Evaluation of Crestal Bone Levels using Simvastatin as an Adjuvant Around Immediate Implants - A Clinico Radiographic Study.

Objective: Simvastatin was used as an adjuvant medication in this clinico-radiographic investigation to assess the impact on crestal bone levels around immediate implantation. Materials and Methods: A randomized controlled trial with 50 patients who needed an implant placed right away was done. Simvastatin was used as an adjuvant in groups ((Group A), whereas group (Group B)) served as the control group for the participants. At baseline and during follow-up visits, clinical measures such as probing depth (PD) and bleeding on probing (BOP) were measured. At baseline and 12 weeks, radiographic measurements of crestal bone levels were taken. Results: At 12 weeks, Group A demonstrated a significantly lower PD and BOP than did Group B. Furthermore, at 12 weeks, Group A showed greater crestal bone preservation than did Group B. The results of the statistical analysis showed that the two groups were significantly different. Conclusion: The results of this study indicate that simvastatin use as an adjuvant medication after immediate implant insertion contributes to better clinical outcomes and greater crestal bone preservation. Simvastatin may be helpful in increasing bone regeneration, decreasing inflammation, and soft tissue healing. These findings demonstrate how simvastatin may be used as an additional therapy to enhance the effectiveness of rapid implant implantation operations.

Influence of wearing complete denture on the glycemic control, serum lipid, and proteins in patients with diabetes.

Aims: The aim of this study was to assess the impact of prosthodontic rehabilitation on glycemic and lipid control in functionally and completely edentulous patients with diabetes. Setting and Design: An in vivo study conducted with the intention of studying the potential link between edentulism and impaired masticatory efficiency with the nutritional status in diabetic patients. Materials and Methods: A total of 20 diabetic patients based on the inclusion criteria were selected. They were rehabilitated using a removable prosthesis, and observations were made across three parameters - glycosylated hemoglobin (HbA1C), serum cholesterol (S col), and serum protein (SP) at three stages - baseline, 3 months, and 6 months posttreatment. This was done to gauge the impact of the prosthetic rehabilitation on their health due to an increased masticatory efficiency potentially causing changes in dietary patterns. Statistical Analysis Used: •Inter group comparison (>2 groups) was done using one way ANOVA followed by pair wise comparison using post hoc test. •Intra group comparison was done using repeated measures ANOVA (for>2 observations) followed by post Hoc test. For all the statistical tests, P < 0.05 was considered to be statistically significant, keeping α error at 5% and ß error ati20%, thus giving a power to the study as 80%. Results: Hba1c at the baseline had a mean value of 8.04%, which reduced to 7.87% at the 3-month stage and 7.38% at the 6-month stage. S col at the baseline had a mean of 151.6 mg/dL; at the 3-month follow-up, it was 166.5 mg/dL, and at the 6-month follow-up, it was 173.95 mg/dL. SP had a mean baseline value of 6.38 mg/dL, which progressed to 6.67 mg/dL at the 3-month stage and 6.97 at the 6-month stage. Conclusion: Within the limitations of this study, it can be concluded that after 6 months of prosthetic rehabilitation in edentulous/functionally edentulous patients: There was a reduction in HbA1c (8.04%-7.38%); however, it was found to be statistically insignificant at that stage There was an increase in S col (151.6 mg/dL-173.95 mg/dL); it was found to be statistically significant There was an increase in SP (6.38 mg/dL-6.97 mg/dL); however, it was found to be statistically insignificant at that stage.

Effect of Osseodensification on Bone Density and Crestal Bone Levels: A Split-mouth Study.

BACKGROUND: Dental implants have become a popular alternative in the oral and maxillofacial rehabilitation after the introduction of the concept of osseointegration. A poor density bone can negatively influence the bone to implant contact (BIC) and delay osseointegration. Various osteotomy techniques and drilling procedures have been used to increase stability in low-density bone. But they have been associated with limitations such as trauma to the surrounding bone and difficulty in controlling the technique. Osseodensification has recently been developed. Densifying burs are specifically designed burs which help in preserving the bone by condensing the bone by rotating in the noncutting direction. MATERIALS AND METHODS: Split-mouth study was conducted on a total of 10 patients wherein implants were placed in the same patient bilaterally in maxillary posterior region where the left maxillary posterior region received implants through sequential osteotomy technique and the right maxillary posterior region received implants through a series of new multifluted tapered burs (Densah™). A cone-beam computed tomography (CBCT) was taken preoperatively, immediately after implant placement, and 3 and 6 months after implant placement. The bone density and crestal bone levels were measured. Results were analyzed by student's paired "t" test and Man-Whitney U test. RESULTS: There is no statistical difference between the levels of the crestal bone between an osseodensified site as compared to a conventional osteotomy site. The width of the residual bone increases after osseodensification and remains in the increased dimension for 3 months and continues at 6 months. Thus, it can be concluded that osseodensification leads to bone expansion. CONCLUSION: The radiographic bone density adjacent to the implant is significantly increased after ossedensification and the bone there remains relatively dense over a period of 6 months aiding in a primary stability and eventual good osseointegration.

Evaluation of the influence of mandibular condylar contour, height, and asymmetry in subjects with myalgia presenting with or without clicking among south coastal Karnataka population - A descriptive cross-sectional study.

Aim: The purpose was to evaluate the morphological variations of the condyle in patients presenting with myalgia associated with and without clicking of temporomandibular joint (TMJ) and its possible effect on the contour and height. Setting and Design: Cross sectional study. Material and Methods: A total of 60 patients comprising of 20 patients with myalgia, 20 patients with myalgia associated with clicking of TMJ, and a control group of 20 patients without any signs and symptoms of temporomandibular disorder were selected for purpose of the study. Using a digital panoramic radiograph, the contour of the condyle was evaluated for shape, condylar height (CH), and condylar asymmetry. Statistical Analyses Used: Chi-square test, One- way ANOVA. Results: Rounded contour of the condyle was the most prevalent shape of the condyle amongst the three groups. There was a significant decrease in mean right and left CH in subjects with myalgia (0.71 cm and 0.73 cm) and subjects with myalgia associated with clicking (0.65 cm and 0.62 cm) compared to control group subjects. There was also an increase in the mean asymmetry index in subjects with myalgia presenting with clicking (2.362 ± 1.4) and without clicking (1.388 ± 2.1) (P < 0.05). Conclusion: Within the limitations of the current study, round contour of the condyle is the most common variant. Subjects with myalgia showed a significant reduction in condyle height. Condyle contour, height, and asymmetry may not predispose the joint for clicking.

A Study to Determine the Correlation between the Intercondylar and Interdental Widths in South Indian Population: A Cross-sectional Study.

AIM: Anatomical landmarks that remain fairly constant throughout an individual's life help determine the position of the artificial teeth closer to that of their predecessors. The aim of the present study was to evaluate whether there is a relationship between the intercondylar widths (ICWs) and the interdental widths (IDWs) in the maxillary and mandibular arches in dentate subjects. MATERIALS AND METHODS: The study was conducted in two parts, with 80 dentate subjects in total. Initially, in the first 40 subjects, a mathematical index was obtained by dividing the mean ICWs by the mean IDWs. In the second part, the ICW was measured and was used along with the index obtained in the first part, to estimate the IDW. These estimated values were then verified with the real IDWs by direct intraoral measurements. An arbitrary earpiece facebow (ARTEX® Gesichtsbogen Facebow) was used to measure the ICW. Statistics was done using SPSS software version 18 using Karl Pearson's correlation test and paired t-test. RESULTS: The IDW was correlated to the ICW; the maximal correlation was found between ICW and lower 6-6 width (L6-6W) (p value 0.033) and the lowest correlation was found between ICW and upper 6-6 width (U6-6W) (p value 0.046). CONCLUSION: ICW can be used as an additional guide to position denture teeth. This method suggested would result in a better buccolingual positioning of the posterior teeth, which would help avoid encroaching on the tongue space, thereby improving phonetics and speech with dentures. CLINICAL SIGNIFICANCE: ICW bears a relationship with the IDWs in the maxillary and mandibular arches. ICW being a fairly constant anatomical landmark can be used as an additional guide aid in positioning the artificial teeth.

Microbial Analysis and Determination of Antibiotic Susceptibility of Dental Laboratory Equipments and Laboratory Attire.

CONTEXT: This study was done to determine the level and type of microbial contamination present on the surface of various dental laboratory equipment and laboratory attire and to determine the antibiotic susceptibility pattern of these isolated pathogens. SUBJECTS AND METHODS: The samples were divided into following groups: six groups of dental laboratory equipment (articulators, facebow, fox plane, polishing buff, micromotor handpiece, and surveyors) and dental attire of laboratory technicians and students. A total of 33 swabs were collected from each dental laboratory equipment, namely, articulators, facebow, fox plane, polishing buff, micromotor handpiece, and surveyors. The dental laboratory attire of students and dental technicians were analyzed separately. The swabs were collected from the laboratory attire at the end of the week, and they were washed once a week and at the beginning of the week. The groups are Group 1 - dental laboratory attire (students), Group 2 - dental laboratory attire (technicians), Group 3 - polishing buff, Group 4 - facebow, Group 5 - surveyor, Group 6 - fox plane, Group 7 - articulator, and Group 8 - micromotor handpiece. The moistened swabs were inoculated into the broth and subcultured on to the MacConkey Agar plates, and then incubated aerobically at 37°C for 24 h. The organisms were identified based on colony morphology, Gram staining, and standard biochemical tests. The antibiotic susceptibility patterns of the isolated organisms were done according to the CLSI guidelines. The collected data were statistically analyzed. STATISTICAL ANALYSIS USED: The data collected were entered into a Microsoft Excel Spreadsheet and analyzed using IBM SPSS Statistics, Version 22 (Armonk, NY, IBM Corp.). The frequency and mean standard deviation of the samples were analyzed using Fisher's exact value test. Percentage of resistance among the isolates to different antimicrobials was also determined. RESULTS: The microorganisms isolated were Staphylococcus aureus, Escherichia coli, coagulase-negative Staphylococcus, Pseudomonas, Klebsiella, nonfermenting Gram-negative bacteria, and Bacillus species. The mean microbial levels in dental laboratory attire were more (5 log10 colony-forming units [CFU]) compared with dental equipment (3 log10 CFU-4 log10 CFU). Furthermore, most of the isolated organisms showed increased antimicrobial resistance. CONCLUSION: Majority of the isolated organisms were not a part of the normal oral microflora and are capable of causing various diseases. The increased resistance to the antimicrobials showed by the isolated organisms proves that there are increased chances of multiresistant organisms to occur in the future.

Effect of Type II Diabetes Mellitus, Candida Albicans and Streptococcus Mutans on the Biofilm Formation on Prosthetic Materials.

AIM: To investigate the biofilm formation on Prosthetic materials as affected by type II diabetes mellitus, Candida albicans and Streptococcus mutans. MATERIALS AND METHODS: Two types of saliva, natural saliva, and artificial saliva were collected and prepared respectively. The natural saliva was divided into diabetic and non-diabetic saliva. The artificial saliva was further divided into two groups, one inoculated with Streptococcus mutans and the second with Candida albicans. The 150 samples of various prosthetic materials were prepared using nickel-chromium alloy, ceramic, soft liner, tooth molding powder; heat cured the acrylic resin. The samples were then immersed in natural saliva and artificial saliva and studied for biofilm formation. RESULTS: Diabetic saliva formed more biofilm than non-diabetic saliva. Streptococcus mutans were able to form more biofilm than Candida albicans in artificial saliva on constitutive androstane receptor (hCAR) and spinal length (SL). In Diabetic saliva, there was a significant difference in the biofilm formation seen between MC and NCA (p < 0.05). No biofilm was formed on hCAR in natural saliva (diabetic or non-diabetic). In artificial saliva inoculated with Candida albicans and streptococcus mutans there is a significant difference in the biofilm formation in all the materials except NCA. CONCLUSION: Diabetic saliva has more potential to form biofilm than non-diabetic saliva. Also, Candida albicans and Streptococcus mutans both can form a biofilm on materials used with the maximum formation on hCAR. Smoother materials formed less biofilm than rougher surfaces like hCAR, PCM, SL. CLINICAL SIGNIFICANCE: It is desirable for dental restorative materials to have a low susceptibility for accumulation and formation of biofilm as it may lead to pathologies such as dental caries, periodontal disease, peri-implantitis, etc. which are plaque-related. The most commonly used materials in prosthodontics have been used in the study to establish a direct relationship with the formation of biofilm, this, in turn, helps us to take the right call in choosing a material for a patient with an already compromised systemic condition.

Effect of Loss of Teeth and its Association with General Quality of Life using Geriatric Oral Health Assessment Index (Gohai) among Older Individuals Residing in Rural Areas.

The development of measures for assessing oral health status is essential to the evolution and maturation of a scientific knowledge based in geriatric dentistry. Their development as branches of clinical care depends in part as ability to demonstrate an effective grasp of the problems of elderly and their solutions. Any strategy for altering the health status of elderly requires a technology for first assessing that health status and then detecting increments of progress. Development of geriatric oral health assessment index (GOHAI) is a self reported measure designed to assess the oral health problems of older individuals. The goal of geriatric assessment is to collect information that will facilitate diagnosis and suggest appropriate interventions. Such a measure would facilitate estimation of prevalence of oral functional problems in older individuals, It would also increase understanding of psychological impact of oral disease and provide a means for comparing the effectiveness of various dental treatment. It also emphasizes on social well being and reflects quality of life following replacement of missing teeth.

The Release of Elements from the Base Metal Alloys in a Protein Containing Biologic Environments and Artificial Saliva - An Invitro Study.

INTRODUCTION: It has been reported that protein containing solutions can accelerate the release of elements from the base metal alloys. AIM: This study aims to determine whether the solution in which an alloy is submerged and the exposure time have any effect on the amount of release of elements from the Ni-Cr and Co-Cr alloys. MATERIAL AND METHODS: A total of 126 specimens were made from the Ni-Cr alloy and 42 specimens were made from Co-Cr alloy in the form of 5mm diameter discs, 2mm in thickness. Dissolution experiments were carried out in Bovine Serum Albumin (BSA) and artificial saliva for a period of seven weeks and atomic absorption spectrophotometer was used for elemental analysis. STATISTICAL ANALYSIS: T-test was done to correlate the difference of elemental release from both BSA and artificial saliva. ANOVA test was done to compare the release at different time intervals and to compare the release of elements at different time intervals within a particular solution. TUKEY HSD test was done for comparison between the elements in a particular solution. RESULTS: The results showed that the elemental release was seen in both the solutions with a significant increase of release in BSA. The release of elements from the Ni-Cr alloy showed the predominant release of Cr. CONCLUSION: The protein containing solution showed maximum release of elements from Ni-Cr and Co-Cr alloys. The elements that released from the alloys never reached their threshold for toxic effects. Hence these alloys can be safely used in fabrication of metal restorations without any ill effects.

Evaluation of condylar inclination of dentulous subjects determined by axiograph and to compare with manual programming of articulators using protrusive interocclusal record.

AIMS: To determine the average condylar inclination using ultrasonic axiograph; to determine the average condylar inclination using protrusive interocclusal bite records; to compare whether there is any marked difference in the values obtained by these techniques. SETTINGS AND DESIGN: This clinical study compares the mean horizontal condylar inclination of the ultrasonic axiograph (Axioquick system) and the manual programming using protrusive interocclusal records. MATERIALS AND METHODS: The study was conducted on a group of 30 subjects reporting to Department of Prosthodontics. Axioquick software system of SAM III (School Articulator Munich) fully-adjustable articulator was used, and interocclusal recording of condylar inclination is the manual method used in semi-adjustable articulators using Aluwax. The condylar inclination of the articulator was adjusted and set using protrusive interocclusal record. STATISTICAL ANALYSIS: The horizontal condylar inclination values of both methods were collected, and the mean of right and left condylar inclination was compared using paired t-test. RESULTS: A statistically significant difference exists between Axioquick system and the manual method of programming articulator with protrusive interocclusal records (P ≤ 0.001). CONCLUSIONS: Within the limitations of the present study, the following conclusions were drawn: The average condylar inclination by axiograph is 42.125°. The average condylar inclination by interocclusal record is 33.25°. Comparison of both values shows a difference of 8.88° ± 4.03° that showed a significant difference (P < 0.001).

Three-Alarm System: Revisited to treat Thumb-sucking Habit.

Thumb and digit-sucking habits or non-nutritive sucking are considered to be the most prevalent among oral habits. Most children stop thumb sucking on their own. If the habit continues beyond 3 to 4 years of age, it not only affects the dental occlusion, but the shape of the thumb/digit may be altered as well. This article presents the management of thumb sucking by modified RURS, elbow guard incorporated with revised 'three-alarm' system. How to cite this article: Shetty RM, Shetty M, Shetty NS, Deoghare A. Three-Alarm System: Revisited to treat Thumb-sucking Habit. Int J Clin Pediatr Dent 2015;8(1):82-86.

Crevicular enzymes in peri-implant sulcus fluid around platform-switched implants: a pilot study.

This study compared levels of the 2 crevicular enzymes-myeloperoxidase (MPO) and alkaline phosphatase (ALP)-in peri-implant sulcus fluid (PISF) around platform-switched implants (implant group) vs the 2 enzymes' levels in gingival crevicular fluid around contralateral natural teeth (control group). Twenty subjects were selected from a population who were set to receive fixed implant prostheses. Samples for PISF were collected at 3 different intervals: 1 week after the placement of a healing abutment, 1 week after the implant prosthesis was loaded, and 3 months post-treatment. Control group samples were taken at the same time points. The results from the implant group showed a statistically significant reduction in MPO levels from the first to the third collection, and a statistically significant increase in ALP levels over the 3-month post-treatment period, as compared to the control group.

Evaluation of colour stability of provisional restorative materials exposed to different mouth rinses at varying time intervals: an in vitro study.

The most important factor affecting esthetics is colour. Whether a definitive prosthesis or a provisional restoration, maintenance of esthetics is of prime concern along with restoration of function. Colour stability of provisional prosthesis is affected by various factors and various studies are documented in the literature on this. The purpose of this study was to evaluate the colour stability of provisional restorative materials exposed to different mouth rinses at varying time intervals. 120 discs, each of self cure tooth moulding material, Protemp 4 and Revotek LC were prepared and immersed in two mouth rinses, hexidine and periogard and evaluated for their colour stability after 1 week, 1 and 3 months. The data obtained was statistically analysed using ANOVA and Tukey's post hoc analysis. The results indicate that there is a significant difference in the colour variation of various materials in two different mouth rinses at different time intervals. Revotek LC was found to be the most colour stable material and periogard had the least staining potential at varying time intervals.

Comparison of Marginal Gap and Microleakage in Copy-Milled and Cad-Milled Zirconia Copings Bonded Using Light Cure and Chemical Cure Resin Bonding Systems.

This in vitro study assessed the marginal gap and marginal microleakage in zirconia copings fabricated using two computer aided techniques- CAD milling and Copy milling and cemented to respective tooth preparations using two resin bonding systems, light cure and self-cure resin bonding systems. 32 extracted premolars were prepared to receive zirconia copings fabricated using CAD/CAM and Copy milling techniques. Once the copings were fabricated, the samples were evaluated for marginal fit prior to cementation through microscopic observation. Evaluation of marginal gap was done again after cementation, in order to incorporate the influence of the resin bonding system on the marginal microgap. The specimens were evaluated under the stereomicroscope for micro-leakage using commercial software. A comparative statistical analysis was done following data collection using Mann-Whitney U test, Wilcoxon test and chi-square test. The data collected regarding marginal gap was well within 120 µ, which is in accordance with previous studies. However, Copy milled specimens showed statistically lesser marginal gap when compared to CAD milled specimens. While comparing microleakage, it was observed that the microleakage in Copy milled specimens bonded with light cure resin bonded cement was statistically lesser than that of specimens cemented with chemical cure resin cement.(P = 0.003). This in vitro study concluded that Copy milling technique fabricated zirconia restorations with lesser marginal gap and microleakage score in comparison to CAD milled samples. Light cure resin bonding system also proved to be more effective option compared to self cure resin bonding systems. However, the limitations of this study should be taken into concern and further research should be aimed at a larger sample size to validate the results.

Prosthetic Rehabilitation of a Patient with Congenitally Deformed Ears.

Treacher Collins syndrome is a rare autosomal dominant congenital disorder characterized by craniofacial deformities and is found in about 1 in 50,000 births. This is a bilaterally symmetrical abnormalities derived from the first and second brachial arches and the nasal placode. Unfortunately, many of the new surgical techniques are extensive and compromise the patient's quality of life, not only function and esthetics but also the psychological status of the patient. These problems require prompt rehabilitation with surgery or prosthetic rehabilitation. This article presents a procedure in the basic fabrication of a prosthetic ear by a three-piece die technique.

Immediate Placement and Restoration of Implant in Periapical Infected Site in the Maxillary Esthetic Zone: A Case Report.

Immediate placement and restoration of the implant is a widely used protocol, but loading of implants in the site which is periapically infected is still not very popular. Very few studies have been conducted and its still in debate. The conventional protocol of placing implant and waiting for it to osseointegrate is time consuming and compromises patients esthetics and psychological comfort. This report presents a case of immediate placement and restoration of implant in the region with periapical infection.

A study to correlate the incidence of cross arch balance and working side occlusal wear facets among different age groups: an in vivo study.

INTRODUCTION: The prevalence of group function and canine guided occlusion is common in natural dentition, but cross arch balance is not often seen. Hence, a study was carried out with following objectives: Analysis of incidence of cross arch balance in different age groups and working side occlusal wear facets in following subjects. MATERIALS AND METHODS: A total of 200 patients with natural dentition were included in the study. Subjects with cross arch balance were analyzed for working side occlusal wear facets. Data were analyzed statistically by Chi-square test. RESULTS: The incidence of cross arch balance in the study group was 0.7%. On examination, subjects with group function on the working side and cross arch balance on the non-working side had more occlusal wear facets. CONCLUSION: From the study, it was observed that there was no significant variation in the number and extent of wear facets between the cross arch and without cross arch subjects due the smaller sample size hence it was difficult to conclude the relationship non-working side contact as interference and its influence in wearing of dentition in this study.

A comparative evaluation of application techniques of a paint-on die spacer in grooves: an in vitro study.

The use of paint-on die spacer to improve the seating of casting has become quite popular in the recent years. The generally accepted range of paint-on die spacer is approximately 20-40 µm, which suggests a range of tolerance. The painting of the retentive grooves with die spacer has always been a subject of debate. The primary purpose of this study was to determine if there was a tendency for the paint-on die spacer to accumulate in grooves of tooth preparation in sufficient thickness to exceed this accepted range of tolerance when applied using two different techniques. Eight die stone blocks with three grooves each were prepared. Half the samples were painted in unidirectional method and the other halves were painted using the haphazard method of application. The thickness of the die spacer was measured at different positions using 200× magnification and the mean and standard deviations were calculated. On analysis it was seen that the thickness of the paint-on die spacer in grooves was in the range of 20-40 µm for unidirectional method of application, whereas in haphazard method of application the thickness of the paint-on die spacer was in the range of 28-132 µm. From the above study it was concluded that the method of application influenced the thickness of the paint-on die spacer. The recommended thickness of the die spacer was achieved on unidirectional method of application.

Comparative Evaluation of Dimensional Accuracy and Tensile Strength of a Type IV Gypsum Using Microwave and Air Drying Methods.

To evaluate dimensional accuracy and tensile strength of a type IV gypsum product, at different time intervals, dried in air or a microwave oven. Eighty specimens prepared from a cylindrical mould were used for measuring tensile strength (group A). Twenty specimens from a master die mould were used for determining dimensional accuracy (group B). In group A, 40 specimens were dried in open air at room temperature (A1). The other 40 were removed after 30 min and air dried for 20 min. These were subjected to microwave oven drying for 5 min (A2). Ten specimens each were tested under diametral compression at each of the following time periods: 1, 2, 4 and 24 h after drying. In group B, ten specimens were dried in open air at room temperature (B1). Ten specimens were removed from the mould after 30 min and air dried for 20 min. These were then dried in a microwave oven for 5 min (B2). The data was statistically analyzed using students unpaired "t" test. At all time intervals, diametral tensile strength (DTS) values for specimens dried in microwave oven were significantly higher than for those dried in open air. There were no significant differences between the dimensional accuracy of the two groups. In this study, microwave oven drying had a positive effect on the DTS of a type IV gypsum and the microwave oven dried specimens were as accurate as the air dried specimens over the same time period.