Prevalence of bony septa, antral pathology, and dimensions of the maxillary sinus from a sinus augmentation perspective: A retrospective cone-beam computed tomography study

PURPOSE: Sinus elevation procedures have become a routine and reliable way to gain bone volume in the edentulous maxilla for dental implant placement. Presence of bony septations and pathology in the maxillary sinus often cause complications leading to graft or implant failure or both. The aim of this study was to retrospectively evaluate the prevalence of pathology, direction of the septa, and sinus width measured at 2 mm, 5 mm, and 10 mm from the sinus floor in maxillary sinuses using cone-beam computed tomography (CBCT). MATERIALS AND METHODS: Seventy-two sinuses from 36 random preoperative CBCT scans referred for implant therapy were retrospectively evaluated for the number, prevalence, and direction of bony septations and presence of pathology. Width of the sinus was also measured at 2 mm, 5 mm, and 10 mm from the sinus floor to account for the amount of bone available for implant placement. RESULTS: Maxillary sinus septa were found in 59.7%. Presence of a single septum was noted in 20 sinuses (27.7%), followed by two septa in 17 sinuses. The most common direction of the septum was the transverse direction. Retention pseudocyst and mucosal thickening were the most commonly seen abnormality/pathology. CONCLUSION: Based on the high prevalence of septa and sinus pathology in this sample, a preoperative CBCT scan might be helpful in minimizing complications during sinus augmentation procedures for dental implant therapy.

Knowledge and practice of evidence-based dentistry among dental professionals: an appraisal of three dental colleges from Lahore - Pakistan

Evidence-based Dentistry [EBD] is a common approach in Dentistry particularly in developed nations. However, there is scarcity of data about the knowledge and practice of EBD among dental professionals in Pakistan. The objective was explore the knowledge and practice of EBD by evaluating awareness, attitudes and barriers to its implementation by interns and faculty members from various dental colleges in Pakistan. The study was a cross sectional survey. Self-administrated questionnaires were distributed among 120 male and female interns and faculty members working at three dental colleges in Lahore, Pakistan. Ethical approval was obtained from respective institutes. Informed consents were obtained from the participants before administering questionnaires among them. SPSS 20.0 was used for data analysis. Descriptive statistics included frequency distribution of various responses. Cross tabulation performed to determine odds ratio. Logistic regression analysis was performed to assess the association between practice of EBD and various factors. A 95% confidence interval was used to determined statistical significance. Ninety one subjects completed questionnaires with a response rate of 76%. Sixty five percent of participants were females, and age ranged from 22 to 55 years. The 52.7% of the respondents reported that they applied EBD in ordering tests or treatment, 24.2% attended EBD course or workshop, and 48.4% regularly read journals. Regarding the components of EBD, only one respondent correctly identified three components. About 26.4% responded that systematic review provides the strongest evidence and 54% identified no access to EBD resources a major barrier to using EBD in clinical practice. EBD not applicable to culture was judged by 39.6% of the respondents, 49.5% agreed that patients were willing to get involved in clinical decision making, and 34.1% reported that only 10% of their patients were capable of participating in clinical decision making. Multivariate logistic regression final model showed that year since graduation was strongly associated with practice of EBD [OR=4.68 91=1.83-11.97]. Almost half of the respondents claimed to practice EBD; only one of them was aware of three components of EBD. There is need to incorporate concepts of EBD in undergraduate dental curriculum and EBD workshops and seminars should be organized for dental professionals on regular bases

Osteoporosis and periodontal disease: an update

The aim of the review is to evaluate the current status of relationship between osteoporosis and periodontal diseases. Now due to aging population in industrialized nations, osteoporosis is a common observation. Osteoporosis is the most common disease of middle-age and elderly people. Its main consequence is the increased risk of bone fractures and tooth loss. It is the thinning of bone tissue and loss of bone density over time. Osteoporosis is amongst the commonest chronic diseases in which bone becomes porous and more susceptible to fracture. It is estimated that on in three postmenopausal women and one in five men over the age of 50 years are affected. There are no symptoms in the early stages of the disease. Symptoms occurring late in the disease include bone pain or fracture. Osteoporosis may contribute to periodontal disease and ultimately tooth loss. Both of these diseases have been a public health concern because of the impact caused by bone fracture and tooth loss. Bone loss is a common feature of periodontitis and osteoporosis. The etiology of tooth loss is multifactorial, but one particular focus of interest has been whether osteoporosis is a contributory factor. Various researchers have addressed this question in studies of varying qualities. The weight of the evidence suggests that there is a significant relationship between the number of teeth present and skeletal bone mineral density. In this article the plausible link has been reviewed between periodontal disease and osteoporosis. It is hoped that the review would help dental professionals to deliver better treatment and comprehensive oral care to their patients. Thus, the elderly could live a healthier and more meaningful quality of life with the prevention of these diseases

Stem cells and periodontal regeneration; present and future potential implications

The aim of this review is to highlight the recent developments in stem cell therapy in periodontal regeneration. The review contains recent developments and progress of knowledge about adult and mesenchymal stem cell research and their clinical implications. An effort has been made to review the classifications of stern cells, their sources from various body tissues and their potential use for periodontal regeneration. The cellular sources of periodontal wound healing, regenerative concepts and techniques are highlighted. Recent developments in understanding of biologics, various growth factors and clinical relevance of stem cell therapy [implications] have been incorporated. It is hoped that the review would develop interest among the dental professionals, to be aware of the recent advancements in stem cell therapy especially in periodontal regeneration. Future trends have been highlighted

Prevention of infective endocarditis in dental practice: past, present, and future perspectives

The aim of this paper is to highlight the importance of Infective endocarditis, the life threatening risk situation in our clinical practice. Our profession has witnessed a great evolution of variable prophylactic antibiotic regimens. The lack of evidence based clinical recommendations for IE prophylaxis has always been in question among professionals. It is interesting to know that in past one decade, there is a major change in this area. Recently the British recommendations have stirred the thought process. The American Heart Associations [AHA] recommendations are World widely accepted. Recently Australian multidisciplinary group has issued supportive/explanatory recommendations in line with the American Heart Association's recommendations The professionals are free to choose any of those, but the ATM are more cautions in protecting professionals and giving comfort level to patients rather than departure from the antibiotic prophylactic regimens. The review paper has covered briefly, the history of Infective endocarditis, past antibiotic regimens, present recommendations and future perspectives Within the limitations of this review, it is hoped that vigilant dental professionals would keep themselves abreast with the updated contemporary guidelines for the safety, quality of life and care of their patients

Laser applications in dentistry: an evidence-based clinical decision-making update

Lasers are being widely used in medicine. In the last two decades laser applications in dentistry have been promoted and backed by randomized controlled clinical trials and laboratory based research. Advances in Laser technology have been accepted in many walks of our daily life. The biological friendly Lasers have been developed and applied for clinical uses in dentistry. The primary aim of this review is to update general and specialist dental practitioners about the recent advances of various lasers uses in dentistry. The updated review has covered many aspects of lasers, e.g, Physics of lasers, classifications, wavelengths, types, clinical uses of surgical and non-surgical lasers in dentistry, including Implant dentistry. Finally, the Laser safety measures in clinical practice, advantages and disadvantages based on Evidence-based literature review have been discussed. The secondary aim of the evidence based review on Lasers is to enable general dentists to make good decision when buying the equipment, based on scientific rationale rather than influenced by marketing forces. One should be technology friendly rather than technophobic one should however, be careful in selecting this equipments, as there are advantages, and disadvantages in the use of Lasers both for the patients and the operators. The clinical decision should be based on evidence-based scientific rationales, affordability and predictable outcomes

Hepatitis - control in dental practice

Hepatitis infection is a silent epidemic. It has high morbidity and mortality in different countries. It is a public health problem in developing countries with limited resources and health budgets. The aim of this review paper is to revisit the hepatitis infection, its epidemiology, its modes of spread, diagnosis, prevention, especially in relation to Pakistan. Special emphasis is laid on hepatitis infection in the dental, and medical practices. The recommendations have been highlighted in the light of latest developments, understanding of hepatitis infection, treatment modalities and need of cost effective preventive regimens to control the infectious disease. The observance and practice of "Universal Precautions" for infection control has been emphasized. It is hoped that the paper will be of great help to health care professionals, those who are active in rendering their services to improve the quality of life of their patients. Further, it would be helpful to dental practitioners to protect themselves, their team and the patients in general, and may minimize the risk with better understanding of the public health problem

Assessment of lipid profile in Saudi type 2 diabetic and non-diabetic periodontal patients

To study the extent of periodontal disease in diabetic and non-diabetic periodontitis patients, and to investigate the relationship of dyslipidemia and periodontal disease, in diabetic and non-diabetic periodontitis patients. This is a cross-sectional study at the Department of Preventive Dental Sciences College of Dentistry and Department of Physiology College of Medicine, King Saud University, Riyadh, Kingdom of Saudi Arabia, from February 2003 to June 2004. A total of 90 patients was recruited, and divided into 3 equal groups of 30 subjects, with age and gender matched, and divided as follows: group 1 healthy group: periodontally and systemically healthy subjects, group 2 periodontitis group: chronic periodontitis patients with no systemic disease, group 3 diabetic group: chronic periodontitis patients with type 2 diabetes mellitus. Plaque index, bleeding on probing, probing pocket depth PPD, and clinical attachment level CAL were measured at the time of initial examination. The glycated hemoglobin, total cholesterol, low density lipoprotein LDL, triglyceride, high density lipoprotein were also measured. Periodontal parameters PPD and CAL were of significantly higher value in the diabetic patients, when compared to the periodontitis patients p<0.05. The total cholesterol, LDL, and triglyceride were also found to be significantly higher among the periodontitis patients than the healthy subjects p<0.05. This study indicated that type 2 diabetic patients had a higher risk to develop advanced periodontal disease than the non-diabetic subjects. It also highlighted the association of dyslipidemia in periodontitis patients

Maternal periodontal disease and preterm low birth weight: an update

In the past decade, there has been mounting scientific evidence suggesting that periodontal disease may play an important role as a risk factor for adverse pregnancy outcomes. Maternal periodontal disease is emerging as a major risk factor for preterm delivery and low birth weight. Preterm birth, resulting in babies born too little and too soon, is a major cause of morbidity and child hood handicap. Data from recent studies have implicated periodontal infections as a potential independent risk factor for preterm low birth weight, but several risk factors for pregnancy outcomes, such as socioeconomic factors, smoking, diabetes and stress, have also been consistently associated with periodontitis. This review focuses on the definition, classification of periodontal disease and its plausible link to preterm low birth weight babies, incidence and the risk factors associated with preterm low birth weight. Additionally this review summarizes the current scientific data on preterm low birth weight and makes a conclusion based on current understanding of the topic. Finally, the clinical relevance of maternal periodontal health and disease has been emphasized and need of antenatal oral health care has been highlighted. It is hoped that both medical and dental practitioner world will realize the importance of maternal oral health in relation to pregnancy outcome. Ultimately, it is hoped that the quantity of life of both mother and infant would improve through early intervention and control of periodontal diseases in pregnant mothers

Contact allergy to materials used in dental practice;an update

A wide range of chemicals and procedures is responsible for allergic contact dermatitis [ACD] in the dental profession. Groups of individuals affected include dentists and orthodontists, dental technicians, dental nurses, dental surgery assistants, dental hygienists and patients. Allergic contact dermatitis in dental personnel is predominantly confined to hand dermatitis, while patients with ACD to dental materials tend to experience stomatitis or cheilitis [type IV allergy] or contact urticaria with or without dissemination [immediate type allergy

Due to changes in dental practice and materials used, 'traditional' allergens previously cited as common causes of allergic contact dermatitis [e.g., local anaesthetics, glutaraldehyde, eugenol] are now being seen less frequently. Increasingly, ACD is seen in association with acrylates, rubber and composite resins. Both public concerns about potential toxicity of metals in oral restorations and greater demand for cosmetic dentistry, have resulted in greater use of acrylics and resins by dental personnel, exposing them to highly allergenic materials

The aim, of the review is to update dental team members about the basic allergy reactions, prevalence of contact dermatitis in dental health personnel, allergy from rubber latex, dental materials; including acrylic and metals and their diagnosis by patch test methods and some basic alternatives to me conditions. It is hoped that the review will help dental team members to learn about ACD, use of alternate methods, materials to protect themselves, their staff and patients from unwanted reactions, leading to a safe dental practice, to improve the quality of care to their patients

Dental hygienist: a dental professional in america

The aim of this article is to introduce the role of dental hygienist, curriculum, tasks, responsibilities, training and other aspects of professional life of dental hygienists in America. It is a brief overview on the birth of the dental hygiene profession and then goes into detail on the number and distribution of dental hygienist in America. It gives a description on licensing requirements for both US citizens and international students seeking license and the examination criteria of the National Board Dental Hygiene Exam. The article is an informational tool for the international community on the dental hygiene profession and issues faced by dental hygienist in America including the minority population such as international students. It provides information on the demographics of the profession and the role of inter national students and minorities and their future in the dental hygiene profession, in the United States of America