Effects of Simvastatin on Gene Expression and Alkaline Phosphatase Activity in the MG-63 Cell Line Treated With Hyperglycemia for Bone Regeneration.

Background Dental implants have become a widespread treatment option for replacing missing teeth. Adequate bone is required for the placement of dental implants, in the absence of which, augmentation by bone regeneration is done. Antiresorptive drugs are used as treatment procedures for bone regeneration. One such antiresorptive drug is simvastatin (SV), a 3-hydroxy-3-methylglutaryl coenzyme used to manage hyperlipidemia. It reduces serum cholesterol levels and has an advantageous effect on new bone formation. Various studies establish that SV stimulates bone morphogenetic protein (BMP)-2 expression and leads to bone formation. SV prevents the production of isoprenoids and mevalonate, which are essential for osteoclastogenesis and contribute to the bone-sparing effect.  Aim The aim of the study was to investigate the osteoregenerative activity of SV in the osteoblast-like cell models, MG-63 cell line, with hyperglycemic conditions. Methodology MG-63 cultures were established under high glucose concentrations during the experiments and cultured with SV concentrations of 1 µM and 3 µM. The quantification of the expression of the genes, namely, BMP-2 and osteocalcin (OCN) was done by real-time quantitative polymerase chain reaction (RTqPCR). The measurement of alkaline phosphatase activity in the SV-treated cells was also determined. Results According to the results of the study, SV had osteoprotective properties resulting from the inhibition of osteoclast stimulation and osteoinductive properties, facilitated by BMP-2 and OCN. In addition, SV at concentrations of 1 µM and 3 µM increased the gene expression of BMP-2 and OCN in the MG-63 cell line. Conclusion The results of this study demonstrated that SV had a significant and direct effect on osteogenesis in osteoblasts in vitro.

Esthetic Rehabilitation of a Young Patient With Immediately Loaded Single-Piece Basal Implants Following a Trauma Involving the Anterior Maxilla: Case Report With Five-Year Follow-Up.

Traumatic injuries to the anterior maxilla usually lead to loss of teeth by means of avulsion or extraction due to fracture. Rehabilitation of such a clinical scenario is complex as it involves various anatomic and esthetic challenges. Single-piece basal implants have been widely used in the rehabilitation of resorbed ridges because they gain adequate anchorage from the basal cortical bone, allowing immediate temporization or loading. However, the use of basal implants in the anterior esthetic zone is not much documented. This case report with a five-year follow-up period describes the rehabilitation of lost teeth in the anterior esthetic zone of the anterior maxilla caused due to trauma following a train accident using single-piece axial basal implants with immediate temporization.

A Literature Review on Biofilm Formation on Silicone and Poymethyl Methacrylate Used for Maxillofacial Prostheses.

Silicone elastomers are considered the most suitable maxillofacial materials for extraoral prostheses to date due to their superior physicochemical properties. The aim of this review was to describe the characteristics of biofilm formation on silicone and polymethyl methacrylate used for maxillofacial prostheses and review different strategies of biofilm management for silicone maxillofacial prosthesis. A structured literature search was conducted using the following databases - PubMed, Google Scholar, ScienceDirect, LILACS, IndeMED, OVID, EMBASE, NIH Clinical Trials - for reports related to the biofilms. English language articles were only included in the study. Biofilms induced various systemic infections if they are not treated at an early stage. Biofilms are formed due to various reasons like fungal, bacterial and mixed infections of the patient and also due to prosthetic appliances. The manual or mechanical pressure physically removes the biofilm and most biofilm molecules from surfaces. Treatment must be given with utmost caution and concern irrespective of the presence or absence of biofilm. With regards to the materials used for fabricating maxillofacial substitutes, it has been defined that both acrylic resin and silicone may harbour microorganisms, however, the larger porosities in silicone make it vulnerable to microbial adhesion. The major limitations of these materials are that they have numerous porosities on their surface and, along with the modification of the anatomy of the facial tissues as a result of the lesion, may compromise the natural balance of the microbial flora, favouring microbial colonization and formation of biofilms.

Platelet-Rich Plasma and Platelet-Rich Fibrin as a Regenerative Tool.

Platelet-rich plasma (PRP) and platelet-rich fibrin (PRF) are used as a valuable adjunct in the treatment of maxillofacial rehabilitation. PRP used along with growth hormone helps in bone healing and tissue regeneration in the areas affected by bone and soft tissue-related defects. It aids not only in faster and better healing of the surgically debrided area but also in regeneration of the bone at a faster rate. This review comprises the applications of PRP and PRF and their uses in various procedures.

The Consequence of Complete Dentures on Quality of Life of Edentulous Patients in the South-Indian Population Based on Educational and Socioeconomic Grades.

Purpose The purpose of this study was to establish the level of denture satisfaction with socio-demographic variables and educational status of the patients rehabilitated with complete denture. Materials and method A total number of 250 completely edentulous patients were selected who fulfilled the inclusion and exclusion criteria. The patients had no past medical history which affects the oral condition; they were first-time denture wearers with period of edentulousness altering between six months to one year and were in the age group of 40-50 years, and were willingly involved in the study. The subjects were grouped according to their socioeconomic status such as employment, education and income level. The correlations were statistically determined using regression analysis. Results Statistical analysis was done using Statistical Package for Social Sciences (SPSS, Chicago, Illinois, USA), version 16.0. The significance of percentage error of the two groups was tested by Student t test and p value denoted level of significance (p<.05). Based on the education level, 30.47% of the population were under primary level of education, 57.82% completed higher secondary education and 11.72% of the population were graduates. Based on employment status, 53.12% of the population was unemployed, 32.03% were employed while 14.84% of the population were pensioners. Based on income per month, the population was classified as 6.25%, 31.25%, 21.09%, 22.66%, 18.75% for no income, less than 3000, 5000, 8000 and more than 10000 respectively. Psychological comfort, social ability, and functional improvement was better with higher secondary education level, employed and lower income individuals. Conclusion Rehabilitation of an elderly individual not only includes clinician skills but also the personal perception by the patient. The study concludes that the though there was no statistically significant difference, the individual with secondary level of education and with employed low socioeconomic status had better denture satisfaction than the other category.

A modified technique to fabricate a complete hollow obturator for bilateral maxillectomy in a patient with mucormycosis-A technical case report.

Maxillectomy performed in acquired lesions is often very extensive or bilateral, sparing very less hard and soft tissue in the oral cavity. These defects need both surgical and prosthetic rehabilitation. A definitive prosthesis is inserted after complete healing, when the patient is accustomed to the interim prosthesis. Definitive obturator warrants better retention and stability and needs a meticulous planning in design for long-term use. Conventional design has a few disadvantages; it needs modification many times to improve retention and psychological comfort of the patient. The article explains an easy technique in fabrication of an obturator. The conventional obturator design has a hollow antral part but usually a solid oral part, which adds to the weight of the prosthesis pressurizing the soft tissues in a maxillectomy, which affects the function and esthetics. This article demonstrates the hollowing of oral part, which bears the artificial teeth, and modifying the antral bulb, which covers the defect. It was designed considering the potential difficulties shared by the patient in wearing the single piece conventional hollow bulb design. This technique when followed was beneficial in reducing the weight of the prosthesis and enhancing retention, and allowed the patient to perform normal functional movements.

The Effect of Complete Dentures on the Quality of Life of Edentulous Patients in the South Indian Population Based on Gender and Systemic Disease.

Purpose Different socio-demographic variables, such as age, gender, and systemic disease, may affect satisfaction with complete dentures. Several studies have failed to show strong correlations either between patient satisfaction with their dentures and their quality or between denture satisfaction and the quality of the denture-supporting tissues. Hence, this study utilized a standardized questionnaire that included questions from domains such as mastication, appearance, speech, comfort, health, denture care, and social status. These questionnaires were used to determine the level of complete denture satisfaction along with socio-demographic variables such as age, gender, and systemic condition. Materials and method A total number of 128 completely edentulous patients aged between 40 and 50 years were selected. A standardized questionnaire, with 19 questions based on denture satisfaction level and masticatory capacity in the domains of functional limitation (FL), psychological discomfort (D1), psychological disability (D2), and social disability (D3), was administered. All the questions were recorded on a scale of 2, 1, 0 based on satisfied, moderately satisfied, and not satisfied, whereas hardly ever, occasionally, and very often were used for masticatory capacity. Questions on denture satisfaction were asked based on the post-treatment satisfaction with the new maxillary/mandibular complete dentures of the patients. Results Based on gender, the distribution of samples was 46.09% for male patients and 53.91% for female patients among the 128 patients selected. Similarly, based on systemic diseases, 66.41% had the presence of systemic disease while 28.13% did not have any systemic disease. Around 5.47% of the sample did not have any medical records. The predominance of psychological satisfaction was more for female patients. Based on systemic disease, it was observed that patients with the presence of systemic disease (Pn) were more psychologically comfortable than those who did not have systemic disease. The predominance of functional satisfaction was not marked in both genders. Based on systemic disease, it was observed that patients with the presence of systemic disease (Pn) had less functional comfort on mastication than those who did not have a systemic disease. Conclusion The acceptance of and satisfaction with complete denture treatment were comparatively higher in patients who had a systemic disease than in those with a non-systemic disease in terms of psychological and social comfort, whereas, in functionality, patients with a non-systemic disease had a higher satisfaction level.

Impact of Prosthodontic Treatment on the Oral Health-related Quality of Life in Mucormycosis Patient: A Case Report.

Mucormycosis is a fulminant fungal infection that occurs most often in diabetic and immunocompromised patients, including those with hematologic malignancies. Patients with maxillary resections present a challenge situation for the maxillofacial prosthodontist. Prosthodontic rehabilitation of such patients presents a significant challenge in restoring speech, deglutition and mastication, and respiration. This report discusses the impact of post-surgical management of mucormycosis patient with prosthodontic treatment and evaluating the oral health-related quality of life using the Oral Health Impact Profile-14 (OHIP-14) questionnaire.

Pre-surgical Provisional Prosthesis for Immediate Non-occlusal-loaded Flapless Implant.

A 49-year-old patient reported for immediate replacement of missing maxillary anterior teeth with implant-retained prosthesis. Elevation of flap alters the mucosal level, causes discomfort, and delays the restorative procedure. To maintain the esthetics, flapless surgery was planned. Since placement of an implant is pre-planned in a predetermined site, fabrication of the prostheses before commencement of the surgery, especially when replacing the teeth in the anterior region, could be a viable option. This case report explains the method of fabrication of the provisional restoration for flapless surgery in the presurgical phase. The technique would avoid any micromotion and implant instability caused due to abutment preparation and impression procedure postsurgically.

Short-term evaluation of dental implants in a diabetic population: an in vivo study.

PURPOSE: The study was conducted to evaluate the efficacy of implant supported tooth replacement in diabetic patients. MATERIALS AND METHODS: The study involved placement of implants (UNITI implants, Equinox Medical Technologies, Zeist, Holland, diameter of 3.7 mm and length 13 mm) in five diabetic patients (three females and two males) of age ranging from 35-65 years with acceptable metabolic control of plasma glucose. All patients included in the study were indicated for single tooth maxillary central incisor replacement, with the adjacent teeth intact. The survival of the restored implants was assessed for a period of three months by measurement of crestal bone heights, bleeding on probing and micro flora predominance. Paired t-test was done to find out the difference in the microbial colonization, bleeding on probing and crestal bone loss. P values of less than 0.05 were taken to indicate statistical significance. RESULTS: Results indicated that there was a significant reduction in bleeding on probing and colonization at the end of three months and the bone loss was not statistically significant. CONCLUSION: The study explores the hypothesis that patients with diabetes are appropriate candidates for implants and justifies the continued evaluation of the impact of diabetes on implant success and complications.