Emergence of lumpy skin disease virus (LSDV) infection in domestic Himalayan yaks (Bos grunniens) in Himachal Pradesh, India.

In this study, we investigated and confirmed natural lumpy skin disease virus (LSDV) infection in Himalayan yaks (Bos grunniens) in Himachal Pradesh, India, based on clinical manifestations and results of genome detection, antibody detection, virus isolation, and nucleotide sequencing. Subsequent phylogenetic analysis based on complete GPCR, RPO30, and EEV gene sequences revealed that the LSDV isolates from these yaks and local cattle belonged to LSDV subcluster 1.2.1 rather than the dominant subcluster 1.2.2, which is currently circulating in India, suggesting a separate recent introduction. This is the first report of natural LSDV infection in yaks in India, expanding the known host range of LSDV. Further investigations are needed to assess the impact of LSDV infection in yaks.

Lumpy Skin Disease Virus Infection in Free-Ranging Indian Gazelles (Gazella bennettii), Rajasthan, India.

Near a zoo in Bikaner, India, 2 free-ranging Indian gazelles (Gazella bennettii) displayed nodular skin lesions. Molecular testing revealed lumpy skin disease virus (LSDV) infection. Subsequent genome analyses revealed LSDV wild-type strain of Middle Eastern lineage. Evidence of natural LSDV infection in wild gazelles in this area indicates a broadening host range.

Perinerural, lymphovascular and depths of invasion in extrapolating nodal metastasis in oral cancer.

OBJECTIVE: The role of tumour thickness (TT), depth of invasion (DOI) from two different reference points (TT2 and TT3), perineural invasion (PNI) and lymphovascular invasion (LVI) were evaluated to predict lymph node metastasis (LNM) in oral squamous cell carcinoma (OSCC). Reference points for measuring the DOI were suggested. MATERIAL AND METHODS: Paraffin-embedded tissues of excisional biopsy cases diagnosed as OSCC were sectioned and stained in haematoxylin and eosin to study variables like TT1, TT2, TT3, PNI and LVI. Out of total 150 cases collected for the study, 136, 123 and 149 cases were qualified for analysis of TT1, TT2 and TT3 respectively. The association with LNM was studied using chi square test of independence. A binary logistic regression model (BLC) was developed to indicate high-risk cases. RESULTS: Receiver operating curve analysis suggested an optimum cut-off value. A significant correlation of TT1 (> 8.64, RR = 1.642, p = 0.018) and TT2 (> 7.64, RR = 2.041, p = 0.016), PNI (p = 0.028) and LVI (p = 0.000) were found with LNM. A mathematical model was suggested as Z = - 1.866 + 0.101TT2 + 2.106VI + e, where Z = log [(p/(1 - p)] p = probability of the case experiencing the event of interest. CONCLUSION: With the suggestion of a standardised reference point to measure DOI for the first time, this study has shown an association of TT1, TT2, PNI and LVI with LNM in Indian Population. The mathematical model can help in identifying high-risk cases in OSCC. CLINICAL RELEVANCE: Such studies would offer avenues for the pre-surgery assessment of depth of invasion and tumour thickness before performing neck dissection, thereby decreasing morbidity.

First report on serological evidence of bovine viral diarrhea virus (BVDV) infection in farmed and free ranging mithuns (Bos frontalis).

Despite reports of BVDV infection in several domestic and wild ruminants, no information exists for mithun (Bos frontalis) species. Hence, this study was undertaken to determine prevalence of BVDV infection in mithuns, which contribute significantly to local economy in the North Eastern region of India. Blood and serum samples were collected between 2013 and 2016 from mithuns (n = 466) belonging to the states of Nagaland, Mizoram, and Arunachal Pradesh. Serum samples were tested for BVDV antibodies by a commercial ELISA and leukocytes were tested for BVDV by real-time RT-PCR. The overall true seroprevalence rate was 13.1% (95% confidence interval, CI: 6.9-17.8%) with higher prevalence in mithuns reared under semi-intensive system (27.5%) than in free-ranging mithuns (7.6%). Among the three states, seroprevalence (16.2%) was highest in Nagaland, while prevalence rates varied markedly among geographical locations. Age-wise data showed highest seroprevalence rate in >6-year-old animals (20.6%) than 2-6 years old (16.9%), 6 months-2 years old (8.5%), and <6-month-old animals (11.3%). The seroprevalence was higher in males (20.9%) than in females (12.1%). Among the four mithun strains, higher prevalence was evident in Manipur (30.3%) than Arunachal (21.3%), Nagaland (11.7%), and Mizoram strain (10.2%). However, no BVDV genomic RNA could be detected. The results provide first serological evidence of BVDV infection in mithun species and extend the knowledge on BVDV host range. The baseline data will help further investigations on epidemiology of BVD in mithun and its impact on mithun production.

Elevated level of pro inflammatory cytokine and chemokine expression in chicken bone marrow and monocyte derived dendritic cells following LPS induced maturation.

The study was designed to characterize and compare chicken bone marrow and peripheral blood monocyte derived dendritic cells (chBM-DC and chMoDC) and to evaluate inflammatory cytokine and chemokine alterations in response upon LPS stimulation. Typical morphology was observed in DCs from 48h of culture using recombinant chicken GM-CSF and IL-4. Maturation of DCs with LPS (1µg/ml) showed significant up regulation of mRNA of surface markers (CD40, CD80, CD83, CD86, MHC-II and DC-LAMP (CD208)), pro-inflammatory cytokines (IL-1ß, IL-6, TNF-α (LITAF)), iNOS, chemokine CXCli2 and TLRs4 and 15. Basal level of TLR1 mRNA expression was higher followed by TLR15 in both DCs irrespective of their origin. Expression of iNOS and CXCLi2 mRNA in mature DCs of both origins were higher than other surface molecules and cytokines studied. Hence, its level of expression can also be used as an additional maturation marker for LPS induced chicken dendritic cell maturation along with CD83 and CD40. LPS matured DCs of both origins upregulated IL-12 and IFN-γ. Based on CD40 and CD83 mRNA expression, it was observed that LPS induced the maturation in both DCs, but chMoDCs responded better in expression of surface markers and inflammatory mediator genes.

Development and evaluation of a truncated recombinant NS3 antigen-based indirect ELISA for detection of pestivirus antibodies in sheep and goats.

The aim of this study was to develop an indirect ELISA using the helicase domain of bovine viral diarrhoea virus (BVDV) NS3 protein instead of full-length NS3 protein for detection of BVDV and BDV antibodies in sheep and goats and its validation by comparing its sensitivity and specificity with virus neutralization test (VNT) as the reference test. The purified 50 kDa recombinant NS3 protein was used as the coating antigen in the ELISA. The optimal concentration of antigen was 320 ng/well at a serum dilution of 1:20 and the optimal positive cut-off optical density value was 0.40 based on test results of 418 VNT negative sheep and goat sera samples. When 569 serum samples from sheep (463) and goats (106) were tested, the ELISA showed a sensitivity of 91.71% and specificity of 94.59% with BVDV VNT. A good correlation (93.67%) was observed between the two tests. It showed a sensitivity of 85% and specificity of 86.6% with VNT in detecting BDV antibody positive or negative samples. This study demonstrates the efficacy of truncated recombinant NS3 antigen based ELISA for seroepidemiological study of pestivirus infection in sheep and goats.

Expression of Bovine Viral Diarrhea Virus Envelope Glycoprotein E2 in Yeast Pichia pastoris and its Application to an ELISA for Detection of BVDV Neutralizing Antibodies in Cattle.

The aim of this article is to express envelope glycoprotein E2 of bovine viral diarrhea virus (BVDV) in yeast Pichia pastoris and its utility as a diagnostic antigen in ELISA. The BVDV E2 gene was cloned into the pPICZαA vector followed by integration into the Pichia pastoris strain X-33 genome for methanol-induced expression. SDS-PAGE and Western blot results showed that the recombinant BVDV E2 protein (72 kDa) was expressed and secreted into the medium at a concentration of 40 mg/L of culture under optimized conditions. An indirect ELISA was then developed by using the yeast-expressed E2 protein. Preliminary testing of 300 field cattle serum samples showed that the E2 ELISA showed a sensitivity of 91.07% and a specificity of 92.02% compared to the reference virus neutralization test. The concordance between the E2 ELISA and VNT was 91.67%. This study demonstrates feasibility of BVDV E2 protein expression in yeast Pichia pastoris for the first time and its efficacy as an antigen in ELISA for detecting BVDV neutralizing antibodies in cattle.

"Survival patterns and prognostic factors of gingivobuccal complex squamous cell cancer: A monocentric retrospective chart audit".

OBJECTIVE: To analyze the impact of clinico-pathological prognostic factors on survival in patients with GBC OSCC. To evaluate the association between various clino-pathological and treatment factors influencing the 3-year and 5-year Overall survival (OS), and Disease specific survival (DSS) in patients with lower GBC OSCC. PATIENTS & METHODS: An Institutional Ethical Committee (IEC) approved retrospective chart audit was performed. Biopsy proven squamous cell cancer of gingivobuccal complex (GBC OSCC) patients from 2010 to 2019 who were treated primarily with surgery with or without adjuvant therapy having complete clinicopathological and follow up data were included. Survival outcomes including 2-year, 3-year & 5-year OS, and DSS were calculated and analyzed. A multivariate analysis was performed to identify significant predictor for the survival outcomes. A p-value < 0.05 was considered significant. RESULTS: 183 patients with primary OSCC were identified out of which 83 patients comprised of OSCC of lower GBC. Age (p < 0.001), tumor grade (p = 0.009), pN status (p = 0.002), PNI (p < 0.001), lymph node metastasis (p = 0.002), treatment given (p = 0.02) and adjuvant therapy (p = 0.02) were found as a significant prognostic factor in univariate analysis. CONCLUSION: The OS & DSS of the patients with lower GBC SCC is 78.3%. The 2-year, 3-year, and 5-year OS of the study population was reported to be 95.2%, 87.9%, and 78.8% respectively. PNI & lymph node metastasis were significant prognostic factor for OS with an adjusted hazard ratio 4.91 and 7.75 respectively.

Is Perineural Invasion an Independent Prognostic Factor for Local Recurrence in Oral Squamous Cell Carcinoma?

Purpose: The purpose of this study was to analyse the independent prognostic significance of perineural invasion (PNI) on local recurrence (LR) in patients with oral squamous cell carcinoma (OSCC) managed primarily with surgery. Subjects and Methods: Clinical and histopathological data of 195 patients with OSCC were analysed retrospectively to identify risk factors associated with PNI and to evaluate its significant correlation with local recurrence, overall survival (OS) and recurrence free survival (RFS). Results: Patients were followed for a mean period of 39.5 ± 1.376 months and median 35 months. PNI was found in 57 patients (29.2%). PNI correlated with tongue subsite (p = 0.001), nodal metastasis (p < 0.000), depth of invasion (DOI) (p = 0.002), stage (p = 0.013) and adjuvant therapy (p < 0.001). Mean time to recurrence with PNI was significantly shorter (p = 0.002).Multivariate analysis did not establish significant relationship between PNI and LR. Kaplan-Meier curve did not show statistical significance with OS (p = 0.085) or RFS (p = 0.110). Conclusion: PNI remains an aggressive factor for nodal metastasis mandating neck management for regional control. Though PNI showed no statistical significance with LR, time to recurrence in PNI positive patients were significantly shorter. Hence, close follow-up regimen becomes necessary.

Whole-Genome-Sequence-Based Evolutionary Analyses of HoBi-like Pestiviruses Reveal Insights into Their Origin and Evolutionary History.

HoBi-like pestivirus (HoBiPeV), classified under Pestivirus H species, is an emerging cattle pathogen of high economic impact. However, the origin and evolution of HoBiPeV are not very clear due to a lack of full genomic sequences from diverse clades. This study aimed to determine full-genome sequences of HoBiPeV strains of three novel clades (c, d and e) and perform full-genome-based genetic and evolutionary analyses. Bayesian phylogenetic analyses herein confirmed the existence and independent evolution of four main HoBiPeV clades (a, c, d and e) globally, with genetic divergence ranging from 13.0% to 18.2%. Our Bayesian molecular clock estimates revealed that HoBiPeV most likely originated in India, with a dated tMRCA of 1938 (1762-2000), evidencing a more recent origin of HoBiPeV. The evolution rate of HoBiPeV was estimated to be 2.133 × 10-3 subs/site/year at full-genome level but varied widely among individual genes. Selection pressure analyses identified most of the positively selected sites in E2. Additionally, 21.8% of the ORF codon sites were found under strong episodic diversifying selection, providing first evidence of negative selection in HoBiPeV evolution. No recombination event was evident for HoBiPeV-c, d and e strains. These findings provide new insights into HoBiPeV origin and evolutionary history for better understanding the epidemiology and host-pathogen interactions and stimulate vaccine research.

Solitary Neurofibroma of Mandible in a 2-Year-Old Child: A Rare Case Report and Review of Literature.

Solitary intraosseous neurofibromas of mandible are very rare and only 40 cases are documented. This case report presents one of the youngest documented case of solitary neurofibroma of mandible, in a 2-years old male child. The tumour was symptomatic and presented as a swelling over right posterior region of mandible. The patient underwent conservative excision under general anaesthesia. The inferior alveolar nerve was preserved. Histopathology was suggestive of benign nerve sheath tumour. Immunohistochemistry showed moderate S-100 and strong CD34 positivity. Postoperative healing was uneventful. This report also reviews forty previously reported cases of solitary intraosseous neurofibromas of the mandible.

Costochondral grafts for reconstruction of acquired mandibular defects involving the temporomandibular joint: Report of two cases.

Autogenous reconstruction of temporomandibular joint (TMJ) with costochondral graft (CCG) has been a popular method of growth center transfer in children. However, unpredictable growth pattern of CCG has been reported in children that often leads to dentofacial deformities in future. This institutional study describes the results of mandibular reconstruction with CCG in two growing children, one with plexiform ameloblastoma of mandible and the other with unilateral TMJ ankylosis. Long-term follow-ups showed a significant growth of the grafts in both the patients. However, there was a lack of uniformity in the amount and rate of growth. The authors support the theory that CCG possesses innate growth potential and is a desirable option for reconstruction of acquired mandibular defects involving the TMJ in pediatric population. However, regular postoperative monitoring is necessary for such patients as the graft shows an unpredictable growth pattern.

Rehabilitation using implants in free fibula flap of a patient with ameloblastoma: Case report with 4-year follow-up.

Ameloblastoma is a locally invasive odontogenic tumor of the jaw. It can advance to large size resulting in facial deformity, loose teeth, and in severe cases pathologic fracture of the jaws. As ameloblastoma shows local invasiveness and tendency for recurrence, radical surgery which includes marginal resection or segmental resection are preferred. This clinical report describes the prosthetic rehabilitation of a patient affected by extensive mandibular ameloblastoma. Enbloc resection of the tumor and reconstruction by fibula-free flap was done. After initial healing for about 18 months, five endosseous implants were placed and implant-supported fixed hybrid prosthesis using computer-aided design and computer-aided manufacturing milled titanium framework was fabricated. Surgical and prosthodontic challenges are discussed. Osseointegrated implants provide a new perspective of treatment to enhance the quality of life of patients resected for oral tumors.

Genetic and phylogenetic analysis of lumpy skin disease viruses (LSDV) isolated from the first and subsequent field outbreaks in India during 2019 reveals close proximity with unique signatures of historical Kenyan NI-2490/Kenya/KSGP-like field strains.

Lumpy skin disease (LSD), an economically important viral disease of cattle caused by lumpy skin disease virus (LSDV) has recently spread into South and East Asia. LSD emerged in India in August 2019, first in Odisha State and spread to other areas, but there is scanty data on source and molecular epidemiology of LSDV involved in the initial outbreaks. Here we report genetic relationships and molecular features of LSDV, causing outbreaks in cattle spanning seven districts in Odisha and West Bengal States during August-December, 2019. Twelve LSDV isolates obtained using lamb testis cells were sequenced and analysed in four complete genes, GPCR, RPO30, P32 and EEV. The phylogenetic analysis revealed that all the Indian LSDV isolates from 2019 outbreaks are very closely related (99.7%-100%) to the historical Kenyan NI-2490/Kenya/KSGP-like field strains. Importantly, our results demonstrated that LSDV strains involved in 2019 outbreaks in India and Bangladesh are very similar in GPCR (99.7%), RPO30 (100%) and partial EEV (100%) sequences, indicating a common exotic source of LSDV introduction. Additionally, a 12-nucleotide insertion was found in GPCR gene of LSDV strains from 2019 outbreaks in India and Bangladesh. The findings of this study highlight the importance of continuous monitoring and molecular characterization of LSDV strains. These data should be useful while developing diagnostic and control strategies against LSD in India.

Molecular characterization of recent HoBi-like pestivirus isolates from cattle showing mucosal disease-like signs in India reveals emergence of a novel genetic lineage.

Natural infections with HoBi-like pestivirus (HoBiPeV) have been detected in cattle in South America, Europe and Asia with a range of clinical manifestations including fatal mucosal disease (MD). In India, although HoBiPeV in cattle has been reported, there is no information on currently circulating HoBiPeV strains and associated severe clinical disease. Between September 2018 and December 2019, suspected cases of bovine viral diarrhoea with severe disease in cattle were noticed in farmers' small holdings in Tamil Nadu State. To determine the extent of pestivirus infection, blood, serum, nasal or oral swab samples of 46 cattle from 18 villages were tested. Based on the real-time RT-PCR, antigen ELISA and nucleotide sequencing results, pestivirus was detected in nine cattle from eight villages in two districts and all pestiviruses were identified as HoBiPeV. All nine HoBiPeV-infected cattle displayed clinical signs resembling MD and HoBiPeV isolates (n = 9) obtained were characterized at genetic and antigenic level. Phylogenetic analyses based on 5'-untranslated regions (5'-UTR), Npro and combined 5'-UTR-Npro gene sequences revealed that eight HoBiPeV isolates clustered into a clade, distinct from all reported HoBiPeV clades (a-d), whereas one belonged to HoBiPeV-d clade, thus providing evidence of emergence of a novel HoBiPeV clade (e). This was also supported by HoBiPeV-e clade-specific amino acid substitutions in Npro and the antigenic reactivity patterns. The study demonstrates the existence and independent evolution of five HoBiPeV clades (four main clades) globally and surprisingly three exclusive to India. Also we confirm first HoBiPeV occurrence in southern India with predominant prevalence of HoBiPeV-e strains. Besides demonstrating increased HoBiPeV genetic diversity, here we show association of HoBiPeV with severe clinical disease involving fatalities highlighting impact of HoBiPeV on cattle health. The emergence of a novel HoBiPeV lineage provides new insights on global HoBiPeV epidemiology and genetic diversity reiterating the need for continuous monitoring of HoBiPeV in India.

Nasoorbitoethmoid fractures in a tertiary care hospital of eastern India: A prospective study.

PURPOSE: The purpose of this study was to report on the pattern of occurrence of nasoorbitoethmoid (NOE) fractures in Odisha and the various factors that influence their distribution. METHODS: The study period was from January 1, 2016 to December 15, 2017. After approval from the Institutional Ethics Committee, all patients diagnosed with naso-orbito-ethmoid fractures reporting to the department of OMFS and Level-1 trauma centers were included in the study. Sociodemographic data along with the etiology and type of fracture were mentioned. Associated injuries to other body parts were noted. Open reduction was possible only in five cases of NOE fractures. The treatment plan including the operative approach and postoperative results was evaluated. RESULTS: A total of 1192 patients with facial fracture were seen, of which 52 (4.36%) patients had NOE fractures. Males far outnumbered females in a ratio of 9:1. Thirty-three patients (63.46%) had unilateral NOE fracture, while the rest 19 (36.54%) had bilateral NOE fracture. Sixteen (30.76%) cases were classified as Type I, 35 (67.30%) as Type II, and 1 (1.92%) as Type III. Road traffic accidents were the most common cause of NOE fractures (69%), followed by fall (17%) and assault (10%). The most common neurological injury to be associated with NOE fractures was pneumocephalus (29%), followed by diffuse axonal injury (8%). Telecanthus (100%) was found to be the primary clinical feature in patients of NOE fracture, followed by a depressed nasal bridge (92%). Fracture of the nasal bone was invariably associated with NOE fracture. Complications observed due to untreated NOE fractures included a shortened and retruded nose, shortened palpebral fissures, telecanthus, and enophthalmos. CONCLUSION: Contemporary management of NOE complex fractures demands precise diagnosis and immediate surgical management with anatomic reduction and rigid fixation of the involved bone segments. With an improvement in socioeconomic status and increased awareness among maxillofacial surgeons, hopefully, a greater number of NOE fracture patients will avail the benefits of open reduction in future.

Comparison of Safety, Efficacy, Patient Compliance and Cost-Effectiveness of Transdermal, Oral and Intramuscular Diclofenac for Pain Control Following Oral Surgical Procedures.

PURPOSE: To evaluate transdermal diclofenac in terms of analgesic efficacy, safety, compliance and cost-effectiveness and to compare it with oral tablets and intramuscular (IM) injections following surgical removal of impacted mandibular third molars. SUBJECTS AND METHODS: A prospective, single-centre, multi-arm parallel, randomized study on subjects undergoing extraction of impacted mandibular third molars was conducted between January 2016 and December 2017. The study included 90 participants, 30 in each group. Participants received the standard once daily (OD) dosages of diclofenac in each group for three post-operative days and were advised to consume paracetamol 500 mg as rescue analgesics if the pain was not alleviated. Outcome measures such as demographics, duration of surgery, post-operative pain, the number of rescue analgesics taken, adverse drug reactions experienced and overall global assessment for three post-operative days were recorded by the participants on a questionnaire. RESULTS: Transdermal and oral forms achieved similar analgesia on all 3 days. Injectable diclofenac had significantly better pain control on the second and third post-operative days compared to tablets and on the third day compared to transdermal diclofenac. A higher number of rescue analgesics was consumed in oral group on day 1. Gastritis and vomiting were seen in 36.66% and 10% cases, respectively, in oral group. 100% of those in IM group had pain on injection. 6.6% complained of dry skin due to patch, while 3.33% had rash and pruritus. Transdermal group had better overall global assessment by patients with 16.67%, 46.67% and 20% participants reporting excellent, very good and good pain control, respectively. The cost in INR was maximum for the transdermal group. CONCLUSION: Transdermal diclofenac is an excellent alternative to oral and parenteral routes of drug administration in oral surgical procedures with adequate analgesic efficacy, good compliance and fewer side effects.

Locking versus non-locking plating system in the treatment of mandibular fractures: A randomized comparative study.

To evaluate fracture stability and complications such as infections, need for hardware removal, malunion, and nonunion when using 2.0-mm locking plating system in fixation of mandible fractures and to compare these to those associated with the 2.0-mm non-locking plating system. A prospective clinical study was conducted in a cohort of mandible fracture patients who were randomly assigned to two groups. Patients in the non-locking group were treated with 2.0-mm non-locking plating system, and those in locking group were treated with 2.0-mm locking plating system. Fracture stability, need for maxillomandibular fixation (MMF) and postoperative complications were assessed and compared. A total of 60 patients (30 in each group) were recruited. Significant differences were found between the two groups with respect to postoperative fracture stability (P = 0.001) and need for MMF (P = 0.005). Multivariate analysis revealed that type of fixation was not the only dependent variable which affected fracture stability. There were no significant differences in postoperative complications between the two groups. The 2.0-mm locking plating system provides greater stability and early functional restoration than the 2.0-mm non-locking plating system, with similar rates of postoperative complications. Thus, it can be used as a reliable and effective treatment modality for treating mandibular fractures.

Serological surveys to inform SARS-CoV-2 epidemic curve: a cross-sectional study from Odisha, India.

This was a population based cross-sectional study carried out to estimate and compare the seroprevalence, hidden prevalence and determine the demographic risk factors associated with SARS-CoV-2 infection among adults in the three largest cities of Odisha, India, and ascertain the association with the progression of the epidemic. The survey carried out in August 2020 in the three largest cities of the state of Odisha, India. Blood samples were collected from the residents using random sampling methods and tested for anti- SARS CoV-2 antibodies using an automated CLIA platform. A total of 4146 participants from the 3 cities of Bhubaneswar (BBS), Berhampur (BAM) and Rourkela (RKL) participated. The female to male participation ratio was 5.9:10 across the three cities. The gender weighted seroprevalence across the three cities was 20.78% (95% CI 19.56-22.05%). While females reported a higher seroprevalence (22.8%) as compared to males (18.8%), there was no significant difference in seroprevalence across age groups. A majority of the seropositive participants were asymptomatic (90.49%). The case to infection ratio on the date of serosurvey was 1:6.6 in BBS, 1:61 in BAM and 1:29.8 in RKL. The study found a high seroprevalence against COVID-19 in urban Odisha as well as high numbers of asymptomatic infections. The epidemic curves had a correlation with the seroprevalence.

Immediate dental implant placement with or without autogenous bone graft: A comparative study.

INTRODUCTION: Immediate dental implants are the most accepted contemporary treatment option for the replacement of missing teeth. One pitfall of immediate implant use, however, is the inevitable residual space that remains between the implant and the socket wall, called the jumping distance, which may lead to bone resorption and formation of a bony defect, decreasing the implant stability. When this jumping distance is more than 2 mm, use of bone grafts is recommended. However, the use of grafts when the jumping distance is <2 mm is not defined in the literature. AIM: To evaluate the peri-implant hard and soft tissue changes following immediately placed implants with a jumping distance of 2 mm with or without autogenous bone grafts. SETTINGS: The study was conducted between January 2016 and December 2017 in the Department of Oral and Maxillofacial Surgery. SUBJECTS AND METHODS: This was a prospective, single-center, two-arm, parallel, randomized study on patients undergoing replacement of missing anterior teeth with immediate implants. There were two groups: the study group which received bone graft and the control group which did not receive any graft. Temporary prosthesis was placed following implant placement which was replaced with definitive prosthesis 4 months later. Patients were followed up for a period of 9 months. The alveolar bone loss was evaluated radiologically using cone-beam computed tomography, and pain, suppuration, mobility, and periodontal probing depth were evaluated clinically. RESULTS: There were 16 participants in the study group and 17 in the control group. The alveolar bone loss was greater in the study group; however, pain, suppuration, and mobility showed no difference between the groups. CONCLUSION: The immediate implants placed with or without bone grafts had similar alveolar hard and soft tissue changes when the jumping distance was <2 mm.