Comparative Assessment of the Periodontal Findings in Child Subjects With a Normal Body Mass Index and in Obese Subjects.

BACKGROUND: Obesity in children is a concerning issue affecting a large population globally. Obesity and overweight are risk factors for various medical conditions, including periodontal diseases, hypertension, cerebrovascular disease, cardiovascular disease, and/or diabetes. AIM: The study aimed to comparatively assess the periodontal findings in child subjects with a normal BMI and in obese subjects. METHODS: The present observational study aimed to comparatively assess 216 school-going child subjects that were divided into two groups: non-obese (BMI<25) and obese, with BMI≥25 having equal gender distribution. In both groups, clinical attachment loss (CAL), probing depth (PD), and bleeding on probing (BOP) were assessed along with a questionnaire on oral hygiene and dietary habits. The data gathered were statistically analysed. RESULTS: The study results showed that in obese subjects, significantly higher values were seen for probing depth, bleeding on probing, and plaque index compared to non-obese subjects with p<0.05. However, no significant difference was noted in the CAL of obese and non-obese subjects (p>0.05). CONCLUSION: The periodontal status is compromised in obese subjects with higher values of probing depth, bleeding on probing, and plaque index compared to child subjects with normal weight. The level of CAL does not differ significantly between obese and non-obese child subjects.

Evaluating the Prevalence and Distribution of Dental Anomalies in the Permanent Dentition of Patients Seeking Dental Care.

BACKGROUND:  Disturbances seen during tooth formation result in developmental dental anomalies presenting in the oral cavity. These anomalies manifest as discrepancies in the number, color, size, and shape of the teeth. These dental anomalies can either be acquired, congenital, or developmental. Their early detection and management are necessary as they affect aesthetics and occlusion. The study had the aim of gauging the prevalence of developmental anomalies in the permanent dentition of Indian subjects. METHODS: A total of 1192 participants recruited from the institute for study purposes, comprising males and females, were examined clinically and radiographically, and their dental casts were also evaluated. These subjects were assessed for anomalies in position, structure, number, and/or shape. Anomalies in the position include transmigration, transportation, and/or ectopic position; anomalies in the structure, including dentinogenesis imperfecta or amelogenesis imperfecta; anomalies in number, including hyperdontia or hypodontia; and anomalies in shape, including peg laterals, taurodontism, fusion, dens evaginatus, talon cusp, and/or microdontia. RESULTS: A statistically significant difference was seen in unilateral microdontia and dentinogenesis imperfecta between males and females, with attained p-values of 0.003 and 0.06, respectively. The results of the present study showed that 9.89% (n = 118) study subjects, whereas 1% (n = 12) study subjects had two dental anomalies in their permanent dentitions, with no subject presenting more than two dental anomalies, showing that various dental anomalies have a low prevalence in the Indian population. CONCLUSION: The present study has led to the conclusion that the prevalence of dental anomalies is low in Indian subjects. However, these anomalies should be detected and treated early to prevent them from causing further complications.

A Cross-Sectional Study on the Evidence-Based Dentistry, Perception Basis, and Use of Articaine Among Dental Practitioners.

Background: Many dentists use articaine as their choice of local anesthetic agent. However, the use of articaine is limited to inferior alveolar nerve blocks (IANBs), and literature data are scarce concerning its perception and choice among various dental practitioners. Aim: The aim of the present study was to assess the extent of articaine use as a local anesthetic in dentistry, its perception basis, and the consistency of evidence of the efficacy and safety of articaine in recent practice. Methods: The present study utilized a survey tool that was given to all the participating dental practitioners, and the participants were given five minutes to fill out the survey questionnaire. The questionnaire was in English and had 14 questions to be answered. The data gathered were statistically assessed to formulate the results. Results: The results of this cross-sectional survey reported that articaine is used as a choice of local anesthetic by more than half of the participating dental practitioners. Sixty percent (n = 480) participants used articaine in their practice, followed by lidocaine, which was used by 33% (n = 264) dental practitioners, mepivacaine by 2% (n = 16) participants, prilocaine by 1% (n = 8) dental practitioners, and other local anesthetics by 4% (n = 32) participants, respectively. Concerning the safety and efficacy of articaine use, 43% used it for all procedures except for IANBs, whereas 20% used it for all procedures, including IANBs. Conclusion: Despite the reported efficacy and safety of articaine as a local anesthetic for all dental procedures, many dental practitioners refrain from using it, especially for IANBs. These data depict a difference between current research evidence and reported clinical practice.

Systematic urine drug testing for detecting and managing opioid misuse among chronic noncancer pain patients in primary care-The HARMS Program: A retrospective chart review of 77 patients.

The prevalence of opioid abuse has reached an epidemic level. National guidelines recommend safer opioid prescribing practices, including potentially monitoring patients with urine drug testing (UDT). There is limited research evidence sur-rounding the use of UDT in the context of chronic noncancer pain (CNCP). We evaluated the efficacy of systematic, randomized UDT to detect and manage opioid misuse among patients with CNCP in primary care. The Marathon Family Health Team (MFHT) designed and implemented a clinic-wide, randomized UDT program called the HARMS (High-yield Approach to Risk Mitigation and Safety) Program. This retrospective chart review includes 77 CNCP patients being pre-scribed opioids, who were initially stratified by their prescriber as "low-risk." Each month, 10 percent of patients were selected for a random UDT with double testing (immunoassay and liquid chromatography-mass spectrometry). The pri-mary outcome measure was UDT leading to a change in management plan. Of the 77 patients in the study, 55 (71 per-cent) completed at least one UDT during the 12-month study period. Overall, 22 patients had aberrant results. UDT led directly to changes in management in 15 of those patients. Four of those 15 patients were escalated to an addictions program, two were tapered from opioids with informed discussion, and nine were escalated to the high-risk monitoring stream. The results of this study show that in low-risk CNCP patients prescribed opioids, applying systematic UDT in a primary care setting is effective for detecting high risk behaviors and addiction, and altering management. Further re-search is needed with larger numbers using a prospective study design.

Thresholds and Targets for Hypertension Management in Adults With Type 2 Diabetes Should Remain at 130/80 mmHg: What's the Evidence?

Hypertension and diabetes are common comorbidities and are both modifiable risk factors for cardiovascular disease and death. Lowering blood pressure reduces target organ damage and prevents cardiovascular disease outcomes. The harmonized Canadian clinical practice guidelines for managing hypertension in people with diabetes provides health-behaviour advice and medical therapy recommendations for a threshold blood pressure of 130/80 mmHg and above and to target blood pressure to below 130/80 mmHg. We have reviewed the studies supporting these recommendations and others, and they appear to be at odds with the guidelines, including those for elderly people and patients with pre-existing cardiovascular disease.

Nature's Benefaction as a Life Saver for an Avulsed Tooth: An In vitro Study.

INTRODUCTION: Dentoalveolar trauma is a very common and avulsion is the most frequent injury. Treatment of choice following avulsion is immediate reimplantation. However, in cases where this might not be possible the prognosis of reimplanted teeth can be improved by the selection of an appropriate storage media. Prevention of ankylosis and replacement resorption depends more on the potential of storage media to maintain cell viability rather than the extraalveolar time period. AIM: To compare and evaluate the efficacy of different storage media in maintaining the viability of Periodontal Ligament (PDL) cells in an avulsed tooth. MATERIALS AND METHODS: A total of 58 freshly extracted human premolar teeth were divided into four experimental groups and two control groups. The positive and negative controls corresponded to 0 minute and an eight hours dry time, respectively. The experimental teeth were stored dry for 30 minutes and then immersed in one of the four media: Hank's Balanced Salt Solution (HBSS), coconut water, aloe vera and saline for 45 minutes. The teeth were then treated with Collagenase Type II and Dispase for 30 minutes. The number of viable PDL cells were counted with a haemocytometer and analysed. The statistical analysis was done using SPSS version 15.0. The Analysis of Variance (ANOVA) and Post-hoc tests (Tukey-HSD) were performed to reveal the statistical significance. The values were represented in number (%) and mean±SD. RESULTS: Statistical analysis demonstrated that among the experimental groups maximum percentage of viable cells were seen in HBSS (87.33%) followed by coconut water (79.87%), aloe vera (70.59%) and saline (50.56%). CONCLUSION: Within the parameters of this study, it can be concluded that the HBSS is the most effective storage media in maintaining the viability of PDL cells. However, in Indian scenario where availability of HBSS is questionable, coconut water can be considered as the best natural storage media for an avulsed tooth followed by aloe vera.