Modified Frenectomy Technique to Eliminate the Aberrant LabialFrenum – A Report of Two Cases

Introduction: A modified frenal treatment for aberrant frenum is presented in this report to reduce scar tissue formation and maintain the attached gingiva. Description: The case report describes two cases in which a V-shaped incision removed the aberrant frenum and then the flaps of the frenum were sutured at the mid line. Results: The results showed reduced scar tissue in the mid line and the tissue healed with adequate attached gingiva. Take-Away Lessons: The modified frenotomy technique presented here is ideal for a large frenum that could expose the underlying connective tissue that could reduce the scar tissue formation.

Neem (Azadirachta indica):Prehistory to contemporary medicinal uses to humankind

The divine tree neem (Azadirachta indica) is mainly cultivated in the Indian subcontinent. Neem has been used extensively by humankind to treat various ailments before the availability of written records which recorded the beginning of history. The world health organization estimates that 80%of the population living in the developing countries relies exclusively on traditional medicine for their primary health care. More than half of the world’s population still relies entirely on plants for medicines, and plants supply the active ingredients of most traditional medical products. The review shows the neem has been used by humankind to treat various ailments from prehistory to contemporary.

Oral health knowledge, attitudes and behavior of elementary school teachers in India / Conhecimento, atitudes e comportamento de professores do ensino primário da Índia sobre saúde oral

Objective: This study assessed the oral hygiene attitudes and behavior of elementary school teachers, and determined the influence of variables likelanguage used in class and gender on oral health knowledge, attitudes and behavior. Methods: A stratified random sampling was done to collect a representative sample of teachers fromthe Udaipur district. The total sample encompassed 126 teachers who teach in Hindi, India?s official language along with English, and 104 teachers who teach in English. Of the 230 filled out questionnaires, 12 (5.2%) were rejected either because the answers were inconsistent, such as two replies to the same question, or because the answer was blank. Results: Teachers who taught in English were more likely to brush their teeth twice daily(77.6%) than those who taught in Hindi (63.3%). All teachers who taught in English used tooth paste while only 71.7% of those who taught in Hindi did. Most females (53.1%) used a soft brush to brush their teeth and were more likely (84.4%) to brush twice daily than males. The brushing frequency differed significantly between genders. All female teachers stated that regular tooth brushing prevents tooth decay. Conclusion: Most school teachers presented acceptable knowledge, attitudes and behavior. Teachers should be made aware of their responsibility as rolemodels, and school staff should be given incentives to encourage their participation.

Objetivo: Este estudo avaliou as atitudes e comportamento dos professores do ensino primário com relação à higiene oral e determinou a influência de variáveis, como o idioma usado na sala de aula e o sexo, sobre o conhecimento, atitudes e comportamento com relação à saúde oral. Métodos: Uma amostragem aleatória estratificada foi realizada para a coleta de dados de uma amostra representativa de professores do distrito de Udaipur na Índia. A amostra completa consistiu de 126 professores que ensinam em hindi, um dos idiomas oficiais da Índia junto com o inglês, e 104 professores que ensinam em inglês. Dos 230 questionários preenchidos, 12 (5,2%) foram rejeitados porque havia respostas inconsistentes, por exemplo, duas respostas para a mesma pergunta, ou respostas em branco. Resultados: Professores que ensinavam em inglês (77,6%) eram mais propensos a escovar os dentes duas vezes ao dia que professores que ensinavam em hindi (63,3%). Todos os professores que ensinavam em inglês usavam creme dental enquanto que apenas 71,7% dos que ensinavam em hindi o fazia. A maioria das mulheres (53,1%) usava uma escova macia para escovar os dentes, e as mulheres eram mais propensas (84,4%) que os homens a escovar duas vezes ao dia. A frequência de escovação entre homens e mulheres diferiu significativamente. Todas as mulheres afirmaram que escovação regular previne a cárie dentária. Conclusão: A maioria dos professores apresentou conhecimento, atitudes e comportamento aceitáveis com relação à saúde oral. Os professores devem estar cientes de sua responsabilidade como exemplo para os alunos e os funcionários da escola deveriam receber incentivos para estimular sua participação.

Isolation and characterization of glucosamine from Azadirachta indica leaves：An evaluation of immunostimulant activity in mice

Objective: To evaluate the potential immunostimulant activity of glucosamine from Azadirachtaindica leaves in mice. Methods: The hexane, chloroform, methanol and aqueous extracts of Azadirachta indica leaves were prepared and its immunostimulant activity was studied. The aqueous extract of Azadirachta indica leaves (AEAIL) showed significant (P<0.001) higher immunostimulant activity than other extracts. Hence, isolation of possible phytoconstituent(s) from AEAIL was carried out and glucosamine was isolated. The Azadirachta indica leaves glucosamine (AILG) was administered at 266, 400 and 800 μg/kg of mice, intraperitoneal route weekly for 4 weeks to evaluate immunostimulant activity. The serum interleukin-2 (IL-2) level and histopathological studies on thymus were performed to confirm AILG immunostimulant activity. Results: The administration of above doses of AILG has significantly (P<0.001) increased serum IL-2 levels in mice than control mice. The dose dependent effect on IL-2 was noticed in AILG treated mice. The weight of thymus, liver and kidney were significantly (P<0.001) increased after the AILG treatments compared to control mice. Also, body weight of AILG treated mice showed significant (P<0.001) increment from second week to fourth week than control mice. The proliferation of T-lymphocytes in thymus after the administration of AILG was observed in histopathological study. Conclusion: The glucosamine was isolated from Azadirachta indica leaves aqueous extract and its immunostimulant activity was confirmed in mice.

Epidemiology of periodontal status in dentate male adults of Jalore, Rajasthan, India: a cross sectional study / Epidemiologia do estado periodontal em homens adultos dentados de Jalore, Rajastão, Índia: um estudo transversal

OBJECTIVE: The purpose of this study was to investigate the epidemiology of periodontal status among dentate male adults in the general population of Jalore, Rajasthan using the Community Periodontal Index. METHODS: The condition of the periodontium was assessed by the Community Periodontal Index with use of the Community Periodontal Index probe. A total of 648 male subjects belonging to five age groups, namely 12, 15, 18, 35-44 and 65-74, were selected by stratified cluster sampling technique and examined. RESULTS: The proportion of total subjects with healthy periodontium was 9.7 percent and the mean number of healthy sextants was 1.7. Bleeding on slight provocation was the most commonly observed condition in all age groups, comprising 38.8 percent of the total subjects. The results showed that the proportions of subjects who reported bleeding, calculus and periodontal pockets decreased steadily with age and a high statistically significant difference was observed among various age groups (p<0.001). CONCLUSION: The results indicate that the study population has more widespread and severe periodontal destruction than other populations. Hence, to maintain periodontal health in this population, appropriate preventive and periodic periodontal therapies should be provided.

OBJETIVO: O objetivo deste estudo foi investigar a epidemiologia do estado periodontal em homens adultos dentados na população geral de Jalore, Rajastão, utilizando o Índice Periodontal Comunitário. MÉTODOS: A condição do periodonto foi avaliada pela sonda Índice Periodontal Comunitário. Um total de 648 homens pertencentes a cinco faixas etárias, 12, 15, 18, 35-44 e 65-74, foram selecionados pela técnica de amostragem estratificada por conglomerados e examinados. RESULTADOS: A proporção de sujeitos com um periodonto saudável foi de 9,7 por cento e o número médio de sextantes saudáveis foi 1.7. Sangramento resultante de pouca provocação foi a condição observada mais comum em todas as faixas etárias, atingindo 38.8 por cento da amostra. Os resultados mostraram que as proporções de indivíduos com queixas de sangramento, cálculo e bolsas periodontais diminuíram de forma constante com a idade e houve diferença significativa entre as várias faixas etárias (p<0.001). CONCLUSÃO: Os resultados indicam que a população estudada apresenta uma destruição periodontal mais generalizada e grave que outras populações. Assim, para manter a saúde periodontal desta população, terapias periodontais preventivas adequadas e periódicas devem ser fornecidas.

Development, characterization and solubility study of solid dispersion of nifedipine hydrochloride by solvent evaporation method using poloxamer 407.

The present research endeavor was towards the enhancement of solubility of nifedipine by solid dispersion method, were prepared by solvent evaporation method and polymers Poloxamer 407 was tried with different proportion with drug and increasing the different sodium lauryl sulphate (SLS) percentages. There was significant increase of dissolution rate of nifedipine, in SD of nifedipine + Poloxamer 407 (1:4) than nifedipine + Poloxamer 407 (1:2) and nifedipine + Poloxamer 407 (1:3). Solid dispersion of nifedipine was evaluated by solubility test, DSC, IR and dissolution characteristics. Solid Dispersion of Nifedipine in Poloxamer 407 improved the dissolution rate of nifedipine, which helps to enhancing solubility of Nifedipine. Dissolution rate of pure nifedipine increased, with increasing the various Polymers content and with increasing the various sodium lauryl sulphates (SLS) content. The solubility of pure nifedipine was observed in pH 7.2 ± 0.2 buffer solution, with increasing the polymer ratio as 1:2, 1:3, 1:4 and with increasing the SLS percentage(%) as 1%, 3% and 5% respectively.

Dandy–Walker malformation: An incidental finding.

Dandy–Walker malformation (DWM) is a rare intracranial congenital abnormality that affects the cerebellum and some of its components; particularly cerebellar vermis, fourth ventricle and is characterized by an enlarged posterior fossa. Although there is an extensive list of signs attributed to DWM, final diagnosis is solely dependent on imaging techniques as there are no signs that are characteristic of DWM. This article reports a case with DWM who was diagnosed by magnetic resonance imaging.

Antibacterial effect of bioactive glass in combination with powdered enamel and dentin.

Background and Objectives: In endodontics, various intracanal medications have been advocated to eliminate bacteria after root canal instrumentation. A recent study has revealed that addition of powdered dentin to bioactive glass (BAG) led to increased glass dissolution, and an increased antibacterial efficacy. Therefore, the present study was undertaken to compare the effect of enamel and dentin powder on the antibacterial efficacy of a commercially available BAG. Materials and Methods: Dentin blocks (dbs) were prepared from single rooted human teeth. These dbs were infected with Enterococcus faecalis for two weeks in Tryptic Soy Broth (TSB), while negative controls were kept in sterile TSB. In group I, the infected dbs were filled with BAG, in group II with BAG + Enamel powder and group III with BAG + Dentin powder. Dentin samples were harvested from the dbs and cultured. Statistical Analysis: Kruskal-Wallis ANOVA was used for multiple group comparison followed by Scheffe's post hoc test for pair-wise comparisons. Results: All the combinations of BAG evaluated significantly reduced the bacterial counts compared to the control group. However, at the end of 24 hours, three days, and five days BAG + Dentin powder showed significant reduction ( P < 0.01) in bacterial counts compared to the other experimental groups. Conclusion: Among the various materials evaluated, it appeared that though BAG exhibits antimicrobial efficacy, the addition of powdered enamel and dentin in aqueous suspension definitely enhanced this property. However, the addition of enamel powder BAG did not significantly alter its antimicrobial efficacy compared to BAG + dentin powder.

Internet usage among undergraduate dental students in India / Uso da internet entre alunos de odontologia na India

Purpose: To assess the internet usage among dental students at a private dental institution in India.Methods: Internet usage was assessed among the first- to senior-year undergraduate dental students at the Darshan Dental College and Hospital, Udaipur, India. The study was conducted during the beginning of the academic year 2007-2008. Data were collected by using a questionnaire, which consisted of nine multiple choice questions. The chi-square test was used to compare the responses between male and female students and to analyze the difference among year classes. Results: The total sample size was 247, and the overall response rate was 66%. Only 5.7% and 4.1% of the students used the internet daily for general and dental purposes, respectively. More than half the subjects (55.5%) never used the internet for academic purposes in comparison to 9.3% for general use. Nearly half of the subjects preferred home for internet access; only 7.9% accessed the internet at school. About 60% of the subjects used search engines to access dental subjects, and the students from clinical years used the search engines for dental education more often than the preclinical students (78% versus 41.2%, P=0.001).Conclusion: Dental students at this private dental institution in India reported lower levels of internet use than students in other countries, which may be due to limited access and availability at the present institution.

Objetivo: Este trabalho avaliou o uso de Internet entre estudantes de Odontologia em uma instituição privada na India. Metodologia: O uso de Internet foi analisado entre 247 alunos do primeiro ao último ano do curso de Odontologia de Darshan Dental College and Hospital, Udaipur, na India. O estudo foi realizado no início do ano acadêmico de 2007-2008. Os dados foram coletados através de um questionário com nove perguntas de múltipla escolha. O teste qui-quadrado foi utilizado para comparar as respostas entre os sexos masculino e feminino e para analisar as diferenças entre os alunos de classes diferentes. Resultados: O tamanho da amostra foi de 247 sujeitos, com uma taxa de resposta total de 66%. Somente 5.7% e 4.1% dos estudantes utilizavam diariamente a Internet para pesquisa com finalidades gerais e odontológicas, respectivamente. Mais da metade dos alunos (55.5%) nunca usou a Internet para finalidades acadêmicas em comparação com 9.3% das respostas para uso geral. Quase a metade dos alunos preferiu acessar a Internet de sua residência; somente 7.9% utilizavam a Internet na faculdade. Cerca de 60% dos alunos utilizou as ferramentas de busca da Internet para obter material relacionado a assuntos de Odontologia, sendo que os estudantes dos últimos anos utilizavam mais a Internet para assuntos acadêmicos que os alunos dos anos pré-clínicos (78% vs. 41.2%, P=0,001). Conclusão: Os estudantes de Odontologia desta instituição na India relataram menores níveis de utilização da Internet que alunos de outros países. Isso pode ser devido a acesso e disponibilidade limitados na instituição avaliada.

Relationship of Body Mass Index with periodontal health status of green marble mine laborers in Kesariyaji, India

It is evident from literature that an increased body mass index (BMI) may be a potential risk factor for periodontitis. Association between BMI and periodontitis has been ascribed to unhealthy dietary patterns with insufficient micronutrients and excess sugar and fat content. The present study population has been plagued by unhealthy nutritional practices, hence the present study intended to assess the relation between BMI and periodontal status among green marble mine laborers of Kesariyaji, in the Udaipur district of Rajasthan, India. The study sample comprised of 513 subjects aged 18-54 years, drawn using the stratified cluster sampling procedure. BMI was calculated as the ratio of the subject's body weight (in kg) to the square of their height (in meters). Periodontal status was recorded using the Community Periodontal Index (CPI). Binary multiple logistic regression analysis was executed to assess the relation between body mass index and periodontitis. The dependent variable for logistic regression analysis was categorized into control group (scores 0 - 2 of the CPI) and periodontitis group (scores 3 and 4 of the CPI). The overall prevalence of periodontal disease was 98.2 percent. Caries status and mean number of teeth present deteriorated with the poor periodontal status. Subjects had an increased risk of periodontitis by 57 percent for each 1kg/m² increase in the body mass index, which means that a higher body mass index could be a potential risk factor for periodontitis among the adults aged 18 to 54 years. In conclusion, evaluation of the body mass index could be used in periodontal risk assessment.

Oral hygiene and periodontal status among Terapanthi Svetambar Jain monks in India

The main objective of the study was to determine the oral hygiene levels and periodontal status among Jain monks attending a Chaturmass in Udaipur, India. To date, no study has been conducted on Jain monks. The study comprises of 180 subjects and the overall response rate was 76 percent among them. Oral hygiene status was assessed by the Simplified Oral Hygiene Index (OHI-S) of Greene, Vermillion14 (1964), and periodontal status was assessed by the Community Periodontal Index. Additional information was collected regarding food habits, education level and oral hygiene habits. Analysis of variance (ANOVA), Chi Square Test and Step-wise multiple linear regression analysis were carried out using SPSS Software (11.0). The results showed that the oral hygiene status of Jain monks was poor and only 5.6 percent of the subjects had good oral hygiene. Overall periodontal disease prevalence was 100 percent with bleeding and shallow pocket contributing a major part (72.8 percent) among all the age groups (p < 0.001). Multiple linear regression analysis revealed that oral hygiene habits, caloric intake and education level explained a variance of 11.7 percent for the Oral hygiene index collectively. The findings confirmed that Jain monks have poor oral hygiene and an increased prevalence of periodontal disease compared to that of the similarly aged general population because, as a part of their religion, many Jain individuals avoid brushing their teeth especially during fasting, keeping in mind not to harm the microorganisms present in the mouth.

Infection control practices among undergraduate students from a private dental school in India / Práticas de controle de infecção entre estudantes de Odontologia de uma instituição privada na Índia

Purpose: To investigate compliance with recommended infection control procedures among junior and senior dental students from a private dental school in India. Methods: The study sample comprised 142 (76 males and 66 females) junior and senior dental students from a private dental institution located in Udaipur city, India. A self applied, closed ended questionnaire (response as "yes" or "no") was used to collect data. The questionnaire consisted of 15 items related to medical history taking, vaccination status, barrier techniques, and infection control practices. Results: Only one tenth of the subjects (9.9%) reported adherence to all infection control procedures. Barely one tenth of the population surveyed used plastic wrappings for sterilized instruments, and approximately three fourths of the subjects were vaccinated against Hepatitis B. Changing of face masks and handpieces between patients was reported by 21.7% and 24.6% of senior students, respectively, in contrast to 1.4% and 8.3% of the junior students. Conclusion: The undergraduate students at this private dental institution in India exhibited poor infection control practices. These findings show the need to change organizational and administrative procedures to enable dental students to follow a strict infection control protocol.

Objetivo: Investigar a adoção de procedimentos de controle de infecção por estudantes de Odontologia de uma faculdade privada na Índia. Metodologia: A amostra constituiu-se de 142 (76 homens e 66 mulheres) alunos de Odontologia do terceiro ano e do último ano de uma faculdade privada na cidade de Udaipur, Índia. Um questionário autoaplicado com respostas fechadas (respostas "sim" ou "não") foi utilizado para coletar os dados. O questionário consistiu de 15 perguntas relacionadas à obtenção da história médica, estado de vacinação, técnicas para barreiras e práticas de controle de infecção. Resultados: Apenas um décimo dos sujeitos (9,9%) aderiu a todos os procedimentos de controle de infecção. Quase 10% relataram uso de envoltórios plásticos para instrumentos esterilizados e aproximadamente três quartos dos sujeitos foram vacinados contra hepatite B. Troca de máscaras e de peças de mão esterilizadas entre pacientes foi relatada por 21,7% e 24,6% de estudantes do último ano da faculdade, respectivamente, em contraste com 1,4% e 8.3% dos alunos do terceiro ano. Conclusão: Os alunos de Odontologia desta faculdade privada na Índia exibiram deficiência de práticas de controle de infecção. Estes resultados mostram a necessidade de mudar os procedimentos organizacionais e administrativos para possibilitar que os estudantes de Odontologia sigam um protocolo rigoroso de controle de infecção.

Tobacco as risk factor for periodontal disease in green marble mine laborers of Rajasthan, India

Aim: To determine the effect of tobacco usage on the severity of periodontal disease in green marble mine laborers. Methods: Marble mine laborers (n=585) aged 15–54 years were selected from four geographic zones in green marble mines area using a stratifiedrandom sampling procedure. A total of 517 (88%) laborers participated in the study. The sample were classified as tobacco users, non users, occasional users, ex users and the data regarding form, duration and frequency of tobacco consumption was also collected by personal interviews. Periodontal status was assessed by community periodontal index. Results: Nearly three fourth (71.9%) of the population was tobacco users. Among the smokers, bleeding and calculus accounted to 33% each whereas the prevalence of these periodontal indicators was 38% and 44% respectively among smokeless tobacco users. Logistic regression analyses revealed that smokeless tobacco users were more liable for presence of periodontal pockets than smokers. Duration had a significant influence with users since more than 20 years being liable for presence of pockets at least twice (OR = 2.625, 95% CI 1.529 – 4.507) than the <5 years group. The odds ratio for presence of periodontal pockets increased by 2.143 (95 % CI 1.060 – 4.333) and 5.596 (95 % CI 2.901 – 10.639) for users of 6 – 10 units/ day and more than 10 units/day than the 1-2 times/day category. Conclusions: Tobacco usage had a significant impact on the severity of periodontal disease with users being more likely to present periodontal pockets than non users. Moreover, the risk of periodontal pockets increased as the duration and frequency of tobacco consumption increased.

Study of thiobarbituric reactive substances and total reduced glutathione as indices of oxidative stress in chronic smokers with and without chronic obstructive pulmonary disease.

BACKGROUND: The imbalance between oxidants and antioxidants is thought to play an important role in the pathogenesis of chronic obstructive pulmonary disease (COPD). METHODS: Biomarkers of lipid oxidation such as thiobarbituric reactive substances (TBARs), total reduced glutathione (GSH) were estimated in chronic smokers with and without COPD, and non-smokers. RESULTS: The following subjects (all males) were studied: (i) chronic smokers (32.5 +/- 8.6 pack years) with stable COPD (n = 20; mean age 47.2 +/- 7.8 years); (ii) chronic smokers (6.3 +/- 1.9 pack years) without COPD (n = 20; mean age 35.3 +/- 4.5 years); and (iii) non-smokers (n = 20; mean age 37.5 +/- 5.5 years). The mean TBARs levels (nmol of malondialdehyde per ml of plasma) were higher among smokers with COPD (5.72 +/- 1.02) when compared with smokers without COPD (4.85 +/- 0.97) and non-smokers (2.58 +/- 0.56) (p < 0.001). The mean GSH levels (micromol/mg of protein) were significantly higher in non-smokers (0.163 +/- 0.113) compared to smokers with COPD (0.083 +/- 0.05) and those without COPD (0.050 +/- 0.051) (p < 0.001). There was no statistically significant difference in the plasma GSH levels among smokers with and without COPD (p > 0.05). CONCLUSIONS: Our observations demonstrate increased lipid peroxidation because of oxidative stress due to smoking.