Assessing Parental Preferences for Children's Oral Health in Rural Areas: A Study on Maintenance and Treatment Choices.

AIM: This article investigates the oral health preferences of parents residing in rural areas for their children, including dental maintenance and treatment. MATERIALS AND METHODS: Data were collected through a cross-sectional survey of 500 parents who sought dental consultation for their children between two and seven years old, excluding those with systemic or neurological disorders. Demographic characteristics, including child and parent age and gender, family structure, and parental education levels, were collected using self-administered questionnaires. RESULTS: The study on oral health preferences of rural parents reveals the following key trends: peak dental treatment interest at six years old (104 children), slight gender disparity favoring males (54.8%), prevalent joint family structures (58%), and families with two children (48%). Most mothers marry before age 21 (62.8%), with varied education levels. Toothpaste and toothbrushes are preferred by the majority (65.2%) for oral hygiene. Common treatments include oral prophylaxis (164), pulpectomy/pulpotomy (114), and extractions (86). However, significant gaps exist: 62.8% do not grasp the importance of primary teeth, and 72% lack knowledge about specific treatments and drug-induced tooth problems, urging targeted educational strategies. CONCLUSION: The study's outcome focuses on parental preferences for oral hygiene maintenance and their choices for dental treatment in primary dentition. The results highlight the influence of various factors on parental preferences and underscore the importance of improving parental knowledge for better oral health outcomes in rural populations.

Evaluation of the Periodontal Inflammatory Effect on Erythrocyte Sedimentation Rate: A Clinical Study.

Context: The link between oral infections and systemic disease is a well-proven hypothesis in the current literature. This relationship is the result of interaction between periodontal microbe that triggers inflammatory processes leading to the secretion of cytokines and other mediators of inflammation resulting in the systemic effects of pathogenesis. Materials and Methods: In this study, erythrocyte sedimentation rate (ESR), probing pocket depth, plaque index, gingival index, and the parameters were assessed initially and 1 month after scaling and root planing (SRP). Statistical Analysis Used: The paired t-test and the Pearson correlation were needed to examine and compare measured data. Results: The data from the study reveal that all the clinical parameters like the plaque index, the gingival index, and the probing pocket depth were statistically significantly reduced after 1 month of SRP with respect to baseline. While ESR mean value was also reduced, that is, 3.27 ± 1.24 mm/hr which was also considered statistically significant. Conclusions: The findings from the study showed a positive correlation between periodontal inflammation and ESR.

Comparison of Surgical Decompression and Steroid Therapy for the Management of Traumatic Optic Neuropathy: A Systematic Review and Meta-Analysis.

Study Design: A systematic review and meta-analysis. Objective: Treatment of traumatic optic neuropathy (TON) has been a subject of debate for many decades due to the scarcity of evidence-based treatment protocols. This review compares surgical decompression (SD) and steroid therapy (ST) as treatment approaches in TON patients. Methods: A PRISMA-guided systematic review using PubMed, Embase, Ovid and Scopus databases was performed till the last search date of July 31st 2021. The outcome of interest was an improvement in visual acuity. A meta-analysis of the odds ratio was performed using a random-effect model and sub-group analysis based upon criteria for assessment of improvement in visual acuity. Results: Sixteen studies (including 1046 patients) were included in the review. The review could identify 590 patients treated with SD and 456 treated with ST. In addition, there was a second cohort of patients presenting with NLP (no light perception). A meta-analysis with a sub-group analysis revealed that there was statistically no significant difference between the two treatment approaches in terms of improvement in VA. Conclusions: There is no difference in treatment results of SD or ST for TON. Several treatment protocols and different criteria for assessing visual acuity led to difficulty in generating evidence for selecting the correct treatment approach.

Unusually isolated Staphylococcus arlettae in intra-oral sutures - Case series.

Introduction: The human oral cavity comprises various niches such as teeth, gingiva, tongue, soft and hard palate, and various dental prostheses, all inhabited by different bacterial species. Although more than 600 taxa belong to the oral cavity, identifying Staphylococcus arlettae , an incompletely understood bacterium, has been rare. Methods: Three patients who underwent periodontal flap surgeries were reported with the incidental finding of S. arlettae associated with the intra-oral sutures placed. Environmental sampling was performed, to establish the exact source of this bacterium. Results: Staphylococcus arlettae was isolated in three patients' intra-oral sutures. All environmental samples were negative for the presence of the bacterium. Conclusion: . To this date, no studies have identified such an occurrence of Staphylococcus arlettae with intra-oral sutures. Its identification in association with foreign materials, such as sutures, can be considered a potential for surgical site infections and requires further investigation.

A sustainable approach to the degradation of dyes by fungal species isolated from industrial wastewaters: Performance, parametric optimization, kinetics and degradation mechanism.

Fungal abetted processes are among the finest approaches for the transformation or degradation and decolorization of dyes in effluents. In this piece of research; biodegradation and metabolic pathways of two toxic dyes Congo Red (CR) and Reactive black 5 (RB5) by two strains of Aspergillus sp. fungus in batch experiments has been investigated. Morphological characteristics of the isolates were observed with both light and electron microscopies. Based on molecular characterization the isolates were identified as Aspergillus flavus and Aspergillus niger. The degradation was also optimized via. operational parameters such as pH, temperature, incubation time, inoculums size, dye concentration, carbon sources and nitrogen sources. Degradation measurements revealed that the isolates effectively degraded 90% and 96% of CR and RB5 respectively. Metabolites were identified with Liquid chromatography-mass spectrometry (LCMS) and degradation pathways of the dyes were proposed. Toxicity assay Phaseolus mungo seeds showed that pure CR and RB5 dyes exhibits significant toxicity whereas fungal treated dye solution resulted in an abatement of the toxicity and cell viability was increased. The results stipulated in this article clearly showed the effectiveness of the isolates on detoxification of CR and RB5 dyes.

Mandibular Alveolar Ridge Split With Simultaneous Implant Placement: A Case Report.

Bone resorption following tooth loss is an obvious, continuous, and unpredictable process, which poses one of the greatest challenges in implant placement. The posterior regions of the jaws show more resorption compared to the anterior regions, with the mandible being affected more. Augmentation of the narrow alveolar ridge has been done using various techniques. The alveolar ridge split technique (ARST) is frequently used for the horizontal augmentation of the narrow ridge. In this case report, a 47-year-old female patient who had partial edentulism on the lower left jaw region associated with a narrow alveolar ridge was treated using the ridge split technique. A piezosurgical unit was used for splitting the ridge, followed by simultaneous implant placement. This alveolar ridge split technique is considered to be more predictable, reliable, and successful as compared to other techniques such as autogenous onlay bone graft and guided bone regeneration.

Posterior cranial vault distraction osteogenesis: A systematic review.

Purpose: Posterior cranial vault distraction osteogenesis (PCVDO) has become the treatment of choice in specific indications within 12 years since its introduction in 2009. It is used to treat or prevent Intracranial hypertension secondary to craniosynostosis. However, there is still a lack of evidence describing this procedure's safety concerning the osteotomy line being close to the torcula. This systematic review aims to generate evidence regarding the safety of this new technique. Materials and method: A systematic search of Pubmed and Embase database were done without any time limit until the last search date of July 31, 2021. Articles focused on posterior cranial vault distraction osteogenesis were shortlisted using defined inclusion criteria. In addition, complications, volume gain, and distraction protocols in patients with craniosynostosis were assessed. Results: The review included 11 articles from 11 different centres. Of the Total 241 patients, 51 were non-syndromic patients, and 190 were syndromic patients. There were 242 procedures done on 241 patients. The proportion of patients with complications was 30%. Wound infection was the most commonly reported complication. PCVDO resulted in 20-25% volume gain and successfully prevented increased intracranial pressure (ICP). Conclusion: The systematic review has significantly identified a 30.606% incidence of complications in PCVDO. No mortality was linked directly to the Posterior cranial vault distraction osteogenesis procedure (PCVDO). The authors identified the evolution of many unique vectors and osteotomy designs customized for patients and practices for safe surgery. The effects of PCVDO on the anterior cranial fossa remain a topic of interest and require observational studies for better understanding.

Apical extrusion of debris with root canal instrumentation in primary teeth: A systematic review.

Aim: This study aimed to systematically review available literature of in vitro studies on apical extrusion of debris through rotary instrumentation in comparison to manual instrumentation in pediatric endodontics, and also to perform a comparison between various rotary instrumentation systems for assessment of debris extrusion. Materials and Methods: A comprehensive search was conducted on PubMed, Medline, Cochrane Library, Embase, Scopus, and Google Scholar without any language restriction and year of publication. A planned search strategy was made for PubMed and applied to other databases. After full-text reading, 7 articles were selected for quantitative synthesis. Modified CONSORT checklist of items for reporting in vitro studies of dental materials was used for quality assessment of included studies. Results: Root canal preparation with rotary instrumentation led to lesser apical debris extrusion than manual instrumentation. Self-adjusting file system was associated with the least debris extrusion among all included studies, followed by ProTaper Next, Kedo-S, ProTaper, K3, Mtwo, Revo-S, and Wave One. Conclusion: More apical debris extrusion was seen with manual instrumentation than rotary instrumentation. Furtrhermore, variance in debris extrusion was seen with different rotary file systems.

Reconstruction options in pediatric population with hemi or total mandibulectomy defects: A systematic review.

Purpose: Mandibular pathologies causing extensive defects in pediatrics is relatively rare, and sparse literature is available for the reconstructive options of the same. The main aim is to provide optimum esthetics and function. Materials and methods: PubMed, Cochrane CENTRAL, Embase, MEDLINE and Scopus databases were searched for articles published only in English language up to May 2021, involving reconstruction of hemi or total mandibulectomy defects in patients with the age of 8 years or less, associated with benign or malignant pathology. Primary outcome variable was the success of reconstruction. Qualitative analysis was performed using a microsoft excel-sheet. Results: Of the 2201 articles reviewed, only fourteen were selected for data extraction. 22 patients were included. Fifteen were benign, six were malignant pathologies, and one was not defined. Hemi-mandibulectomy was performed in twenty-one cases, while one underwent total mandibulectomy. Condyle was preserved in five cases, while was removed in nine. Single-stage reconstruction was done in nineteen cases, while second-stage reconstruction was done in the other three. Reconstruction was done with fibular graft in thirteen cases, while CCG was used in others with variable follow-up time. Though minor complications were observed, success was observed in all cases post reconstruction with either fibula or CCG graft, defined either by function, or growth. Conclusion: Irrespective of the age-group, nature of pathology and size of the defect, reconstruction should be considered with either fibula or CCG in single-stage, as they are equally efficacious, with minor complications. Well-defined reconstructive paradigm should be developed for pediatric mandibular reconstruction.

Silver Diamine Fluoride Versus Atraumatic Restorative Treatment in Pediatric Dental Caries Management: A Systematic Review and Meta-analysis.

INTRODUCTION: The objective was to compare the clinical efficacy of silver diamine fluoride (SDF) and atraumatic restorative treatment (ART) in arresting active caries in primary teeth and first permanent molars in children. MATERIALS AND METHODS: The study protocol was registered in PROSPERO (CRD42020205675). A systematic search was performed in PubMed, Scopus, Embase, Cochrane Library, and gray literature for randomized controlled trials (RCTs) published in English language with a minimum follow-up of 6 months, comparing the caries arrest potential of SDF with ART in primary teeth and first permanent molars in children. The risk of bias and quality assessment of the studies was done using the Cochrane Collaboration Tool and Joanna Briggs Institute Critical Appraisal Tool. Data analysis was performed using RevMan software; the outcomes were summarized in meta-analysis (MA) using the random-effects model, and the odds ratio (OR) at 95% confidence interval (CI) was computed. RESULTS: A total of 1059 studies were identified, out of which 562 remained after removal of duplicates. Eight studies were considered for full-text eligibility, and four studies were included in the qualitative review. Three out of four studies were conducted on primary dentition, whereas one study was done on erupting first permanent molars in children. MA of the two studies compared 30% SDF with ART in primary molars at 12 months and revealed the OR to be 2.02 (95% CI: 0.86-4.71; I 2 = 62%; P = 0.10). CONCLUSION: The current review points to the lack of solid evidence comparing SDF with ART for arresting active caries in primary teeth, especially in the first permanent molars. No statistically significant difference between 30% SDF and ART in primary molars at 12 months was found in the present review. Well-designed RCTs are required to determine a minimum concentration of SDF which is effective and safe for caries arrest in children.

Relapse and temporomandibular joint dysfunction (TMD) as postoperative complication in skeletal class III patients undergoing bimaxillary orthognathic surgery: A systematic review.

OBJECTIVES: The aim of this study was to determine Relapse and TMD as postoperative complication in skeletal class III patients undergoing bimaxillary orthognathic surgery. MATERIALS AND METHODS: Data was obtained by database searching using The Cochrane Central Register of Controlled Trials (central), PUBMED, SCOPUS, EMBASE, Google scholar, National Medical library, New Delhi. The titles and abstracts of the electronic search results were screened and evaluated by two observers for eligibility according to the inclusion and exclusion criteria. RESULTS: 5261 articles were retrieved for the review. Among these, 3474 duplicate articles were removed. 418 studies were selected based on the eligibility criteria. For the present review, 30 articles were included after elimination according to the inclusion criteria. The Prisma diagram flowchart demonstrates our selection scheme. Quality assessment criteria to evaluate the studies were decided by two review authors in accordance with CONSORT guidelines. Each study was assessed using the evaluation method described in the Cochrane Handbook for Systematic Reviews. Among the 30 studies included in the review, marked degree of relapse in the mandible was noted from 3 months - 1 year postoperatively in 8 studies, 5 studies reported both TMD prevalence and relapse, whereas only 4 studies reported TMD disorder alone. CONCLUSION: Complications of relapse and TMD are associated with bimaxillary orthognathic surgery procedures. More RCTs and CCTs are needed in this regard to get better quality evidence. This review was registered with PROSPERO: CRD42020211342.

Radiation treatment in early stage triple-negative breast cancer in New Zealand: A national database study.

INTRODUCTION: We aimed to investigate the impact of radiation treatment in early-stage triple negative breast cancer (TNBC). METHODS: Patients with early stage (T1-3, N0-2, M0) TNBC were identified using the New Zealand breast cancer register. The outcomes of local recurrence (LRFR), local recurrence free survival (LRFS), loco-regional recurrence free rate (LRRFR), loco-regional recurrence free survival (LRRFS), breast cancer specific survival (BCSS), metastasis free (MFS) and overall survival (OS) were determined. Predefined univariate and multivariate cox regression analyses were used to explore associations between known prognostic and treatment factors. RESULTS: 1209 patients were identified with a median follow-up of 3.88 years. The majority were post- menopausal. The mean tumour size was 26mm, the majority had grade III disease and a third were node positive. 625 patients had mastectomy and 584 had breast conservation surgery (BCS). 92% of BCS and 38% of mastectomy patients received radiation. 67% received adjuvant chemotherapy. The 5 year OS was 77.6% (95% CI 74.6-80.2), 5 year BSS was 82.1% (95%CI 79.1-84.7), 5 year LRRFS was 73.9% (95% CI 73.87-73.93), 5 year LRFS was 75.4 (75.37-75.43) and the 5 year LRFR was 92.4% (95% CI 90.6-94.2). The significant prognostic/predictive factors for OS were adjuvant radiation treatment, chemotherapy, T stage, lymph node involvement and lympho-vascular space invasion. Results were similar for BSS, DMFS, LRFS and LRRFS except that LVSI was not significantly associated with BCSS, LRFS or LRRFS. When analysed by surgical type, in the WLE group, radiation was found to be significantly associated with improvement in all outcomes. In mastectomy group, radiation was not found to be significant for BCSS, LRFS, LRRFS or OS. CONCLUSION: Radiation treatment is significantly associated with improved outcomes in early stage TNBC. This argues against the hypothesis that TNBC has inherent radiation resistance.

Ischaemic heart disease following conventional and hypofractionated radiation treatment in a contemporary breast cancer series.

INTRODUCTION: We report the incidence of ischaemic cardiac toxicity in a contemporary cohort of patients receiving conventional (CFRT) or hypofractionated (HFRT) radiation after surgery for early breast cancer and investigate the interplay of cardiac risk factors and fractionation. METHODS: Included were patients receiving external beam radiation treatment from 2002 to 2006 at the Christchurch public hospital. Hospital coding databases, oncology databases and medical records were reviewed for baseline characteristics, treatment details and outcomes. The primary outcome was cardiac toxicity (including myocardial infarction, admission for cardiac chest pain, coronary angiogram positivity and ischaemic cardiac death). Kaplan-Meier methods were used to derive ischaemic cardiac event free and overall survival. Predefined univariate and multivariate analysis was performed to investigate interaction with radiation fraction size, cardiac risk factors, age and side of cancer. Standardised mortality ratios were constructed. RESULTS: Five hundred and one patients were identified, 220 treated with CFRT and 281 with HFRT. The median age was 56 and median follow-up 10.33 years. The 10-year breast cancer specific survival was 81.8% (95% CI %.78.1-85.0). The 10-year freedom from cardiac death was 98.6% (95% CI 96.9-99.4). There were 27 post radiation cardiac events including 5 cardiac deaths and 19 cases of acute myocardial infarction. 265 (53%) had at least one cardiac risk factor. Twenty five of the 27 patients with a cardiac event had cardiac risk factors. On univariate and multivariate analysis, fractionation schedule was not significantly associated with a post radiation ischaemic event, however, there was a significant relationship with age and the presence of a cardiac risk factor. The standardised mortality ratio was 0.89 (95% CI: 0-3.13). CONCLUSIONS: Our study has shown a low rate of ischaemic cardiac disease for both CFRT and HFRT in women treated for breast cancer with no evidence of an effect with fractionation schedule. Coexisting cardiac risk factors are common in the population.

First Australian experience of treating localised prostate cancer patients with CyberKnife stereotactic radiotherapy: early PSA response, acute toxicity and quality of life.

INTRODUCTION: This study is to evaluate biochemical response, acute toxicity and health-related quality-of-life (QOL) outcomes among prostate cancer patients following stereotactic body radiation therapy (SBRT) in the first Australian CyberKnife facility. METHODS: Forty-five consecutive patients with clinically localised prostate cancer were treated with SBRT using CyberKnife technology and enrolled in this study. Protocol treatment consisted of 36.25 Gy in five fractions. PSA and acute toxicity was assessed at each follow-up visit and QOL was assessed using the European Organisation for Research and Treatment of Cancer (EORTC) Global Health Status (GHS) C30 and PR25 questionnaires and the Karnofsky Performance Status (KPS). Distance of travel for treatment was recorded. RESULTS: The median prostate-specific antigen (PSA) level declined from the initial value of 6.9 ng/mL to 1.5 ng/mL at 6 months and 0.6 ng/mL at 18 months post-treatment. Results were similar in patients who did not receive hormone therapy. Acute grade 1 gastrointestinal (GI) and genitourinary (GU) toxicities were found in 11.1% and 24.4% of patients respectively. Acute grade 2 GI and GU toxicities were found in 2.2% and 11.1% of patients respectively. There were no grade 3 and grade 4 toxicities. Mean urinary symptom score was 14.8 at baseline, 17.2 at 6 weeks and 18.3 at 6 months (P > 0.05). Mean bowel symptom score was 2.7 at baseline, 4.2 at 6 weeks and 6.3 at 6 months (P > 0.05). The mean GHS score improved from 81.3 at baseline to 82.4 at 6 weeks, and was 75.6 at 6 months (P > 0.05, not significant). Compared to baseline KPS, there was a significant mean decrease from baseline of 96.7 to 93.3 at the 6-week follow-up (P = 0.0043), which then recovered to 94.3 at the 6-month follow-up (P = 0.1387). CONCLUSIONS: Early results show promising PSA response. Acute toxicity seemed comparable to results from conventionally fractionated radiotherapy and to international prostate SBRT studies. EORTC PR25 and C30 scores did not reveal any significant change from baseline, and although there was a decrease in KPS, the absolute decrease was small.

Nonsurgical treatment of two periapical lesions with calcium hydroxide using two different vehicles.

Calcium hydroxide is used extensively as an intracanal medicament in endodontics for many years. It is used in various clinical situations such as to promote apexification, to repair perforation, to enhance healing of periapical lesions, to control root resorption, and to control exudation in teeth with persistent periapical inflammation. This paper presents a case report in which Ca(OH)2 was used as an intracanal medicament for treatment of periradicular lesions using two different vehicles in two different teeth of same patient.

Unusual gingival enlargement: a rare case report.

This is an atypical case report of a 20-year-old male patient who suffered from unusual unilateral, gingival enlargement together with rapidly progressive alveolar bone loss. The enlarged gingiva completely covered his left posterior teeth in both arches. The patient was diagnosed with gingival fibromatosis and aggressive periodontitis based on the clinical, histological, and radiographic findings. The gingival enlargement was treated by conventional gingivectomy under local anaesthesia. The postoperative result was uneventful.

Root End Generation: An Unsung Characteristic Property of MTA-A Case Report.

Management of immature teeth with necrotic pulp and periapical lesion has long presented a challenge. The treatment of choice for such teeth is apexification, which is induction of apical closure to produce more favorable conditions for conventional canal obturation. Traditionally, calcium hydroxide has been used for the apexification of immature permanent teeth, however, Mineral Trioxide Aggregate (MTA) holds significant promise not only as an alternative to multiple treatment visits with calcium hydroxide but also having the potential to induce root end development, eventually forming a completed root apex. This case report presents a successful healing and apexification with the use of calcium hydroxide and MTA. A 5-year follow-up revealed root development with MTA.

Comment on "Evaluation of Manual and Two-Rotary NiTi Retreatment Systems in Removing Gutta-Percha Obturated with Two Root Canal Sealers".

Proper research design, appropriate evaluation and measurement methods, use of correct statistical tests, interpretation, and inference are the essentials without which any scientific research reporting is incomplete and does not serve its proposed purpose. In this communication, some common flaws in research designing, evaluation, analysis, and inference have been explained using a published article as a reference. The purpose of the paper is to help the scientific community recognize the significance of proper research designing and planning in order to achieve the results which are worthwhile.

Comment on "dental prosthetic status and prosthetic need of the institutionalized elderly living in geriatric homes in mangalore: a pilot study".

Public Health Dentistry is a speciality which is targeted towards the larger benefit of community and society. Dental health surveys in specific population groups should be planned adequately and the data should be analyzed in such a way so that it may help in making strategies for the intervention to improve the existing status. This could be only done with the help of proper planning, analysis and interpretation of a sample survey. The present study highlights the research design, statistical and inferential errors in a published work of public health dentistry in order to bring about the common mistakes and errors made. The renewed suggested approach helps in interpreting the results in a better way and makes them objective-oriented.