Clinical and Microbiological Evaluation of the Chemomechanical Caries Removal Agents in Primary Molars.

BACKGROUND: Chemomechanical caries removal (CMCR) is a noninvasive procedure that uses a chemical substance to remove the diseased dentin. The natural dental architecture is also preserved using this technique, preventing patient discomfort and pulp irritation. This method of eliminating caries is based on disintegration. This method removes soft carious dentin using chemical agents and non-traumatic mechanical force. This study was carried out to evaluate the clinical and microbiological evaluation of the chemomechanical caries removal agents in primary molars. METHODS: For the elimination of caries, teeth in category I (polymer bur category) were treated with Smartburs II® (SS White Dental, Lakewood, New Jersey, United States) (n = 40). Teeth treated with the new Carisolv® technology (Mediteam, Sweden) to remove caries (n = 40). Teeth were treated for removal cavities in category III (conventional group) using excavators and carbon steel low-speed round burs from Dentsply Maillefer in Switzerland (n = 40). There was an evaluation of the efficacy of caries removal, the time required for caries removal, patient satisfaction, and microbial culture assessment. RESULTS: In comparison to the other two categories, the conventional category median caries detector dye values were considerably lower (p value<0.05). There was no substantial difference observed between study participants belonging to category I and category II with a p-value greater than 0.05. Time taken during the removal of caries was substantially greater in category I (455.46±73.7) as compared to category II (129.21±44.18) and the traditional category (113.26±37.7). The value of significance was less than 0.05. Contrarily, no discernible difference was observed between category I and category III (the p-value was greater than 0.05). In comparison to the other two categories, the conventional group's median facial expression scale scores were substantially higher (p = 0.02). In comparison, there was no discernible difference between categories I and II (p = 0.65). It was observed that there was no substantial variation in three categories regarding the number of colonies of bacteria prior to the eradication of caries (p-value greater than 0.05). After caries had been removed, the number of living bacterial colonies in category I was noticeably greater than those in the other two categories. However, there was no discernible variation between category II and category 1 (p-value greater than 0.05). CONCLUSION: The mechanical approach has the highest clinical efficacy for removing caries. Carisolv required the most time to remove cavities. Patient satisfaction levels were greater with Carisolv than with the mechanical approach. It was also observed that Carisolv as well as the mechanical technique had greater antibacterial effectiveness.

Salivary and Serum Aspartate Aminotransferases and Alanine Aminotransferases in Insulin-Dependent Diabetes Mellitus and Normal Children: A Comparative Study.

AIMS AND OBJECTIVES: The aim of the study was to estimate and compare aspartate aminotransferases (AST) and alanine aminotransferases (ALT) levels in saliva and serum of insulin-dependent diabetes mellitus (IDDM) and normal children, and the objective was to evaluate the significance of these enzymes in assessing the salivary gland injury in IDDM children. MATERIALS AND METHODS: The study group comprised of thirty children clinically and biochemically diagnosed for IDDM and thirty healthy children of similar age in the control group. Saliva and serum samples were collected and enzyme assay was performed by optimized ultraviolet test method (according to International Federation of Clinical Chemistry). The values obtained were subjected to statistical analysis using Mann-Whitney U-test for comparison of the variables and Karl-Pearson's coefficient test for correlation. The SPSS 16.0, (SPSS Inc., Chicago, USA) was used for statistical analysis. RESULTS: Higher values of AST (mean = saliva 91.60 IU/L) and ALT (mean = saliva 94.93 IU/L) were found in the saliva than in serum (AST serum = 15.83 IU/L) (ALT serum = 20.80 IU/L) among the patients and the differences were statistically highly significant (P = 0.001). A similar comparison in the control group did not show statistical significant difference (saliva - AST mean = 23.50 IU/L, ALT mean = 21.95 IU/L and serum - AST mean = 12.60 IU/L, ALT mean = 13.25 IU/L). On correlation between patient and normal group, greater values of AST and ALT were observed in saliva of patients and the difference was statistically highly significant ([AST-mean = patients 91.166 IU/L and controls = 23.500 IU/L] [ALT-mean = patients 94.933 IU/L and controls 21.950 IU/L]). The serum values of patients and controls did not show statistical difference. Although higher values of salivary ALT and AST were observed in patients with the disease for 0-5-year clinical duration (ALT mean = 100.21 IU/L and AST mean = 95.39 IU/L) than those with the disease for 6-10-year duration (ALT mean = 77.57 IU/L and AST mean = 77.28 IU/L), values were statistically nonsignificant. CONCLUSION: Elevated salivary AST and ALT levels in IDDM patients suggest the injury to salivary glands and could aid as a salivary marker for the involvement of salivary glands in IDDM.

Approach of pharmacists and herbalists while offering guidance on potentially malignant oral lesions: a cross-sectional survey.

OBJECTIVES: To investigate the approach of both pharmacies and herbalists' shops while offering a proper advice for patients seeking guidance on a potentially malignant oral lesion. MATERIALS AND METHODS: A cross-sectional, descriptive study was undertaken using the standardized patient approach on a representative sample of pharmacies and herbalists' shops in Bhopal city. The study sample was selected by stratified random sampling technique and was contacted by telephone. Our patient's introductory statement was, "I have a painful ulceration on the tongue since 3 months. What would you advise?" To avoid the hypothetical bias in telephone answers, another study was designed for two regions of the city, of which pharmacies were visited in one and herbal shops in the other one. RESULTS: A total of 497 establishments were contacted. Out of these, 368 were pharmacies (74.1%) and 129 were herbalists' shops (25.9%). Patients with potentially malignant lesions were more frequently referred to a dentist (16.03%) or a physician (23.36%) by the pharmacies compared to the herbalists' shops. In contrast, most of the herbalists' shops prescribed over-the counter (OTC) remedies (66.66%) and showed no interest in referring the patient to a dentist or a physician. CONCLUSION: Apart from pharmacists, the new probable off-clinical counselors (herbalists and pharmacy assistants) have been identified as potential factors of patient diagnostic delay in oral cancer. Educational strategies to improve advice and referral for these identified groups should be designed.

Role of unani system of medicine in management of orofacial diseases: a review.

In recent times, oral diseases have gained an importance and are considered as a major health problem worldwide. Oral cancer, dental caries, and periodontal diseases are among the most important global oral health problems. Although new treatments and technologies for dealing with them are plentiful, nonetheless more and more patients are now looking for simpler, gentler therapies for improving the quality of life and avoiding iatrogenic problems. Traditional medical systems are easily accessible, cheaper and relatively safer than other conventional medicines. The time tested herbal formulations indicated in Unani material medica have been proven effective and safe. The exploration and identification of various botanicals used in traditional and complementary medicine, may lead to development of novel preventive or therapeutic strategies for oral health. The present scientific evidence based review is focused on possible role of Unani system of medicines in the management of various orofacial disorders.

Assessment of periodontal status among eunuchs residing in Bhopal city, Madhya Pradesh, India: a cross-sectional study.

AIM: To assess the periodontal status among eunuchs residing in Bhopal city, Madhya Pradesh, India. MATERIALS AND METHODS: Based on convenient non-probability snow ball sampling technique, all the self-identifi ed eunuchs residing in the city of Bhopal along with a matched control consisting of cross section of the general population residing in the same locality where these eunuchs live was examined to assess the periodontal status of the population by using WHO oral health assessment proforma 1997. All the obtained data was entered into a personal computer on Microsoft excel sheet and analyzed by using a software; SPSS version 20. Data comparison was done by applying chi square test, ANOVA and multiple logistic regression analysis. RESULTS: A total of 639 subjects comprised of 207 eunuchs, 218 males and 214 females. The overall gingival and periodontal disease prevalence was 87.3% with calculus and shallow pocket contributing a major part i.e., 67%. Among study participants, 56.9% males were having highest prevalence for calculus. Whereas, eunuchs were having highest prevalence for bleeding (17.4%), shallow pocket (22.7%) and deep pocket (9.7%). However, highest of 19.7% males and 10.1% eunuchs were having attachment loss of 4-5 mm and 6-8 mm respectively. However, 6.3% eunuchs were having attachment loss of 12 mm or more. CONCLUSION: The results of the current study showed poor periodontal status among eunuch population with most of the population requiring simple therapy. This indicates that comprehensive oral hygiene instruction and dental prophylaxis need to be initiated.

Quick response code in acrylic denture: will it respond when needed?

Use of acids and other caustic substances in destroying the human body to avoid personal identification is drawing great deal of attention in recent times. With rapid industrial growth, incidence of industrial disasters has increased. In an event of chemical industry disaster, human identification can become a challenge. Embedding bar codes and other electronic means for identification in denture have proved to be a novel innovation in identification of edentulous patients. However, the validity of this method in events of chemical extremes has not been assessed. Hence, the study was undertaken to know the effect of different acids on dentures embedded with quick response codes. Results of this study indicate that simple bar code can be readable up to 33 h after acid treatment. With minimal armamentarium, bar code can be generated incorporating large data into it, providing it to be a cheap and reliable means of denture identification.

Effect of Two Desensitizing Agents in Reducing Dentin Hypersensitivity: An in-vivo Comparative Clinical Trial.

OBJECTIVE: A randomized, double blind, split mouth, controlled clinical trial was conducted to evaluate the effect of two desensitizing agents on reduction of Dentin Hypersensitivity (DH). MATERIAL AND METHODOLOGY: A sample of 73 teeth from 13 patients, among which at least 3 teeth had dentin hypersensitivity, was randomly allocated into 3 treatment groups: Group A: treated with 30% ethenolic extract of Indian Propolis, Group B: treated with GC tooth mousse, and Group C: treated with sterile water. A Verbal Rating Scale (VRS) was used to record the degree of hypersensitivity, based on patient's response to tactile and air blast stimuli. The baseline scores were obtained. Each intervention group received applications of their respective agents consecutively on 1(st), 7(th), 14(th) and 21(st) days. After each application, the scores were recorded. RESULTS: Both the 30% Indian Propolis and GC tooth mousse showed significant reductions in dentin hypersensitivity. CONCLUSION: GC tooth mousse was found to be significantly better in reducing the dentinal hypersensitivity as compared to Propolis and sterile water (p< 0.01).