Flap versus Flapless Immediate Implants with Bone Augmentation: A Novel Study.

Background: This study aimed to equate implants placed using a traditional flap elevation technique with implants placed using a flapless process regarding bone healing and success in clinical conditions. Materials and Methods: Sixty subjects were included in this research work. The participants were randomly divided into two groups. Patients in group A underwent implant placement with the flap elevation technique. Similarly, group B patients underwent implant placement without flap reflection. Parameters such as plaque index, wound healing index, crestal bone loss, and radiograph were considered to estimate the effectiveness of the two techniques. Results: Plaque indexes were improved in both groups. The modified gingival index also improved in all the phases of healing. The flapless method showed a better crestal bone. Conclusion: It can be concluded that this study showed that with the right augmentation techniques, implants could be successfully performed immediate extraction sockets, both with and without elevation of the mucoperiosteal flap.

Characteristics and Management of Children With Suspected COVID-19 Admitted to Hospitals in India: Implications for Future Care.

INTRODUCTION: There is a growing focus on researching the management of children with COVID-19 admitted to hospital, especially among developing countries with new variants alongside concerns with the overuse of antibiotics. Patient care can be improved with guidelines, but concerns with the continued imprudent prescribing of antimicrobials, including antibiotics, antivirals, and antimalarials. OBJECTIVE: Consequently, a need to document the current management of children with COVID-19 across India. Key outcome measures included the percentage of prescribed antimicrobials, adherence to current guidelines, and mortality. METHODOLOGY: A point prevalence study using specially developed report forms among 30 hospitals in India. RESULTS: The majority of admitted children were aged between 11 and 18 years (70%) and boys (65.8%). Reasons for admission included respiratory distress, breathing difficulties, and prolonged fever. 75.3% were prescribed antibiotics typically empirically (68.3% overall), with most on the Watch list (76.7%). There were no differences in antibiotic prescribing whether hospitals followed guidelines or not. There was also appreciable prescribing of antimalarials (21.4% of children), antivirals (15.2%), and antiparasitic medicines (27.2%) despite limited evidence. The majority of children (92.2%) made a full recovery. CONCLUSION: It was encouraging to see low hospitalization rates. However, concerns about high empiric use of antibiotics and high use of antimalarials, antivirals, and antiparasitic medicines exist. These can be addressed by instigating appropriate stewardship programs.

A novel, new generation drill coating for osteotomy site preparation.

BACKGROUND: Implant success and survival rate ranges from 93% to 97%; however, failures are not very uncommon. These failures can be caused due to a variety of reasons out of which increased heat during drilling of osteotomies is a major contributor. AIM: The aim of this study was to develop a new generation diamond-coated drill and compare the thermal changes between commercially available drills and the experimental diamond coated drill during implant site preparation in artificial bone. MATERIAL AND METHODS: Three types of drills were selected for the study; Group A (Carbide), Group B (Stainless Steel), and Group C (Experimental). A total of 60 implant site preparations were performed with all the drills in artificial bone using a surgical unit linked to a testing device, in order to standardize implant drilling procedures. Bone temperature variations were recorded when drilling at a depth of 10 mm. A constant irrigation of 50 ml/minute and drilling speed of 800 r.p.m. was maintained. RESULTS: The mean temperature of Group A, Group B, and Group C was 35.57°C, 36.83°C and 34.23°C, respectively. The results were assessed and statistically analyzed using ANOVA test and post hoc Bonferroni test. Statistically significant higher temperatures were obtained with stainless steel drill and carbide drill when compared with the experimental diamond coated drill. (P = 0.000). CONCLUSIONS: Diamond coated osteotomy drills have shown promising results in reducing heat generation at the osteotomy. Further studies need to be conducted to maximize the potential use of diamond as components of drills in implant dentistry.

A comparative evaluation to assess the efficacy of 5% sodium fluoride varnish and diode laser and their combined application in the treatment of dentin hypersensitivity.

BACKGROUND: Dentin hypersensitivity (DH) is an age old complaint with a great number of treatment modalities, but none of these are totally effective till date. Lasers being one of the latest treatment options in periodontics, a study was conducted to test the efficacy of diode laser (DL) in DH alone and in comparison with 5% sodium fluoride (NaF) varnish. AIM: The aim of the present study was to compare the effectiveness of 5% topical NaF varnish and 980 nm gallium aluminum arsenide (GaAlAs) DL alone and combination of 5% NaF + 980 nm GaAlAs DL in the management of DH. MATERIALS AND METHODS: The study was conducted on 120 teeth in thirty patients with DH assessed by tactile and air blast (AB) stimuli measured by visual analog scale (VAS). Teeth were randomly divided into Group 1 (P) placebo-treated control group, Group 2 (NaF) treated by 5% NaF varnish, Group 3 (DL) treated with 980 nm DL, and Group 4 (NaF + DL) treated with both 5% NaF varnish and 980 nm DL (combination group). RESULTS: There was a significant reduction in DH. The VAS reduction percentages were calculated, and there was a significant decrease in DH above all in G4 (NaF + DL) than G3 (DL) and G2 (NaF). CONCLUSION: Even though all the three groups (2, 3, and 4) showed improvement in terms of DH reduction, 5% NaF varnish with DL showed the best results among all the groups.

Recurrent peripheral cemento-ossifying fibroma.

Peripheral cement-ossifying fibroma (PCOF) is a rare osteogenic neoplasm that ordinarily presents as an epulis-like growth. It frequently occurs in maxillary anterior region in teenagers and young adults. We report a case of PCOF in a 42-year-old male, which was previously surgically excised and recurred after a period of 2 years. PCOF should be considered in the differential diagnosis of reactive hyperplastic lesions originating from gingiva. Hence, early diagnosis with proper surgical excision and aggressive curettage of the adjacent tissues is essential for prevention of recurrence.

Orthodontic bracket designs and their impact on microbial profile and periodontal disease: A clinical trial.

AIM: The aim of the present study was to compare the undisturbed plaque formation on teeth bonded with Preadjusted (Captain Ortho, Libral Traders, Mumbai, India) and Begg Brackets (Captain Ortho, Libral Traders, Mumbai, India) with nonbonded control sites via a de novo plaque growth over a period of 7 days. MATERIALS AND METHODS: A clinical trial with the split-mouth design was set up enrolling 10 dental students. Within each subject sites with (Preadjusted) (P-site), Begg brackets (B-site) and control sites were followed. Plaque index and gingival index were recorded on days 3 and 7. Supra-gingival and sub-gingival plaque samples were taken from the brackets and the teeth on days 3 and 7, and were sent for aerobic and anaerobic culturing. The total number of bacterial colony forming units (CFU) was assessed for each sample using a colony counter. Tukeys and Dunnett test then statistically analyzed data. RESULTS: The mean plaque index and gingival index increased on P-site and B-site on the third and 7(th) day. The shift from aerobic to anaerobic species was observed earlier in P-sites than in B-sites. The CFU were significantly higher for all sites on day 7 when compared with day 3. The aerobe/anaerobe CFU ratio was significantly lower in P-sites than in B-sites and then control showing an increase in the number of anaerobic species on the 3(rd) and 7(th) day (P < 0.05). Based on observed means, the mean difference was significant (P < 0.05). CONCLUSION: The present data suggest that Preadjusted brackets accumulated more plaque than Begg brackets. Bracket design can have a significant impact on bacterial load and on periodontal parameters.

NSAIDs and bleeding in periodontal surgery.

AIM: To evaluate and compare the clinical effects of ibuprofen and diclofenac sodium on bleeding during periodontal surgery. MATERIALS AND METHODS: Thirteen medically healthy men and women of mean age 37.5±17.67 (mean age± standard deviation) were selected for the study. All the subjects were divided into three groups: control (C) and test groups (T1) and (T2). Each subject of T1 group and T2 group was given ibuprofen and diclofenac sodium respectively, prior to surgery. Bleeding times of patients were recorded prior to performance of periodontal flap surgical procedures. RESULTS: It was found that there was increased bleeding time and increased peri-operative bleeding when ibuprofen and diclofenac sodium were taken prior to surgery and this was statistically significant. (2.5538 (T1), 1.8385 (T2) versus 1.2385 (C) minute, p= .001) (mean blood loss) and (62.0325 ± 9.0594 (T1), 51.082 ± 9.792 (T2) versus 37.4992 ± 5.99 (C) millilitre, p = .000). CONCLUSION: The findings of this study suggested that pre-operative administration of ibuprofen and diclofenac sodium could increase bleeding time and peri - operative blood loss.

Idiopathic gingival enlargement associated with generalized aggressive periodontitis in a 19-year-old female.

Gingival enlargement, one of the manifestations of gingival and periodontal disease, is also known as gingival overgrowth. Idiopathic gingival enlargement is a rare gingival overgrowth, which is of an undetermined cause. This unknown etiology has now been linked to specific genes and idiopathic gingival enlargement is at times referred to as hereditary gingival enlargement. This condition is a benign, slow growing proliferation of gingival tissues. Aggressive periodontitis is the rapid form of periodontal disease which is characterized by extensive periodontal tissue destruction, increased host-susceptibility toward periodontal disease progress and a genetic predilection toward disease occurrence. We present a rare case of idiopathic gingival fibromatosis associated with generalized aggressive periodontitis in a young female. The patient presented with classic clinical and radiographic presentation associated with gingival enlargement and aggressive periodontitis. The diagnosis was then confirmed by histopathological and neutrophil functions tests.

Interrelationship between chronic periodontitis and anemia: A 6-month follow-up study.

BACKGROUND: In India, anemia is a common and serious health disorder among both sexes and all age groups, with anemia of chronic disease (ACD) being the second most prevalent anemia. Periodontitis is an inflammatory disease of the supporting tissues of the tooth caused by specific microorganisms. An immune response to bacteria and their products induces a major vascular response, offering explanatory mechanisms for the interactions between periodontal infection and a variety of systemic disorders. Therefore, periodontitis results in low-grade systemic inflammation, which may cause lower number of erythrocytes and, consequently, lower hemoglobin concentration. MATERIALS AND METHODS: A total of 100 systemically healthy male patients visiting the outpatient department participated in the study. Of these, 50 patients had healthy periodontium and 50 patients had chronic periodontitis. Clinical parameters and red blood cell parameters of all the patients were assessed at baseline and 6 months after non-surgical periodontal therapy. Statistical analysis using Student's t-test was performed. RESULTS: Data analysis revealed that patients with chronic periodontitis showed an improvement in both clinical and red blood cell parameters from baseline to 6 months after non-surgical periodontal therapy. CONCLUSION: From the present study, it can be concluded that like any other chronic condition, chronic periodontitis can lead to ACD. It also provides evidence that non-surgical periodontal therapy can improve the anemic status of patients with chronic periodontitis.

Idiopathic gingival enlargement and its management.

Idiopathic gingival enlargement is a proliferative fibrous lesion of the gingival tissue that causes esthetic and functional problems. Both genetically and pharmacologically induced forms of gingival enlargement exist. This case report addresses the diagnosis and treatment of a case of idiopathic gingival enlargement in a 13-year-old female. The patient presented with generalized diffuse gingival enlargement involving the maxillary and mandibular arches extending on buccal and lingual/palatal surfaces and covering incisal / occlusal third of the tooth resulting in difficulty in speech and mastication since last three years. Patient also gave a history of surgical treatment being carried out four years back in upper anterior region suggesting of recurrence. Biopsy report confirmed the diagnosis of gingival hyperplasia. Gingivectomy was carried out in all four quadrants by using four different methods.