Six-month follow-up of salivary antioxidant defense outcomes of individuals using medicated toothpaste.

Objective: The objective of this study was to study the effect of medicated toothpaste on oral health, a 6-month follow-up. Methods: Four hundred and twenty-seven participants were screened and followed up for 6 months. The intraoral examination was performed to record caries, gingival bleeding, and plaque index. Saliva collected was evaluated for pH, total antioxidant capacity (TAC), malondialdehyde (MDA), and Vitamin C level for 6 months, and data were analyzed. Results: On the usage of medicated toothpaste with herbal extract for 6 months, the salivary pH levels were increased, the interquartile range for plaque, and the gingival bleeding index decreased. The percentage change in salivary TAC, MDA, and Vitamin C levels in the caries-free group of subgroup I was 174.8, 58.06, and 59.98, respectively, in subgroup II was 133.3, 52.08, and 58.51, and in subgroup III was 63.77, 45.11, and 47.77. The percentage change in salivary TAC, MDA, and Vitamin C levels in the caries-active group of subgroup I was 136.62, 57.27, and 72.83, subgroup II was 108.59, 37.50, and 61.55, and in subgroup III was 35.62, 30.82, and 54.10, respectively. Conclusion: The salivary pH levels increased on the usage of medicated toothpaste with herbal extract; plaque and the gingival bleeding index scores were decreased. The salivary antioxidant defense was increased in individuals using medicated toothpaste with herbal extracts which signifies an improvement in overall oral health in the 6-month follow-up.

Dental practice management during COVID-19 times-Now and beyond.

AIM: Coronavirus disease 2019 (COVID-19) being declared a global public health emergency has become a significant challenge for all healthcare workers, including dentistry, recognised as a high-risk profession during these times. This consensus statement aims to highlight and provide guidelines necessary to be implemented for a clinical dental practice. MATERIALS AND METHODS: A total of nine conservative Dentists and Endodontists and one Oral and Maxillofacial Surgeon; with four panelists from government dental colleges, one each from the North, South, East and West India and six resource persons from private colleges in South India, all of them being clinicians and administrators practicing dentistry since the inception of the pandemic, collaborated in this consensus statement. The consensus statement was developed through a symposium conducted on the topics; general dental practice during COVID-19 times, the importance of aerosols in clinical dental practice in the spread of COVID-19, effective standard operating protocols for clinical dental practice and Institutional settings with scientific evidence-based justifications, followed by a panel discussion with to devise mandatory protocols to be followed in clinical and institutional settings. The symposium was attended by 46 practitioners who participated in the deliberation. RESULTS: This consensus statement provides clinicians and researchers with protocols for the dental practice, agreed upon by experts in the field. The Consensus Statement has been formulated according to the AGREE Reporting checklist for the formulation of guidelines. CONCLUSION: The experts and panelists reached a Consensus on the protocols and guidelines for the safe clinical and institutional dental practice.

Comparative analysis of bond strength and microleakage of newer generation bonding agents to enamel and dentin: An in vitro study.

AIMS: This study aims to evaluate the bond strength (BS) and microleakage (ML) of the newer bonding agents to enamel and dentin. OBJECTIVE: (1) To analyze the BS between self-etch and total-etch adhesives. (2) To analyze the depth of ML between self-etch and total-etch adhesives. MATERIALS AND METHODS: Sixty mandibular premolars were fabricated and randomly divided into three groups: Group I (n = 20)-bonded with self-etch adhesive + nanohybrid, Group II (n = 20) with total-etch adhesive + micro hybrid and Group III (n = 20) with total-etch adhesive + nanocomposite. Teflon ring molds were used to make composite resin cylinders bonded to the buccal surface. Class II box cavity was prepared on the samples' proximal surface and condensed with composite resin with each group's specific bonding protocol. Shear BS and ML testing were conducted, and data analyzed. STATISTICAL ANALYSIS: Kruskal-Wallis analysis was done to statistically differentiate the BS and ML between the three experimental groups; the P < 0.05, it showed a statistically significant difference. Intergroup comparison was made using the Mann-Whitney U test. CONCLUSIONS: Within this study's limitation, resin bonded with self-etch G-Premio Bond used in selective etch technique showed the highest BS and resistance to ML.

Protection of wear resistance behaviour of enamel against electron beam irradiation.

INTRODUCTION: Irradiation is known to cause oxidation process among the tissue-altering the properties of teeth leading to tissue necrosis and caries formation. Hence protection of the oral cavity is a major concern to deal with therapy side effects. AIM: Evaluation of wear resistance property of Enamel against electron beam radiation and analysing the radio protective effects of natural organic compounds. MATERIALS AND METHODS: Total of 36 healthy extracted human molar teeth were collected, four samples were used as control, and remaining 32 were divided into four groups (N = 8 each): radiation control group and three groups treated with organic compounds during radiation treatment. The enamel samples were tested for FTIR spectroscopy, XRD analysis, SEM and EDAX analysis before and after 70 Gy radiation treatment. RESULTS AND DISCUSSION: The particle size of radiation control samples had increased showing decrease in its crystallinity index. Calcium to Phosphorous ratio had also decreased along with structural changes as observed by SEM analysis. But groups treated with organic compounds has maintained tooth integrity in comparable to control groups after radiation treatment. CONCLUSION: Virgin coconut oil, vitamin E oil and curcumin has potential radioprotective action against radiation in protecting tissue properties. Hence, with further advanced research, these natural substances should emerge as a topical applicator during radiotherapy to oral cancer patients.

Saliva as a biomarker for dental caries: A systematic review.

AIM: The aim of the present review article is to establish a systematic review to describe the role of various salivary components such as pH, buffering capacity, proteins, electrolyte, antioxidant, enzymes, and minerals in occurrence and initiation of dental caries in participants with and without dental caries. METHODOLOGY: An electronic search was conducted in the PubMed, Scopus, Web of Science, and Google Scholar databases. The MESH terms (Medical Subject Headings) were "dental caries susceptibility," "caries risk assessment, "Salivary Biomarker," "saliva," "Proteins," "electrolytes," "biomarker," "Anti-oxidant's." The database search was limited to the studies published between 2008 and 2018 and only human studies were included. Furthermore, the STROBE criteria checklist was used to analyze the studies which had to be included in the systematic review. RESULTS: A total of 150 articles were retrieved through electronic database. After evaluating the title, abstract, and full text of these articles, only 11 were selected for the present systematic review. However, two articles were excluded because they were classified as high risk of bias according to the STROBE criteria. Out of 9 studies selected, 5 were classified as low-risk bias and 4 were classified as moderate-risk bias. CONCLUSION: Based on the results of the systematic review, out of 11 studies, 7 found to have a statistically significant difference between individuals with and without caries experience. Hence, it can be concluded that there is an association between various components of saliva and dental caries.

Clinical protocols in dental practice: Post-COVID-19.

The COVID-19 pandemic, still on the growth curve, has had a devastating effect on the dental health sector for the past 3 months. This has become an area of enormous concern for the dentists professionally and the patients in terms of dental health. Dentistry at this point needs a complete structural change to prevent cross-infection among the patients and dentists owing to the unique characteristic of a dental health-care setting as well as to offer a sense of safety and security to the patients. This article highlights the salient points to be considered for the post-COVID phase in dentistry.

Postsurgical consequences in lower third molar surgical extraction using micromotor and piezosurgery.

BACKGROUND: One of the most critical and crucial steps in surgical extraction is cutting the bone or osteotomy, for which many techniques are used, e.g., chisels and mallet, rotary instruments, and ultrasound bone-cutting instruments. If they are not used judiciously, they can be hazardous. OBJECTIVES: To assess the efficiency of piezosurgery unit over micromotor while performing surgical extraction of lower third molars by assessing the time taken for the surgery and measuring postoperative parameters such as pain, trismus, and swelling. MATERIALS AND METHODS: Thirty patients having bilateral impacted third molars with the same difficulty index were selected for the study. One side surgical removal was done using micromotor and other side by piezosurgery with an interval of 15 days. After each surgery, time taken to finish was measured and patients were followed up on postoperative days 1, 3, 5, 7, and 15 for assessing pain, trismus, and swelling. Data obtained were statistically analyzed. RESULTS: The mean time taken for the micromotor group is 37.90 min whereas by the piezosurgery group is 54.63 min, showing a statistically significant difference (P < 0.001). Furthermore, there is statistically significant difference (P < 0.001) in the level of pain, trismus, and swelling on postoperative days 1, 3, 5, and 7. Even the intragroup comparison of piezosurgical group for trismus and swelling showed no statistically significant difference on postoperative day 7, indicating faster recovery of trismus and swelling. On postoperative day 15, there was no difference in any parameter in both groups indicating complete symptom-free recovery in both groups. CONCLUSION: It takes more time to perform surgical extraction of third molars when piezosurgical unit is used. Despite that, it causes less pain postoperatively with faster improvement in trismus and quicker reduction in swelling.

Evaluation of total antioxidant capacity of saliva and serum in caries-free and caries-active adults: an in-vivo study.

CONTEXT: Oxidative stress is defined as an imbalance between the production of reactive oxygen species and antioxidant defense systems which are widely recognized as an important feature of many diseases including dental caries, suggesting that total antioxidant status may be of importance in determining the progression of caries. AIM: The aim of this study was to estimate the total antioxidant capacity (TAC) in saliva and serum of caries-free and caries-active adults and to correlate the TAC level with DMFT index (D = decayed, M = missing, F = filled, T = teeth). SETTINGS AND DESIGN: The present study included 100 healthy adults who were divided into four groups: Control, group I, group II, and group III, with a DMFT index 0, <3, <10, and >10, respectively. MATERIALS AND METHODS: Saliva and serum samples were collected from all the four groups. The TAC of saliva and serum was estimated by phosphomolybdenum method. STATISTICAL ANALYSIS USED: One-way analysis of variance (ANOVA) was used to compare the TAC of saliva and serum. Only differences with "P" < 0.05 were considered statistically significant. RESULTS: The mean TAC level of both saliva and serum increased significantly (P < 0.001) with the DMFT index. CONCLUSION: Total antioxidant capacity of saliva has a linear relation with caries, i.e., as the severity of caries increases, the TAC level also increases.

Spindle cell carcinoma in maxilla.

Spindle cell carcinomas (sarcomatoid carcinomas) are rare tumours. It is a variant of squamous cell carcinoma which has spindled tumour cells, which simulate a true sarcoma, but are epithelial in origin. They are extremely uncommon in the head and neck region. Only five cases with maxillary origin have been discussed in the literature. As compared to squamous cell carcinoma of maxilla, this variant is associated with poor diagnosis and advanced disease at presentation, as is demonstrated in the case presented. There are no standard recommendations for management owing to the rarity of this histology. Surgery and radiotherapy form the mainstays of treatment. We report a rare case of spindle cell carcinoma involving the maxilla.

Salivary pH and buffering capacity in early and late human immunodeficiency virus infection.

BACKGROUND: Human immunodeficiency virus (HIV) causes severe immunosuppression due to progressive decrease in the CD4 T lymphocyte cells during the course of the disease and this affects all the body systems including glandular secretions. A number of lesions affecting the salivary glands have been noted in HIV infection. The objective of this study was to evaluate the salivary pH and the buffering capacity in HIV positive individuals and comparing it with the HIV negative healthy individuals. MATERIALS AND METHODS: The study was carried out on 200 HIV positive subjects aged 20-40 years, divided into two groups on the basis of CD4 count and 100 HIV negative healthy individuals as control group. Both unstimulated and stimulated saliva were collected and the pH and buffering capacity ascertained using the saliva check kit. (GC Asia Dental Pvt. Ltd., Singapore, 508724). RESULTS: All the three groups were compared using the ANOVA and it was found there was highly significant decrease in pH and buffering capacity with increase in immunosuppression. The intergroup comparison was carried out using the Tukey honestly significant difference (HSD) and the Chi square test. Group 1; CD4 count <200 and Group 2, CD4 count >200 showed a significant decrease in unstimulated salivary flow, stimulated salivary flow, and pH in comparison to HIV negative individuals; however, change in buffering capacity in Group 2 was not significant. CONCLUSION: There is a decrease in pH and buffering capacity in HIV infected patients. This decrease may be one of the factors responsible for increased caries in HIV infected population.

The pattern of the maxillofacial fractures - A multicentre retrospective study.

Aim of the present study was to report on the survey of fractures, frequency of presentation, sex and age distributions, aetiology, site distributions, associated injuries & modalities of treatment rendered at muticentres treated by the division of oral and maxillofacial surgery between 2000 and 2005 in Karnataka state of India. Study revealed that the common cause for the facial fractures was found to be traffic accidents (72.7%) with a male preponderance and peak incidence during 20-30 years of age. Isolated mandibular fractures were most frequent [1035 patients (41.7%)] followed by isolated mid face fractures [526 patients (21.2%)]. Among mid face fractures, zygomatic bone and arch were most frequently involved. Open reduction and internal fixation and closed method were used in almost the same frequency. Traffic accidents are the leading cause of the maxillofacial fractures from the observation made from the study. Legislations preventive measures to be enforced and abided by every citizen.