Evaluation of Anti-plaque and Anti-gingivitis Efficacy of Two Commercially Available Herbal and Non-herbal Toothpastes.

BACKGROUND:  Plaque-associated oral disease affects a considerable portion of the population and is considered one of the major causes of tooth loss. The presence of plaque may be the reason for dental caries, gingivitis, periodontal problems, and halitosis. Many mechanical aids are used to control plaque, including toothbrushes, dental floss, mouth rinses, and dentifrices, and the most effective method of controlling gingivitis is supragingival plaque control. AIM AND OBJECTIVE: To evaluate and compare the anti-plaque and anti-gingivitis efficacy of commercially available herbal toothpaste (Meswak) and non-herbal toothpaste (Pepsodent). MATERIALS AND METHOD: 50 subjects aged between 10 and 15 years with a full complement of dentition were included in the study. The two toothpastes were provided to the subjects in plain white tubes by the investigator. Subjects were instructed to brush their teeth twice daily using the given toothpaste for 21 days. Plaque and gingival scores on days 0, 7, and 21 were recorded, and the data were subjected to statistical analysis. RESULT: At the end of the 21-day study, there was a statistically significant difference between the groups for plaque and gingival scores. CONCLUSION: The plaque and gingival scores were significantly reduced throughout the study in both groups. In comparison, the herbal dentifrices show more effectiveness in reducing plaque and gingival scores, but no statistically significant difference was seen between the two groups.

Choosing Periodontology for Specialty Specialization: Perspective of Dental Undergraduate Students.

BACKGROUND: The attitudes of dental students to study a particular specialty of dentistry in post-graduation are of great importance as these facilitate workforce planning in the dental sector. AIM AND OBJECTIVE: To assess the attitude of dental students towards choosing periodontology as their future career and to explore demographic variables that affect their choice. MATERIALS AND METHODS: A cross-sectional survey based on a questionnaire was conducted, including students of the third and fourth years and interns of the dental college. Twenty-seven questions, graded on a Likert scale (5-point) were included in the questionnaire, and the responses were categorised via three attitudes: negative (score 0-21), neutral (score 22-44) and positive (score 45-64). The Chi-square test for proportions was used to examine the differences between groups. RESULTS: Among 114 participants, 53 (46.5%) were males and 61 (53.5%) were females. One-third of the respondents had a positive attitude towards selecting periodontology as their future career, and the majority had a neutral perspective, with a few students having a negative attitude (20.2%). Out of the total, 34.2% of respondents had a positive attitude, and 45.6% showed a neutral attitude or perspective. CONCLUSION: Efforts should be intensified, and undergraduate (UG) students should be motivated by broadening the scope of the field in the UG curriculum by the dental council so that the students show considerable interest in pursuing the field as their future career.

Comparative Evaluation of Clinical Efficacy of Diode LASER and Cryosurgery for Gingival Pigmentation: A Split-Mouth Randomized Clinical Study

ABSTRACT Objective: To compare and evaluate the clinical efficacy of diode laser and cryosurgery for treating melanin pigmentation of gingiva. Material and Methods: A total of twenty-five subjects with physiological gingival pigmentation on the facial aspect of both maxillary and mandibular anterior arches (50 sites), both male and female, with an average age ranging from 18-35 years, participated in the study. The sites were randomly divided into Group I: depigmentation by Laser and Group II: depigmentation by Cryosurgery. The following parameters were assessed for the evaluation of treatment results: Melanin Oral Pigmentation Index (PI), Visual Analogue Scale (VAS) for pain evaluation and Healing index (HI). The data collected was statistically evaluated. Results: On intergroup comparison, there was no statistical difference in the score from baseline (p>0.05); however, a statistically significant difference was seen at the end of 1 year (p<0.05). Moreover, 57-60% of arches showed recurrence of pigmentation in the laser group whereas; only 12.7-17% recurrence was seen in the cryosurgery group at the end of the first year. Conclusion: Treatment of gingival hyperpigmentation with laser and cryosurgery shows a marked improvement of gingival pigmentation in both groups, but the cryosurgery depigmentation sites showed more sustainability.

Jaw Swelling Back with Vengeance.

Rhabdomyosarcoma (RMS) is a highly aggressive lesion and is commonly seen in children below the age of 10 years. The survival rate is not very high as an early diagnosis is often difficult. However, the treatment involves mainly surgery followed by chemotherapy and sometimes radiotherapy.

Severity of Periodontal Disease in Chronic Kidney Disease Patients: A Hospital-Based Study.

Background Periodontal disease is a chronic inflammatory condition of multifactorial origin. The inflammatory mediators released during the progression of disease may affect all the organs of the body. Renal disease is a chronic systemic disease which may influence the progression of periodontal disease. Therefore, this study was conducted to evaluate and compare the prevalence of periodontal disease among individuals with chronic kidney disease undergoing maintenance hemodialysis with healthy individuals. Methodology In this cross-sectional study including 150 participants, 75 patients with different renal diseases undergoing hemodialysis (Group I) and 75 healthy controls (Group II) were included. The general examination of the patients was done. Blood pressure, pulse, and body mass index were recorded, followed by biochemical investigations, in which serum urea, serum creatinine, and random blood sugar were evaluated for each participant. Plaque Index (PI) and Gingival Index (GI) scores were recorded. Probing pocket depth (PPD) and gingival recession GR were measured, and clinical attachment level (CAL) was calculated based on the obtained values. The subjects were then categorized into three groups, namely, no/mild, moderate, and severe periodontitis. Results Out of the total study participants, 68% were men and 32% were women, with a mean age of 47 years. Serum markers were significantly elevated in Group I compared to Group II. Poor oral hygiene and periodontitis were observed to be much higher in dialysis patients compared to the control group. The two groups also significantly differed in PI, GI, PPD, GR, and CAL, all of which were higher in Group I. Conclusions The results suggest that patients with renal disease must be screened for periodontal disease.

Comparative evaluation of push-out bond strength of AH-Plus, MTA-Fillapex and Epiphany SE root canal sealers: An Ex-Vivo study.

Background: A successful root canal (RC) treatment depends upon creation of a fluid impervious seal that is commonly built by using a RC sealer along with gutta-percha. The bond strength of the RC sealer is a hallmark as it will minimize the risk of treatment failure by reducing the possibility of filling detachment from dentin. Aim: To evaluate and compare the push-out bond strength of AH-Plus and MTA-Fillapex with Gutta-Percha and Epiphany Self Etch/Resilon system using the Universal Testing Machine. Materials and Method: About 60 mandibular premolars with single canals were prepared apically with Hyflex CM files upto size #30. Out of total, 20 teeth were obturated with AH-Plus/GP (group 1), 20 with MTA-Fillapex/GP (group 2), and other 20 with Epiphany Self Etch/Resilon system (group 3). Teeth were sectioned into three slices of 2 mm each and were subjected to Universal Testing Machine. Statistical Analysis: The data obtained were tabulated and statistically evaluated using SPSS version 21.0 statistical analysis software (IBM, Chicago, Illinois, USA). Results: The mean push-out bond strength was highest for AH-Plus (14.32 MPa) followed by MTA-Fillapex (12.18 MPa) and then Epiphany SE (8.44 MPa). The results were statistically significant. Conclusion: Significantly, higher push out bond strength was displayed by AH-Plus sealer than MTA-Fillapex and least being Epiphany SE sealer. The push out bond strength was significantly highest at apical third and lowest at coronal third.

Comparative evaluation of periodontal inflammatory conditions among gutka-chewers with and without prediabetes.

BACKGROUND: The metabolic syndrome has become one of the major public-health challenges worldwide which include diabetes, prediabetes (raised blood glucose level), abdominal obesity, high cholesterol level, and high blood pressure. Periodontitis is described as a multi-factorial irreversible and cumulative condition and, is also the sixth complication of diabetes. Areca nut chewing has already been linked with the development of various cancers, and more recently with metabolic syndrome. Therefore, the purpose of the study is to investigate the association of periodontal inflammatory conditions among gutka chewing with and without prediabetes patients. MATERIALS AND METHODS: There are about 50 pre-diabetic and 50 healthy patients, both males and females with the age range of 18 years to 45 years, were included in the study. They were then divided into 4 groups based upon gutka chewers and non-chewers i.e., pre-diabetic gutka chewers (PDC), pre-diabetic non-chewers (PDNC), healthy gutka chewers (HC), and healthy non-chewers (HNC). A complete demographic data was obtained along with clinical and radiographic parameters i.e. plaque index (PI), sulcus bleeding index (SBI), probing depth (PD), marginal bone loss (MBL) were recorded. A statistical analysis was performed and Bonferroni adjustment post hoc test was performed for multiple comparisons. RESULTS: The overall results suggested that the clinical periodontal parameters i.e., PD, PI, SBI and radiologic parameters i.e., MBL are significantly higher in prediabetes chewers compared with healthy chewers and healthy non chewers. CONCLUSION: The periodontal inflammatory conditions are worse in gutka chewers compared to non-chewers in healthy and pre-diabetic patients, concluding that the severity of periodontal inflammation is governed by hyperglycemia when compared to habitual gutka usage.

Comparative Evaluation of Altered Taste Perception among Oral Submucous Fibrosis Patients.

BACKGROUND: Taste perception is an important factor in sustaining human life. Impairment of taste is one of the important features of oral submucous fibrosis (OSMF), and it has not received much attention, owing to limited research work in the field. Therefore, the present study was conducted to determine taste alteration in OSMF patients. MATERIALS AND METHODS: A total of 200 participants, both males and females with the age range of 20 years to 55 years, were included in the study. Four basic tastants (i.e., sweet, salt, sour, and bitter) were prepared as follows: sucrose for sweet (0.1-1.0 mol/l), sodium chloride for salty (0.01-1.0 mol/l), citric acid for sour (0.320-0.032 mol/l), and quinine sulfate for bitter (0.01-1.0 mol/l) and full mouth rinse test was performed for a complete taste response examination, after which punch biopsy was taken from buccal mucosa to determine histopathological staging. The data obtained were tabulated and analyzed by the Pearson Chi-square test; P < 0.05 was considered statistically significant. RESULTS: The overall results suggested that there was a significant alteration of taste. The sweet taste was altered followed by salty and bitter was least affected. CONCLUSION: The study points out at the significance of alteration in taste perception is OSMF patients related to sweet, salt, sour, and bitter taste by using physiological stimuli tastants.

Oral health status and treatment needs of substance abusers in Western Uttar Pradesh.

BACKGROUND: Substance abuse has often associated with high caries, poor periodontal health, and altered functioning of the individual. The substance abuse may be natural or synthetic in origin, both causing deleterious effect on the oral and overall health of the individual. AIM: To assess the oral health status and treatment needs of substance abusers attending deaddiction centers in Western Uttar Pradesh. MATERIALS AND METHODS: A cross-sectional study was conducted among 220 substance abusers from 6 randomly selected deaddiction centers. The subjects were divided into four groups: Group 1, alcohol (A); Group 2, nicotine (N); Group 3, alcohol + nicotine (AN); and Group 4, other drugs (O). A demographic record along with full-mouth examination was recorded based on the World Health Organization pro forma. RESULTS: The overall results showed that out of the total participants, 144 had oral mucosal lesions. Alcohol group had significantly higher mean community periodontal index code 3 (pockets 4-5 mm) than the other groups (P < 0.05). The prevalence of decayed, missing, filled teeth (DMFT) was 83.33%, and the mean DMFT of the alcohol group was significantly higher than the other combinations group (P < 0.01). CONCLUSIONS: The oral health status of substance abusers was poor, with a large number of oral mucosal lesions. The dental caries status and periodontal status were the worst among the alcohol group.

Surface Treatment and Implant Bone Interface: A Systematic Literature Review.

In the present scenario, dental implants have proven to be a very reliable and popular treatment option for partial and completely edentulous arches. The biological, chemical, local, clinician, and implant related factors determine sequence of bone turnover that eventually enhances the success of implant therapy. The positioning of implant is followed by an inflammatory process that results in de novo bone formation and deposition on the implant surface. Pure titanium is commercially the prime material of choice for an implant. The implant surface can be chemically altered by a change in manufacturing, finishing, thermal treatment, blasting etching, coatings, and even sterilization procedures. These techniques have led to major innovations in implant dentistry as they roughen the surface, promoting bone deposition and stability. The current paper gives a comprehensive review of the diverse topographical characteristics of an implant surface and the altered techniques offered to create appropriate roughness to enhance osseointegration starting from fundamental to the latest techniques.

Comparative evaluation of tooth surface roughness caused by three different powered toothbrushes and a novel manual toothbrush -An SEM and AFM study.

BACKGROUND: Toothbrush is the most frequently used tool for mechanical plaque control. Variety of manual and powered toothbrushes are available in the market, and it is often a dilemma for a common man that which one to choose among the wide range. Thus, the purpose of the present study was to evaluate and compare the tooth surface roughness caused by three different powered toothbrushes. METHOD: In total, 160 samples comprising of 80 enamel and cementum each were equally and randomly divided into four groups: Group 1 multi-directional powered toothbrushing; Group 2 oscillating/rotating/pulsating powered tooth brushing; Group 3 sonic powered tooth brushing; and Group 4 manual tooth brushing. They were further sub-divided equally into Control and Test. The Test samples were brushed for 2 min every day for a period of 1 month. The prepared samples were evaluated for surface roughness using scanning electron microscope at 1000 × magnification and atomic force microscope at the nanoscale. RESULT: A statistically significant difference was seen in the enamel and cementum roughness between multi-directional tooth brush group and sonic (P = 0.00); multi-directional tooth brush group and manual tooth brush group (P = 0.00); oscillating tooth brush group and sonic group (P = 0.00); oscillating tooth brush group and manual tooth brush group (P = 0.00); and sonic group and manual tooth brush group (P = 0.00). CONCLUSION: The surface microroughness caused by tooth brushing was found to be least using multi-directional and oscillating/rotational/pulsating powered toothbrush, followed by sonic powered toothbrush and maximum in manual toothbrush.

Midline Congenital Upper Lip Sinus: A Rare Case.

To present a rare case of a midline congenital upper lip sinus and its management. Background: A lip sinus is a rare condition, where a failure of the complete union during early stages of development leads to its formation. The prevalence of lower lip sinus is estimated to be about 0.00001% of the white population and that of upper lip sinus is even rarer. A congenital lip sinus maybe associated with syndromes such as; Von der Woude syndrome, or maybe present in isolation. A 25-year-old male presented to our clinic with intermittent swelling in the upper lip region. Clinical examination revealed a congenital midline lip sinus in the upper lip region, which had no intra-oral communication, and was managed by surgical excision. Till date, there has been a hand full of case reports of upper lip sinuses and fistulae, out of which only few are reported in India. We herein report a case of congenital upper lip sinus presenting as an intermittent swelling of the upper lip with its successful surgical management.

Evaluation and comparison of hydroxyapatite crystals with collagen fibrils bone graft alone and in combination with guided tissue regeneration membrane.

BACKGROUND: The combination of collagen in bone grafts is being used because of its properties that accentuate the degree of regeneration. Furcation involvement poses challenge to the prognosis of a tooth, the use of bone grafts and a combination of grafts and membranes have proved to be beneficial in the treatment of furcation defects. Thus, the aim of the present study was to clinically evaluate and compare the effectiveness of collagen fiber bone graft with and without a membrane in the treatment of mandibular Grade II furcation defects. MATERIALS AND METHODS: A clinical split-mouth randomized control trial, which included ten patients having bilateral mandibular Grade II furcation defects, was randomly assigned to Group I, treated with bone graft of hydroxyapatite with collagen fibers, and Group II, treated with bone graft of hydroxyapatite with collagen fibers and guided tissue regeneration membrane of polyglycolide and polylactide copolymer, respectively. The clinical measurements were recorded at baseline and 6 months after surgery; and plaque and gingival index were recorded at baseline and at 3 and 6 months after surgery. The data obtained was statistically evaluated. RESULTS: The overall results showed that the treatment procedures demonstrated statistically significant reduction in probing pocket depth, vertical defect fill, and horizontal depth of furcation, with a gain in clinical attachment level. On comparison of both the groups, Group II showed superior results with a statistically significant difference in all parameters except in gingival recession. CONCLUSION: The findings of the study demonstrated superior clinical results obtained with hydroxyapatite with collagen fibers, used in combination with polyglycolide and polylactide copolymer as compared to used alone in the treatment of Grade II furcation defects.

Prevalence of periodontitis in patients with pulmonary disease: A cross-sectional survey in the industrial district of India.

BACKGROUND: Evidence state that periodontitis may have a contributory role in the onset and progression of pulmonary diseases. However, very limited data are available till date, studying the coexistence of both the conditions. AIM AND OBJECTIVE: The aim and objective of this study are to determine the prevalence of periodontitis among patients affected with various pulmonary diseases in Moradabad District, Uttar Pradesh, India. MATERIALS AND METHODS: A total of 700 patients suffering from pulmonary diseases including tuberculosis (TB), chronic obstructive pulmonary disease, or pneumonia within the age group of 12-70 years were selected for the study. A detailed case-history for both pulmonary and periodontal status was taken. Periodontal Disease Index and Periodontal Index for Risk of Infectiousness were recorded for all patients. The scores were calculated and subjected to statistical analysis. RESULTS: Individuals with pulmonary diseases showed a statistically significant prevalence of periodontal disease with higher values of periodontal disease index (31%) and periodontal index for risk of infectiousness (55%) at P < 0.05. Patients suffering from TB within the age group of 51-60 (42%) showed the highest prevalence of periodontitis with a more number of males (43%) being affected as compared to females at P < 0.01. CONCLUSION: Most of the study population was diagnosed with periodontitis with a higher proportion categorized under high-risk category as per PIRI scores.

Multifaceted assessment of dentine hypersensitivity, evaluation of demographic prevalence along with associated factors: A cross-sectional study.

BACKGROUND: Dentine hypersensitivity (DH) is a relatively common problem which may affect the adult population. The etiology remains multi-factorial with interactions between stimulus and pre-disposing factors causing its aggravation. AIM: To study the prevalence of DH and associated factors and also to find the association between various factors and DH. MATERIALS AND METHODS: A cross-sectional study was carried out and a total of 5091 patients, both male and females, were evaluated through questionnaire. Out of the total only 1400 patients were included in the study and were further evaluated clinically. A complete demographic data was obtained and the DH was confirmed by the use of air -water jet of the dental chair and scratching the suspected tooth with a dental probe. The pain response of the subject was recorded using the visual analog scale (VAS) and verbal rating scale (VRS). The data obtained was statistically evaluated and Chi-square test was applied for comparison of different demographic factors with DH. RESULTS: The overall prevalence of DH was 27.4%. Various demographic factors were found to affect DH such as age, gender, education, and diet. The most common stimulus was found to be cold (21.4%) and common predisposing factor was gingival recession and attrition (28.6%). Clinical examination yielded a statistically significant association between VAS and VRS scores for DH and demographic factors. CONCLUSION: The prevalence of DH in present study was 27.4% which is attributed to gingival recession as predisposing factor and cold stimuli as the precipitating factor.

Does Oral Submucous Fibrosis Affect the Hearing Ability of an Individual? A Cross-Sectional Study in North Indian Population

Abstract Objective: To evaluate the hearing efficiency of Oral Submucous Fibrosis (OSF) patients using Pure Tone Audiometry (PTA) and to correlate between the hearing efficiency and clinical stage of OSF. Material and Methods: Twenty-five patients clinically diagnosed as OSF were evaluated for hearing loss using 'PTA'. Patients were grouped as mild cases and severe cases. Mild cases comprised of Group A and B, and severe cases comprised of Group C and D. Patients suffering from the previous hearing were excluded from the study. The data were submitted to statistical evaluation using the Chi-square test. The level of significance was set at 5% Results: Out of the total patients, 52.4% were diagnosed as mild cases (Group M) OSF and 47.6% as severe cases (Group S). The analysis of the data of mild cases and severe cases revealed a significant association between advancing stages of OSF and hearing loss (p = 0.026). The cases in Group M after otoscopic evaluation demonstrated no visible ear defect. However, 30% of cases in Group S showed retraction of the tympanic membrane Conclusion: The results indicate an association between stages of OSF and hearing loss. With advancing stages of OSF, there may be involvement of muscles of soft palate namely the levator veli palatine or tensor veli palatine, which may lead to the narrowing of the Eustachian tube leading to a decrease in air conduction demonstrating it as hearing loss of varying degrees depending upon the involvement.

Evaluation and Immunolocalization of BMP4 and FGF8 in Odontogenic Cyst and Tumors.

Growth factors like bone morphogenetic protein 4 (BMP4) and fibroblast growth factor 8 (FGF8) play a major role in organogenesis and specifically in odontogenesis. They are also believed to have a role in oncogenesis. Thus, any discrepancies in their standard behavior and activity would lead to serious abnormalities including odontogenic cyst and tumors. The present research work investigated the expression of BMP4 and FGF8 in odontogenic tumors (OT) and cyst as well as developing tooth germs to elucidate their roles. Dental organs of various odontogenic stages and 30 OTs including solid multicystic ameloblastomas (SMA, 10 cases), ameloblastic fibroma (AF, 10 cases), odontogenic myxoma (OM, 10 cases), and odontogenic cysts: odontogenic keratocyst (OKC, 10 cases) were evaluated in both epithelial and mesenchymal components for the expression of BMP4 and FGF8 using immunohistochemistry. The epithelial nuclear expression of BMP4 was highest in OKC (9 cases) while FGF8 was highest in SMA (10 cases). The mesenchymal nuclear expression of both BMP4 (8 cases) (p = 0.001) and FGF8 (9 cases) (p = 0.045) were significantly high in OMs among all OTs. Both growth factors were actively expressed in different stages of tooth development. The expression of BMP4 and FGF8 corelates well with the proliferative component of the pathologies, indicating a possible role in the pathogenesis and progression.

Necrotising sialometaplasia: a diagnostic perplexity? An innocent entity to malignant masquerade.

OBJECTIVE: Necrotising Sialometaplasia is a benign self limiting reactive condition of major and minor salivary glands, which can arouse suspicion for malignancy, clinically and histopathologically. Here, we report a case of 38-year-old female with a painful ulcer on the palate. The case enlightens the importance of clinicopathologic correlation and diligent follow up in diagnosis and management of the case.

Chronic non-healing ulcer of the oral cavity: tuberculosis or carcinoma?

OBJECTIVE: Tuberculosis is a chronic granulomatous lesion, which primarily has an affinity for the lungs. It can involve other sites like lymph nodes, kidney, oral cavity. Infection of the oral cavity by M. tuberculosis can be as a Primary infection or as a Secondary infection. Primary presentation of oral tuberculosis is in the form of the chronic non healing ulcer. A Primary infection or an Asymptomatic Secondary infection can impose a great diagnostic dilemma, as it may mimic neoplasia. Here we present a case of a 32-year-old asymptomatic female with secondary infection.

Efficiency of three different polishing methods on enamel and cementum: A scanning electron microscope study.

BACKGROUND: Tooth polishing is an integral part of clinical dentistry. The main purpose of polishing is to smoothen the surface of the tooth and minimize the deposition of plaque to allow a healthy periodontal maintenance postscaling. Today, polishing by different methods is available to a clinician. Traditional bristle brush and rubber-cup polishing are being widely practiced and gradually getting replaced by novel air polisher. Pros and cons of each method should be weighed before its clinical applications. AIM AND OBJECTIVES: To evaluate and compare the efficiency of three different polishing systems on enamel as well as on cementum surfaces by scanning electron microscope (SEM). MATERIALS AND METHODS: A total of 120 samples were divided into three groups randomly - Group 1 (bristle brush), Group 2 (rubber cup), and Group 3 (air polisher) - with 20 samples each of enamel and cementum, which were subdivided into 10 control and 10 test group (subjected to polishing). The samples were analyzed by SEM at ×1000 magnification, and the data obtained were compiled and subjected to statistical analysis. RESULTS: Polishing with bristle brush demonstrated less surface roughness and debris when compared to air polisher at P = 0.58, P = 0.03 for enamel surface and P = 0.003, P = 0.21 for cementum, respectively. The surface roughness was reduced considerably by rubber cup at P = 0.03 for enamel and P = 0.003 for cementum, compared to air polisher at P = 0.99 and P = 0.21 for enamel and cementum, respectively. CONCLUSION: The results indicate that polishing with rubber cup was more effective and statistically significant when compared to bristle brush polishing and air polisher for the crown and root surface smoothening and debris removal.