Evaluating the osteogenic potential of insulin-like growth factor-1 microspheres on osteoblastic activity around dental implants in patients with type 2 diabetes mellitus using bone scintigraphy: A split-mouth randomized controlled trial.

STATEMENT OF PROBLEM: Dental implants are susceptible to early failure when placed in patients diagnosed with type 2 diabetes mellitus. The osteoinductive potential of insulin-like growth factor-1 (IGF-1) has been widely investigated in animals with type 2 diabetes mellitus, but studies investigating the osteoinductive potential of IGF-1 around dental implants in patients diagnosed with type 2 diabetes mellitus are lacking. PURPOSE: This randomized controlled trial was conducted to assess the osteogenic efficacy of poly(lactide-co-glycolide)- (PLGA) encapsulated IGF-1 microspheres around dental implants placed in patients diagnosed with type 2 diabetes mellitus. MATERIAL AND METHODS: A split-mouth, randomized controlled trial was conducted in 10 participants diagnosed with type 2 diabetes mellitus and with bilaterally missing mandibular posterior teeth. The 20 sites were randomly allotted to receive the PLGA encapsulated IGF-1 or placebo microspheres followed by the placement of Ø3.8×11-mm implants. Osteoblastic activity was quantitatively assessed with bone scintigraphy scanning on the thirtieth, sixtieth, and 90th day after implant placement. The Shapiro-Wilks test was used to analyze the normality of data, followed by the independent t test to compare the experimental and placebo groups. Intragroup comparison was performed by using repeated-measures ANOVA and the post hoc Bonferroni test (α=.05). RESULTS: Statistical analysis revealed that the mean osteoblastic activity was higher in the experimental group which received the PLGA-encapsulated IGF-1 than in the placebo group at the 30th, 60th, and 90th day after implant placement (P≤.001). CONCLUSIONS: This randomized controlled trial indicated that the PLGA-encapsulated sustained release of IGF-1 microspheres enhanced the process of osseointegration in patients diagnosed with type 2 diabetes mellitus until the 90th day after implant placement.

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.

Influence of Teaching Strategies and its Order of Exposure on Pre-Clinical Teeth Arrangement - A Pilot Study.

INTRODUCTION: Teeth arrangement is a vital skill for the undergraduate dental student. The attainment of skills depends largely on the methodology of teaching. In a dental curriculum, the students are exposed to a wide variety of inputs and teaching methodologies from different sources. The educational unit in dental school must identify the sequence of teaching methods that enhance the learning and practising ability of students. AIM: The aim of this study was to evaluate the effectiveness of three different teaching methodologies for teeth arrangement and compare the differences between the orders of exposure to each teaching methodology on the development of teeth arrangement skills. MATERIALS AND METHODS: The first year B.D.S students were study participants and were divided into three groups A, B, C. They were exposed to three teaching patterns namely live demonstration with video assisted teaching, group discussion with hand-outs and lectures with power point presentation. After each teaching methodology, their skill was assessed. The groups were exposed to three methodologies in different order for three arrangements. The scores obtained were analysed using Kruskal Wallis rank sum test and Dunn test for statistical significance. RESULTS: Significantly higher scores in the teeth arrangement procedure were obtained by the Group A students who were exposed initially to live demonstration with video-assisted teaching. Difference in the scores was noted among and within the groups. The difference between Group A and Group C was statistically significant after both first and third teeth arrangement (p=0.0031, p=0.0057). CONCLUSION: The study suggests each pre-clinical practice should begin with a live demonstration to enhance immediate learning absorption followed by lectures with power point presentation and group discussion for retention of knowledge and memory retrieval.