing, and filled teeth (DMFT) of 12- and 15-year-old subjects was calculated to be 0.22 and 0.29 respectively. CONCLUSION: The currently surveyed population showed a low caries prevalence and the use of the tool highlighted the caries spectrum in an impressive way. CLINICAL SIGNIFICANCE: A well-designed tool to assess the carious spectrum of an individual or a community, thus enabling the responsible stakeholders to plan an appropriate care that is necessary.

Collagen and Its Role in predicting the Biological Behavior of Odontogenic Lesions.

INTRODUCTION: Odontogenic cysts and tumors have variable recurrence rates. Recurrence rate is mainly due to the activity of the epithelium. The epithelium of these lesions has been investigated extensively in regard to their role in proliferative and aggressive behavior of the lesions. However, the role of the connective tissue wall in their behavior has not been studied as extensively. Collagen is an essential part of the connective tissue as a whole and fibrous wall of cystic lesions especially. It is demonstrated by picrosirius red dye staining combined with polarization microscopy. This method permits the evaluation of the nature of the collagen fibers in addition to their thickness. MATERIALS AND METHODS: A total of 56 histopathologically diagnosed cases comprising odontogenic follicle, dentigerous cyst, unicystic ameloblastoma, keratocystic odontogenic tumor (KCOT), multicystic/solid ameloblastoma, and ameloblastic carcinoma were taken and stained using picrosirius red stain and evaluated using a polarizing microscope. RESULTS: Collagen fibers in odontogenic follicles and dentiger-ous cysts showed predominant orange-red birefringence; fibers in unicystic ameloblastoma and KCOT showed both orange red and greenish-yellow birefringence; and fibers of multicystic/ solid ameloblastoma showed predominant greenish-yellow birefringence and ameloblastic carcinoma that showed almost complete greenish birefringence. As the biological behavior of the lesions in the spectrum studied progress toward aggressive nature, increase in immature collagen fibers is noticed. CONCLUSION: This study suggests that the nature of collagen fibers plays a pivotal role in predicting the biological behavior of odontogenic lesions. CLINICAL SIGNIFICANCE: Aggressive nature of the odontogenic lesions is determined by both the epithelium and the connective tissue components (collagen). Studying the nature and type of collagen helps in predicting its biological behavior.

Analysis of Psychological Distress and Dental Anxiety in Patients Attending Dental Care During the COVID-19 Pandemic.

Background: The COVID-19 epidemic has affected all facets of patient care, including dentistry services, and placed hitherto unheard-of demands on healthcare systems throughout the world. More and more emphasis is being paid to psychological discomfort and dental anxiety that epidemic patients face when seeking dental care. The purpose of this research was to examine the psychological distress and dental anxiety levels of patients receiving dental care during the COVID-19 pandemic in a tertiary care setting between 2021 and 2022. Methods: For this study, 300 patients with regular dental checkups were selected as a convenience sample. Self-report questionnaires measuring dental anxiety and psychological discomfort were filled out by participants. Descriptive and inferential statistics were used to analyze the data once demographic information was gathered. Findings: The majority of participants experienced psychological anguish (66.7%) and dental anxiety (73.3%) at moderate-to-severe levels. When compared to pre-pandemic values, there was a substantial increase in psychological distress (P < 0.001) and dental anxiety (P < 0.001) throughout the pandemic period. Conclusion: Current research shows how the COVID-19 pandemic significantly affected the mental health of patients receiving dental care, underscoring the need of catering to patients' mental health needs in dental practices during public health emergencies.

Evaluation of Treatment Outcomes and Quality of Life in Patients with Obstructive Sleep Apnea Receiving Oral Appliance Therapy.

Background: A frequent sleep condition linked to considerable morbidity and death is obstructive sleep apnea (OSA). Continuous positive airway pressure (CPAP) therapy is not the only noninvasive treatment option for OSA. Another option is oral appliance therapy (OAT). The purpose of this study was to assess the quality of life and treatment results for OSA patients receiving OAT in a tertiary care environment. Methods: Over the course of 1 year, prospective observational research was carried out at a tertiary care facility. Patients with consecutive Obsructive Sleep apnea as per polysomnography report were enrolled in the sudy. Medical history, baseline demographics, and sleep characteristics were noted. Both before and after the start of OAT, objective sleep metrics and subjective results were evaluated. Adverse events and therapeutic compliance were tracked. To assess the effectiveness and tolerability of the medication, statistical analysis was done. Findings: The research had 150 patients in all, with a mean age of 52.4 years and a 66.7% male preponderance. Objective sleep metrics showed considerable improvements after starting OAT, with the apnea-hypopnea index decreasing from 28.7 to 9.3 episodes per hour (P < 0.001). Improvement was also evident in subjective outcomes as ESS ratings dropped from 12.6 to 6.2 (P < 0.05). Evaluations of quality of life indicated improvements in the categories of physical and mental health (P < 0.001). There were few reported adverse effects and a good level of adherence to OAT. In tertiary care settings, OAT is an effective and well-tolerated therapeutic option for individuals with OSA. The noteworthy enhancements in treatment results and overall well-being highlight the practicality of OAT as a substitute for CPAP therapy. To fully understand the long-term effectiveness and cardiovascular advantages of OAT in the treatment of OSA, more investigation is necessary.

Analysis of the Impact of Sleep Apnea on Cardiovascular Health and Mortality: A Long-Term Cohort Study.

Background: A common sleep problem linked to poor cardiovascular outcomes and death is "sleep apnea (SL)." Nevertheless, little is known about how SL affects cardiovascular health in the long run. The purpose of this research was to investigate the relationship between a tertiary care center's long-term cohort's cardiovascular morbidity and mortality and the severity of their SL. Methods: Between January 1, 2010, and December 31, 2020, 500 individuals at a tertiary care facility who had been diagnosed with SL participated in this retrospective cohort research. Electronic medical records were used to collect patient data, which were then examined for cardiovascular outcomes, treatment methods, comorbidities, sleep research findings, and demographics. Heart failure, myocardial infarction, stroke, and cardiovascular-related mortality were among the cardiovascular events that were noted throughout the follow-up period, and the severity of SL was classified using the "apnea-hypopnea index." Findings: Of the 500 patients in the cohort, 60% were men and the mean age was 55.7 years. Fifty percent of people had one or more cardiovascular risk factors, including diabetes, high blood pressure, and smoking. During the course of the follow-up, 100 cardiovascular-related fatalities were reported, and 40% of patients had at least one cardiovascular event. The severity of SL was shown to be positively correlated with the occurrence of cardiovascular events (16.7% in mild, 25% in moderate, and 40% in severe SL, P < 0.05). Conclusion: In a cohort of patients receiving tertiary care, this research shows a substantial correlation between the severity of SL and cardiovascular morbidity and death. It is crucial to identify and treat SL early on to reduce cardiovascular risks and enhance patient outcomes. To further understand the underlying processes and develop treatment approaches for people with cardiovascular comorbidities and SL, more research is necessary.

Retrospective Study of Anesthesia-Related Complications in Elderly Patients Undergoing Surgery.

Background: Anesthesia administration in elderly surgical patients presents unique challenges due to age-related physiological changes and comorbidities. Knowing anesthesia-related complications is crucial for optimizing perioperative care in this vulnerable population. Methods: A retrospective review of electronic medical records was conducted to identify anesthesia-related complications in elderly subjects aged 65 and above undergoing surgery between January 2018 and December 2020. Data collection included demographic characteristics, comorbidities, anesthesia techniques, and postoperative outcomes. Results: There were a total of 100 elderly patients. Cardiovascular events (35%) were the most common complication, followed by respiratory issues (20%) and adverse drug reactions (15%). Statistical analysis revealed significant associations between cardiovascular events, respiratory issues, adverse drug reactions, and anesthesia. Conclusion: Anesthesia-related complications pose significant risks in elderly surgical patients. Tailored anesthesia management strategies, including comprehensive preoperative assessment and vigilant intraoperative monitoring, are essential for mitigating perioperative risks and improving outcomes in this vulnerable population.

An atypical presentation of Pindborg tumor in anterior maxilla.

Pindborg tumor, the eponymous counterpart of calcifying epithelial odontogenic tumor (CEOT), is a rare benign odontogenic neoplasm that was first described by a Dutch pathologist Jens Jorgen Pindborg in 1955 and accounts for approximately 1% of all odontogenic tumors. Its origin as well as its malignant potential is controversial. This neoplasm is possibly of stratum intermedium origin and occurring predominantly in the mandible of adults. We hereby report a case of Pindborg tumor arising in the premaxilla which is seldom (9 out of 200 cases) documented in the scientific literature.

Glandular odontogenic cyst: report of an unusual bilateral occurrence.

Glandular odontogenic cyst (GOC) is a recently recognized rare developmental odontogenic cyst having an aggressive behavior and accounting for 0.012% to 1.3% of all jaw cysts. GOC usually presents as a painless, slow-growing swelling that tends to affect the anterior part of the jaws. It chiefly occurs in the fourth and fifth decades of life and presents as an expansion of jaws with or without pain or paresthesia. Aggressive nature of the lesion has been reported, as supported by the fact that 25 to 55% of cases recur following curettage. So far only just over 113 cases of GOC have been reported in the literature. Here, we report a case of bilateral GOC in the posterior region of the maxilla, in a 29-year-old male patient, which is unique, being the first case of bilateral GOC to be reported in the literature.