Correlation of Serum Vitamin D with Crestal Bone Level in Dental Implant Patients Using CBCT: A Clinical Retrospective Study.

AIM: The purpose of this study is to correlate the role of serum vitamin D levels associated with crestal bone in dental implant patients using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: This retrospective study enrolled patients among whom implants were placed after a detailed planning using CBCT and the delayed loading protocol was followed. After 3 months and 6 months of loading, CBCT evaluations were carried out, serum vitamin D levels were also tested at the end of 6 months of loading. A total of 30 patients were recruited with 15 patients in each group based on normal and deficient levels of vitamin D to correlate with crestal bone levels using CBCT. RESULTS: Clinically acceptable crestal bone loss (CBL) was visible with all the implants at different time intervals. Statistical analysis was done for intergroup and intragroup comparisons which showed significant p-value (< 0.05) for CBL at the time of loading, at 3 months, and at 6 months follow-up for both normal and deficient serum values. In the deficient group, the mean value at baseline was 9.69 mm ± 1.10 and the CBL at 6 months follow-up was 8.80 mm ± 1.10 whereas for the normal group at baseline, the mean was 9.08 mm ± 1.21 and at 6 months follow-up was 8.12 mm ± 1.25 which showed meaningful difference. CONCLUSION: There is a positive correlation seen between CBL on CBCT and vitamin D serum levels. The success of the implant is significantly affected by vitamin D as it regulates the bone physiology and has systemic effects on accelerating bone formation around titanium implants. CLINICAL SIGNIFICANCE: Vitamin D is essential in maintaining the balance of bone minerals and assists to preserve the crestal bone level making the implant treatment more predictable and successful.

Management of achalasia cardia: Expert consensus statements.

Achalasia cardia (AC) is a frequently encountered motility disorder of the esophagus resulting from an irreversible degeneration of neurons. Treatment modalities are palliative in nature, and there is no curative treatment available for AC as of now. Significant advancements have been made in the management of AC over last decade. The introduction of high resolution manometry and per-oral endoscopic myotomy (POEM) has strengthened the diagnostic and therapeutic armamentarium of AC. High resolution manometry allows for the characterization of the type of achalasia, which in turn has important therapeutic implications. The endoscopic management of AC has been reinforced with the introduction of POEM that has been found to be highly effective and safe in palliating the symptoms in short-term to mid-term follow-up studies. POEM is less invasive than Heller's myotomy and provides the endoscopist with the opportunity of adjusting the length and orientation of esophageal myotomy according to the type of AC. The management of achalasia needs to be tailored for each patient, and the role of pneumatic balloon dilatation, POEM, or Heller's myotomy needs to be revisited. In this review, we discuss the important aspects of diagnosis as well as management of AC. The statements presented in the manuscript reflect the cumulative efforts of an expert consensus group.

Need for a reliable alternative to custom-made Implant Impression trays: An in vitro study comparing accuracy of custom trays versus specialized aluminum stock tray.

PURPOSE: The aim of the present study was to evaluate and to compare the accuracy of implant casts obtained by open tray pick-up impression technique using 2 types of custom-made trays and a specialized aluminum stock impression tray. MATERIALS AND METHODS: A heat-cure acrylic resin master model was fabricated. Two implants were placed parallel to each other. Ten impressions were made from each group. Polyvinylsiloxane impression material with single step putty wash technique was used for making all the impressions. The resultant casts obtained were compared to the master models with respect to the distances measured between the reference points using a stereomicroscope. The data obtained was statistically analyzed using one-way ANOVA, Tukey's post hoc procedures, and t-test. RESULTS: Mean value obtained was 2.012967 cm (±0.007060) for corimplant stock tray, 2.012627 cm (±0.007945) for autopolymerizing acrylic resin tray, 2.010279 cm (±0.006832) for light-cure hybrid composite tray. P value was calculated to be >0.05; hence, there was nonsignificant deviation of observations from standard value in each group. CONCLUSION: Statistically insignificant difference was found between the accuracy of casts obtained by the different impression trays. However, light-cure hybrid composite trays showed best results followed by autopolymerizing acrylic resin trays and Corimplant stock tray.

Knowledge, awareness and decision making of population visiting north indian institute towards dental implant as a treatment modality: a cross-sectional study.

OBJECTIVES: The knowledge and awareness surrounding dental implants have significantly increased over the years, driven by advancements in technology, improved educational resources, and increased accessibility to dental care. Despite their widespread use, it is essential to assess the level of knowledge and awareness among patients regarding dental implants. The purpose of the present study is to measure the knowledge, awareness and decision making in dental implant therapy in North Indian population. SETTINGS AND DESIGN: An analytical closed ended questionnaire based study. METHODS: A cross-sectional well structured questionnaire survey was conducted amongst 300 out patients randomly either by interview or Google form to assess the knowledge and awareness about dental implant as a treatment modality. There were seven questions which were close ended multiple choice type concerning patient knowledge and 10 questions for assessing awareness and decision making towards dental implants. Date was collected and descriptive analysis was done. RESULTS: 43.67 % of population was either well informed or moderately informed about replacement of missing teeth. For replacement of missing tooth, most of them (83 %) had the knowledge of dental implant therapy. Dentist was the main source of information about implants. 90.67 % studied population believed that implants provide better treatment because of increased chewing efficiency of implants as compared to removable partial dentures or fixed partial dentures. 86.67 % patients thought that implantologist is better qualified that general dental surgeon. 94 % patients were keen to know more about implants. There is non-significant difference in knowledge and awareness as well as decision making for males and females (p<0.05). CONCLUSION: People have partial knowledge about dental implants and there is need of spreading awareness about implant therapy in the region. Dentist plays a crucial role for dissemination of knowledge. Cost is a constraining factor for this implant therapy to be chosen as a treatment modality.

Effects of Nitric Oxide Supplementation on the Levels of Interleukin-6 in Saliva after Dental Implant Placement - A Prospective Study.

Introduction: The purpose of the study was to evaluate and compare the levels of salivary Interleukin-6 (IL-6) before and after the placement of dental implants in patients who are supplemented with nitric oxide (NO). Materials and Methods: The study comprised 34 patients, divided into control and study groups (17 in each group). The control group was given a placebo and in the study group, nitric oxide supplement was prescribed, whereas the control group received a placebo. Saliva samples were taken before placement of dental implants, first and third day after the implant placement. The levels of salivary IL-6 were assessed using an enzyme-linked immunosorbent assay test. Results: Statistical analysis showed a significant P value (<0.05) with respect to IL-6 levels on first and third days after placement of dental implants. Salivary IL-6 levels in the study group declined significantly. On day three, the IL-6 values for the control and study groups were 0.0639 and 0.0443, respectively. Within the groups, it was observed that there was a significant decrease in IL-6 values from day one to day three. Discussion: The levels of salivary IL-6 reduced from day one to day three more significantly and consistently in patients prescribed with NO supplements post-dental implant placement, suggesting better resolution of inflammation.

Validity and reliability of the Hindi version of the Summated Xerostomia Inventory-5 among head and neck cancer irradiated patients in Delhi, India.

Objectives: To cross-culturally adapt and determine reliability and validity of the Hindi version of the Summated Xerostomia Inventory (SXI-H). Background: Xerostomia is common among older individuals and patients with head and neck radiation or autoimmune diseases, and it can affect their oral as well as systemic quality of life. To assess the perception of this condition, SXI-H can be used. Materials and Methods: This was a multi-centric cross-sectional observational study of volunteers suffering from hypo-salivation in three tertiary care cancer hospitals in Delhi, India. The English version of Summated Xerostomia Inventory (SXI-5) was translated into Hindi according to standard guidelines and field tested. The Hindi version of SXI-5 (SXI-H) was tested on 120 patients with xerostomia. All the participants signed the informed consent form before being interviewed with SXI-H. Thirty participants were interviewed again after 15 days. A global question was asked for criteria validity. Data were analyzed through IBM SPSSTM Statistics for windows version 24. Significance was set at P ≤ 0.05. Results: Overall SXI-H score of sample was 11.48 ± 2.29. Cronbach's α value was 0.81. The correlation between the SXI-H summary score and the standard question was 0.79 (95% CI 0.65-0.74). It was found that the intra-class correlation coefficient value for the test-retest reliability was 0.90 and scores for individual question ranged from 0.41 to 0.76. Conclusion: The SXI-H demonstrated excellent psychometric properties and can be considered a valid tool for assessing xerostomia in a dry mouth patient.

Oral Health-related Quality of Life among Patients after Complete Denture Rehabilitation: A 12-month Follow-up Study.

INTRODUCTION: Complete edentulism is an eventual oral health outcome and results from the combined pathology of dental caries, periodontal disease, or faulty method of rehabilitation due to reduced cost. Complete edentulism has a significant concern and leads to reduced quality of life (QoL) along with impact on general health. However, it has been observed that due to wider and better oral health services globally, edentulism rate is decreasing every decade. Edentulism is directly related to masticatory and nutritional problems, and some authors regard it as a good mortality indicator. METHODOLOGY: The sample population consisted of 100 individuals comprising 63 males and 37 females who fulfilled the inclusion criteria. Geriatric oral health assessment index (GOHAI) was administered by a single investigator at baseline (preinsertion) and also 6 and 12 months postdenture insertion. Sociodemographic data, including age and gender, were also collected. RESULTS: It was observed that the overall oral health-related QoL (OHRQoL) scores of the sample improved significantly at 6 and 12 months postinsertion (P < 0.001) when compared to baseline scores. When GOHAI scores were compared individually for males and females (pre- and post-insertion), it was observed that there was statistically significant improvement in OHRQoL (male - pre = 25.02 ± 1.34 and post-12 months = 8.84 ± 1.26, P < 0.001, female - pre = 25.19 ± 0.88 and post-12 months = 9.05 ± 1.20, P < 0.001) postinsertion of denture in both the groups. CONCLUSION: OHRQoL in patients improved after complete denture rehabilitation. There was an upward shift in score for each item in GOHAI from preinsertion to 6 and 12 months postinsertion of dentures, reflecting improvement in OHRQoL of the sample.

Clinical and scanning electron microscopic assessments of porcelain and ceromer resin veneers.

PURPOSE: Recently available Ceromer resin materials are promising for fabrication of esthetic anterior laminates and provices an alternative, cost effective treament modality to porcelain laminates for discolored anterior anterior teeth. It was proposed to study the esthetic quality and surface finish of veneers fbricated from ceromer resin and compare it with the standard porcelain veneers, both clinically as well as by scanning electron microscope (SEM) at baseline and at 12 months. If found comparable, ceromer resin veneer could provide an alternative to porcelain veneers which is an expensive technique for a developing country like India. MATERIALS AND METHODS: Seventy-two veneers, 36 porcelain and 36 ceromer were placed in 12 subjects who were studied at 0, 6 and 12 months for clinical acceptability, and at 0 and 12 months for SEM assessment. The restorations were luted with Opal luting composite and Scotchbond multipurpose system; polyvinyl siloxane was used as the impression material. The clinical assessment was made using modified United Public Health Services criteria, whereas the SEM assessment was made by quantitative analysis of the marginal fit and surface characteristics of the two veneering materials. RESULTS: Ceromer exhibited good anatomical form during the study period, but depicted changes in color, surface appearance, marginal adaptation, increased marginal discoloration, and tissue response. Inability to achieve a good finish with high gloss was a major drawback of the ceromer. Porcelain exhibited better esthetics, marginal adaptation, finish qualities, and tissue response. The SEM showed good to excellent marginal fit at baselinne in ceromer and porcelain veneers, but loss of luting resin at the margins was evident in both the materials after 12 months, leading to visible gaps in a number of veneer restorations. Ceromer veneers exhibited poor surface characteristics in several restorations, which further degraded in an oral conditions over 12 months. CONCLUSION: Veneering is an effective mode of treating discolored teeth. Ceromer veneers exhibited deterioration of surface finish and increased marginal discolouration over a period of 12 months. Clinically ceromer veneers were less acceptable to the patients than porcelain veneers. Porcelain out-scored ceromer as a permanent mode of treatment for discolored teeth, as over a period of 12 months it yielded good clinical results in comparison to ceromer.

Menopause and the oral cavity.

Menopause is associated with a large number of symptoms ranging from physical to psychological. These symptoms may unfavorably affect oral health and treatment needs requiring dentists to be aware of the symptoms and health care needs of peri-menopausal/menopausal/postmenopausal women. This article attempts to provide an insight into the multifarious oral manifestations at menopause along with the relevant prosthodontic implications.

Epidemiology and symptom profile of gastroesophageal reflux in the Indian population: report of the Indian Society of Gastroenterology Task Force.

BACKGROUND: Gastroesophageal reflux disease (GERD) and its complications are thought to be infrequent in India; there are no data from India on the prevalence of and risk factors for GERD. The Indian Society of Gastroenterology formed a task force aiming to study: (a) the frequency and profile of GERD in India, (b) factors including diet associated with GERD. METHODS: In this prospective, multi-center (12 centers) study, data were obtained using a questionnaire from 3224 subjects regarding the frequency, severity and duration of heartburn, regurgitation and other symptoms of GERD. Data were also obtained regarding their dietary habits, addictions, and lifestyle, and whether any of these were related or had been altered because of symptoms. Data were analyzed using univariate and multivariate methods. RESULTS: Two hundred and forty-five (7.6%) of 3224 subjects had heartburn and/or regurgitation at least once a week. On univariate analysis, older age (OR 1.012; 95% CI 1.003-1.021), consumption of non-vegetarian and fried foods, aerated drinks, tea/coffee were associated with GERD. Frequency of smoking was similar among subjects with or without GERD. Body mass index (BMI) was similar in subjects with and without GERD. On multivariate analysis, consumption of non-vegetarian food was independently associated with GERD symptoms. Overlap with symptoms of irritable bowel syndrome was not uncommon; 21% reported difficulty in passage of stool and 9% had mucus in stools. About 25% of patients had consulted a doctor previously for their gastrointestinal symptoms. CONCLUSION: 7.6% of Indian subjects have significant GERD symptoms. Consumption of non-vegetarian foods was an independent predictor of GERD. BMI was comparable among subjects with or without GERD.