Clinicoradiographic Evaluation of Long-term Efficacy and Risk Factors Associated with Dental Implants used for Full Mouth Rehabilitation.

Background: Despite various complications and failure factors, newer implants are designed that allow placement in sub-optimal conditions to allow the operator to place implants at sites with low bone quality. These newer designs also allow improved stability with higher survival rates in the short term. Aims: The present study was undertaken to evaluate long-term efficacy and risk factors associated with dental implant placement for full mouth rehabilitation. Materials and Methods: In 24 subjects, 438 implants were placed. The data collected were surgical and were retrospectively analyzed. The data collected included medical history, local, patient satisfaction, marginal bone loss, and systemic risk factors affecting implant survival. Outcome variables assessed were peri-implantitis, implant success, and survival at the follow-up visit. The data were expressed in terms of percentage and number, and the results were derived. Results: Peri-implantitis was seen in 31.05% (n = 136) of implants. 76.02% (n = 333) of implants were considered successful at recall. Concerning survival, compromised and satisfactory survival was shown by 10.04% (n = 44) and 2.96% (n = 13) of implants, respectively. 10.95% (n = 48) of implants were considered as failures. Conclusion: The present study concludes that good, long-term survival rates are associated with full mouth rehabilitation using dental implants.

Efficacy, Safety and Patient Preference of Knotted Floss Technique in Type I Gingival Embrasures.

Purpose: The purpose of this study was to evaluate the efficacy and safety of the knotted floss (KF) technique with respect to plaque biofilm accumulation, gingival inflammation, bleeding, trauma, and patient preference when used in Type I gingival embrasures, in a crossover-comparison with a conventional flossing (CF) technique.Methods: Thirty healthy, non-flossing adults with at least one Type I gingival embrasure participated in this two-treatment-phase, crossover study. Each subject was randomly assigned to perform either KF or CF technique in the first 6-weeks, and the comparative technique in the second 6-weeks, with a 2-week washout phase in-between. Test-sites were scored at baseline, 2-weeks, 4-weeks, and 6-weeks using the Rustogi Modification of Navy Plaque Index (RMNPI), Modified Gingival Index (MGI), Modified Papillary Bleeding Index (MPBI), and the Carter-Hanson et al., scoring method for gingival trauma. A 3-factor analysis of variance was performed on the data to rule out treatment sequencing as a significant factor. Data was analyzed for differences between groups at respective time points using the student t-test and the paired t-test was used for changes within groups over time (p ≤ 0.05).Results: Analysis of data showed a statistically significant improvement in RMNPI, MGl and MPBI scores within both flossing groups over the period of 6-weeks from baseline. The RMNPI scores were significantly less in the KF group at 2, 4, and 6 weeks when compared to the scores between the KF and CF treatment groups. No significant gingival trauma was recorded in either treatment group. Seventy-five percent of the subjects completing the study, chose KF when asked about their preferred flossing technique with respect to its ability to clean interdentally, while 71% chose KF as the flossing technique that they were willing to continue to use.Conclusion: KF is as effective and safe as an inter-dental oral hygiene technique for reducing plaque biofilm and gingival inflammation and bleeding, as compared to CF in Type I gingival embrasures, when both were used in conjunction with regular tooth-brushing. KF was shown to be better than CF in in terms of improved plaque biofilm scores.

Selective nerve root blocks vs. caudal epidural injection for single level prolapsed lumbar intervertebral disc - A prospective randomized study.

BACKGROUND: Chronic lumbar radiculopathy has a lifetime prevalence of 5.3% in men and 3.7% in women. It usually resolves spontaneously, but up to 30% cases will have pronounced symptoms even after one year. AIMS: A prospective randomized single-blind study was conducted to compare the efficacy of caudal epidural steroid injection and selective nerve root block in management of pain and disability in cases of lumbar disc herniation. METHODS: Eighty patients with confirmed single-level lumbar disc herniation were equally divided in two groups: (a) caudal epidural and (b) selective nerve root block group, by a computer-generated random allocation method. The caudal group received three injections of steroid mixed with local anesthetics while selective nerve root block group received single injection of steroid mixed with local anesthetic agent. Patients were assessed for pain relief and reduction in disability. RESULTS: In SNRB group, pain reduced by more than 50% up till 6 months, while in caudal group more than 50% reduction of pain was maintained till 1 year. The reduction in ODI in SNRB group was 52.8% till 3 months, 48.6% till 6 months, and 46.7% at 1 year, while in caudal group the improvement was 59.6%, 64.6%, 65.1%, and 65.4% at corresponding follow-up periods, respectively. CONCLUSIONS: Caudal epidural block is an easy and safe method with better pain relief and improvement in functional disability than selective nerve root block. Selective nerve root block injection is technically more demanding and has to be given by a skilled anesthetist.