Dasan Swaminathan

Histologic, histomorphometric, and cone-beam computerized tomography analyses of calcium sulfate and platelet-rich plasma in socket preservation: a pilot study.

Objectives: To assess dimensional changes and histologic/histomorphometric aspects of grafted sockets using either calcium sulfate-platelet-rich plasma (CS-PRP) or CS alone in socket preservation procedure. Study Design: Twelve subjects with single nonmolar teeth underwent atraumatic extraction. Six sockets received CS grafts and 6 sockets received CS-PRP grafts. Cone-beam computerized tomography scans taken immediately after extraction and 4 months after surgery were used to measure vertical and horizontal dimensional changes. Histologic and histomorphometric analyses of grafted sites were performed at 4 months after surgery. Intergroup changes were compared using Mann-Whitney U test. Results: CS group demonstrated 18.6% horizontal resorption as compared with 9.2% in CS-PRP group. Resorption for buccal height (BH) (14%) and palatal/lingual height (PH) (13.7%) in CS group was nearly 3 times more than resorption in BH (5%) and PH (4.6%) for CS-PRP group. Mineralized bone component in CS-PRP group (11.19% ± 6.59%) was significantly more than CS group (1.51% ± 2.86%) (P = 0.01). Conclusion: CS-PRP–grafted sites demonstrated higher mineralized bone content than CS-grafted sites.

Identification of Gingival Crevicular Fluid Sampling, Analytical Methods, and Oral Biomarkers for the Diagnosis and Monitoring of Periodontal Diseases: A Systematic Review

Background. Several studies in the last decades have focused on finding a precise method for the diagnosis of periodontal disease in its early stages. Aim. To evaluate from current scientific literature the most common and precise method for gingival crevicular fluid (GCF) sample collection, biomarker analytical methods, and the variability of biomarker quantification, even when using the same analytical technique. Methodology. An electronic search was conducted on in vivo studies that presented clinical data on techniques used for GCF collection and biomarker analysis. Results. The results showed that 71.1%, 24.7%, and 4.1% of the studies used absorption, microcapillary, and washing techniques, respectively, in their gingival crevicular fluid collection. 73.1% of the researchers analyzed their samples by using enzyme-linked immunosorbent assay (ELISA). 22.6%, 19.5%, and 18.5% of the researchers included interleukin-1 beta (IL-1β), matrix metalloproteinase-8 (MMP-8), and tumor necrosis factor-alpha (TNF-α), respectively, in their studies as biomarkers for periodontal disease. Conclusion. IL-1β can be considered among the most common biomarkers that give precise results and can be used as an indicator of periodontal disease progression. Furthermore, paper strips are the most convenient and accurate method for gingival crevicular fluid collection, while enzyme-linked immunosorbent assay can be considered the most conventional method for the diagnosis of biofluids.

The Influence of Socioeconomic and Demographic Variables on Willingness to Donate Cadaveric Human Organs in Malaysia

AbstractThe growing shortage in human organs has raised serious concerns. To address this problem, we examine in this article the association between demographic and socioeconomic factors, and respondents’ willingness to donate cadaveric organs using a large survey of Malaysian adults aged 18 years and above.A convenience sampling method was used to extract information from a total of 10,350 participants from Metropolitan Kuala Lumpur over the period of April 2, 2013 to February 29, 2014. In addition to analyzing the data using incidence of willingness to donate by demographic and socioeconomic factors, we carried out logistic regression analysis to estimate the odds ratio of respondents’ willingness to become cadaveric organ donors controlling for age.About less than a third of the participants pledged to donate their organs upon death with women (35.6%) showing a higher incidence compared with men (33.2%). The Chinese (35.7%) and Malays (35.0%) pledged to contribute more than the Indians (31.6%) and the logistic regressions show that Malays (adjusted odds ration [OR] = 1.18) and Chinese (adjusted OR = 1.21) are more likely to donate than Indians (reference group). The results by religion were significant among Muslims and Hindus but not Buddhists. The likelihood of Muslims donating was the lowest (adjusted OR = 0.26). Income was also highly significant but the relationship with willingness to donate was negative. Against tertiary education, all other occupations were significant. However, the respondents with primary education enjoyed the highest adjusted OR (5.46) whereas that of secondary (0.48) and higher secondary (0.83) education was low. Among occupations (against supervisory, clerical, and direct workers), it was significant only among the unemployed and managers with adjusted OR of 1.50 and 1.58, respectively.Sex, education, ethnicity, religion, and income are important demographic and socioeconomic influences on the likelihood of Malaysians willing to become cadaveric organ donors. The Malaysian evidence suggests that awareness programs should be targeted at men, Muslims, Hindus, Malays, and the rich more than the others.

Biomimetic Coating of Modified Titanium Surfaces with Hydroxyapatite Using Simulated Body Fluid

This study investigated the viability of coating commercially pure titanium (CPTi) surfaces, modified via sandblasting and acid etching, with hydroxyapatite (HA)/tricalcium phosphate coatings using a simulated body fluid (SBF) solution. The samples were immersed in SBF from 3 to 7 days. The morphology and the chemistry of the HA/tricalcium phosphate coating were then analysed. Prior to immersion in SBF, the samples were sandblasted and acid etched to mimic the morphology and roughness of commercially available dental implants. The SBF aided in the formation of crystalline HA/tricalcium phosphate coatings on all the samples. The coatings were uniform and had roughness values higher than the underlying substrate. The highest roughness values for the coatings on the surfaces were obtained at 7 days of immersion in SBF with average values of 2.9 ± 0.2  µm. The presence of HA/tricalcium phosphate on the surfaces was confirmed by the Scanning Electron Microscope (SEM), Energy Dispersive Spectrometer (EDS), the X-Ray Diffraction (XRD), and the Fourier Transform Infrared Spectrometer (FTIR) analysis. This study shows that it is possible to obtain an adequate and uniform hydroxyapatite coating on pure titanium substrates in a shorter period of time with characteristics that favour the ultimate goal of implants therapy, that is, osseointegration.

Effects of Nonsurgical Periodontal Therapy on Clinical Response, Microbiological Profile, and Glycemic Control in Malaysian Subjects with Type 1 Diabetes.

The association between diabetes mellitus and chronic periodontal disease has long been established. Most of the researches linking these two very common chronic diseases were based on type 2 diabetes mellitus and chronic periodontal disease. However, this study was conducted to investigate the association between type 1 diabetes and chronic periodontal disease in Malaysian subjects. Forty-one Malaysian subjects, of which 20 subjects were type 1 diabetics and with chronic periodontal disease (test group) and 21 subjects with only chronic periodontal disease (control group), were included in the study. Periodontal parameters and plaque samples for microbiological evaluation were done at baseline, 2 and 3 months after nonsurgical periodontal therapy. Blood samples were taken from only the test group and evaluated for HbA1c at baseline and 3 months after periodontal therapy. There were no statistically significant difference in periodontal parameters between groups (P>0.05) and no significant improvement in the level of HbA1c in the test group. Microbiological studies indicated that there were significant reductions in the levels of the tested pathogens in both groups. The results of our study were similar to the findings of several other studies that had been done previously.

Legal Implications in Routine Clinical Practice

Medico-legal management forms an important part of the total patient care. With the rapid progress of medical science and technology, the law and ethics pertaining to clinical practice have become more complicated in order to meet the various complex issues that have arisen. Medical ethics is a code of behavior accepted voluntarily within the profession, as opposed to statutes and regulations that are imposed by official legislation. Much of medical ethics consists of good manners and civilized behavior in the general sense, but there are certain matters, which are particular to the practice of the profession of medicine. Matters of immediate concern in routine clinical practice are pertaining to consent, confidentiality and negligence.