Evaluation of oral health education programs among patients with schizophrenia in India: An interventional study.

BACKGROUND: Schizophrenia is a mental disease that can drastically affect oral health. Hence, this remains a significant factor that affects oral health-related quality of life (OHRQoL). Assessing the OHRQoLin schizophrenic patients is one of the primary needs. The oral health impact profile is an impressive range of instruments that assesses the impact of oral conditions on well-being and quality of life. MATERIALS AND METHODS: A 100 schizophrenic individuals were randomly selected from the Psychiatry Department of Government Hospital, Patna, Bihar, India, and grouped into two groups: (a) Group I with.group-based sessions and (b) Group II with one-on-one interactions. Inclusion criteria: (a) Individuals who received the clinical confirmatory diagnosis of schizophrenia, (b) Patients who regularly reported to the psychologist for periodic evaluation, and (c) Patients who could follow instructions. Exclusion criteria: (a) Patients or their caregivers who were unwilling to participate in the study, (b) Patients with any other mental health disability other than schizophrenia, (c) Patients with muscular or nervous system disorders, and (d) Patients who could not follow instructions. Patients were educated on the modified Bass technique, and mean ± standard deviation plaque scores were compared at the baseline and after 12 weeks of intervention. RESULTS: Statistical analysis was performed using the Chi-square analytical test and paired "t-test." Statistically significant differences were observed in plaque scores in both groups (P < 0.001). CONCLUSION: Educational training tools help in improving oral health in schizophrenic patients.

Comparison of efficacy of lignocaine, ropivacaine, and bupivacaine in pain control during extraction of mandibular posterior teeth.

BACKGROUND: The management of pain during extraction of mandibular third molars is an important requisite to achieve patient comfort and to obtain desired result in an effective manner. There are various anesthetics that can be used to achieve regional or local anesthetic effect in this regard. AIM: The aim of this study was to compare the efficacy of 2% lignocaine with 1:80,000 adrenaline, 0.75% ropivacaine and bupivacaine in pain control during extraction of mandibular posterior teeth. MATERIALS AND METHODS: This prospective, cross-sectional study included 300 study participants indicated for mandibular third molar surgical extractions. The study subjects were categorized into three broad groups - (a) Group I (n = 100): Third molar extractions performed using 2% Lignocaine with 1: 80,000 epinephrine; (b) Group II (n = 100): This group included subjects who underwent extractions of mandibular third molars using 0.75% ropivacaine and (c) Group III (n = 100): This group included patients who underwent extractions of mandibular third molars with bupivacaine. Inclusion criteria were: (a) partially impacted mandibular third molars which were symptomatic; (b) written informed consent. Exclusion criteria were - (a) any systemic diseases and/or undergoing any medication for same; (b) subjects not willing for extraction after clinical and radiographic examination and opinion and (c) subjects undergoing orthodontic therapy. Subject response for pain was recorded using - (a) visual analog scale (VAS) and (b) Verbal Rating scale (VRS). Postoperative pain was assessed using requirement of analgesics after extraction. SPSS version 21.0 was employed as statistical software. Statistical tool used was the Analysis of Variance test which was used for determining statistical significance which was set at a P value of lesser than 0.05 (significant). RESULTS: On analysis of visual analog scale (VAS), it was observed that in Group I (2% Lignocaine with 1:80,000), no pain during the extraction procedure was demonstrated in 30 study participants while minimal or less pain was present in 70 patients, while in Group II (0.75% ropivacaine), 90 patients presented with no pain while ten patients had presented with minimal amount of pain during tooth extraction. While on the other hand, Group III patients whose mandibular third molars were extracted using local anesthesia by injecting bupivacaine, lack of any pain was observed in 69 patients while minimal pain was noted in 31 individuals. While making statistical comparison between three groups, a significant P = 0.03 was observed. Also, postoperative pain was noted in 60% of cases who underwent extraction using 2% lignocaine (Group I), 10% patients who had third molar extractions under Bupivacaine anesthesia presented with pain whereas none of the patients (0%), demonstrated the presence of pain following third molar extraction. CONCLUSION: 0.75% Ropivacaine is the most effective local anesthetic agent that can be used for extracting mandibular third molars due to its effective pain control both during and following the procedure when compared to 2% lignocaine and bupivacaine.

Predictors and prevalence of periodontitis among pregnant women of slum areas of Patna, India: An opportunity for oral health promotion.

BACKGROUND: There is abundant documentation in literature that presence of maternal periodontal infections has been attributed to serious health problem to the mother and the child. Regular evaluation of any illness burden is required for planning preventive and treatment strategies and fills the existing health gap. There is a lack of literature about the predictors and prevalence of periodontal diseases in expectant women in the slum areas of Patna. MATERIALS AND METHODS: It was a cross-sectional study conducted on pregnant women of slum areas of Patna, Bihar, by convenience sampling method. Using a questionnaire, data collection was carried for demographic and oral hygiene habits information. Periodontal examination was done using modified community periodontal index criteria (WHO, 2013) by recording bleeding on probing (BoP), periodontal pockets (PD) and loss of attachment (LoA). The prevalence of potential predictors was estimated and bivariate analysis was performed with BoP, PD, and LoA and then to explore the prevalence of odds ratio (ORs) multivariate logistic regression framework was employed. The level of significance was kept at P < 0.05. RESULTS: A higher level of BoP and PD was observed among women who had the habit of cleaning their teeth once daily a day than those who cleaned their teeth with brush twice a day. Oral cleanliness (hygiene) frequency established the maximum OR of 2.77 (2.07-3.71) for BoP. Gingival bleeding robustly was related with PD. Among all multivariate framework of predictors of LoA, BoP, and PD came as the firmest predictors. CONCLUSION: Teaching correctly how to maintain oral hygiene and periodic periodontal check-up can improvise the general well-being and adverse pregnancy outcomes can be lessened.

Association of maternal periodontal health with preterm birth and a low birth weight among newborns: A cross-sectional study.

BACKGROUND: Despite numerous advancements in prenatal and natal care, complications arising in pregnancy and related to child-birth are major concerns in public health. Various risk factors responsible for poor outcomes include - life-style, biological, social, infectious, hormonal, and metabolic conditions. Oral diseases have been identified as a risk factor for low birth weight both under preterm and at-term states. AIM: The aim of this study was to find an association of maternal periodontal health with preterm births and low birth weight among newborn infants. MATERIALS AND METHODS: This was a cross-sectional observational study comprising of 300 pregnant females who had underwent child deliveries within the past 24 h with an age range of 21-30 years. Study participants were selected after interviewing for gestational history and obtaining prior informed consent. Postpartum female subjects following delivery within a time period of 24 h were included in the study. Gingival index (by Loe and Silness) was calculated for the evaluation of bleeding from gingival tooth surfaces. All data tabulations were done by performing statistical analysis into Microsoft Excel Worksheet 2007. RESULTS: Mean age group of study participants was calculated to be 25 years. On analyzing brushing frequency, it was observed that approximately 40% brushed three times daily whereas 35% used to brush twice daily while the remaining, 25% brushed only once daily. No statistical significance was obtained on comparing brushing frequency with gingival health (P = 0.8). Similarly, no association was found between periodontal health and preterm low weight child births. CONCLUSION: This study found no association between maternal periodontal health and preterm and low-birth weight births among newborns.

Assessment of C-reactive Protein Level and Efficacy of Diclofenac Sodium and Mefenamic Acid in Relieving Pain in Mandibular Impacted Third Molar Surgery.

AIM: To compare the efficacy of diclofenac sodium and mefenamic acid in relieving pain in mandibular impacted third molar surgery and to assess the level of the C-reactive protein (CRP) level. MATERIALS AND METHODS: This study was conducted on 90 patients of impacted mandibular third molars. All patients were administered with 2% lignocaine with 1:80,000 adrenaline, and surgical removal of impacted third molar was done following the standardized surgical procedure by a single oral surgeon. Patients were divided into two groups of 45 each. In group I, patients were prescribed 50 mg diclofenac sodium and in group II patients were prescribed 500 mg mefenamic acid for three times a day for 3 days. The CRP level was again evaluated after 3 days of analgesics. Pain was assessed using the visual analog scale (VAS). RESULTS: The mean VAS was 2.58 in group I and 3.46 in group II, which was statistically considerable (p < 0.05). The mean CRP level postoperatively in group I was 15.7 and after 3 days was 27.2 in group I, whereas it was 25.1 postoperatively and 31.5 after 3 days in group II. CONCLUSION: Authors found that diclofenac sodium as useful as mefenamic acid. The CRP level was raised significantly following surgery, thus reflecting that it is an indicator of inflammation. CLINICAL SIGNIFICANCE: Diclofenac sodium can be used to relieve pain. The CRP level evaluation can be helpful to assess inflammation following surgery.

Factors affecting patient satisfaction among patients undergone removable prosthodontic rehabilitation.

BACKGROUND: Patient's satisfaction is of utmost importance to the dental professionals among all those who have undergone prosthodontic rehabilitation. The success of every dental prosthesis lies in the patient wearing those removable prostheses thereby restoring masticatory function and Phonatics, hence the aim of the present study is to determine various factors affecting the patient satisfaction among patients undergone removable Prosthodontic rehabilitation. MATERIALS AND METHODS: The present study is a cross-sectional questionnaire descriptive study. The study is conducted among 183 patients undergone removable Prosthodontic rehabilitation and visiting private dental clinics for follow-up. The study was conducted in October to December 2019. The study was conducted among patients age between 21 and 60 years of age wearing removable prosthesis. RESULTS: Among all study participants, majority of study participants were moderately satisfied with the Retention {79 (43.16%)}, Esthetics {87 (47.54%)}, Mastication {68 (37.15%)}, Finish of the denture {89 (48.63%)}, and Overall satisfaction for maxillary and mandibular dentures {93 (50.81%)}. Patient's behavior was significantly associated with overall patient satisfaction (P = 0.00*). CONCLUSION: Factors affecting any parameter of patient satisfaction was age, Gender, Smoking habits, duration of wearing prosthesis, no. of removal prosthesis used, number of times denture was repaired, patient behavior was significantly associated with overall patient satisfaction.

Assessment of the Role of Vitamin D in the Treatment of Oral Lichen Planus.

AIM: Lichen planus is an autoimmune disease that can affect the skin and mucous membranes, including the oral mucosa. Vitamin D plays a very important role in the bone health along with boosting immunity. This study was carried out to assess the role of vitamin D in the treatment of oral lichen planus. MATERIALS AND METHODS: A sample size of 450 was taken which included patients showing clinical presentation of oral lichen planus. The patients were equally divided into three different groups based on their vitamin D levels. The data were analyzed using SPSS version 26.0. RESULTS: The patients who were given the vitamin D supplementation showed the maximum improvement. The comparison of the data were found to be statistically significant. CONCLUSION: It was concluded that vitamin D played an important role in the treatment of oral lichen planus. CLINICAL SIGNIFICANCE: The role of vitamin D in lichen planus needs to be explored. This study may be useful in conducting further study to assess the role in vitamin D supplementation in the treatment of oral lichen planus.

A Comparative Assessment of the Management of Mandibular Angle Fractures Using 3D Plates and 2D Miniplates.

AIMS: The aim of this study was to compare 2D plates with 3D miniplate system in the management of mandibular angle fractures. MATERIALS AND METHODS: The study was conducted on 146 patients with mandibular angle fracture, who were equally divided into two groups of 73. Patients in group I were treated with 3D plating and in group II with 2D plating. In all cases, 2.0 mm titanium miniplates were used. The etiology of fracture, amount of mouth opening, and pain and sensory deficit were recorded. Clinical and radiographic assessment was done at 1, 3, and 6 months. RESULTS: The etiology of mandibular angle fracture is roadside accident (RSA) seen in 110 (75.3%) cases, fall in 24 (16.4%), and assault in 12 (2.6%) cases. There was significant (p < 0.05) mouth opening in group I at 1 month postoperatively (32.4 mm) as compared to group II (27.5 mm), at 3 months in group I (33.6 mm) as compared to group II (30.2 mm), and at 6 months in group I (36.4 mm) as compared to group II (31.6 mm). After 1 month, sensory deficit was present in six patients in group I and 10 patients in group II. After 3 months, group I had no patients and three patients in group II. Right angle fracture was found in 71 patients (group I-36, group II-35). Mandibular right angle fracture in 58 patients (group I-28, group II-30). CONCLUSION: The authors found that the 3D miniplate system is more useful in the management of cases of mandibular angle fracture as compared to 2D miniplates. CLINICAL SIGNIFICANCE: There has been increase in mandibular fractures in the last few years. Appropriate management with 3D miniplates may be useful in providing better treatment outcomes.

Evaluation of marginal bone loss around dental implants in cigarette smokers and nonsmokers. A comparative study.

BACKGROUND: The overall success of osteointegrated dental implants depends on various factors. The deleterious effects of smoking on wound healing after the tooth extraction and its association with poor quality of bone are well documented. Similar effects of tobacco use on the success of dental implants are expected. Cigarette smoke mainly contains nicotine that delays the bone healing and increases the rate of infections at the implant insertion site. AIM: The purpose of the present study was to evaluate and compare the marginal bone loss around dental implants in smokers and nonsmokers. MATERIALS AND METHODS: The study was conducted on 500 individuals who received dental implants in maxillary or mandibular edentulous regions from 2010 to 2017. The sample was divided into two groups: Group I (smokers, n = 280) and Group II (nonsmokers, n = 220). Marginal bone loss was measured on mesial, distal, buccal, and lingual side of each implant using periapical radiographs 3 months after loading, 6 months after loading, and 12 months after loading. RESULTS: The crestal bone loss around dental implants was significantly greater in smokers (Group I) as compared to nonsmokers (Group II) irrespective of the duration of loading (P < 0.001). Marginal bone loss did vary significantly by location in either groups. CONCLUSION: Smoking overall lowers the success rate of dental implants. Increased duration and frequency of smoking leads to a greater degree of marginal bone loss around dental implants.

Comparative evaluation of 2D miniplates and 3D miniplates fixation in mandibular angle fracture - A clinical study.

INTRODUCTION: Mandibular angle fracture is common in road traffic accidents. This study was conducted to compare 3D miniplate system with 2D plates for treatment of mandibular angle fractures. MATERIALS AND METHODS: The study was conducted on 120 patients with mandibular angle fracture of both genders. After selecting patients, patients were divided into 2 groups of 60 each. In group I, patients were treated with 3D, 2.0-mm titanium plates, and in group II, patients were treated with 2D, 2.0-mm titanium miniplate in mandibular angle fracture. Patients were evaluated regularly after 1, 3, and 6 months for outcome of treatment. RESULTS: In group I, males were 22 and females were 38. In group II, males were 40 and females were 20. Right angle fracture was seen in 32 patients in group I and 26 in group II. Left angle fracture was seen in 24 in group I and 28 in group II. Right angle and left parasymphysis fracture was seen in 3 in group I and 4 in group II. Left angle and right parasymphysis fracture was seen in 1 in group I and 2 in group II. [Table 3], [Graph 1] shows that in group I, after 1 month sensory deficit was present in 5 patients and in group II in 12 patients. After 3 months, there were no patients with sensory deficit in group I and 2 in group II. Preoperatively in group I, mouth opening was 24 mm and in group II patients was 25.80 mm, which increased to 31.20 mm in group I and 28.20 mm in group II at 1 month, 32 mm in group I and 30 mm in group II at 3 months, and 37.20 and 32.12 mm in groups I and II, respectively, at 6 months. The difference was significant (P < 0.05). CONCLUSION: 3D miniplate system is reliable and effective treatment modality for mandibular angle fractures as compared with traditional 2D miniplates.[INLINE:1].

Incidence of postoperative flare-ups after single-visit and multiple-visit endodontic therapy in permanent teeth.

AIM: Single- and multiple-visit root canal treatment has been the subject of long-standing debate in the endodontic community, so the purpose of this study was to determine the incidence of postoperative flare-up after single- and multiple-visit endodontic therapy in permanent teeth. MATERIALS AND METHODS: A total of 65 children aged >10 years who underwent root canal treatment were randomly categorized equally into two treatment groups: the first group underwent single-visit treatment, and the other group underwent multiple-visit therapy. The visual analog scale was employed to evaluate pain preoperatively and postoperatively after obturation. Recall visits were carried out after 1 week, 1 and 3, 6 and 9 months. The Statistical Package for the Social Sciences version 15.0 was employed for statistical analysis. RESULTS: Except at the baseline, at all the other time intervals, the mean pain score in the multiple-visit group was higher as compared to that of the single-visit group; statistically no significant difference was found. CONCLUSION: The mean pain score in the single-visit group was lower as compared to that of the multiple-visit group; however, the difference between the two groups was statistically significant (P > 0.05).

Platform switching technique and crestal bone loss around the dental implants: A systematic review.

Background: The overall success of dental implants depends on the crestal bone support around the implants. During the initial years of dental implant placement, the bone loss around the implants determines the success rate of treatment. Platform switching (PLS) concept preserves the crestal bone loss, and this approach should be applied clinically for the overall success of dental implants. Purpose: The purpose of this study is to discuss the literature dealing with the concept of PLS concept and preservation of marginal bone, the mechanism by which it contributes to maintenance of marginal bone, its clinical applications, advantages, and disadvantages, to assess its survival rates. Materials and Methods: PubMed and Google Scholar search was done to find out the studies involving PLS concept from 2005 to 2017. Data were analyzed using SPSS statistical software. Results: Literature search revealed studies involving concepts of PLS, comparison of platform-switched and nonplatform-switched implants, case reports on PLS, and studies with histological and finite element analyses regarding PLS. Conclusion: PLS helps preserve crestal bone around the implants, and this concept should be followed when clinical situations in implant placement permit.

RésuméContexte: Le succès global des implants dentaires dépend du support osseux crestal autour des implants. Au cours des premières années de la pose des implants dentaires, la perte osseuse autour des implants détermine le taux de réussite du traitement. Concept de commutation de plate-forme (PLS) préserve la perte osseuse crestale, et cette approche devrait être appliquée cliniquement pour le succès global des implants dentaires. But: le Le but de cette étude est de discuter de la littérature traitant du concept de concept PLS et de la préservation de l'os marginal, du mécanisme par lequel il contribue au maintien de l'os marginal, ses applications cliniques, ses avantages et ses inconvénients, pour évaluer ses taux de survie. Matériels et méthodes: La recherche PubMed et Google Scholar a été effectuée pour trouver les études impliquant le concept PLS de 2005 à 2017. Les données ont été analysées à l'aide du logiciel statistique SPSS. Résultats: La recherche documentaire a révélé des études impliquant des concepts de PLS, la comparaison de implants à commutation de plates-formes et à commutation de plates-formes, rapports de cas sur PLS et études avec analyses histologiques et d'éléments finis concernant PLS. Conclusion: PLS aide à préserver l'os crestal autour des implants, et ce concept doit être suivi lorsque des situations cliniques dans l'implant permis de placement.

Attitude and knowledge of dental students of National Capital Region regarding HIV and AIDS.

BACKGROUND: India is estimated to have third highest number of Human Immunodeficiency Virus (HIV) infection in world with about 2.4 million people currently living with HIV/Acquired Immunodeficiency Syndrome (AIDS). There is a possibility of HIV transmission in the oral health care setting and thus adequate knowledge and proper attitude among dental students is vital to prevent the chances of transmission and for proper care of the patient. AIMS AND OBJECTIVES: The present study aimed to investigate the knowledge of dental students about HIV infection and their attitude toward treating HIV/AIDS patients and behaviour practiced. MATERIALS AND METHODS: A cross-sectional survey was conducted among 600 dental students of different colleges present in National Capital Region (NCR). The students were from third and fourth year and they completed a predesigned questionnaire assessing the knowledge, attitude and willingness to treat HIV/AIDS patients. One-way analysis of variance (ANOVA) was applied to compare mean level of knowledge and attitude toward HIV/AIDS. RESULT: The results showed that only 28% students have excellent knowledge regarding HIV/AIDS. Certain misconceptions were prevalent regarding mode of transmission. It also shows that around 43% of the dental students have an overall negative attitude. CONCLUSION: The findings suggest that the students had adequate knowledge about HIV/AIDS and their attitude toward this group of people was significantly negative. There is need and scope to provide correct and detailed information on HIV/AIDS for dental students.