Assessment of knowledge and awareness among North Indian populations about oral precancerous lesions (OPL): A cross-sectional survey study.

Background: A precancerous lesion is a morphologically altered tissue in which oral cancer is more likely to occur than its apparently normal counterpart. They are quite common in the Indian population due to the habitual habit of chewing tobacco. The aim of this study was to evaluate the awareness of oral precancerous lesions by a questionnaire-based survey among the study subjects having been diagnosed with it. Methods: In this descriptive study, a structured questionnaire having 11 survey questions has been used to record the response from study subjects who have been diagnosed and reported for treatment for oral premalignant lesions in the Department of Oral Medicine and Radiology. A total of 1013 study subjects were assessed for awareness about OPL and its consequences. Results: 44.3% of the study population was addicted to smoking tobacco (cigarettes) while 57.9% of study subjects were addicted to non-smoking tobacco (Pan masala). The reason behind their addiction was reported to be stress (54.9%) and workload (25.3%). Most of the study subjects were diagnosed with oral sub-mucous fibrosis (53.4%). 78.6% of study subjects diagnosed with OPL were not aware of it and 94% were willing to quit the addiction. Conclusion: The awareness about OPL among patients was found to be low. Although many wanted to quit their addiction to smoking and chewing tobacco but were unable to do so. So it is a need for time to develop a national policy on tobacco use and related diseases. This policy will definitely reduce the burden of oral premalignant lesions and oral cancer in Indian population.

Gabapentin for cessation of smoking and non-smoking tobacco habits in Indian population.

BACKGROUND: The effectiveness of gabapentin in tobacco dependence has been evaluated by many researchers. The randomized control trials, testing the efficacy of gabapentin in quitting the habit in smokers and users of smokeless tobacco, have not been published yet. We attempted to address this lacuna in knowledge in reducing dependence on tobacco use by gabapentin. METHODS: Our study involves 150 study subjects, 75 of whom were identified as chronic users of tobacco and assigned randomly to one of the three groups consisting of 25 subjects each. Gabapentin in tablet form was prescribed thrice a day for 8 weeks wherein group 1 received a dose of 300mg, group 2 received 600 mg, and group 3 was prescribed 900 mg. An age and sex matched control group have received calcium tablets as placebo in three times daily dose for a period of 8 weeks. RESULTS: Among the three doses of gabapentin, stoppage of habit was reported to be highest in the group-2 followed by group 1 and group 3 respectively. In our study, we found differences in response to quitting tobacco use between duration of habit prior to pharmacologic intervention amongst both smokers and the users of smokeless tobacco. CONCLUSIONS: Gabapentin at dose of 600 mg TDS has optimum effect. Smokers having smoking for more than ten years showed notable benefit with gabapentin. Among smokeless tobacco users who quit tobacco dependence was better having history of habit less than 2 years.

Comparative evaluation of neodymium-doped yttrium aluminum garnet laser with nanocrystalline hydroxyapatite dentifrices and herbal dentifrices in the treatment of dentinal hypersensitivity.

BACKGROUND: The aim of this study was to compare and evaluate the efficacy of neodymium-doped yttrium aluminum garnet laser with and without herbal and nanohydroxyapatite dentifrices in management of dentinal hypersensitivity (DH). MATERIALS AND METHODS: A total of 180 patients who responded to air-blast test and cold-water test using verbal rating scale (VRS) were included in this study. The patients were randomly assigned to six groups (n = 30): control group (CG), scaling and root planning (SRP) + nanocrystalline hydroxyapatite dentifrices, SRP + nanocrystalline hydroxyapatite dentifrices + laser, SRP + herbal dentifrices, SRP + herbal dentifrices + laser, and SRP + laser. Each group was evaluated at baseline, 1 week, 1 month, and 6 months. In every visit of each patient, their clinical examination was done. RESULTS: Among all groups', repeated ANOVA measures and Kruskal-Wallis test was performed in which laser groups showed maximum reduction in DH in all indices while the CG showed minimum reduction in DH. The VRS values showed maximum reduction in SRP + nanocrystalline hydroxyapatite dentifrices + laser group with mean of 0.3 ± 0.5 and minimum reduction in CG with mean of 3.0 ± 0.5 (P < 0.001). CONCLUSION: Among all the groups, SRP + Nanocrystalline hydroxyapatite + Laser can be an effective treatment modality for DH.

Frenectomy with conventional scalpel and Nd:YAG laser technique: A comparative evaluation.

BACKGROUND: Frenectomy is complete excision of the frenum attachment to the underlying bone. Conventional frenectomy with blade has been widely used; however, laser-assisted frenectomy is the most recent alternative. AIM: The present study aims to compare two methods of frenectomy for the pain experienced, intraoperative bleeding, healing outcome, and need for analgesics. MATERIALS AND METHODS: Twenty patients with high labial frenum attachment requiring frenectomy were included in this study. Patients were randomly divided into Group A: scalpel group and Group B: neodymium-doped yttrium aluminum garnet (Nd:YAG) laser group. Visual Analog pain score, intraoperative bleeding, number of analgesics used, and healing outcome 3 months postoperatively were recorded. RESULTS: Group B patients experienced less pain (P = 0.016), less bleeding (P = 0.016), and required fewer number of analgesics (P = 0.008). Healing outcome at 3 months showed no significant difference between the two groups (P = 0.095). CONCLUSION: Based on the results of this study, it can be concluded that Nd:YAG laser is an efficient and a more comfortable alternative to scalpel for frenectomy.

Non-invasive treatment of pyogenic granuloma by using Nd:YAG laser.

Pyogenic granuloma is a 'reactive lesion' in the oral cavity caused due to hormonal imbalance or poor oral hygiene. There are different methods to excise this lesion but most successful is treatment with lasers. Currently, there are different lasers available commercially and are used by clinicians to excise this lesion. In this case report, a 20-year-old female patient reported to the department with a complaint of overgrowth of gingiva on lower canine. It was excised by using neodymium-doped yttrium aluminium garnet laser and the patient was asked for regular follow-up after 1 week and 6 months. The excised lesion was sent to pathology where the lesion was confirmed to be pyogenic granuloma. The patient reported no pain, no blood loss during or postsurgery. Laser is a useful technique for excisional surgeries; it is safe, effective and reduces time of treatment as well as time of healing.

Cytotoxicity of chlorhexidine and neem extract on cultured human gingival fibroblasts through fluorescence-activated cell sorting analysis : An in-vitro study.

OBJECTIVE: To assess the influence of chlorhexidine (CHX), neem vehicle control (NVC), and neem extract (NE) on cultured human gingival fibroblasts (hGFs) using 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) assay and fluorescence-activated cell sorting (FACS) analysis. MATERIALS AND METHODS: Fibroblasts were derived from healthy gingival biopsy specimens harvested aseptically. The effects of CHX, NVC, and NE were evaluated on cultured hGFs through FACS and MTT assay. RESULTS: MTT assay with hGFs indicated altered morphology with maximum cell death at 10% CHX, while NVC and NE showed similar results at a concentration of 75% and above. On FACS analysis, beyond 1%, CHX adversely affected the cell cycle phase distribution whereas NE exerted a detrimental effect only at 100%. Moreover, both with NVC and NE cells were well differentiated in all the three phases of the cell cycle, with distinction getting lost at 50% to finally causing cell death at 100%. CONCLUSIONS: CHX beyond 1% concentration exhibited a toxic effect on hGFs at 1, 5, and 15 min time exposure. However, NE did not adversely affect the fibroblasts even up to 50% concentration showing a less toxic effect in comparison with CHX on these cells. The cytoprotective and oral friendly quality of NE emphaisze the superiority of NE over CHX.