Detection of Visually Imperceptible Blood Contamination in the Oral Surgical Clinic using Forensic Luminol Blood Detection Agent.

AIM AND OBJECTIVES: Oral surgical procedures can cause spread of infections in the clinics through visually imperceptible, splattered, and aerosolized blood. The aim of this study was to evaluate visually imperceptible blood contamination of clinical surfaces and personal protective equipment (PPE) in an oral surgery clinic using luminol. MATERIALS AND METHODS: Following ethical approval, oral surgical procedures were performed under local anesthesia in a disinfected clinic, and PPE was used by the oral surgeon, dental assistant, and patients. After the procedure, clinical surfaces and PPE were evaluated for traces of visually imperceptible blood contamination using luminol. Data regarding blood contamination and the duration of the procedure were collected. Nonparametric tests, with 95% significance level (Epi Info, Stat Calc 7, CDC, Atlanta, USA), were used to identify statistical interactions between the duration of the procedure and the frequency of blood contamination. RESULTS: Blood contamination was detected in flooring below surgical field (86.67%), instrument tray, operating light, dental chair, and suction unit (100%). Except head caps and shoe covers, blood contamination was detected in all the PPE used by the clinical personnel, and the eyewear and chest drapes used by patients. An increase in the surgical time beyond 40 min significantly increased the risk of blood contamination in the handcuffs of the clinical personnel (P < 0.01). DISCUSSION AND CONCLUSION: Visually imperceptible blood contamination of the clinical surfaces and PPE is associated with minor oral surgical procedures. This mandates the cleaning and disinfection of all clinical surfaces before and after minor oral surgical procedures and PPE for clinicians and patients during every procedure.

Biomarkers as Independent Predictors of Bone Regeneration around Biomaterials: A Systematic Review of Literature.

BACKGROUND: Biomarkers are detected during bone formation and resorption associated with the dynamics of bone metabolism and are gaining importance as preferential indicators of bone healing in comparison with conventional methodologies. Current literature suggests that the usage of bone turnover markers for monitoring bone regeneration in association with biomaterials is limited. AIM: To systematically review literature and evaluate whether bone-biomarkers can independently predict bone regeneration following implantation of various bone biomaterials. MATERIALS AND METHODS: An electronic search was conducted in PubMed (MEDLINE) database from 1980 to January 2017. The articles for systematic review were selected based on formulated inclusion and exclusion criteria Results: Upon database searching, 443 articles were retrieved and thoroughly reviewed based on the inclusion and exclusion criteria. In all, 41 studies were finally included for evaluation out of which 4 were clinical studies and the remaining 37 studies utilized animal models. On further evaluation, 12 studies reported the presence of biomarkers in association with cellular response during bone regeneration around bio-materials. Moreover, biomarkers related to enzyme activity and matrix protein derivatives were enhanced during bone-matrix deposition as reported in 14 studies. Inorganic skeletal matrix biomarkers indicative of bone mineralization showed positive expression in eight studies. CONCLUSION: Several biomarkers appear to be useful for the assessment of bone regeneration around biomaterials. Although biomarkers are capable of independently predicting bone regeneration, lack of substantial evidence in the literature limits their true clinical utility. CLINICAL SIGNIFICANCE: Noninvasive and inexpensive methods of isolating and characterization of biomarkers from cellular and extracellular skeletal matrix during bone regeneration have proven value in evaluating success of bone biomaterials.

Periodontal therapy as an adjunctive modality for HbA1c reduction in type-2 diabetic patients.

OBJECTIVES: This study aimed to evaluate the role of nonsurgical periodontal therapy in improving glycemic control among type 2 diabetes mellitus (T2DM) patients. MATERIALS AND METHODS: Adult T2DM patients with mild-to-moderate periodontal disease, reporting to a tertiary care diabetes center in South India, from January to June 2014, were enrolled in the study. Medical management of T2DM along with diet and physical exercise was an inclusion criterion. Patients with factors affecting periodontal health and an inability to follow-up were excluded from the study. All patients underwent nonsurgical periodontal therapy (scaling, root planing, and irrigation of chlorhexidine [0.12%]). Periodontal status and glycated hemoglobin A1c (HbA1c) were assessed preoperatively and 6 months posttreatment. Dental status, diabetic history, and demographic characteristics were recorded to evaluate confounding roles. RESULTS: A total of 266 T2DM patients (91 females/175 males; mean age 47.65 ± 5.93 years/range 25-55 years), fulfilling the inclusion criteria, were enrolled. The mean pre- and post-treatment HbA1c levels were respectively, 8.44 ± 1.87 and 7.98 ± 1.81, with a mean reduction of 0.46 ± 0.26 (P < 0.001). Significant HbA1c reduction (P < 0.001) was observed in patients with good pretreatment glycemic control (0.54 ± 0.26; 7.9%), regular follow-up (0.51 ± 0.28; 6.2%), and good oral hygiene (0.60 ± 0.49; 8.0%). CONCLUSION: Nonsurgical periodontal therapy is associated with significant HbA1c reduction among T2DM patients with mild-to-moderate periodontitis after a 6-month follow-up period.

Perceptions of dental interns in Saudi Arabia toward implant placement in medically compromised patients.

BACKGROUND AND AIM: Increasing incidence of medically compromised patients seeking dental treatment and implant rehabilitation, necessitates greater knowledge toward managing such patients. The objective of the present study was to evaluate the perceptions of dental interns in Riyadh, Saudi Arabia, toward dental implant therapy for medically compromised patients. MATERIALS AND METHODS: Using a convenience random sampling technique, a cross-sectional questionnaire-based study was conducted to evaluate the perceptions of the interns from dental schools in Riyadh, Saudi Arabia. Data pertaining to demographic details of the participants, academic grade point average (GPA), clinical implant training and experience and perceptions about dental implant therapy for medically compromised patients were collected. RESULTS: The survey response rate was 82.9% (n = 174/210; Males-129/Females-45). Less than half of the interns (n = 82/174; 47.1%) had performed dental implants, out of which 41.5% (n = 34/82) had placed implants in medically compromised patients. Most medical illnesses except controlled diabetes mellitus and hypertension were perceived by the interns as contraindications for dental implant placement. CONCLUSION: Based on the results of the present study, it could be concluded that courses with a greater emphasis toward management of dental patients with medical problems and undergraduate implant training for such patients would result in better knowledge and perception among dental interns regarding dental implant placement in medically compromised patients.

Oral manifestations in patients with neurofibromatosis type-1: a comprehensive literature review.

UNLABELLED: Oral health status is jeopardized in patients with neurofibromatosis (NF) type-1 (NF-1). The aim of the present study was to comprehensively review the oral manifestations in NF-1 patients. PubMed/Medline and Google-Scholar databases were explored using different keywords. Reviews, commentaries, letters to Editor and articles published in languages other than English were excluded. RESULTS: Neurofibromas of oral and perioral soft tissues with subsequent periodontitis, impacted and supernumerary teeth, enlarged alveolar process with dental spacing, morphological changes in teeth and class III molar relationship have been reported in NF-1 patients. Plexiform neurofibromas were reported both in oral soft tissue, maxilla and mandible with evidence of malignant transformation in some cases. Facial skeletal abnormalities, including enlargement of mandibular foramen, increased dimensions of the coronoid and sigmoid notches and notching of the posterior border of the mandible have also been reported. Association between dental caries and NF-1 remains unclear.