Comparative Evaluation of Microleakage of Zinc Phosphate Cement, Resin-Modified Glass Ionomer, and Two Dual-Cure Resin Cements: In Vitro Study.

Aims: The aim of this study is to evaluate and compare the sealing ability of a new resin cement which was undergoing trial with other three luting cements. Settings and Design: In vitro study. Subjects and Methods: Forty extracted intact human premolars were selected and standardized class 5 preparations for inlays were done at cementoenamel junction of buccal surfaces and direct composite inlay was fabricated. The samples were randomly grouped into 4: Group I luted with Rely X ARC resin cement, Group II with DCRC-10, a new indigenously developed resin cement, Group III with FujiCEM, and Group IV with zinc phosphate. After 24 h storage, samples were thermocycled and immersed in basic fuchsine dye. The longitudinal sections were assessed under a stereomicroscope for microleakage using graded criteria. Statistical Analysis Used: To analyze leakage scores among four groups and between enamel and dentin/cementum margins, Kruskal-Wallis nonparametric test and the Mann-Whitney test at P < 0.05 were used. Results: The dye penetration at cementum/dentin margins showed a statistically significant difference among four groups (P < 0.001). Adhesive luting cements produced lesser leakage scores at both margins than those cemented with zinc phosphate. Conclusions: The indigenously developed resin cement (DCRC-10, Group II) is comparable to that of Group I (RelyX ARC) in terms of its luting efficiency.

Does parkinsonism affect periodontal health? A cross-sectional study in a tertiary hospital.

BACKGROUND: Muscular rigidity, tremors, and bradykinesia with diminished motor skills are the characteristic features of Parkinson's disease (PD). AIM: The study investigated the influence of reduced motor proficiency on the periodontal health of PD patients and compared it with controls. SETTING AND DESIGN: A cross-sectional study was conducted on PD patients selected from outpatient section of a tertiary healthcare center and compared with age- and gender-matched controls. MATERIALS AND METHODS: Oral health status of the subjects was graded based on decayed, missing, and filled teeth index, oral hygiene index (OHI), modified gingival index, probing pocket depth (PPD), clinical attachment level (CAL), tooth mobility, interproximal PPD, and interproximal CAL measurements. PD patients were categorized based on Hoehn and Yahr scale and duration to assess the influence of PD severity and progression. STATISTICAL ANALYSIS: Difference in the mean values of quantitative variables was analyzed by parametric t-test and Chi-square test for categorical variables. RESULTS: In PD patients, 84.4% of subjects had moderate-severe gingivitis, while it was 2.4% in the control group. Mean number of interproximal sites with CAL >5 mm in PD patients and control subjects was 8.41 ± 6.37 and 1.12 ± 2.28, respectively (P < 0.05). The mean OHI was 2.90 ± 0.81 in patients with mild PD and increased to 3.77 ± 0.52 as PD severity exalted. CONCLUSION: PD patients had impaired oral condition with higher OHI and increased gingival inflammation with a likelihood of male predisposition. Substantial interproximal tissue destruction, debilitated periodontal health as PD progresses, suggests early attention toward their oral health.

Assessment of Flexural Strength and Cytotoxicity of Heat Cure Denture Base Resin Modified with Titanium Dioxide Nanoparticles: An In Vitro Study.

AIMS: To assess the effect of titanium dioxide nanoparticles (NPs) on flexural strength and cytotoxicity of heat-cured polymethyl methacrylate (PMMA) resins. METHODOLOGY: Sixty-four rectangular and 12 circular specimens were fabricated from metal dies to test flexural strength and cytotoxicity, respectively. The rectangular specimens were grouped into four (16 specimens each)-control group (Group 1), Group 2 with 3% TiO2, Group 3 with 5% TiO2, and Group 4 with 7% TiO2. They were tested for flexural strength using universal testing machine. The circular specimens were grouped into two (six specimens each)-control group and the test group which included the group which showed a highest flexural strength. They were tested for cytotoxicity using MTT assay. The analysis of variance (ANOVA) test was used to analyze the mean flexural strength of each group and Tukey's post hoc test, for pairwise group comparison (p <0.05). An independent sample t-test was used to analyze the cytotoxicity between the groups (p <0.05). RESULT: The study showed that there was a significant decrease in the flexural strength from the control group (mean: 298.95), which reduced as the concentration of TiO2 increased. However, the toxicity reduced considerably from 24 hours to 7 days in both groups while the test group showed better cell viability (%) than the control group. CONCLUSION: The flexural strength of heat cure acrylic resin (modified and unmodified) was much higher than the recommended flexural strength for these resins. On adding TiO2 NPs, flexural strength decreased when compared to the control group. However, with 3% TiO2 NPs, there was no significant decrease in flexural strength as compared to conventional resins. TiO2 NP-modified heat cure acrylic resin showed less toxicity on day 1 and even lesser toxicity after 7 days indicating that it is biocompatible. CLINICAL SIGNIFICANCE: TiO2 NPs incorporated at 3% concentration in denture base resin had less cytotoxicity and adequate flexural strength, to be used as a promising alternative to conventional denture base resin.

Patient safety in primary and outpatient health care.

Primary care services provide an entry point into the health system which directly impact's people well-being and their use of other health care resources. Patient safety has been recognised as an issue of global importance for the past 10 years. Unsafe primary and ambulatory care results in greater morbidity, higher healthcare usage and economic costs. According to data from World Health Organization (WHO), the risk of a patient dying from preventable medical accident while receiving health care is 1 in 300, which is much higher than risk of dying while travelling in an airplane. Unsafe medication practices and inaccurate and delayed diagnosis are the most common causes of patient harm which affects millions of patients globally. However, majority of the work has been focussed on hospital care and there is very less understanding of what can be done to improve patient safety in primary care. Provision of safe primary care is priority as every day millions of people use primary care services across the world. The present paper focuses on various aspects of patient safety, especially in the primary care settings and also provides some potential solutions in order to reduce patient harm as much as possible. Some important challenges regarding patient safety in India are also highlighted.