The Efficiency of Three Irrigating Solutions after Surgical Removal of Impacted Mandibular Third Molars: A Cross-sectional Study.

AIM: The present study was conducted to assess the effect of irrigation with three different irrigants, namely normal saline, chlorhexidine, and povidone iodine on pain, alveolar osteitis, swelling, trismus, infection, and food impaction during surgical removal of impacted mandibular third molar. MATERIALS AND METHODS: Forty-eight patients, including 26 males and 22 females, fulfilling criteria for inclusion in this study were divided into three groups: group I where irrigant used was normal saline, group II as chlorhexidine, and group III as povidone iodine group. RESULTS: The pain was significantly more in groups I and III in 24 hours and 7th day as well. Alveolar osteitis was noted in groups III and I, nil in group II. The facial swelling measured in millimeters on 24 hours and on 7th day was significantly higher in 24 hours in groups I and III than in group II. Trismus was significantly more in group I and group III than in group II (with p < 0.01) on 7th day. CONCLUSION: It is concluded that chlorhexidine is effective in reducing pain, alveolar osteitis, swelling, and trismus when used as an irrigant following surgical removal of impacted third molar. CLINICAL SIGNIFICANCE: Chlorhexidine as irrigating solution helps in reducing the postoperative consequences after third molar surgery. Further studies are required using large sample size.

Effect of Periodontal Therapy on Crevicular Fluid Interleukin-18 Level in Periodontal Health and Disease in Central Maharashtra (India) Population.

AIM: The incidence and progression of the periodontal disease depend on periodontal microflora and the multifaceted response of the host, and these interactions are mediated by cytokines and chemokines. Interleukin-18 (IL-18) is a proinflammatory cytokine of the IL-1 superfamily. The aim of the present study was the assessment of the periodontal therapy in IL-18 level in periodontal disease and health. MATERIALS AND METHODS: Based on clinical attachment loss (CAL), probing pocket depth (PPD), gingival index (GI), and plaque index (PI) patients were divided into three groups: Group I with healthy patients, group II with chronic periodontitis, and group III with posttreatment patients having periodontitis. RESULTS: Mean PI, PPD, CAL, and gingival crevicular fluid (GCF) volume were significantly higher in groups II and III compared with group I. However, there were no significant differences between GI in groups I, II, and III. The total amount of IL-18 in GCF was significantly higher in group II when compared with groups I and III (p < 0.05). CONCLUSION: The present study confirmed that the IL-18 level in GCF was lower in healthy patients, higher in periodontally involved patients, and reduced at baseline, 3 and 6 weeks after nonsurgical periodontal therapy. CLINICAL SIGNIFICANCE: The IL-18 might be hypothetically beneficial in distinguishing health from disease and monitoring periodontal disease activity.

Efficacy of botulinum toxin in treating myofascial pain and occlusal force characteristics of masticatory muscles in bruxism.

AIM AND OBJECTIVE: The present study was conducted in patients with bruxism to evaluate the effect of botulinum toxin type A (BTX-A) (Botox, Allergan, Inc., Irvine, CA, USA) in the treatment of myofascial pain and the occlusal force characteristics of masticatory muscles. MATERIALS AND METHODS: Twenty-four diagnosed with bruxism were randomly divided into three groups (n = 8) and treated by bilateral intramuscular injection of BTX-A and placebo-treated with saline placebo injections and control group where no injections were given. The clinical parameters such as pain at rest and during chewing were assessed and occlusal force analysis system to measure the distribution of occlusal force in bruxism patients. All the three groups were assessed at baseline time and at 1 week, 3 months, and 6 months follow-up appointments. Descriptive analysis showed that improvements in parameters such as pain at rest; pain during chewing clinical outcome variables were higher in the botox treated group than in the placebo-treated subjects. RESULTS: The pain at rest and at chewing decreased in the BTX-A group while remaining constant in the placebo group and control group. There was a significant change in maximum occlusal force in the BTX-A group compared with the other two groups (P < 0.05, post hoc Bonferroni test, no exact P value), and there was no significant difference between the placebo and control groups (post hoc Bonferroni test, no exact P value). CONCLUSION: Results from the present study supported the efficacy of BTX-A to reduce myofascial pain symptoms in bruxers, and effective in reducing the occlusal force.