Comparison of antifungal efficacy of ethanolic extracts of Woodfordia fruticosa leaf and Punica granatum peel in uncontrolled diabetic patients wearing removable dentures: A randomized controlled clinical trial.

BACKGROUND AND PURPOSE: The search for the development of a suitable novel antimicrobial agent for fungal diseases continues to be a key problem in the current clinical field. The present investigation was aimed to determine the antifungal effect of the ethanolic crude extracts of Woodfordia fruticosa leaf (Wfl) and Punica granatum peel (Pgp) in uncontrolled diabetic patients wearing removable dentures. MATERIALS AND METHODS: The ethanolic extracts of both plants were prepared using the soxhlet extraction method, and the obtained metabolites were confirmed by thin- layer chromatography. After the preparation of the mouthwash, a total of 100 subjects were randomly divided into two groups. Each subject was given physiological saline at the baseline. Group I was provided with P. granatum mouthwash, while Group II was given W. fruticosa mouthwash. Following the administration of the mouthwash, the patients were requested to rinse the mouthwash using the oral rinse technique twice daily 5 ml/rinse for 30 sec. Subsequently, colony-forming units (CFU) were evaluated in the participants. Post-therapeutic samples were collected 1 h and 1 week after the mouthwash use. RESULTS: The mean reduction of CFU was calculated at the baseline, as well as 1 h and 1 week after using mouthwash. The results indicated a drastic reduction in CFU 1 h and 1 week after the application of Wfl mouthwash. CONCLUSION: The obtained data revealed that Wfl had potential anticandidal activity against Candida yeast cells, probably owing to its bioactive compounds like glycosides. Therefore, this agent can be used effectively as a natural remedy for the treatment of oral candidiasis. However, the exact mechanism of action of this plant needs to be elucidated.

Estimation of changes in C-reactive protein level and pregnancy outcome after nonsurgical supportive periodontal therapy in women affected with periodontitis in a rural set up of India.

AIMS AND OBJECTIVES: Estimation of changes in C-reactive protein (CRP) level and pregnancy outcome after nonsurgical supportive periodontal therapy in pregnant women affected with Periodontitis. MATERIALS AND METHODS: A total of 100 pregnant females with periodontitis were assigned to treatment and control groups. All the details about previous and current pregnancies were obtained. Full-mouth periodontal examination was done at baseline, which included oral hygiene index simplified plaque index, gingival index, and clinical attachment loss. CRP level was also measured from collected blood sample initially at baseline and later after the delivery in both the group. Subjects in the treatment group received nonsurgical periodontal treatment during the second trimester of gestational period, and those in the control group did not receive any periodontal therapy during this period. Periodontal therapy included mechanical plaque control instructions and scaling and root planning. Outcome measures assessed were changes in CRP levels, gestational age, and birth weight of the infants. When delivery occurred at <37 weeks of gestation, it was considered as preterm birth (PTB), and low birth weight (LBW) was recorded when the infant weighed <2500 g. RESULTS: In the treatment group, 32% of PTB and 68% of Normal term birth (NTB) delivery whereas in the control group 72% PTB and 28% of NTB were recorded. Infants measured with LBW were 36% in the treatment group and 52% in the control group. Mean birth weight was 2644.44 ± 450.53 g in the treatment group and 2447.82 ± 368.02 g in the control group (P < 0.05). Mean gestational age in the treatment group was 35.57 ± 2.40 weeks and 34.17 ± 2.92 weeks in the control group (P < 0.05). The treatment group showed statistically significant reduction in mean values of CRP level after delivery in comparison to baseline values (P < 0.05), whereas control group showed no significant reduction in values (P > 0.05). CONCLUSION: Nonsurgical supportive periodontal therapy may lower the risk of preterm delivery in females affected with periodontitis by reducing CRP level.

Assessment of professional competency and need of smoking cessation counseling for dental students.

PURPOSE: The aim of this study was to analyze the smoking prevalence among dental students and to assess the need for promoting tobacco education and intervention by exploring their knowledge about smoking related risk factors. The study also examined the attitudes and practices of the students toward tobacco consumption, and their responsibilities toward the community. METHODS: In total, 53 male students participated in the study (21 juniors and 32 seniors). The training program was divided into three modules, and the questionnaire was administered before and after the counseling sessions, which provided the comparative data on the students' views about smoking cessation. RESULTS: The most commonly practiced mode of tobacco consumption was found to be cigarette smoking (90.6 %), while a few consumed Gutkha (9.4%). All the junior students (100%) reported to have been benefitted by the counseling program, while 68.8% of the students from the senior group reported the same. Bivariate statistical analysis was conducted using the Pearson's chi-square test for testing the difference across the age groups. P-values less than 0.05 were considered statistically significant. CONCLUSION: Curbing tobacco influence on dental students in their initial days can ensure a smoke-free life for them, as well as prevents them from feeling embarrassed or experiencing a lack of confidence while seeing their patients. Thus, tobacco education and intervention programs can motivate the students and increase their potential to be credible advisors regarding smoking cessation.

Is advertising by dental professionals having a negative impact on consumers?: the perspectives of Indian consumers.

Advertising by dentists is a controversial issue. Many feel that advertising is necessary for creating dental awareness, whereas, many others feel that it should be banned to keep intact the ethical aspect of the profession, which aims at serving the community. This study explores consumers' ideas about advertising. A total of 562 respondents from various parts of India participated in this study. The response rate was 46.83%. The data were analyzed by applying the chi-square test of association and the Z test of difference between two proportions at 5% and 1% level of significance (i.e., p<.05 and p<.01).

A Novel Surgical Pre-suturing Technique for the Management of Ankyloglossia.

Ankyloglossia or "tongue-tie" is a congenital anomaly caused by tight lingual frenulum that abnormally connects the tongue base to the floor of the mouth. Ankyloglossia can results in difficulty during speech and deglutition. This case series presents a novel surgical technique in the management of ankyloglossia in using presuturing technique in which different sets of sutures are given on lingual frenum before severing it. This results in reduced opening of the wound, minimal bleeding, pain and discomfort. Two male patients with severe ankyloglossia had been managed with this technique and after 2 years of follow-up of these cases showed satisfactory protrusive and lateral movement of the tongue with minimal scarring and discomfort.

A silent tumor of the gingiva: An unusual case report and surgical management with 1 year follow-up.

Neurofibroma is a benign tumor of the peripheral nerve sheath characterized by the proliferation of Schwann's cells, perineural cells, and endoneurial fibroblasts. Here, we present a case of unique variation in the observed characteristics of a neurofibroma, with no relation to neurofibromatosis (NF) type-1 or von Recklinghausen disease of the skin. A swelling was observed in the right maxillary gingiva in relation with 14-16 regions of a 25-year-old female patient. The lesion was smooth, with sessile base, painless, non-ulcerated, and with normal color. An excisional biopsy of the lesion was performed, and histologically the diagnosis was confirmed. The patient remains uneventful after 1 year of clinical follow-up. Oral cavity involvement by a solitary neurofibroma in patients with no other signs of NF is uncommon and the gingival involvement is very rare.

Correlation of mast cells in periodontal diseases.

BACKGROUND: Among the cells involved in immune and inflammatory responses in periodontal disease, mast cells have been shown to be capable of generating a large number of biologically active substances. Mast cells are mobile, bone-marrow-derived, granule-containing immune cells that are found in all connective tissue and mucosal environments and in the peripheral and central nervous systems. Mast cells are able to phagocytose, process and present antigens as effectively as macrophages. The present study was undertaken to quantify the mast cells in health and disease, whether they correlate degree of inflammation and clinical features of periodontium. MATERIALS AND METHODS: Ten cases of localized chronic periodontitis (CP), 10 cases of dental plaque-induced gingivitis (DPIG) and 10 cases of clinically healthy gingival tissues were selected. Samples were obtained from patients undergoing for periodontal surgery in CP and DPIG. In health group third molar impacted and covered with operculum without any inflammation were selected. Sample fixed in 10% buffered formalin and stained with Toludine blue stain and observed under binocular microscope. CONCLUSION: In human periodontal disease there is an increase in the number of mast cells that may be participating either in the destructive events or in the defense mechanism of periodontal disease via secretion of cytokines.

Evaluation of Calendula officinalis as an anti-plaque and anti-gingivitis agent.

BACKGROUND: Calendula officinalis (C. officinalis), commonly known as pot marigold, is a medicinal herb with excellent antimicrobial, wound healing, and anti-inflammatory activity. AIM: To evaluate the efficacy of C. officinalis in reducing dental plaque and gingival inflammation. MATERIALS AND METHODS: Two hundred and forty patients within the age group of 20-40 years were enrolled in this study with their informed consent. Patients having gingivitis (probing depth (PD) ≤3 mm), with a complaint of bleeding gums were included in this study. Patients with periodontitis PD ≥ 4 mm, desquamative gingivitis, acute necrotizing ulcerative gingivitis (ANUG), smokers under antibiotic coverage, and any other history of systemic diseases or conditions, including pregnancy, were excluded from the study. The subjects were randomly assigned into two groups - test group (n = 120) and control group (n = 120). All the test group patients were advised to dilute 2 ml of tincture of calendula with 6 ml of distilled water and rinse their mouths once in the morning and once in the evening for six months. Similarly, the control group patients were advised to use 8 ml distilled water (placebo) as control mouthwash and rinse mouth twice daily for six months. Clinical parameters like the plaque index (PI), gingival index (GI), sulcus bleeding index (SBI), and oral hygiene index-simplified (OHI-S) were recorded at baseline (first visit), third month (second visit), and sixth month (third visit) by the same operator, to rule out variable results. During the second visit, after recording the clinical parameters, each patient was subjected to undergo a thorough scaling procedure. Patients were instructed to carry out regular routine oral hygiene maintenance without any reinforcement in it. RESULTS: In the absence of scaling (that is, between the first and second visit), the test group showed a statistically significant reduction in the scores of PI, GI, SBI (except OHI-S) (P < 0.05), whereas, the control group showed no reduction in scores when the baseline scores were compared with the third month scores. Also, when scaling was performed during the third month (second visit), there was statistically significant reduction in the scores of all parameters, when the third month scores were compared with the sixth month scores in both groups (P < 0.05), but the test group showed a significantly greater reduction in the PI, GI, SBI, and OHI-S scores compared to those of the control group. CONCLUSION: Within the limits of this study, it can be concluded that calendula mouthwash is effective in reducing dental plaque and gingivitis adjunctive to scaling.

Student apathy for classroom learning and need of repositioning in present andragogy in Indian dental schools.

BACKGROUND: In the world of technology, when today's student is approaching the on-line /distance learning in the open universities and doing on-line self-assessment, the classroom learning is vanishing slowly. Globally, teachers are taking efforts to improve the pedagogy by implementing effective methods to retain the classroom teaching and student attendance. The present study aims at shedding some light on the need of changing the adult education strategies (andragogy), which can effectively improve the student attendance for lectures. METHODS: It is an observational study, and the conceptual framework of it is based on beliefs, opinions and personal experiences of the respondents. Triangulation method is used for collecting the data. The data is achieved from three groups of concerned population who could provide valid results to support the study. It is collected by interviewing 10 senior faculty members who are/were the 'education experts' in the universities, while the main concerned groups of present educational stream, i.e. 'institution-teachers' and the 'students', were given questionnaires. 570 teacher respondents and 200 student respondents are the main participants of this study. RESULTS: As per data, it has been observed that senior faculty (90%) and students (93.25%) feel need of student motivation more than the institutional teachers (52.44%). P-values were obtained using Chi-Square test for testing the significance of difference between agreement and disagreement for a specific question. CONCLUSIONS: In India, Universities have already sensed the need of 'teacher development programmes'. But teachers in dental colleges, demand more efforts to be taken by universities and managements in this regard and expect better educational policies to give them accessibility to prove themselves.

Gingival zenith and its role in redefining esthetics: A clinical study.

BACKGROUND: The purpose of this study was to quantify some clinical parameters useful as esthetic guidelines when gingival contour is modified and to compare the left and right sides of six maxillary anterior teeth. MATERIALS AND METHODS: Maxillary casts mounted on an articulator according to the axis orbital plane were photographed from 35 young adults. The angle formed between the gingival line and maxillary midline (GLA) and the distance between the gingival zenith of the lateral incisor and the gingival line were measured (LID) using a flexible protractor and digital vernier caliper, respectively. The asymmetry was evaluated using a paired t test for the left vs right measurements of GLA and LID. The descriptive statistics for GLA and LID were calculated. RESULTS: The GLA measurements of the left side (86.7°±4.2°) were significantly greater than those of the right side (84.6°±5.4°), and the mean absolute symmetry for GLA was 1.7°±4.4°. The mean LID measurement was 0.92΁0.11. CONCLUSIONS: The gingival zenith of the canine is apical to the gingival zenith of the incisors (GLA <90°) and the gingival zenith of the lateral incisor is below or on (17%) the gingival line when head is oriented on the axis orbital plane. A directional asymmetry was shown with the right side higher than the left side. Along with the other parameters related to dental esthetics, these clinical parameters may serve as esthetic guidelines and may enable us to obtain a more predictable outcome.