Estimation of vestibular depth: An observational cross-sectional study.

Background: The vestibular depth (VD) varies to a great extent among individuals and at different points of reference. The normal range of depth of the vestibule at different areas in the mouth remains to be established. Aim: The primary objective of this study is to assess the average VD around different teeth in the maxilla and the mandible. Furthermore, an attempt has been made to identify the various ranges of VD and understand what could be suggestive of a normal VD. Materials and Methods: The participants included were divided into four age groups, i.e., 6-14 years (Group 1), 15-30 years (Group 2), 31-50 years (Group 3), and >50 years (Group 4). Further, the subjects were grouped into subgroup A, periodontally healthy and subgroup B, gingival recession (GR). Group 1, 2, and 3 included 30 subjects each in subgroup A, while Group 4 subgroup B had 18 subjects. In case of subgroup B, Group 2 included 9 subjects, Group 3-31 subjects, and Group 4-30 subjects. Measurements included the depth of vestibule from 2 reference point, i.e., gingival margin (GM) and incisal edge (IE). Results: In subgroup A, the average VD from GM was found to be the least in the Group 1 i.e., 6-14 years (9.2 mm ± 4.26 in maxilla and 7.01 mm ± 3.14 in the mandible) and the highest in the Group 4 i.e., >50 years (12.06 mm ± 2.73 in maxilla and 10.08 mm ± 2.58 in the mandible). In the case of subgroup B, the least depth from GM was found in the Group 3 i.e., >30-50 years (9.44 mm ± 2.73 in the maxilla and 8.32 mm ± 1.7 in the mandible) and the maximum depth in the Group 4 (>50 years) (11.28 ± 2.31 in maxilla and 9.42 ± 2.87 in the mandible). Conclusion: The study provides a range of VD s in different areas of the mouth in periodontally healthy and individuals with GR, which will contribute to constitute a normal range of VD.

ISP good clinical practice recommendations for gum care.

Oral health is vital for the general well-being, overall body health and the quality of life throughout our lifetime. Most of the oral diseases and conditions are largely related to the maintenance of oral hygiene, lacking that people suffer from diverse oral diseases at different times in their life. With greater life expectancy, the individuals have teeth involved with periodontal diseases that would not only require professional care but also home gum care for them to last a lifetime. Indian Society of Periodontology (ISP) has recognized the need for systematic documents to update everyday clinical practice of general dental practitioners and have provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral healthcare delivery across the country. The current set of clinical practice recommendations focused to "Gum Care for All", is aimed at emphasizing and enhancing the awareness regarding oral health promotion, maintenance, and disease prevention. Twenty-five subject matter experts from across the nation, prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three distinct sections, namely pretherapeutic, therapeutic, and post therapeutic, to provide guidance during the respective phases of patient management and may serve as a quick and concise reference to the readers. The guidelines shall provide the distinct definitions, signs and symptoms, treatment required; recall visit specifications for plausible clinical case situations, home care advice regarding maintenance of oral hygiene including information on brushing technique, care and change of brush, use of interdental aids, and mouthwashes, etc. The document should advocate and guide the combined efforts of general dentists, and the population at large toward an empowered, evidence based, integrated, and comprehensive oral health care, which shall enhance the healthful functioning and longevity of the dentition and general health of the individual.

Prevalence of Dental Caries in the Indian Population: A Systematic Review and Meta-analysis.

OBJECTIVES: To evaluate the pooled prevalence of dental caries among Indian population through systematic review and meta-analysis. MATERIALS AND METHODS: A keyword search was conducted in PubMed, Science Direct, Google Scholar, Cochrane, and Scopus databases using relevant key words to extract the data pertaining to dental caries in Indian population. The search criteria included manuscripts published in English language from March 2009 to March 2019 and employed standard Boolean operators. The studies which met the inclusion criteria were independently reviewed by two researchers and their quality was assessed by the Newcastle-Ottawa Scale. The overall prevalence was deduced using the random effects model with prime focus given to the site of anatomical origin. R software version 3.5.2. was used for statistical analysis. RESULTS: Post screening, out of the 253 articles identified, 70 met the inclusion criteria and were used to generate the meta-analysis. Among them, only few studies investigated the prevalence of root caries (n = 1). Overall prevalence of dental caries was 54.16% (CI: 0.4966-0.5866), whereas age-specific prevalence was 62% in patients above 18 years and 52% among 3-18 years of age (P < 0.0001). Maximum overall prevalence was noted in mixed dentition (58%). Region wise prevalence was more in western India (72%). Use of decayed, missed, and filled teeth as diagnostic criteria for early childhood caries was only 29%. CONCLUSIONS: Besides an overall prevalence of 54.16%, there exists a remarkable variation in dental caries prevalence rates as per age, diagnostic criteria, dentition, and geographical region. Furthermore, research should be focused on the prevalence of anatomical site specific caries as well.

Assessment of basal implants in compromised ridges.

AIM: The aim of the present study was to evaluate clinically, radiographically, and functionally the outcomes of immediately loaded basal implants when placed in patients with compromised bone/alveolar ridges. MATERIALS AND METHODS: A total of 18 systemically healthy (9 male and 9 female) subjects with compromised bone with poor quantity or quality were included in the study. A total number of 57 implants was placed, out of which 26 implants were placed in maxilla and 31 implants in mandible. There were 6 patients in which single implants were placed and in rest of the 12 patients, multiple implants were placed, out of which full mouth rehabilitation was done in one patient. In 10 patients, implants were placed immediately in fresh extraction socket and in 7 patients, implants were placed in healed edentulous site. In all the patients, loading was done immediately within 72 h of implant placement. All patients were evaluated for primary and secondary stability, pain, periimplant bone levels using IOPA with grid and CBCT, bleeding, suppuration, sulcular bleeding index, prosthetic complications, and patient satisfaction at specified time intervals. RESULT: All the values obtained during the study were expressed in the form of mean, standard deviation, and standard error of the mean. The parameters were compared between groups using Paired t-test for intragroup comparison at a similar time, i.e., baseline, 1 month, and 3 months. The data collected was comprehensively analyzed using SPSS software. All implants were successful, with no incidence of infection, nil mobility at the end of the study period of 6 months. CONCLUSION: Thus, it can be concluded from the present study, that Basal implants can play a vital role in the rehabilitation of patients, where compromised quality and/or quantity of bone is present and additional augmentation procedures would be required for the placement of conventional root form implants.

Use of mineral trioxide aggregate for retreatment of a tooth with large periapical lesion, wide-open apices and vertical root fracture.

Chronic periapical lesions in necrotic teeth with open apex are difficult to manage. The situation becomes more complex if the tooth has a fracture line. This case report describes the management of a traumatised tooth that had already undergone unsuccessful endodontic treatment with a large periapical lesion and open apex along with a fracture line in the root. An attempt was made to save the tooth by using mineral trioxide aggregate (MTA) cement for orthograde filling, retrograde filling and also for sealing of the fracture line. Moreover, the bone defect was filled with autogenous bone harvested from the external oblique ridge. MTA, a bioactive tricalcium silicate cement, has been used in treating complex endodontic cases as it shows promising potential by inducing the biological mechanisms necessary for repair of involved teeth. A 1-year follow-up showed progressive healing as evident by radiographs and lack of any clinical signs and symptoms.

Assessment of Oral Health Knowledge, Attitude and Self-Care Practice Among Adolescents - A State Wide Cross- Sectional Study in Manipur, North Eastern India.

INTRODUCTION: The World Health Organization global strategy of promoting oral health have shown vast improvements in developed countries but the scenario is glum among underprivileged communities due to lacunae in implementation of these promotional programs. Manipur, a North Eastern state in India, is one such marginalized area. AIM: The study aimed to evaluate Knowledge, Attitude and Practice (KAP) towards oral health in 15-18 year adolescents residing in Manipur together with the association of these variables to sociodemographic factors. MATERIALS AND METHODS: This cross-sectional study included 810 healthy adolescents drawn from various primary health care centers spanning in all the nine districts of Manipur. A closed ended questionnaire for the purpose of collecting data was used in the survey. RESULTS: Of the total participants 90.9% had high knowledge, 79.8% had favorable attitude and 70.4% had adequate practice towards oral health. Education of the parents and respondents was the only factor significantly associated with all three variables, knowledge, attitude and practice. Significant and positive linear correlation between knowledge-attitude (r=0.369, p<0.01) knowledge-practice (r=0.405, p<0.01) and attitude-practice (r =0.353, p<0.01), were observed. CONCLUSION: An overwhelming majority of the respondents had high knowledge, favorable attitude and sound practice with respect to oral health. A positive linear correlation exists between the knowledge, attitude and practice. Evidence based reinforcement programs should be introduced to further reduce the gap between knowledge, attitude and practice. The study will also serve as a reference value for use in future evaluation to help measure the effectiveness of the planned activities. Future research needs to focus on establishing the dental caries prevalence and oral hygiene status of Manipuri youth.