Knowledge, attitude, and practice of teledentistry in periodontal diagnosis: Is it the required upgrade to conventional periodontics?

Background: Teledentistry which is similar to telemedicine has emerged as a new tool for various dental disciplines. Teleperiodontics is a branch of telehealth which focuses on the application of digital communication technology into the field of periodontics without demanding a specialist presence. An early detection and diagnosis of periodontal conditions can not only treat the disease in its early stage but also prolong the health of the periodontium, thereby improving the overall quality of life of an individual. However, teledentistry has not penetrated into the field of periodontics to a level it has to in providing periodontal care. Hence, the aim of this questionnaire study was to assess the knowledge, attitude, and application of teleperiodontics into everyday practice among the dental surgeons at various levels. Materials and Methods: An electronic questionnaire consisting of 29 close-ended questions including sections assessing the knowledge, attitude, and practice of teledentistry and teleperiodontics was sent to dental colleges present in East and West Godavari districts of Andhra Pradesh. Results: A total of 350 responses were received and 80.57% dental surgeons were aware about teledentistry, and a total of 74% dental surgeons were likely to prescribe oral hygiene aids and medication for temporary management of periodontal conditions. Conclusion: Teleperiodontics is an emerging science whose knowledge, attitude, and application are yet to be explored.

Periodontal status of mandibular second molar after extraction of impacted mandibular third molars- a prospective clinical trial.

Purpose: Mandibular third molar (M3) extraction is the common surgical procedures carried out; however, one of the complications is development of periodontal disease in adjacent second molars (M2). Hence the purpose of this study was to evaluate the effect of extraction of M3 on the periodontal status of M2. Materials and methods: Study included 120 sites with mandibular M2 adjacent to the impacted M3. Plaque index(PI), gingival index(GI), probing pocket depths(PD), clinical attachment levels(CAL), Gingival recession(GR) and alveolar bone height(ABH) before and 9-12 months after surgical extraction of M3 were assessed. Patients perception was assessed using dichotomous rating. Four types of impactions(IMP) were included along with surgical cofactors like degree of impaction, flap design, bone removal, tooth sectioning. Results: At baseline mesioangular and horizontal IMP showed greater PPD and CAL. After extraction of M3 there was significant decrease in PPD & CAL. 14% cases showed significant increase gingival recession at the distobuccal of M2. Although 10.9% of patients had an alveolar bony defect(ABD) distal to the M2, there was considerable improvement in ABH from baseline. The ABDs are mostly associated with mesioangular and horizontal IMP. Conclusion: Extraction of impacted M3 proves to be beneficial on periodontal status of M2. However, occasionally, mesioangular and horizontal IMP are likely to develop ABD distal to M2 and hence can be followed by regenerative procedures to prevent the formation of ABD.

Analysis of root coverage esthetic score in patients treated for gingival recession: An interexaminer reliability.

BACKGROUND: Awareness about pink esthetics among dentists in general needs to be assessed as root coverage procedures are the mainstay of treatment for gingival recession. Concordance among the dentists in figuring out the esthetic outcomes after root coverage procedures is inconsistent. Hence, this study aims to evaluate inter- and intra-examiner reliability of root coverage esthetic scores (RES) between periodontists and nonperiodontists. MATERIALS AND METHODS: The study was conducted using twenty baseline and 6-month posttreatment photographs of Miller's Class I and Class II gingival recessions. The participants that constituted ten periodontists and ten nonperiodontists were assembled in the seminar hall to receive training on protocol and procedures for RES by the investigator. All the participants were shown twenty projections of side-by-side baseline and 6-month outcomes of root coverage procedures. Each projection was shown for 30 s during which the participants were made to use RES system to evaluate the surgical outcomes. RESULTS: Periodontists showed the highest reliability in the scores of marginal tissue contour with an overall intraexaminer reliability to be perfect among periodontists. Intraexaminer reliability among nonperiodontists was fair, and gingival margin was the parameter with the highest reliability among them. Interexaminer reliability between periodontists and nonperiodontists showed slight reliability concerning gingival margin, and fair reliability was found for marginal tissue contour, soft-tissue texture, mucogingival junction, and gingival color. CONCLUSION: Satisfying the esthetic component of gingiva is the duty of every dentist in general and not only the periodontists. Significant variability was found in esthetic scores between the groups, which can probably be attributed to the lack of sufficient knowledge regarding pink esthetics among the nonperiodontists, which needs to be improved.

Impact of periodontal knowledge and attitude on the status of the periodontium: A profile on West Godavari district, Andhra Pradesh, India.

BACKGROUND: Although regular patient education regarding the periodontal health/disease is advocated as a means of improving oral health, impregnable associations of periodontal knowledge and attitude with periodontal status have not been demonstrated. MATERIALS AND METHODS: In a cross-sectional study conducted, 2400 participants were surveyed using a specially designed pretested pro forma to evaluate the knowledge and attitude concerning periodontal health and disease. The oral exanimation included recording of oral hygiene index, gingival index (GI), community periodontal index (CPI), and loss of attachment. Ethical clearance was obtained from the institutional review board. The data were analyzed using IBM SPSS version 21.0. RESULTS: The mean age of the study population was 41.6 ± 9.5 years. The greater portion of individuals had high knowledge score (55.9%) and negative attitude (68.4%) toward periodontal health/disease. The mean oral hygiene index scores and GI scores were higher among individuals with high knowledge score and with negative attitude, and the differences were statistically significant among the groups. There was no difference in the mean plaque scores among individuals with different knowledge scores, but a higher score for individuals with negative attitude (1.24 ± 0.87) was evident. The proportion of individuals with healthy periodontium (score 0 for CPI and loss of attachment) had low knowledge score (54.3%); however, a positive attitude was elicited in 51.9% of the population. CONCLUSION: High knowledge score and negative attitude were related to periodontal status in West Godavari. Therefore, it can be emphasized that the presence of a positive attitude plays a key role in achieving better periodontal status.

Comparing the Effect of Combination of 1% Ornidazole and 0.25% Chlorhexidine Gluconate (Ornigreat™) Gel and Aloe vera Gel in the Treatment of Chronic Periodontitis: A Randomized, Single-Blind, Split-Mouth Study.

AIM AND OBJECTIVE: The aim of this study is to compare the efficiency of subgingivally delivered 1% ornidazole and 0.25% chlorhexidine (CHX) gluconate (Ornigreat™ gel) and Aloe vera (AV) gel in the treatment of chronic periodontitis. MATERIALS AND METHODS: Twenty chronic periodontitis patients with pocket depths ranging from 4 to 6 mm bilaterally at least in one site were included in the study. After a thorough nonsurgical periodontal therapy, 1% ornidazole and 0.25% CHX gluconate (Ornigreat™ gel) and AV gel were subgingivally delivered into the pocket sites, and the clinical parameters such as plaque index (PI), gingival index (GI), bleeding index (BI), and clinical attachment level (CAL) were evaluated at baseline and after 4 weeks. RESULTS: In both the groups, a reduction in PI, GI, and probing depth readings was evidenced after 4 weeks. A significant improvement was noticed in the BI in the AV group when compared with that of Ornigreat™ group. Taking CAL into consideration, though improvement was there in both the groups, it was not appreciable. CONCLUSION: AV which is an herbal derivative when subgingivally delivered in the pocket site could be an equally effective and affordable substitute for Ornigreat™ gel.

Do dental research journals publish only positive results? A retrospective assessment of publication bias.

BACKGROUND: The study aimed to determine the presence of publication bias in the top five dental journals with high impact factor published during 2007-2016. MATERIALS AND METHODS: The journals included are Journal of Clinical Periodontology, Dental Materials, Clinical Oral Implant Research (COIR), Journal of Endodontics, and Journal of Dental Research (JDR). The content of these journals was hand searched by two authors for scouring the proportion of positive or negative results. Articles showing two outcomes (primary and secondary) were registered depending on the primary result. RESULTS: The present study revealed higher percentage of statistically significant results in the published dental literature. Of five journals, JDR has shown fewer tendencies toward publication of nonsignificant results, whereas COIR has evidenced the highest publication of nonsignificant results. The journals with higher impact factor showed significantly different acceptance rate for research with positive results. However, year-wise publication (2007-2016) did not depict any significant difference. CONCLUSION: In dental research journals, articles with positive results are finding a better way in getting published compared to articles with negative results.

Awareness, Attitude, and Prevalence of usage of magnification devices among the dental practitioners in the state of Andhra Pradesh - A questionnaire-based study.

BACKGROUND: Dentistry, dealing with teeth and supporting tissues in the oral cavity is not only an ever-evolving science but also an art combined with good eye-hand coordination. It not only encompasses clinical and theoretical skills which play a crucial role in the success of therapy but also a lot of intrinsic work is accomplished in dentistry. In a journey to fulfill the above accomplishments and for facilitating early diagnosis of pathologies which usually go unnoticed, a clearer and magnified field of vision are also essential. The purpose of this study is to evaluate the awareness, attitude, and prevalence of the usage of magnification devices among the dental practitioners in the state of Andhra Pradesh. MATERIALS AND METHODS: A questionnaire-based study was conducted to assess the awareness, attitude, and prevalence of magnification devices among the 370 dental practitioners in Andhra Pradesh. All the participants were provided with a prestructured questionnaire comprising of 24 questions and answering was completely self-based. RESULTS: Among the participants, majority were aware about magnification in dentistry (91.1%), and also of the different types of magnification devices available (90.5%). On the other hand, when the reason for not using magnification devices was taken into consideration, 32.7% attributed that they have not experienced the devices and 32.4% felt that devices were too expensive. Moreover, when regarding the usage of devices was taken into account, only 23.8% of the total participants were exposed to the usage of magnification aids. CONCLUSION: Among the selected group of participants, even though majority were aware of magnification in dentistry its application in practice was very less.

Comparison of the number of gingival blood vessels between type 2 diabetes mellitus and chronic periodontitis patients: An immunohistological study.

BACKGROUND: The relationship between diabetes and periodontitis has been studied for more than 50 years and is generally agreed that the periodontal disease is more prevalent in diabetic patients compared to nondiabetics. Vascular changes like increased thickness of basement membrane in small vessels has been reported in diabetic patients, but the quantity of blood vessels in gingiva of diabetic patients has not been discussed much. The aim of this study was to compare the number of blood vessels in gingiva between chronic periodontitis (CP) patients, CP with diabetes (type 2), and normal healthy gingiva. MATERIALS AND METHODS: The study included 75 patients, divided into three groups of 25 patients each-Group I with healthy periodontium (HP), Group II with CP, and Group III with CP with diabetes mellitus (CPDM). Gingival biopsies were obtained from the subjects undergoing crown lengthening procedure for Group I, and in patients with CP and in CPDM biopsies were collected from teeth undergoing extraction. Sections were prepared for immune histochemical staining with CD34. RESULTS: Difference was observed in the average number of blood vessels when compared between HP, CP, and CPDM groups. Statistical significant difference was observed when the HP and CP groups and HP and CPDM groups were compared. CONCLUSION: The results of the study indicated that the number of blood vessels in gingival connective tissue is significantly higher in CP and CPDM patients.