ABSTRACT
Background: Oral malodor is a major periodontal complaint, but the best method for assessing the halitosis grade is still undefined. The primary objective of the study was to detect the halitosis grade in the exhaled breath using the three distinct techniques and to compare the readings with different clinical indices to find out the best method of halitosis grading. Materials and Methods: A total of 90 patients with chronic periodontitis having oral malodor were included in the study. The subjective assessment of the exhaled breath (halitosis grading) was done by three different methods; using a handheld portable Tanita FitScan sulfide monitor, by Halitox toxin assay, and by organoleptic (Sniff test) method. The findings were then compared with the clinical parameters of poor oral hygiene like plaque index (PI), gingival index (GI), gingival bleeding index (BI), and pocket depth (PD) to detect the best method of halitosis grading. Results: The mean age of the patients included was 38.23 ± 8.83 (mean ± standard deviation) years. The median value of halitosis grading as obtained by Tanita FitScan was 3.0 (95% confidence interval as 2 and 4) which was then compared with clinical indices (PI, GI, BI, and PD) and the results were statistically significant (P < 0.05), whereas the other two techniques of halitosis grading gave insignificant results. Conclusion: The results confirmed that the halitosis grading done using Tanita FitScan sulfide monitor is more appropriate with respect to clinical indices when compared with the other two techniques.
ABSTRACT
Gingival enlargement can be multifactorial; it can be due to nutritional deficiency or can be because of several drugs. Poor oral hygiene may further worsen the gingival hyperplasia, because of which the patient may have difficulty in chewing the food, and the speech may get affected. It may end up in psychosocial stigma for the patient as the patient is even neglected by friends or relatives due to poor oral hygiene and horrifying look of gingival overgrowth. Here, we report a case of gingival enlargement in a 22-year-old married female. The enlargement was massive, such that the teeth were barely visible in the anterior mandible. Based on history and histological findings, the case was diagnosed as idiopathic gingival enlargement. Conventional gingivectomy was planned. The patient was kept on the maintenance phase, and no recurrence was recorded. During the whole treatment phase, there was a notable change in the behavior of the patient. Surgical correction and subsequent maintenance of good oral hygiene may improve the disease condition, which in turn helps the patient in not only improving the aesthetics but also results in better social acceptance.
ABSTRACT
INTRODUCTION: Systemic sepsis releases several cytokines among which tumor necrosis factor alfa (TNFα) has emerged as key cytokine causing septic shock. Single Nucleotide Polymorphisms (SNPs) at positions -238, -308, -376 and +489 in the promoter region of TNF gene exhibit differential association to inflammation and increased TNF production in sepsis. MATERIALS AND METHODS: This research work was carried out in 278 critically ill patients and 115 controls. The patients were divided into four groups: Healthy controls, SIRS, Sepsis and Septic shock. Plasma cytokine level was evaluated by ELISA. Specific sequences of TNF gene (-238, -308, -376, +489) were amplified using polychromase chain reaction (PCR). SNP detected by BamHiI, NcoI, FokI, TaiI restriction enzymes. RESULTS: Mean plasma TNFα level in healthy Control group was 8.37 ± 2.23 pg/ml, in SIRS group, the mean plasma TNFα level was 77.99 ± 5.51 pg/ml, in Sepsis patients 187.1 ± 14.33 pg/ml and in septic shock 202.2 ± 14.85 pg/ml; range 56.17-417.1 pg/ml. SNP was studied among different patient groups, which showed a higher frequency of mutants among sepsis and shock patients as compared to control. CONCLUSION: Plasma TNF alpha level was significantly high in patients with sepsis and septic shock. SNP of TNF gene showed significant association between polymorphism and development of severe sepsis and septic shock, this would help us in evaluating patients at high risk for septic shock and such patients needed to obtain a rational basis for therapy.
