Psychometric approach to evaluate periodontal disease using Revised Illness Perception Questionnaire.

INTRODUCTION: Illness perception is the cognitive representation of an illness, which determines how a person responds to it. The Revised Illness Perception Questionnaire (IPQ-R) assesses seven components of illness representation in various chronic diseases, but queries prevail about its factor structure. The study assesses the components of illness representation in patients with chronic periodontitis. MATERIALS AND METHODS: A total of 625 voluntary, consecutive dental patients with a clinical diagnosis of periodontitis were recruited into the study. The Hindi version of IPQ-R was used, consisting of three parts-identity scale, structured scale, and perceived causes of the patient's ailment. RESULTS: Of the 625 participants, 44.0% reported cyclical disease pattern, 30.4% said their disease was a mystery. Only 1.6% predicted it to remain throughout their life. A total of 44.0% of participants reported the disease to impact their day-to-day life severely. A significant difference was observed between males and females across seven components of IPQ-R. While 21.6% of participants attributed stress to be a major cause for their diseased state, 20.8% reported workload to be a major cause, but 42.4% attributed poor medical care in the past to be a major cause for their state. CONCLUSIONS: A sensible approach to treating a disease is to measure the patient's illness perception and target specific interventions accordingly. It would be cost-effective and break misconceptions about diseases in patients, ultimately providing them with better overall health and satisfaction.

Role of adjunct use of omega 3 fatty acids in periodontal therapy of periodontitis. A systematic review and meta-analysis.

BACKGROUND: Host modulation therapy has emerged as a new concept for the treatment of periodontal disease. Recently, a lot of research is being done in product containing docosahexaenoic acid (DHA) and eicosapentanoic acid (EPA). Omega-3 PUFA have therapeutic, anti-inflammatory and protective properties. This systematic review analysed the adjunctive use of omega-3 fatty acids in periodontal therapy of periodontitis patients. METHODS: PICO question (patient, intervention, comparison, and outcome) was formed. Keywords were generated and were fed in databases. The databases were Pubmed, Cochrane library and LIVIVO. Studies selected are Randomized clinical trial, clinical studies, and longitudinal studies. Meta -analysis were performed for Pocket depth (PD), Clinical attachment level (CAL), Gingival index (GI) and Plaque Index (PI). Risk of bias was also assessed. RESULTS: On analysis of all the 8 studies at 3 months showed significant effect of omega -3 fatty acid on clinical attachment level (CAL), Pocket depth (PD). There was significant effect of omega-3 fatty acids in 4 studies at 6 months. CONCLUSION: Within the limitation of the review, omega- 3 polyunsaturated fatty acids seems to have a positive effect on periodontal healing following periodontal therapy. Chronic periodontitis patient should be counselled to incorporate omega -3 fatty acid in their diet along with standard periodontal therapy.

To Study the Role of Absolute Lymphocyte Count and RDW in COVID 19 Patients and their Association with Appearance of Symptoms and Severity.

OBJECTIVE: The present study was undertaken to evaluate prognostic relevance of select circulating immune mechanistic biomarkers in COVID-19 positive patients for early identification and categorization of symptomatic patients who would need critical care with consequent adequate and optimal resource allocation and definitive management protocol. MATERIALS AND METHODS: The present retrospective observational study, on 35 symptomatic and 35 asymptomatic patients, was carried out in SMS Medical College and Hospital, Jaipur comparatively assessing epidemiological history, clinical features and laboratory investigations. RESULTS: During the course of study, 35 symptomatic and 35 asymptomatic patients were assessed. All the patients were of Indian ethnicity and had a history of contact with a COVID 19 positive case. Male patients constituted of 67 % of the population. The median age of patients in symptomatic and asymptomatic group was 60 years and 30 years, respectively. Out of the 70 patients studied, 47 (67%) patients recovered and were discharged whereas 23 (32.8 %) succumbed to the disease process. Lymphopenia was observed in 80% of symptomatic patient population, though only 11.5% of asymptomatic patients documented lymphopenia. Among the patients who died of COVID 19 (n=23), lymphopenia was observed in 18 (82%) patients, with moderate lymphopenia present in 13 (59 %) and severe lymphopenia present in 5 (22.7%) patients. Neutrophilia was observed across both category of patients, symptomatic and asymptomatic. Neutrophilia featured prominently in the symptomatic COVID-19 group with a median nadir in ALC of 7 × 109/L as compared to that of 3.8 × 109/L so observed in asymptomatic sample population. Red cell distribution width was slightly raised in both groups with a median RDW of 15.3% in COVID 19 patients which was raised as compared to that observed in normal population (range: 12.8 ± 1.2 %). CONCLUSION: Lymphopenia is an effective and reliable indicator of onset of symptoms and severity of disease in COVID-19 patients. RDW was found to be higher in COVID 19 patients in comparison to normal patients, however it had no significant relationship with appearance of symptoms or severity of the disease.

Efficacy of Locally Administered 1.2% Rosuvastatin Gel in Patients with Periodontitis: A Randomized Placebo Controlled Clinical Trial.

OBJECTIVE: Periodontitis initiation and progression are a result of host immune inflammatory response to oral pathogens. Several pharmacological agents are being delivered locally, to improve periodontal health. Hence, the present randomized placebo controlled clinical trial is designed to check the clinical and antimicrobial efficacy of locally delivered 1.2% rosuvastatin (RSV) in intrabony defects (IBD) in periodontitis patients. MATERIALS AND METHODS: One-hundred patients were randomly allotted into two treatment groups: group A received 1. 2% RSV gel, scaling and root debridement and group B received placebo gel, scaling and root debridement. Clinical parameters, including modified sulcus bleeding index (mSBI), probing depth (PD), clinical attachment level (CAL), and plaque index (PI), were recorded at baseline before phase 1 and after 6 months. Radiographic assessment of IBD was done by cone beam computed tomography at baseline and after 6 months. Anaerobic colony count was done at baseline and after 180 days. RESULTS: On intragroup comparison, there is a significant improvement in periodontal parameters in both the groups. On intergroup comparison, there is significant gain in CAL in group A than group B (p = 0.04). There is significant decrease in PD in group A, compared to group B. There is significant bone fill in group A (p = 0.034), compared to group B. With respect to mSBI, PI, and anaerobic colony count, there is no significant difference between the two groups after 6 months. No adverse effect was noticed in any subjects. CONCLUSION: The author concludes that 1.2% RSV gel when delivered locally into IBD improved periodontal clinical parameters such as PD and CAL and showed significant bone fill.

Rehabilitation of Posterior Maxilla with Obturator Supported by Zygomatic Implants.

Prosthetic rehabilitation of atrophic maxilla and large maxillary defects can be done successfully by zygomatic implant-supported prosthesis. Zygomatic implants are an avant-garde to complex and invasive-free vascularised osteocutaneous flaps, distraction osteogenesis, and the solution to flap failures. A treated case of tuberculous osteomyelitis, with a class II (Aramany's classification) maxillary defect, reported to oral maxillofacial department, Government Dental College (RUHS-CODS). The defect in this group was unilateral, retaining the anterior teeth. The patient was previously rehabilitated with a removable maxillary obturator. Inadequate retention affected essential functions like speaking, mastication, swallowing, esthetics, and so on due to lack of sufficient supporting tissues. A fixed prosthetic rehabilitation of posterior maxillary defect was done with obturator supported with two single-piece zygomatic implants. At 1-year follow-up, the patient was comfortable with the prosthesis, and no further complaints were recorded.

Disseminated Histoplasmosis with Oral Manifestation in an Immunocompetent Patient.

A case of disseminated histoplasmosis (DH) in a 60-year-old female patient is reported from Jaipur, Rajasthan, India. The patient presented with multiple papules on the skin surrounding the lips, face, torso, trunk, and back. She also complained of growth in the palate. Histoplasmosis was confirmed by biopsy and histopathology of skin and palatal lesions. This case report highlights the presenting features and occurrence of histoplasmosis in nonendemic region in India.

Prosthetic management of malpositioned implant using custom cast abutment.

Two cases are reported with malpositioned implants. Both the implants were placed 6-7 months back. They had osseointegrated well with the surrounding bone. However, they presented severe facial inclination. Case I was restored with custom cast abutment with an auto polymerizing acrylic gingival veneer. Case II was restored with custom cast UCLA type plastic implant abutment. Ceramic was directly fired on the custom cast abutments. The dual treatment strategy resulted in functional and esthetic restorations despite facial malposition of the implants.