Sajith Vellappally

Smoking Related Systemic and Oral Diseases

This article reviewed smoking related systemic diseases and oral diseases. Smoking is related to lung cancer, cardiovascular diseases and many other systemic diseases. Cigarette smoke affects the oral cavity first, so it is evident that smoking has many negative influences on oral cavity, for example, staining of teeth and dental restorations, wound healing, reduction of the ability to smell and taste, and development of oral diseases such as oral cancer, periodontitis, smokers palate, smokers melanosis, hairy tongue, leukoplakia, oral candidiasis and implant survival rate. The article also discusses the relationship between smoking and dental caries in detail.

Xerostomia in geriatric patients: a burgeoning global concern

Saliva plays a key role in maintaining oral homeostasis, function, and health. The prevalence of xerostomia and its consequences are rising due to the increasing aging population, the effects of some systemic diseases, medical management, and commonly-prescribed medications that reduce saliva production. When salivary function is diminished, patients are at a greater risk of developing caries, discomfort in wearing dentures, and opportunistic diseases, such as candidiasis. The psychosocial aspects of xerostomia can range from a mild effect on self-rated oral health to frustration, embarrassment, unhappiness, or substantial disruptions in quality of life. This article reviews the clinical features, diagnosis, and prevalence of dry mouth, as well as its treatment strategies.

The prevalence of malocclusion and its association with dental caries among 12-18-year-old disabled adolescents.

BackgroundTo assess the prevalence of malocclusion among 12-18-year-old disabled adolescents in Chennai, Tamil Nadu, India, by using the Dental Aesthetic Index (DAI) and to determine the association of malocclusion with dental caries.MethodsThis cross-sectional study included 243 children with various mental disabilities with or without physical infirmities. The Dental Aesthetic Index (DAI) and the dentition status were recorded using the World Health Organization Oral Health Surveys – Basic Methods (1997) Pro-forma. The Decayed (D), Missing (M) and Filled (F) components of the DMF index were calculated using the Dentition Status and Treatment Need (DSTN). A Chi-square test, ANOVA, and t-test were used to derive inferential statistics.ResultsThe mean DAI score ± standard deviation was 39.0 ± 12.3. A total of 123 (50.6%) participants (74 males and 49 females) had DAI scores of 36 and above, which indicated a handicapping malocclusion requiring mandatory orthodontic treatment. Sixty-nine (28.4%) adolescents (36 males and 33 females) had DAI scores between 31 and 35, which indicated severe malocclusion, for which orthodontic intervention was desirable. Incisal segment crowding (84.8%) was the most common aspect of the malocclusion. The mean DMFT score was 4.36 ± 3.81, and 82.8% of the participants had a DMFT score > 0. There was no statistically significant correlation between the mean DAI and DMFT scores (r = 0.090, p = 0.15). Only 16 (6.6%) of the adolescents had minor or no anomaly not needing orthodontic treatment.ConclusionsThe prevalence of malocclusion and dental caries was found to be high. However, there was no positive correlation between the severity of malocclusion and dental caries among the surveyed disabled adolescents.

Oral health survey of 6-12-year-old children with disabilities attending special schools in Chennai, India

BACKGROUND The dental literature is replete with reports on the oral health surveys of normal children. Relatively few data exist for the oral conditions of mentally challenged children and adolescents with multiple disabilities in India. AIM To assess the oral hygiene practices and treatment needs among 6-12-year-old disabled children attending special schools in Chennai, India, between 2007 and 2008. DESIGN A cross-sectional study data were collected using WHO criteria, a questionnaire (for the parents/guardians) regarding demographic data and oral hygiene practices, medical record review, and clinical examination. RESULTS Among 402 disabled children, majority of the children brushed their teeth once daily (89.7%) and with assistance from the caregiver (64.4%). The utilisation of the dental services was minimal (extractions 14.4%, oral prophylaxis 1.7%, and restorations 1.7%). There was significant difference between residents and non-residents for the mean dft/DMFT. The periodontal health was comparatively better among the residents of the institutions than the non-residents (P < 0.001). Regression analysis revealed that various variables were significantly associated with dft/DMFT and Community Periodontal Index (CPI). CONCLUSION This study gives sufficient evidence to suggest that the oral health status of this disabled population was poor and there was an increased unmet dental treatment needs.

Genotoxic Hazard and Cellular Stress in Pediatric Patients Treated for Psoriasis with the Goeckerman Regimen

Abstract:  The Goeckerman regimen (GR) represents a local treatment of psoriasis and includes topical dermal application of crude coal tar (containing polycyclic aromatic hydrocarbons) and exposure to UV‐irradiation. The aim of the study was to evaluate contribution of GR to genotoxic risk and cellular stress in pediatric patients who represent a sensitive population subgroup. Genotoxic risk (42 patients) was evaluated by using chromosomal aberrations (CA) in peripheral lymphocytes. Cellular stress (26 patients) was assessed by using heat shock proteins (Hsp70). All indicators were determined in blood samples collected before GR and immediately after GR. Decreasing of psoriasis area and severity index (PASI) score indicated higher likelihood of GR (p < 0.001). Significantly increased CA (p < 0.001) and Hsp70 (p < 0.05) indicated higher genotoxic risk and cellular stress in sensitive pediatric patients, immediately after GR.

THE INFLUENCE OF CIGARETTE SMOKING ON VARIOUS ASPECTS OF PERIODONTAL HEALTH

Tobacco is one of the most important risk factors for oral diseases, including oral cancer, oral mucosal lesions and periodontal diseases. There is substantial evidence suggesting that the risk of oral diseases increases with frequent use of tobacco and that quitting smoking results in reduced risk. In this article, the influence of cigarette smoking on the periodontium will be discussed, giving importance to the effects on immune responses, alveolar bone loss, periodontal pathogens and briefly outlining the negative effects of smoking on wound healing and periodontal treatment procedures.

Biomimetic approaches with smart interfaces for bone regeneration

A ‘smart tissue interface’ is a host tissue-biomaterial interface capable of triggering favourable biochemical events inspired by stimuli responsive mechanisms. In other words, biomaterial surface is instrumental in dictating the interface functionality. This review aims to investigate the fundamental and favourable requirements of a ‘smart tissue interface’ that can positively influence the degree of healing and promote bone tissue regeneration. A biomaterial surface when interacts synergistically with the dynamic extracellular matrix, the healing process become accelerated through development of a smart interface. The interface functionality relies equally on bound functional groups and conjugated molecules belonging to the biomaterial and the biological milieu it interacts with. The essential conditions for such a special biomimetic environment are discussed. We highlight the impending prospects of smart interfaces and trying to relate the design approaches as well as critical factors that determine species-specific functionality with special reference to bone tissue regeneration.

Multifunctional nano manganese ferrite ferrofluid for efficient theranostic application

Ferrofluid-based manganese (Mn(2+)) substituted superparamagnetic iron oxide nanoparticles stabilized by surface coating with trisodium citrate (MnIOTCs) were synthesized for enhanced hyperthermic activity and use as negative magnetic resonance imaging (MRI) contrast media intended for applications in theranostics. The synthesized MnIOTC materials were characterized based on their physicochemical and biological features. The crystal size and the particle size at the nano level were studied using XRD and TEM. The presence of citrate molecules on the crystal surface of the iron oxide was established by FTIR, TGA, DLS and zeta potential measurements. The superparamagnetic property of MnIOTCs was measured using a vibrating sample magnetometer. Superparamagnetic iron oxide substituted with Mn(2+) with a 3:1 molar concentration of Mn(2+) to Fe(2+) and surface modified with trisodium citrate (MnIO75TC) that exhibited a high T2 relaxivity of 184.6mM(-1)s(-1) and showed excellent signal intensity variation in vitro. Hyperthermia via application of an alternating magnetic field to MnIO75TC in a HeLa cell population induced apoptosis, which was further confirmed by FACS and cLSM observations. The morphological features of the cells were highly disrupted after the hyperthermia experiment, as evidenced from E-SEM images. Biocompatibility evaluation was performed using an alamar blue assay and hemolysis studies, and the results indicated good cytocompatibility and hemocompatibility for the synthesized particles. In the current study, the potential of MnIO75TC as a negative MRI contrast agent and a hyperthermia agent was demonstrated to confirm its utility in the burgeoning field of theranostics.

SEALING ABILITY OF MINERAL TRIOXIDE AGGREGATE, CALCIUM PHOSPHATE CEMENT, AND GLASS IONOMER CEMENT IN THE REPAIR OF FURCATION PERFORATIONS

OBJECTIVES The purpose of this study was to evaluate the in vitro sealing ability of three repair materials. Mineral trioxide aggregate (MTA; Group A), calcium phosphate cement (CPC; Group B), and light cured glass ionomer cement (GIC; Group C) when used to repair the perforation created in the pulpal floor of fifty extracted human permanent molars. MATERIALS AND METHODS Preparation of access openings and furcation perforations were done, and the teeth divided into five experimental groups (A, B, C) including two controls (D, E) with ten samples in each group randomly. Following the repair procedure, the pulp chambers and access openings were filled with composite resin and immersed in 2% methylene blue solution for 48 hours. The teeth were sectioned longitudinally and the linear dye penetration measured under a stereomicroscope. RESULTS The comparison of the linear length of micro-leakage (mm) among the experimental groups revealed no significant difference (p = 0.332). On calculating the percentage of depth of leakage to the total length of the perforation, it was observed that the mean leakage was 35.5% in Group A, 53.6% in Group B and the highest, 87.5% in Group C. The mean of leakage percentage was statistically significant by Kruskal-Wallis test (p = 0.003). The results indicated that the dye penetration used as furcation perforation repair material was least with mineral trioxide aggregate. Comparing the depth of penetration of dye, 50% of the Group A samples showed less than 25% of depth penetration. While 40% of Group B cases had more than 50% dye penetration. In our study, all Group C teeth had > or = 50% dye penetration. CONCLUSIONS The present study indicated that GIC had the greatest dye penetration followed by CPC and MTA. Mineral trioxide aggregate and calcium phosphate cement had comparatively better sealing ability than glass ionomer cement.

Sub-inhibitory Concentrations of Antifungals Suppress Hemolysin Activity of Oral Candida albicans and Candida tropicalis Isolates from HIV-Infected Individuals

Secretion of hydrolytic enzymes such as hemolysin is considered an important virulence attribute of the opportunistic pathogenic fungus Candida. It is known that Candida spp. isolated from HIV-infected patients produce copious hemolysins. As common antifungal agents may perturb the production of extracellular enzymes, we evaluated the effect of three antifungals nystatin, amphotericin B and fluconazole on the hemolytic activity of Candida albicans and Candida tropicalis isolates from HIV-infected individuals. The impact of antimycotics on hemolytic activity was assessed by a previously described in vitro plate assay, after exposing ten isolates each of C. albicans and C. tropicalis recovered from HIV-infected individuals to sub-minimum inhibitory concentrations (sub-MIC) of nystatin, amphotericin B and fluconazole. All Candida isolates showed a significant reduction in hemolytic activity. The reduction was highest for amphotericin B-exposed C. albicans and C. tropicalis followed by nystatin and fluconazole. The effect of antimycotics was more pronounced on the hemolytic activity of C. tropicalis compared to that of C. albicans. Commonly used antifungal agents significantly suppress hemolysin activity of Candida species. This implies that the antifungals, in addition to their lethality, may modulate key virulence attributes of the yeast. The clinical relevance of this phenomenon in HIV disease and other similar pathologies remains to be determined.