Clinical and Microbiological Evaluation of Diode Laser and Systemic Doxycycline as an Additive to Scaling and Root Planing for Stage II and Stage III Periodontitis Patients.

AIM: To assess and contrast the effectiveness of systemic doxycycline and diode laser as supplements to scaling and root planing (SRP) in terms of clinical and microbiological parameters. MATERIALS AND METHODS: A total of 33 patients diagnosed with periodontitis stages II and III were included and randomized into group A (SRP + diode laser), group B (SRP + doxycycline), and group C (SRP alone). Selected sites were assessed for clinical and microbial parameters-plaque index (PI), gingival index (GI), pocket probing depth (PPD), relative attachment level (RAL), and colony-forming units (CFUs). Every clinical parameter was noted at baseline and after three months. The arithmetic mean, followed by the standard deviation, was calculated for the required assessment intervals. Analysis of variance (ANOVA) was used to compare all parameters between groups, and if the results of the ANOVA test were significant, post hoc analysis was performed. For intragroup comparison, student t-tests were performed. RESULTS: The clinical parameters significantly improved within three months for all groups. In terms of relative attachment level, a statistically significant difference (P < 0.001) was obtained at the three-month interval compared to the baseline value, with the most statistically significant difference seen in group A (3.36±0.50 to 0.64±0.50), followed by group B (3.18±0.40 to 2.18±0.40). The mean pocket probing depth observed at three months, compared to the baseline value, showed a statistically significant difference (P < 0.001) in group A (5.91±0.70 to 2.18±0.40) compared to group B (6.18±0.75 to 4.36±0.50), followed by group C (5.82±0.75 to 5.27±0.64). CONCLUSION: The use of diode laser-assisted pocket disinfection and systemic doxycycline, in addition to scaling and root planing, has proven to be efficient for treating periodontal pockets.

Safety and Efficacy of Plaque Removal Using Manual and Powered Toothbrush in Cerebral Palsy Children by Parents/Caregivers: A Randomized Control Crossover Trial.

Aim: The aim of our study was to check the safety and efficacy of plaque removal using manual and powered toothbrush in cerebral palsy children by parents/caregivers. Materials and methods: This was a single blinded, crossover randomized control trial conducted on 60 cerebral palsy children between the age of 6 to 14 years. They were randomly divided using a flip coin method into two groups: group A-manual toothbrush and group B-powered toothbrush. The plaque index (PI), gingival index (GI), and gingival abrasion (GA) score were measured at baseline, then at an interval of 3, 6, 9, and 12 weeks. This was followed by a crossover between two groups with a washout period of 1 week. Results: Both manual and powered toothbrush showed a significant reduction in plaque and gingival score before and after crossover when compared to baseline (p < 0.05). The GA score was reduced to 100% in both groups. However, there was no statistically significant difference between both the groups before and after the crossover. Also, through the questionnaire it was observed that both child (86.6%) and parent (70%) showed positive feedback towards powered toothbrush. Conclusion: It can be concluded from the present study that the efficacy of a powered toothbrush is comparable to that of a manual toothbrush. Parents and caregivers, on the contrary, displayed a favorable attitude towards the use of powered toothbrushes due to their ease of use. Clinical relevance: Cerebral palsy is one of the most common neurological disorders among children. It is associated with poor motor skills and manual dexterity that hampers their ability to brush and thus leads to poor oral hygiene. A powered toothbrush seems more appealing and is specially designed for patients with poor neuromotor coordination. How to cite this article: Deshpande AN, Naik K, Deshpande N, et al. Safety and Efficacy of Plaque Removal using Manual and Powered Toothbrush in Cerebral Palsy Children by Parents/Caregivers: A Randomized Control Crossover Trial. Int J Clin Pediatr Dent 2023;16(2):344-349.

ISP Good Clinical Practice Recommendations for the management of Dentin Hypersensitivity.

Dentin hypersensitivity (DH) is a rising concern in clinical dentistry that causes pain and discomfort and negatively affects the quality of life of patients. Indian Society of Periodontology conducted a nationwide survey, involving 3000 dentists in December 2020, which revealed significant knowledge gaps regarding DH, viz., under-diagnosis, incorrect differential diagnosis, and treatment strategies/recommendations for the management of DH patients in daily clinical practice. The current paper has been envisioned and conceptualized to update the practicing Indian dentists regarding the so-called enigma of dentistry "Dentin Hypersensitivity," based on the best available contemporary evidence. An expert panel was constituted comprising 30 subject experts from across the country, which after extensive literature review and group discussions formulated these recommendations. The panel advocated routine screening of all dentate patients for exposed dentin areas and DH to avoid under-diagnosis of the condition and suggested an early preventive management. Consensus guidelines/recommendations for the use of desensitizing agents (DAs) at home, including the use of herbal agents, are also provided within the backdrop of the Indian context. The guidelines recommend that active management of DH shall be accomplished by a combination of at home and in-office therapies, starting with the simplest and cost-effective home use of desensitizing toothpastes. A diagnostic decision tree and a flowchart for application in daily practice are designed to manage the patients suffering from DH or presenting with exposed dentin areas in dentition. Various treatment methods to manage DH have been discussed in the paper, including the insights from previously published treatment guidelines. Further, a novel system of classification of DH patients based on specific case definitions has been developed for the first time. Explicit charts regarding the available treatment options and the chronology of institution of the agent, for the management in different case categories of DH, have been provided for quick reference. The management strategy takes into account a decision algorithm based on hierarchy of complexity of treatment options and intends to improve the quality of life of the patient by long-term maintenance with an innovatively defined triple C's or 3Cs approach.

Effect of green tea, ginger plus green tea, and chlorhexidine mouthwash on plaque-induced gingivitis: A randomized clinical trial.

BACKGROUND: Dental plaque, a microbial biofilm, is the primary etiological factor leading to the initiation of gingivitis and dental caries. It is therefore important to prevent it by taking effective plaque control measures. This research aimed at comparing the anti-plaque and anti-gingivitis effects of green tea (GT), GT plus ginger (GT + G), and chlorhexidine mouthwash (CHX) in children. MATERIALS AND METHODS: This was a randomized clinical trial, with a sample size of 60 children between the age group of 10-14 years with plaque and gingivitis. They were randomly allocated in three different groups, depending upon the mouthwash used: Group A (GT mouthwash), Group B (GT plus ginger mouthwash), and Group C (CHX mouthwash). Plaque index and gingival index were recorded at baseline, then at interval of 15 days and 30 days after using mouthwash. RESULTS: The mean gingival score and plaque showed a significant reduction from the baseline among all the three groups when compared with subsequent recall visits (15 days after using mouth-rinse and 30 days after using mouthwash) with P < 0.05. CONCLUSION: It can be concluded that the results of all three groups are comparable and hence herbal mouthwash can be used effectively as an alternative to CHX and as an adjunct to mechanical plaque control.

Comparative evaluation of human chorion membrane and platelet-rich fibrin membrane with coronally advanced flap in treatment of Miller's class I and II recession defects: A randomized controlled study.

BACKGROUND: Root coverage procedures have gained much popularity in recent years, due to increasing esthetic demands of patients. Coronally advanced flap (CAF) is a predictable technique for treating gingival recessions. Platelet-rich fibrin (PRF), an autologous platelet concentrate, has properties to enhance soft-tissue wound healing. A current method in dentistry is the use of human chorion membrane, a placental derivative, having biologic properties that help in healing and regeneration. Thus, the aim of the study was evaluation and comparison of the efficacy of chorion membrane and PRF membrane in the treatment of Miller's Class I and Class II recession defects. MATERIALS AND METHODS: This was a randomized controlled clinical study. Totally 30 sites with Miller's Class I and Class II recession were taken and randomly allocated to chorion membrane (test) PRF membrane (control) group. The clinical parameters recorded were clinical attachment level (CAL), recession height (REC-HT), recession width (REC-WD), width of keratinized gingiva (WKG) and gingival tissue thickness (GTH). RESULTS: Significant differences were seen from baseline to 6 months in test group regarding gain in CAL (P < 0.001), reduction in REC-HT (P < 0.001), decrease in REC-WD (P = 0.02), increase in WKG (P < 0.001), and increase in GTH (P < 0.001). In the control group also, significant difference was noted at the end of 6 months i regarding gain in CAL (P < 0.001), reduction in REC-HT (P < 0.001), decrease in REC-WD (P = 0.029), increase in WKG (P < 0.001), and increase in GTH (P < 0.001). Intergroup analysis showed significant differences between test and control groups at the end of 6 months, with CAL, REC-HT, WKG, and GTH showing statistically significant differences with P = 0.002, 0.001, 0.001, and 0.026, respectively. No significant difference was seen regarding REC-WD (P = 0.39). CONCLUSIONS: Both are effective materials in root coverage, but chorion membrane showed better and more stable results at the end of 6 months as compared to PRF membrane in treating gingival recession.

Comparative evaluation of platelet-rich fibrin membrane and collagen membrane along with demineralized freeze-dried bone allograft in Grade II furcation defects: A randomized controlled study.

BACKGROUND: The management of the furcation areas in multirooted teeth is often challenging due to difficulty in access. Platelet-rich fibrin (PRF), a second-generation platelet concentrate, has shown to accelerate the healing of soft and hard tissues. This study was designed to evaluate the efficacy of autologous PRF as a membrane in treatment of Grade II furcation defects in molars as compared to collagen membrane along with demineralized freeze-dried bone allograft in both the groups. MATERIALS AND METHODS: A split-mouth study was planned with 18 patients having 2 sites of Grade II furcation defects each. Random allocation of the defect site was done for the test and control group. Plaque index, probing depth (PD), relative vertical clinical attachment level (RVCAL), gingival marginal level, and radiographic bone levels were recorded at baseline, 3 months, and 6 months postoperatively. RESULTS: Both the groups showed statistically significant outcomes in intragroup comparison from baseline to 3 and 6 months. However, there was no statistical difference between PRF membrane and collagen membrane groups on intergroup comparison. CONCLUSION: There was a significant reduction of PD, improvement in RVCAL, and defect fill with autogenous PRF as membrane. This indicates its role as a regenerative material in treating furcation defects, which can be used as alternative to other expensive membranes.

A Comparative Scanning Electron Microscopic Analysis of the Effect of QMix® and SofScale™ as an Adjunct to Scaling and Root Planing on Periodontally Compromised Root Surfaces: An In vitro Study.

AIM: This study aimed to comparatively analyze, under scanning electron microscope (SEM), the effect of the use of QMix® and SofScale™ as an adjunct to scaling and root planing (SRP) on periodontally compromised root surfaces. SETTINGS AND DESIGN: This study was carried out in K. M. Shah Dental College and Hospital, Vadodara. METHODOLOGY: This was a single-blinded in vitro study which compared QMix® and SofScale™ as an adjunct to SRP on periodontally compromised root surfaces under SEM. STATISTICAL ANALYSIS USED: Statistical analysis was done using a nonparametric Mann-Whitney U-test to test the null hypothesis that there is no difference between the test and control groups. RESULTS: The sum of ranks for QMix® was 306.50 and the sum of ranks for SofScale™ was 513.50. The group which was treated with QMix® showed statistically significant results (P = 0.004) as compared to group which was treated with SofScale™. CONCLUSION: Comparative analysis showed that QMix® had significantly better smear layer removal ability as compared to SofScale™. However, uniform root surface was achieved with both QMix® and SofScale™.

Comparative Evaluation of Gingival Depigmentation by Tetrafluroethane Cryosurgery and Surgical Scalpel Technique. A Randomized Clinical Study.

INTRODUCTION: Importance of good smile cannot be underestimated in enhancement of beauty, self-confidence and personality of a person. Health and appearance of gingiva is an essential part of attractive smile. Gingival pigmentation gives rise to unesthetic smile line. In present world, with increasing awareness to esthetic, people have become highly concerned about black gums. Various treatment modalities like abrasion, scrapping, scalpel technique, cryosurgery, electrosurgery and laser are available for treatment of gingival pigmentation. The present study was conducted with an objective of comparing efficacy of gingival depigmentation by cryosurgery and scalpel technique. METHOD: A Randomized control split mouth study was conducted for 25 patients with gingival pigmentation. Gingival pigmentation Index (GPI) for pigmentation and Visual Analoug Scale (VAS) for pain was evaluated for both test (Cryosurgery) and control sites (Scalpel technique) at baseline, 1month, 3months and 6 months. RESULTS: GPI score was 3 and 2 for 21/25 and 4/25 control sites and was 22/25 and 3/25 test sites respectively at baseline. Both the groups showed significant reduction in GPI score i.e., 0 at 1 and 3 months interval after treatment. GPI score increased to 1 for 5/25 sites treated with scalpel technique and 2/25 sites treated with cryosurgery at 6 months interval (P =0.0691). This indicates recurrence rate for pigmentation is higher after scalpel treatment. VAS Score was 3 for 10/25 sites treated with scalpel and was 2 for 12/25 sites treated with cryosurgery (P <0.001). CONCLUSION: It can be concluded that cryosurgery can be effectively and efficiently used for depigmentation by keeping patients acceptance and comfort in mind and also the long term results and ease of use when compared to scalpel technique.

Obesity and oral health - Is there a link? An observational study.

INTRODUCTION: Periodontitis is defined as a destructive inflammatory disease involving the supporting tissues of the teeth due to specific microorganisms which results in a progressive destruction of supporting structures of the periodontium. Obesity is excessive body fat in proportion to lean body mass, to such an extent that health is impaired. Obesity, a serious public health problem, relates to a chronic low-grade systemic inflammation and is involved in the development of obesity-linked disorders including insulin resistance, type 2 diabetes, cardiovascular diseases, dyslipidemia, and metabolic syndrome. The accurate process whereby obesity can affect periodontal health is so far unclear. The aim of the present study was to evaluate the association between obesity (using body mass index [BMI] and waist circumference [WC]) and periodontal health and disease using various periodontal parameters. MATERIALS AND METHODS: A total of 100 participants were randomly taken and were divided into two groups (fifty participants per group). The participants with BMI more than 30 were considered as obese and participants with BMI <30 were considered nonobese. WC was also measured. Gingival index (GI), pocket probing depth (PPD), gingival recession (REC), and clinical attachment level (CAL) were measured by a single examiner. RESULTS: Independent t-test was performed to compare GI, probing depth, gingival recession, and clinical attachment level among obese and nonobese participants. The prevalence of periodontitis was significantly more in obese as compared to nonobese group (P < 0.05 for GI, P < 0.05 for PPD, and P < 0.031 for CAL). CONCLUSION: Strong correlation was found to exist between obesity and periodontitis. Obese participants could be at a greater risk of developing periodontal disease.

Comparative evaluation of oral hygiene status and gingival enlargement among epileptic and healthy children as related to various antiepileptic drugs.

BACKGROUND: Epilepsy is a gathering of neurological disorders characterized by epileptic seizures. Epileptic children, who are on active treatment with antiepileptic drugs, have a well-recognized side effect of gingival enlargement. Therefore, all efforts should be made, particularly for the population who are diagnosed or affected by the systemic disease. This study was conducted with an aim to determine oral hygiene status and gingival enlargement among epileptic and healthy children as related to various antiepileptic drugs. MATERIALS AND METHODS: The cross-sectional observational study was conducted in the department of pedodontics and attached general hospital. A sample size of 120 participants with 60 healthy and 60 epileptic children between age 2 and 14 years were included. Oral health status of participants was examined using oral hygiene simplified index and plaque index. Gingival enlargement was assessed using Miranda-Brunet index. For statistical analysis, one-way ANOVA test, independent t-test, and Pearson's Chi-square test were used. RESULTS: From the total participants included in the study, 49% of participants had good oral hygiene from healthy group, and 28% participants had poor oral hygiene from the epileptic group. Sodium valproate was the most common drug used and was associated with increased gingival enlargement. CONCLUSION: Conclusion can be drawn that epileptic children under medication had poor oral hygiene and an increased risk for gingival enlargement as compared to their healthy counterparts. It must be stressed that the epileptic patients should be given dental care without conditions and provided with best possible care to restore esthetics and functions.

A comparative evaluation of extraction socket preservation with demineralized freeze-dried bone allograft alone and along with platelet-rich fibrin: A clinical and radiographic study.

AIMS: To investigate clinically and radiographically, the bone fill in extraction sockets using demineralized freeze-dried bone allograft alone and along with platelet-rich fibrin (PRF). MATERIALS AND METHODS: A randomized controlled clinical trial was carried out on 36 nonrestorable single-rooted teeth sites. Sites were randomized into demineralized freeze-dried bone allograft (DFDBA) combined with PRF - test and DFDBA - control groups using a coin toss method. After the placement of graft material, collagen membrane was used to cover it. The clinical parameters recorded were ridge width and ridge height. All the parameters were recorded at baseline and at 90 and 180 days. STATISTICAL ANALYSIS USED: Independent t-test and paired t-test. RESULTS: In both groups, there is significant reduction in loss of ridge width and ridge height from baseline to 90 days (P < 0.001), baseline to 180 days (P < 0.001), and 90-180 days (P < 0.001). However, when both the groups were compared the test group favored in the reduction of ridge width while there was no statistical difference in reduction of ridge height among at different intervals. CONCLUSIONS: Although DFDBA is considered as an ideal graft material, PRF can be used as an adjunctive with DFDBA for socket preservation.

Timeline of History of Hypertension Treatment.

It is surprising that only about 50 years ago hypertension was considered an essential malady and not a treatable condition. Introduction of thiazide diuretics in late 50s made some headway in successful treatment of hypertension and ambitious multicenter VA co-operative study (phase 1 and 2) started in 1964 for diastolic hypertension ranging between 90 and 129 mmHg and completed by 1971 established for the first time that treating diastolic hypertension reduced CV events such as stroke and heart failure and improved mortality. In the following decade, these results were confirmed for the wider US and non-US population, including women and goal-oriented BP treatment to diastolic 90 became the standard therapy recommendation. But isolated systolic hypertension (accounting for two-thirds of the 70 million hypertensive population in USA alone) was not considered treatable until 1991 when SHEP study (systolic hypertension in elderly program) was completed and showed tremendous benefits of treating systolic BP over 160 mmHg using only a simple regimen using small dose chlorthalidone with addition of atenolol if needed. In the next two decades, ALLHAT and other studies examined the comparability of outcomes with use of different classes and combinations of antihypertensive drugs. Although diastolic BP goal was established as 90 in the late 70s and later confirmed by HOT study, the goal BP for systolic hypertension was not settled until very recently with completion of SPRINT study. ACCORD study showed no significant difference in outcome with sys 140 vs. 120 in diabetics. But recently completed SPRINT study with somewhat similar protocol as in ACCORD but in non-diabetic showed almost one-quarter reduction in all-cause mortality and one-third reduction of CV events with systolic BP goal 120.

Translation and validation of Hindi version of Oral Health Impact Profile-14.

TITLE OF THE STUDY: Validation of Hindi Version of Oral health Impact Profile (OHIP-14). AIM: To validate the Hindi version of OHIP-14. SETTINGS AND DESIGN: The study was carried out in K.M. Shah Dental College & Hospital, Vadodara. MATERIALS AND METHODS: OHIP-14 was translated into Hindi language.102 participants were given English as well as Hindi versions of OHIP-14. STATISTICAL ANALYSIS USED: Individual question were analyzed using Pearson Chi-Square test, Likelihood Ratio test and Linear-by-Linear Association test. The entire questionnaire in English and Hindi language were comparatively analyzed using Unpaired T test & Pearson correlation coefficient test. RESULTS: All the 14 questions showed no statistically significant difference between the English OHIP-14 and the translated Hindi version of OHIP-14. Results of Unpaired T test (P = 0.61) were statistically insignificant. Pearson Correlation coefficient test was 0.963 suggesting that the translated Hindi version was highly correlated to the original English version. CONCLUSION: The translated Hindi version of OHIP-14 is hence established as a valid tool for conduction of oral health related & quality of life surveys in Hindi language which is the most commonly used language in the Indian subcontinent.

Role of psychotherapy in managing a case of generalised aggressive periodontitis.

Generalised aggressive periodontitis is characterised by "generalized interproximal attachment loss affecting at least three permanent teeth other than first molars and incisors." The management of generalised aggressive periodontitis is challenging as it involves an interdisciplinary approach. When the patient presents himself late to the clinician, the tooth and bone loss can be up to 60%. Natural teeth and alveolar bone contribute to the contour and aesthetics of the face. Loss of teeth in younger age may lead to attitude, behaviour changes and may cause psychological depression and withdrawal from society. The main distinguishing feature of this case report is the psychological counselling provided along with periodontal and prosthetic treatment.

Effectiveness of autologous platelet-rich fibrin in the treatment of intra-bony defects: A systematic review and meta-analysis.

The aim of the present meta-analysis is to determine the clinical and radiographic outcomes of using platelet-rich fibrin (PRF) for the treatment of periodontal intra-bony defect (IBD) compared with open flap debridement (OFD). MEDLINE/PubMed, EBSCO and Cochrane database were used to identify studies in English language published from January 1, 2005 to January 31, 2013. An additional hand search of the relevant journals and of the bibliographies of the paper identified was also performed. Articles retrieved were screened using specific inclusion criteria by five independent reviewers: Studies investigating the effect of platelet concentrate in surgical procedure for the treatment of periodontal intra osseous defects compared with the control group in which platelet concentrate was not used were included. Five relevant articles were selected for the meta-analysis of which 3 articles were retrieved after electronic search and two articles were included after hand search. The number of patients in studies ranged from 15 to 62 (32-90 sites) with mean age ranging from 29.47 to 39.7. A total of 298 sites were treated using PRF either in combination with graft or as a monotherapy in comparison to traditional OFD procedure. The meta-analysis showed a standard mean difference of 0.95 mm; 95% confidence interval (CI): 0.20-1.71 in clinical attachment level (CAL) and 2.33 mm; 95% CI: 1.43-3.23 in IBD after treatment of IBD with PRF compared with OFD. The meta-analysis showed clinically significant improvements in periodontal parameters such as CAL, IBD, and reduction in probing depth when IBDs were treated with PRF alone when compared to OFD.

Low resource screening method of pre-cancerous lesions and its reversal by Triphala in teen-age Indian population.

BACKGROUND: Cancer screening is the main weapon for early detection at a pre-invasive or premalignant stage. It has been reported that over 12 million people use some form of tobacco, which is one of the high risk factors and has hence become an alarming world-wide problem. AIM: To evaluate the effective diagnostic screening of disease in its early stage by inexpensive method and also to evaluate the effect of indigenous mouthrinse on reversal of pre-cancerous lesions. MATERIALS AND METHODS: The screening for teenagers belonging to low socio-economic status was carried out. Suspected subjects were evaluated for the reversal of the lesions by use of Ayurvedic preparation as a mouthwash. From 13 to19 years working-child population of North India was selected for the study. Screening was performed by new method-visual inspection with acetic acid. The positive subjects were further investigated by pap smear and biopsy was done as a confirmatory histopathological report. In second phase, the subjects showing positive lesions were advised indigenous anti-cancer mouth rinse and its effect was evaluated after 6 month and 9 month of prescribing the rinse. RESULTS: The total 1095 children were screened (831 boys and 264 girls). Out of total 34 teenager boys were diagnosed, as acetowhite positive lesion. All the acetowhite positive lesions were found exclusively in males. Histological findings after 9 month use of Triphala mouth rinse revealed no changes in cells in 23 (85.2%), hyperkeratinization in 2 (7.4%), hyperkeratinization and spongiosis was evident in 1 (3.7%), mild pleomorphism in 1 (3.7%) patient. Comparative evaluation from 0-9 month showed statistically highly significant test (P < 0.01). CONCLUSION: Use of different forms of tobacco and betel nut showed convincing relationship between developments of oral pre-cancerous lesions. Triphala was found to have great potential for reversal of these lesions.

Randomized, controlled clinical study to evaluate efficacy of novel indigenously designed controlled release flurbiprofen gel system for management of periodontal diseases.

BACKGROUND: This randomized, controlled clinical study was planned to evaluate the use of anti-inflammatory drug flurbiprofen in the form of locally delivered controlled release gel in the treatment of periodontal disease. MATERIALS AND METHODS: The flurbiprofen gel was indigenously prepared in the concentration of 0.3%. The 30 patients with localized periodontal pockets measuring ≥5 mm were randomly divided into three groups. The groups received flurbiprofen gel, flurbiprofen gel after prophylaxis, and placebo gel after oral prophylaxis, respectively. The clinical parameters for plaque and gingival inflammation were evaluated at baseline, 7(th) day, and 14(th) day. RESULTS: The results of the study suggested the statistically significant (P < 0.05) improvement in the gingival status of the patients with the use of flurbiprofen gel as an adjunct to scaling and root planing as compared to oral prophylaxis or gel alone. CONCLUSION: The data demonstrated that the additional use of local drug delivery of flurbiprofen through gel media enhances the positive effects of scaling and root planing and helps in faster resolution of the inflammation.

Management of impacted dilacerated maxillary central incisor: A clinical case report.

The impacted maxillary incisor is detrimental for problems related to esthetics and occlusion in permanent dentition stage. A case with an unerupted maxillary central incisor was diagnosed radiographically with impacted dilacerated maxillary central incisor. The management of the case was carried out surgically and orthodontically. By combining two stages of surgical exposure, orthodontic traction and alignment, the impacted dilacerated incisor was successfully moved into desired position. A two-year follow-up of the stability and periodontal health showed that the tooth placed in the occlusion maintained both esthetics and function.

Alliance of oral hygiene practices and abrasion among urban and rural residents of Central India.

OBJECTIVES: To attain alliance between the oral hygiene practices with prevalence of tooth abrasion among urban and rural adult population of Central India. To plan dental care services in inaccessible areas and to suggest appropriate remedial measures to prevent this avertable and self-inflicted injury of teeth in this cross-sectional study. MATERIALS AND METHODS: A sum of 1045 adult residents both from Urban (529) and rural (516) parts of Bhopal district (Central India) was selected on a random basis. The multistage sampling technique was adopted to ascertain the sample size. In urban area the study population consisted of 240 males, 289 females and 201 males and 315 females in rural area respectively. All residents above 18 years of age from the Bhopal district were included in cross-sectional study. Assessment form comprises of questionnaire and general information on oral hygiene practices, dietary habits and medical history. Abrasion was assessed using diagnostic criteria recommended by Smith and Knight (modified). Chi- square test was used to test associations between categorical variables at 5% level of significance. Regression analysis attempted to define for risk factors causing abrasion. Literature on the prevalence of abrasion is very sparse, so attempt is made to correlate the etiological factors and recommend to prevent tooth wear. RESULTS: Investigation of this cross-sectional study was aggregate of 1045 residences. Result shows high prevalence of abrasion 70.2%. Higher prevalence concomitant with diffident habits related to oral hygiene maintenance was recorded more among rural (76.9%) when compared to urban dwellers (63.7%). Presence of abrasion verifies statistical significance in relation to age, rural urban difference and variations in habit of oral hygiene care. Stated in the present study, avertable and self-inflicted is tooth abrasion, recurrently resulted by the reprehensible brushing method and common use of indigenous material for the maintenance of oral hygiene. CONCLUSION: Shows significant liaisons with the presence of abrasions in relation to Urban and rural dwelling, age, material used and mode of brushing and duration of brushing. Indigenous and course material causes high amount of enamel wear and with the advancement in age abrasion tend to increase. Prevalence of abrasion does not show any gender predilection. Cultural believes, lifestyle and transition reflects in deviating presence of abrasion in populations.