Santosh Patil

Evaluation of antimicrobial efficacy of calcium hydroxide paste, chlorhexidine gel, and a combination of both as intracanal medicament: An in vivo comparative study

Aim: To compare the antimicrobial efficacy of calcium hydroxide (CH), 2% chlorhexidine gel (CHX) and a combination of both, on obligate anaerobes, facultative anaerobes and Candida spp . Materials and Methods: 90 single rooted permanent teeth were included in the study. After complete disinfection and access opening, the first microbiological pre-treatment sample (S1) was collected. After completion of instrumentation, a post-instumentation sample (S2) was taken and the teeth were divided into three groups: Group I: CH, Group II: 2% CHX, Group III: 2% CHX with CH. After 1 week, a post-medication sample (S3) was collected. Results: All three medicaments were effective in the elimination of obligate anaerobes. CHX and combination showed higher antimicrobial effect against facultative anaerobes and Candida spp. in comparison with CH. But there was no statistical significant difference between Group II and Group III. Conclusion: CHX with or without CH was more effective than CH alone against all the tested micro-organisms.

Prevalence of dental anomalies in Indian population.

Objectives: Developmental anomalies of the dentition are not infrequently observed by the dental practitioner. The aim of the present study was to determine the prevalence of dental anomalies in the Indian population. Study Design: A retrospective study of 4133 panoramic radiographs of patients, who attended the Department of Oral Medicine and Radiology, Jodhpur Dental College General Hospital between September 2008 to December 2012 was done. The ages of the patients ranged from 13 to 38 years with a mean age of 21.8 years. The orthopantomographs (OPGs) and dental records were examined for any unusual finding such as congenitally missing teeth, impactions, ectopic eruption, supernumerary teeth, odontoma, dilacerations, taurodontism, dens in dente, germination and fusion, among others. Results: 1519 (36.7%) patients had at least one dental anomaly. The congenitally missing teeth 673 (16.3%) had the highest prevalence, followed by impacted teeth 641 (15.5%), supernumerary teeth 51 (1.2%) and microdontia 41 (1.0%). Other anomalies were found at lower prevalence ranging from transposition 7 (0.1%) to ectopic eruption 30 (0.7%). Conclusion: The most prevalent anomaly in the Indian population was congenitally missing teeth (16.3%), and the second frequent anomaly was impacted teeth (15.5%), whereas, macrodontia, odontoma and transposition were the least frequent anomalies, with a prevalence of 0.2%, 0.2% and 0.1% respectively. While the overall prevalence of these anomalies may be low, the early diagnosis is imperative for the patient management and treatment planning. Key words:Dental anomaly, prevalence, panoramic radiography.

Prevalence of impacted and supernumerary teeth in the North Indian population.

Objectives: Dental impaction is a very frequent problem. Supernumerary teeth, or hyperdontia, are the presence of additional teeth to the normal series in the either of the dentition. The presence of impacted and/or supernumerary teeth can cause various complications. The objective of the present study was to determine the prevalence of impacted and supernumerary teeth in the North Indian population. Study Design: The panoramic radiographic records of 4750 patients attending the Department of Oral Medicine and Radiology, Jodhpur Dental College General Hospital between September 2008 to December 2012 were examined for this retrospective study. The ages of the patients ranged from 8 to 72 years, with a mean of 34.6 years. Results: A total of 798 (16.8%) patients presented with 1126 impacted teeth. Impacted canines were the most prevalent (9.7%), followed by impacted premolars (4.3%). Supernumerary teeth (1.6%) and impacted molars (1.2%) were less prevalent. Among the 842 impacted teeth, the most frequently affected teeth were the canines (56.7%), followed by premolars (27.8%), and supernumerary teeth (9.3%), while the prevalence of impacted molars was quite lower (6.2%). Conclusion: The most frequently impacted teeth were maxillary canines and the mesiodens were the most common supernumerary tooth. The early diagnosis of supernumerary and impacted teeth is essential to prevent malocclusion and malalignment of permanent teeth demonstrating the importance of panoramic radiographs in their detection. Key words:Impacted, supernumerary, prevalence, canines, mesiodens.

Prevalence of tongue lesions in the Indian population

Objective: Tongue lesions are a health concern for the dental practitioners and the patients as they constitute a significant proportion of oral mucosal lesions. The aim of the present study was to determine the prevalence of various tongue lesions in the Indian population. Material and methods: 4926 patients attending the Department of Oral Medicine and Radiology were examined for the presence of various tongue lesions during the period from October, 2010 to September, 2012. The age of the patients ranged from 12-80 years with a mean age of 36.51 years. Results: The prevalence of tongue lesions was 12.07%. The most common lesion diagnosed was coated tongue affecting 28.0% of the subjects, followed by geographic tongue (16.4%), fissured tongue (14.9%) and depapillated tongue (11.5%). Males were more frequently affected than females. The most common systemic condition observed in the patients with tongue lesions was anaemia (189), followed by hypertension (47) and diabetes mellitus (38). Conclusion: The high prevalence necessitates adequate awareness of the various tongue lesions in the general population. The dental clinicians should also be knowledgeable about the etiopathogenesis, clinical presentation, diagnosis, and treatment of these lesions. Key words:Tongue lesions, prevalence, Indian population, coated tongue.

Comparison of oral health status between children with cerebral palsy and normal children in India: A case-control study.

Background: The aim of the present research was to describe and compare the oral health of children with cerebral palsy (CP) with the normal children in India. Materials and Methods: Fifty children with CP of the age range 7-17 years and fifty normal children were selected for the study. An oral examination was carried out and decayed, missing, and filled teeth (dmft/DMFT) index, oral hygiene index-simplified (OHI-S) index, Angles malocclusion were charted along with other significant dental findings. Data were analyzed using Student′s t-test and Kruskal-Wallis one-way ANOVA test. Results: The mean dmft/DMFT of the CP group was 4.11 ΁ 2.62, while that of controls was 2.95 ΁ 2.75, which showed higher caries prevalence in the CP group. There was a significant association between the dmft/DMFT (P = 0.03), OHI-S (P = 0.001), and Angles Class 2 malocclusion and CP. Conclusions: Cerebral palsy group had higher caries, poor oral hygiene and Class 2 malocclusion when compared to controls primarily because of their compromised general health condition and also less dental awareness. Effort should be made for better organization of preventive dental care and promoting dental health of this challenged population.

Prevalence of recurrent aphthous ulceration in the Indian Population

Objective: Patients with an oral ulcer may present initially to a general physician or a dental practitioner. Majority of the ulcers are benign and resolve spontaneously but small proportions are malignant. The aim of the present study was to determine the prevalence of recurrent aphthous ulcerations in the Indian population. Material and Methods: 3244 patients attending the Department of Oral Medicine and Radiology during the period from November, 2010 to December, 2012 with various complaints were examined. Of the patients examined 1669 were females and 1575 were males. Results: 705 patients presented with recurrent aphthous ulceration (21.7%). Females (56.3%) were more commonly affected than males (43.7%). Patients in the third and fourth decade were most commonly affected. Stress was the most common factor associated with recurrent aphthous stomatitis (386 patients). 54.5% patients did not take any medications and 72.9% patients opined that the condition needed no dental consultation. Conclusion: The results of the present study indicate that recurrent aphthous ulceration is a common mucosal disorder in the Indian population. The early and proper diagnosis of the ulcers will help the dental practitioner in providing information to the patient regarding awareness and management of the condition. Key words:Recurrent aphthous ulcers, prevalence, Indian population.

Prevalence of cysts and tumors around the retained and unerupted third molars in the Indian population.

AIM Tooth impaction is a frequent phenomena and surgical removal of these teeth are the commonest of the dental surgical procedures. The debate over the removal of asymptomatic impacted third molars still continues. The aim of this retrospective study was to determine the incidence of development of cysts and tumors around the retained and unerupted third molars in the Indian population. MATERIAL AND METHODS 5486 impacted third molars of 4133 patients were studied through the panoramic radiographs for the presence of associated cysts and tumors. The ages of the patients ranged from 17 to 67 years, with a mean of 33.7 years. The results were evaluated using the Pearson chi-square test. P-values less than 0.05 were considered to be statistically significant. RESULTS There were 134 cysts (2.24%) and 63 tumors (1.16%) found that were associated with impacted third molars, of which 3 were malignant (0.05%). 143 patients had symptoms such as swelling or pain due to cystic or neoplastic lesions. The remainder 54 patients had no symptoms suggestive of pathology. The most common cyst was dentigerous cyst and the most common tumor was ameloblastoma. CONCLUSION The results indicate that cysts and tumors do develop in a relatively small but still considerable minority of patients. The fact that a considerable number of patients had no signs or symptoms indicating pathology is certainly worth considering. Consultation should be sought from dental specialists if there are symptoms in the third molar region.

Treatment modalities of oral lichen planus: an update

Oral lichen planus is an immunologically based, chronic, inflammatory, mucocutaneous disorder of undetermined etiology. It is a relatively common disorder affecting stratified squamous epithelia. It is of special importance due to its malignant potential and can be a source of morbidity. The management of oral lichen planus should therefore address both the transformation rate as well as the patient symptoms. Care and management of such patients challenges even the most experienced clinician. There is currently no cure for OLP. Treatment is aimed primarily at reducing the length and severity of symptomatic outbreaks. The review critically analyses the various options in the literature and discusses the practical management from the Indian perspective.

Prevalence of oral lesions in kidney transplant patients: A single center experience

Kidney transplant patients (KTPs) have a potential tendency to develop oral lesions due to the administration of immunosuppressive drugs, but their prevalence is still obscure. The aim of the present study was to investigate the oral clinical findings in a group of renal transplant patients in comparison with ageand sex-matched healthy controls (HCs). Three hundred KTPs who underwent transplantation at least six months earlier and 296 HCs were examined clinically for the presence of any oral lesions. Demographic and additional details regarding medications, systemic diseases and duration after transplantation were recorded. Statistical analysis was performed using the Chi-square test, with significance set at P <0.05. The prevalence of oral lesions in KTPs was 56.8% as compared with 29.7% in HCs. The most common lesion observed in KTPs was gingival overgrowth (21.8%), followed by candidiasis (17.1%). Coated tongue (15.9%), followed by leukoplakia (11.3%), were common in HCs. Both gingival hyperplasia and coated tongue were significantly related to poor oral hygiene (P <0.05), but were not significantly related to the immunosuppressive therapy (P >0.05). The findings of the present study indicate the need for a routine and regular oral health check-up, with emphasis on maintenance of oral hygiene for renal transplant patients.

Prevalence and the relationship of oral mucosal lesions in tobacco users and denture wearers in the North Indian population.

Aim: The aim of the present study was to determine the prevalence and the relationship of oral mucosal lesions in tobacco users and denture wearers in a North Indian population. Materials and Methods: The study comprised 3,749 patients attending the Department of Oral Medicine and Radiology, Jodhpur Dental College General Hospital between September 2008 and December 2012, for the treatment of dental problems other than oral mucosal lesions. The ages ranged from 28 years to 83 years, with a mean age of 49.7 years. The results were evaluated using the Pearson Chi-square test, with Yate’s correction and ANOVA tests. Results: A total of 2,318 patients were diagnosed with lesions associated with the use tobacco and the wearing of dentures. The most frequently seen lesion was melanin pigmentation (29.9%) followed by linea alba (22.2%) and frictional keratosis (19.9%). Ulcers (6.1%) were the most common oral lesion seen in patients who wore dentures, followed by hyperplasia (4.8%). A statistically significant relation (P < 0.05) was established between tobacco and melanin pigmentation, frictional keratosis, traumatic ulcerations and leukoplakia. In those who wore dentures a statistically significant relation (P < 0.05) was found between candidiasis, traumatic ulceration and frictional keratosis. Conclusion: The results of the present study indicate that the association of frictional keratosis with tobacco users and wearers of dentures can help in determining the diagnosis and treatment plan for oral cancer. Wearers of dentures should also be recalled for periodic checks at regular intervals and optimum preventive measures implemented.