Association between traditional oral hygiene methods with tooth wear, gingival bleeding, and recession: A descriptive cross-sectional study

Oral hygiene maintenance is crucial for prevention of various oral diseases. Oral hygiene practices across the country vary largely and people in peri-urban and rural areas use traditional methods of oral hygiene like powders, bark, oil and salt etc. Their effect on oral soft and hard tissues need to be studied to understand their beneficial and/ or harmful effects on maintenance of oral hygiene and prevention or causation of oral diseases. Objectives: This study aimed to assess the plaque-cleaning efficacy, gingival bleeding, recession and tooth wear with different traditional oral hygiene methods as compared to use of toothpaste-toothbrush, the most accepted method of oral hygiene practice. Study Design: Hospital based cross sectional analytical study. Results: Total 1062 traditional oral hygiene method users were compared with same number of toothpaste-brush users. The maximum number in the former group used tooth powder (76%) as compared to other indigenous methods, such as use of bark of trees etc and out of tooth powder users; almost 75% reported using red toothpowder. The plaque scores and gingival bleeding & recession were found to be more in traditional oral hygiene method users. The toothwear was also more severe among the toothpowder users. Conclusions: Traditional methods were found to be inferior in plaque control as was documented by increased bleeding and gingival recession. Its effect on hard tissues of teeth was very damaging with higher tooth wear scores on all surfaces.

Flapless versus open flap techniques of implant placement: A 15‑month follow‑up study.

Aim: To evaluate and compare the effect of flapless and “open flap” techniques of implant placement on crestal bone height (CBH) around implants. Materials and Methods: This prospective study comprised of 32 implants placed in 16 subjects with a bilateral missing mandibular first molar. In each subject, one implant was placed with “flapless” and other using “open flap” technique. Radiographic assessment of CBH was carried out using standardized intraoral periapical radiograph of the site at baseline, 3 months, 9 months and 15 months after implant placement. Statistical Analysis: Data were analyzed using STATA 11.0 statistical software. To determine the changes in CBH from baseline, at 3‑, 9‑, and 15‑month, repeated measures analysis of variance followed by post‑hoc Bonferroni was used for each of the two techniques for mesial and distal aspects separately. For both techniques, changes in CBH from baseline to 15 months were compared using an independent t‑test with a confidence interval of 95%. Results: For “flapless” technique, there was no statistically significant (P > 0.05) reduction of CBH in initial 9 months but was significant for the 9–15 months period while for “open flap” technique, statistically significant (P < 0.05) reduction was observed up to 15 months. Comparison of both techniques showed significantly lesser reduction with “flapless” than “open flap” technique. The overall average crestal bone loss was 0.046 ± 0.008 mm on mesial aspect, 0.043 ± 0.012 mm on distal aspect with “flapless” technique and 1.48 ± 0.085 mm on mesial aspect, 1.42 ± 0.077 on distal aspect “open flap” technique. Conclusions: Both techniques showed a reduction in CBH with time but the flapless technique showed a lesser reduction. Therefore, the flapless technique can be considered as a better treatment approach for placement of implants, especially where adequate width and height of available bone are present.

Experience With Uterine Balloon Therapy For Dysfunctional Uterine Bleeding.

Uterine balloon therapy is a minimally invasive technique for dysfunctional uterine bleeding done on day care basis. It can be offered as a treatment of option to women who have completed their family and have a diagnosis of dysfunctional uterine bleeding. The study was undertaken to analyse the success rate, complications of UBT and incidence of patients requiring alternative methods of treatment for DUB. Twenty four patients were treated with UBT (Thermachoice) for DUB. Efficacy of the procedure was analyzed at follow up periods of one, 3, 6 and 12 months. After undergoing UBT, at twelve months follow up, amenorrhea was achieved in 29.17% of patients, 33.33% were having oligomennorhea, 33.33% were eumenorrehic and no response was seen in 4.17% of patients. Our overall treatment success and patient satisfaction rate was 95.83%.Uterine balloon therapy is a safe, minimally invasive day care procedure requiring no extra expertise for the treatment of DUB in patients who want to save uterus with instant results. Post procedure there is improved patient well being and high treatment satisfaction.

An alternative adhesive based technique of raising the occlusal vertical dimension.

Purpose: Decimated dentitions may require raising the vertical dimension in some conditions while performing a full mouth rehabilitation treatment. Increase in a vertical dimension should be diagnosed by reversible methods prior to performing any irreversible methods for a minimum time period. Reversible methods like splints and overlay dentures are often used for this purpose. These methods however cannot be used in some conditions like in cases of brittle teeth. Method: An alternative technique based on adhesive technology has been described which is reversible and yet minimally traumatic to teeth. Conclusions: The technique has two basic aims. The first is to accurately implement the occlusal scheme as planned in the diagnostic wax‑up in the reversible method of altering the vertical dimension. The second aim is to increase the vertical dimension with minimal damage to the teeth.

Prosthetic rehabilitation after orbital exenteration: A case series.

Orbital exenteration is executed by the ophthalmic surgeon to treat various neoplasms or non-malignant diseases. But it leads to several functional, esthetic and psychological problems for the patients. Orbital prosthesis is a good alternative for cosmetic and psychological rehabilitation, if reconstructive surgery is not possible or not desired by the patient. In the following article, diff erent materials and retentive aids for fabrication of an orbital prosthesis given in the literature along with few novel methods have been discussed for four patients who underwent orbital exenteration. Factors that an ophthalmic surgeon should consider during surgery, which may later on help the prosthodontist to obtain good cosmetic results, are also discussed briefly. Remarkable results can be obtained if both work as a team for one common goal i.e. improvement of quality of life of the patient after orbital exenteration.

A preliminary study to find out maximum occlusal bite force in Indian individuals.

Purpose: This preliminary hospital based study was designed to measure the mean maximum bite force (MMBF) in healthy Indian individuals. An attempt was made to correlate MMBF with body mass index (BMI) and some of the anthropometric features. Methodology: A total of 358 healthy subjects in the age range of 18-47 years (mean age = 26.66 ± 6.83) were selected following the selection criteria. Demographic details along with general physical and facial parameters such as height, weight, facial form, facial profile, arch form, and palatal contour were recorded in a predesigned proforma. The maximum bite force was recorded on both (right and left) sides using a specially designed piezoelectric transducer based device. Results: The MMBF in Indian individuals was found to be 372.39 ± 175.93 Newton (N). Males had significantly higher (P = 0.000) MMBF (448.47 ± 191.82 N) as compared to females (296.31 ± 116.79 N). Facial form (P = 0.001) and palatal contour (P = 0.000) showed a significant relationship with MMBF. Subjects having square facial form (421.34 ± 187.32 N) showed significantly higher MMBF as compared to other facial forms, that is, square tapered (358.86 ± 143.56 N; P = 0.038), ovoid (338.40 ± 163.02 N; P = 0.000) and tapered (349.22 ± 184.82 N; P = 0.028). Subjects with flat palatal contour showed significantly higher MMBF when compared to high (P = 0.002) and medium palatal (P = 0.002) contour. Though facial profile was not significantly related to MMBF, it was significantly higher in subjects having concave facial profile when compared to convex (P = 0.045) and straight (P = 0.039) facial profile. BMI and arch form showed no significant relationship with MMBF. Conclusion: The MMBF is found to be affected by gender and some of the anthropometric features like facial form and palatal contour.

Avenues for rehabilitation of auricular defects.

Irrespective of the cause, abnormalities in shape, size, and position of body organs are often perceived as looking wrong. This perception can subject the individual to significant peer ridicule and social ostracism. Rehabilitation of patients with auricular defects can either be done by reconstructive surgery or by prosthetic means. The article draws a comparison between the implant-supported prosthesis and reconstructive surgery, listing the benefits, limitations, indications and contraindications of both the techniques. As both the available techniques give excellent results in appropriately selected situations, the restorative team must present all the alternatives to the patient and choose judiciously the better of the two.

An electromyographic study to assess the minimal time duration for using the splint to raise the vertical dimension in patients with generalized attrition of teeth.

Background: To investigate the effect of restoration of lost vertical by centric stabilizing splint on electromyographic (EMG) activity of masseter and anterior temporalis muscles bilaterally in patients with generalized attrition of teeth. Materials and Methods: EMG activity of anterior temporalis and masseter muscle was recorded bilaterally for 10 patients whose vertical was restored with centric stabilizing splint. The recording was done at postural rest position and in maximum voluntary clenching for each subject before the start of treatment, immediately after placement of splint and at subsequent recall visits, with splint and without the splint. Results: The EMG activity at postural rest position (PRP) and maximum voluntary clench (MVC) decreased till 1 month for both the muscles. In the third month, an increase in muscle activity toward normalization was noted at PRP, both with and without splint. At MVC in the third month, the muscle activity without splint decreased significantly as compared to pretreatment values for anterior temporalis and masseter, while with the splint an increase was seen beyond the pretreatment values. Conclusion: A definite response of anterior temporalis and masseter muscle was observed over a period of 3 months. This is suggestive that the reversible increase in vertical prior to irreversible intervention must be carried out for a minimum of 3 months to achieve neuromuscular deprogramming. This allows the muscle to get adapted to the new postural position and attain stability in occlusion following splint therapy.

Oral Rehabilitation of A Case of Amelogenesis Imperfecta.

Amelogenesis imperfecta has been described as a group of hereditary enamel defects not associated with systemic diseases. Restoration of these defects is important not only because of aesthetic and functional concern, but also because there may be a positive psychological impact for the patient. Among various treatments described for rehabilitation of Amelogenesis imperfecta, this case report described the rehabilitation of patient with Amelogenesis imperfecta utilizing twin stage procedure with aim of improving patient’s function, appearance, restoring the proper contacts and simplifying the prosthetic clinical and lab work procedures. Twin stage procedure is based on the fact that described to prevent horizontal forces acting during various mandibular excursion in full mouth rehabilitation case, to control horizontal forces concept of disocclusion was given which in turn depends upon the condylar path, incisal path, cusp angle. Among them cusp angle role is more supported whereas condylar path and incisal path role is considered unreliable.

Implant-supported auricular prosthesis.

Differences in the balance of shape, size, and position of body organs are immediately perceived as "looking wrong" and this perception can subject the individual to significant peer ridicule and social ostracism, often expressing as intense shame and anguish in the attitude of the afflicted. Rehabilitation of such patients can be remarkably beneficial on the individual's self-esteem and body image. The onus of the deed lies in the hands of a team that combines artistic excellence with surgical expertise, by combining the skills of anaplastologists, surgeons, and prosthodontists. This is a review of a few surgical and prosthetic considerations in the management of auricular defect and a case description of management of a patient of microtia following similar guidelines in fabrication of the epithesis.

Prosthodontic rehabilitation in Papillon-Lefevre syndrome: A case report.

Papillon-Lefevre syndrome is a rare recessive genetic disorder. The clinical manifestations include palmar-plantar hyperkeratosis with precocious rapidly progressive periodontal disease that results in premature exfoliation of primary and permanent dentitions. Patients are often edentulous at an early age. Here is the report of prosthodontic rehabilitation of a case of Papillon-Lefevre syndrome in a 6-year-old child.