Level of Knowledge, Understanding, and Impact of the COVID-19 Pandemic on Continuing Fixed Orthodontic Treatment in Adults: A Questionnaire Study.

OBJECTIVES: To evaluate the level of knowledge, understanding, and impact of the coronavirus disease 2019 (COVID-19) pandemic on adult patients regarding their ongoing fixed orthodontic treatment. SUBJECTS AND METHODS: A cross-sectional and descriptive survey was conducted on 108 adult patients undergoing fixed orthodontic treatment at GSL Dental College (GSLDC), India. All the candidates were aged 18 years and above, who were in lockdown due to the COVID-19 pandemic and devoid of treatment. RESULTS: Among the patients 43.5% were male and 56.5% were female; 22.3% were not at all aware that the COVID-19 virus spreads quickly in a dental setup; 64.8% were definitely willing for their status disclosure and to undergo pretreatment screening; 71.3% were definitely willing to adhere to strict appointment timings for adequate sanitization of the clinical area; 60.2% thought that missed appointments during the COVID-19 pandemic would prolong their overall orthodontic treatment and affect their treatment outcome; and 51.9% were financially affected due to the pandemic. CONCLUSIONS: Not all adult orthodontic patients were in knowledge of COVID-19 cross infection. The majority were in a state of understanding and willing to follow infection-eradicating protocols. Patients' view on overall orthodontic treatment was altered due to the psychological and financial impact of COVID-19.

Comparative evaluation of soft and hard tissue changes following endosseous implant placement using flap and flapless techniques in the posterior edentulous areas of the mandible-a randomized controlled trial.

BACKGROUND: Dental implant-supported restorations have long been used as a successful modality for replacing missing teeth. There are two well-established methods of implant placement. The traditional approach to implant surgery involves raising a mucoperiosteal flap and the alternative approach does not involve reflecting a flap, each having its own advantages and disadvantages. The purpose of the present study was to compare and evaluate the soft and hard tissue changes around endosseous implants placed using flap and flapless surgery in mandibular posterior edentulous sites over a period of time. MATERIALS AND METHODS: A total of 20 systemically healthy patients with a single edentulous site in the posterior mandible were enrolled in this study and 20 endosseous implants were placed (10 in the flap group and 10 in the flapless group). The peri-implant probing depth was assessed. Radiographic assessment was done for changes in the marginal bone levels at the mesial and distal side of the implant with measurements made at baseline, 6 months, and 12 months. Patient-centered outcomes were assessed by using the visual analogue scale (VAS). All these parameters were statistically analyzed using the Wilcoxon signed-rank test, paired Student t test, and two-way ANOVA test and were considered to be significant if the p value was ≤ 0.05. RESULTS: Twenty patients were enrolled in the present study and endosseous implants were placed. Eighteen subjects were followed up throughout the study period and two patients were excluded from the study. The mean PD in the flapless group was comparatively less than the flap group at 12 months and was found to be statistically significant. During the observation period of 12 months, reduction of crestal bone height around the implants placed by flapless and flap surgery were statistically significant. The flapless group showed less change in the crestal bone height which was statistically significant compared to the flap group. The mean VAS score on day 0 in the flap and flapless group was statistically significant. The flapless group showed significantly less pain when compared to the flap group. CONCLUSION: Although the flapless technique of endosseous implant placement had statistically significant less PD, bone loss, and pain than the flap technique, the difference was found to have uncertain clinical significance.

E-cadherin and CD1a expression in gingival epithelium in periodontal health, disease and post-treatment.

BACKGROUND: Epithelial integrity is important for maintenance of periodontal health. It is not fully known if non-surgical periodontal therapy is capable of recreating the epithelial barrier in its functional state. PATIENTS AND METHODS: Sixty-five patients (31 males and 34 females) were included in the study. They were divided into group A (healthy gingiva 16 patients), group B (gingivitis 17 patients), group C (periodontitis 17 patients), and group D (post-treatment 15 patients). Gingival samples were collected and immunohistochemical study was done using E-cadherin and CD1a antibody. Statistical analysis was done using analysis of variance (ANOVA), followed by Tukey-Kramer multiple comparison test for CD1a and Tukey's highly significant difference (HSD) test for E-cadherin. RESULT: There was a statistically significant difference (P < 0.001) in the expression of E-cadherin between healthy (1.846±0.555), gingivitis (1.100±0.994), and periodontitis group (0.700±0.483). Similarly, there was a statistically significant difference (P < 0.001) in the expression of CD1a between healthy (75.70±3.09), gingivitis (42.53±3.09), and periodontitis group (29.07±3.08). However, the expression of E-cadherin (1.242±0.653) and CD1a in post-treatment samples (52.18±2.90) was lower with no statistically significant difference when compared to health. DISCUSSION: The significant reduction in E-cadherin and CD1a levels in periodontal disease when compared to health could possibly be a result of invasion by the periodontopathogens and its subsequent sequel. Although, the post-treatment samples showed significant improvement when compared to disease, the reduction in E-cadherin and CD1a levels when compared to gingival health suggests that the epithelial barrier was not yet fully established in its functional state.