Preservation of Alveolar Ridge using Graft Material after Tooth Extraction: A Clinical Trial.

BACKGROUND: The alveolar process is a tooth-dependent structure, and hence, removal of teeth results in the alteration of alveolar process. To alter bone remodeling after dental extraction, various techniques have been put forward for ridge preservation. AIM: The aim of this study is to evaluate and compare the changes of hard and soft tissues in postextraction socket after the application of bone graft material. MATERIALS AND METHODS: Healthy patients of sample size of 40 were selected who underwent the extraction of anterior tooth irrespective of the arch, from premolar of one side to another, with the exception of incisors in mandible. Twenty patients were randomly selected as the control group and other 20 as the experimental group using an allograft bone material, i.e., beta-tricalcium phosphate to fill the socket. Cone-beam computed tomography (CBCT) was done as baseline preoperative and postoperative at 14 weeks after the extraction. CBCTs data help in recording linear and volumetric measurements which was performed by calibrated examiners to record all the measurements. After measurements, digital planning of dental implants was performed. RESULTS: Forty participants were selected, in which 20 patients each were as the experimental and control groups. No significant difference was found at basal line at any of the cases. At follow-up of 14 weeks, statistical significance was seen in buccal and lingual plate height in the experimental group, and no significant difference was seen in the control group.(P = 0.023). CONCLUSIONS: This study clearly points out that an alveolar ridge preservation technique provides therapeutic benefit by limiting bone resorption in comparison to extraction alone.

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.

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.

Assessment of Effect of Different Sterilization Agents on Dimensional Accuracy of Different Impression Materials in Implant Prosthesis - An In vitro Study.

AIM: Sterilization of impression materials is of paramount importance. The present study was conducted to compare the effect of different disinfectants on dimensional accuracy of elastomeric impression materials used for implant prosthesis and other routine treatments. MATERIALS AND METHODS: The present study was conducted with polyvinyl siloxane (PVS) (regular body), PVS (medium body), PVS (heavy body), and polyether (medium body) impression materials. Glutaraldehyde (2%) and sodium hypochlorite (NaOCl, 0.525%) were the disinfectant solutions employed in the study. After 16 h, the specimens were measured under Leica WILD stereomicroscope and dimensions were compared with master die. RESULTS: The dimensional change in the Controls, 2% glutaraldehyde (Group I), and 0.525% NaOCl (Group II) was non significant where as Group III and Group IV showed statistically significant difference (P < 0.05). Results also showed significantly higher tear strength (newton/millimeter) in Control group followed by Group I and Group II. CONCLUSION: PVS (heavy body) was found to be most stable, and polyether was seen to be stable of all the impression materials.

Assessment of Oral Health Status with Visually Impaired Children in Patna City, Bihar.

AIM: Children with a visually impairment often face various challenges in their day-to-day skills. Oral hygiene maintenance is one major task for them. Such child has difficulty to live current normal life and demands of permission or healthy life. The present study aims to assess the oral health in children with visually impaired using oral health status assessment tool in Patna city. METHODOLOGY: A cross-sectional institutional survey was implicated among visually impaired children who attend special school in Patna city. A total of 180 visually impaired children were selected as per the inclusion criteria. Participant's parents gave written consent for the study. The oral hygiene practices of visually impaired children were recorded by teachers. Oral health assessment tool (OHAT) findings were recorded by the principal investigator. RESULTS: Sixty-seven percent of children had gingival inflammation and 59.8% had normal tongue. 55.2% of children had 1-3 decayed or broken teeth and 16.1% had unhealthy natural teeth. 78.7% of children had change in oral hygiene. CONCLUSION: Oral health status of visually impaired child was very poor and gingivitis was also seen according to usage of oral hygiene assessment tool(OHAT). The sentence should be chaged as Oral health status of visually impaired child was very poor and gingivitis was also seen according to usage of oral hygiene assessment tool (OHAT).

Evaluation of Efficacy of Pilocarpine and Bethanechol in Xerostomic Denture Wearers.

AIM: The aim of this study was to evaluate effectiveness of bethanechol and pilocarpine among xerostomic denture wearers. MATERIALS AND METHODS: This in vitro study was conducted in 60 complete denture wearers of both genders. For assessment of salivary flow, resting saliva and stimulated saliva were collected. Patients were split into two groups consisting of 30 patients each. Pilocarpine was given to patients in group I and patients in group II received bethanechol. Salivary flow was measured at baseline, after 2 weeks, and after 4 weeks. RESULTS: The mean whole resting saliva in patients of group I was 0.61 mg/mL and in that of group II was 0.65 mg/mL. The mean whole stimulated saliva in patients of group I was 1.35 mg/mL and in group II it was 1.51 mg/mL. The mean whole resting saliva after 2 weeks in patients of group I was 0.83 mg/mL and in group II was 0.92 mg/mL. Whole stimulated saliva in patients of group I was 1.67 mg/mL, and in patients of group II it was 1.86 mg/mL. The difference noted was significant (P < 0.05). The mean whole resting saliva after 4 weeks in patients of group I was 1.23 mg/mL and in that of group II was 1.43 mg/mL. Whole stimulated saliva in patients of group I was 1.98 mg/mL and in patients of group II it was 2.04 mg/mL. CONCLUSION: Authors found that both agents were effective in increasing salivary secretions. However, pilocarpine is a more effective sialagogue as compared to bethanechol in completely edentulous patients with xerostomia.

To Compare Mineral Trioxide Aggregate, Platelet-rich Fibrin, and Calcium Hydroxide in Teeth with Irreversible Pulpitis: A Clinical Study.

AIM: Numerous pulp-capping agents such as mineral trioxide aggregate (MTA), calcium hydroxide (Ca(OH)2), platelet-rich fibrin (PRF), and biodentine have been suggested. This clinical study was conducted to compare MTA, PRF, and Ca(OH)2 in teeth with irreversible pulpitis. MATERIALS AND METHODS: The 60 mandibular molar teeth with irreversible pulpitis were used in this study, which were restored with Ca(OH)2, MTA, and PRF. Assessments of the treatment were carried out at 6 months and 1 year by clinical examination and also radiographically. RESULTS: A nonsignificant difference was observed in pain intensity recorded at numerical rating scale at baseline, 24h, 1 week, 1 month, 3 months, 6 months, and 1 year. A nonsignificant (P > 0.05) difference was reported in clinical and radiographic success rate recorded at 6 months and 1 year in all groups. CONCLUSION: Pulp-capping agents such as Ca(OH)2, MTA, and PRF yielded similar success rate when used in teeth with irreversible pulpitis.

Assessment of Aluminum Chloride Retraction Cords, Expasyl, and Tetrahydrozoline-Soaked Retraction Systems in Gingival Retraction.

AIM: The aim of this study was to assess different gingival displacement systems such as aluminum chloride retraction cords, expasyl, and tetrahydrozoline-soaked retraction cord to record intracrevicular margins of tooth preparations. MATERIALS AND METHODS: This study included 60 patients. Patients were divided into four groups of 15 each. In group I, aluminum chloride retraction cords, in group II expasyl, in group III tetrahydrozoline-soaked retraction cord, and in group IV no retraction cord were used. RESULTS: The mean gingival displacement (µm) in group I was 825.6, in group II was 482.1, in group III was 742.3, and in group IV was 214.8. Significant difference was seen in between groups by one-way analysis of variance as P < 0.05. Post hoc Tukey analysis showed significant difference during multiple comparison between groups. CONCLUSION: Authors found that maximum gingival retraction was achieved with aluminum chloride retraction cords followed by tetrahydrozoline and expasyl.

Assessment of Efficacy of 5% Topical Amlexanox and 0.1% Topical Triamcinolone Acetonide in Management of Recurrent Aphthous Stomatitis.

AIM: The aim of this study was to assess the efficacy of 5% topical amlexanox and 0.1% topical triamcinolone acetonide in recurrent aphthous stomatitis (RAS) management. MATERIALS AND METHODS: Sixty adult patients of RAS of both genders were divided into two groups with each group having 30 patients. In group I, 0.1% topical triamcinolone acetonide was prescribed. In group II, 5% topical amlexanox was prescribed. Patients were recalled regularly and size of ulcer, erythema, and pain score was recorded on days 1, 3, and 5. RESULTS: The mean ulcer size (mm) on day 1 in group I was 4.3 and in group II it was 4.1, on day 3 it was 3.5 in group I and in group II it was 3.6, on day 5 in group I it was 1.3 and in group II it was 1.7. The result was not statistically significant (P > 0.05). The mean pain score recorded on visual analog scale was in descending grade day by day on first, third, and fifth days. In group I, healing was seen in 29 (96.6%) patients and in 28 (93.3%) patients in group II. Partially healing was seen in 1 (3.3%) patient in each group, whereas in group II nonhealing was observed in 1 (3.3%) patient. The statistical significance was not achieved as P > 0.05. CONCLUSION: Authors found that above drugs were effective in reducing pain, size of ulcer, erythema, and improving healing in patients with recurrent aphthous stomatitis. There were better results with triamcinolone acetonide as comparison of amlexanox.

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.

A 10 years retrospective study of assessment of prevalence and risk factors of dental implants failures.

AIM: The present study was conducted to determine the prevalence rate of dental implants failure and risk factors affecting dental implant outcome. MATERIALS AND METHODS: The present retrospective study was conducted on 826 patients who received 1420 dental implants in both genders. Length of implant, diameter of implant, location of implant, and bone quality were recorded. Risk factors such as habit of smoking, history of diabetes, hypertension, etc., were recorded. RESULTS: In 516 males, 832 dental implants and in 310 females, 588 dental implants were placed. Maximum dental implant failure was seen with length <10 mm (16%), with diameter <3.75 mm, and with type IV bone (20.6%). The difference found to be significant (P < 0.05). Maximum dental implant failures were seen with smoking (37%) followed by hypertension (20.8%), diabetes (20.3%), and CVDs (18.7%). Healthy patients had the lowest failure rate (4.37%). CONCLUSION: Dental implant failure was high in type IV bone, dental implant with <3.75 mm diameter, dental implant with length <10.0 mm, and among smokers.

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.

Efficacy of 2% Lignocaine and 4% Articaine in Oral Surgical Procedure: A Comparative Study.

AIM AND OBJECTIVE: To compare the efficacy of 2% lignocaine and 4% articaine in the extraction of mandibular molars. MATERIALS AND METHODS: This study was conducted on 120 patients requiring surgical removal of tooth. Patients were categorized into 2 groups with 60 samples each. Group I patients were administered 2% lignocaine with 1:50,000 epinephrine and group II patients were administered 4% articaine with 1:100,000 epinephrine for the extraction of mandibular molar. Inferior alveolar nerve, lingual, and buccal nerve block used in both groups to anesthetize the area. RESULTS: The mean onset of action in group I was 85.2 seconds and in group II was 52.6 seconds, duration of anesthesia in group I was 170.2 minutes and in group II was 226.8 minutes, duration of procedure was 30.4 minutes in group I and 32.6 minutes in group II, pain during procedure in group I was 2.75 and in group II was 1.42, pain after procedure was 1.41 in group I and 0.82 in group II, pain during anesthesia insertion was 1.52 in group I and 1.04 in group II. Forty-six (76.7%) patients in group I and 52 (86.7%) patients in group II did not require re-anesthesia, while 12 (20%) in group I and 8 (13.3%) in group II required 1 time re-anesthesia and 2 (3.3%) patients required 2 times re-anesthesia in group I. CONCLUSION: Articaine can be effectively used in oral surgical procedures as there is early onset of action, longer duration of anesthesia, and less need of re-anesthesia. CLINICAL SIGNIFICANCE: Articaine is more effective compared to lignocaine, hence it can be recommended alternatively for tooth extraction and other oral surgical procedures.

Cellular infiltrative angiolipoma of cheek in an infant.

Lipomas represent about 1 to 5% of all neoplasms of the oral cavity most commonly presenting as painless, mobile, soft, round mass. Angiolipoma, spindle cell lipoma, mylelolipoma, chondrolipoma and myxolipoma are histological variants of lipoma arising from fat tissues. Although the angiolipoma is the most common tumour in the trunk and the extrimities of young people, it occurs infrequently in the head and neck region. In this article we present clinical, radiological and histological features of a cellular infiltrative angiolipoma exicised from the buccal mucosa of a 9 months old female child.