Shreya Shetty

Hydroxyapatite as an in-office agent for tooth hypersensitivity: a clinical and scanning electron microscopic study.

BACKGROUND Pain caused by hypersensitivity is very common and a variety of agents have been tried and tested to put an end to this ailment, but with limited or short-term success. The search for an agent that would predictably and permanently occlude the tubules and blend with them has prompted the use of durapatite/hydroxyapatite (HAP), which is the principal inorganic constituent of the tooth. METHODS A total of 486 hypersensitive teeth in 45 patients with hypersensitive symptoms confirmed by visual analog scale and verbal rating scale were divided into four groups. Two were treated with HAP in two forms (dry sol gel and liquid precipitate form), and the other two groups included a positive control group (distilled water) and a negative control group (no treatment). The responses were evaluated at 0 and 1 days, and 1, 2, 4, and 8 weeks, for all groups. Ten freshly extracted teeth were prepared and treated as mentioned previously and subjected to scanning electron microscopy to assess the tubule occlusion. RESULTS HAP-treated teeth showed statistically significant reduction in hypersensitive symptoms (P <0.001) compared to the other groups at the end of 1 day and 1, 2, and 4 weeks, but at the end of 8 weeks all four groups showed no statistical differences (P <0.5). The scanning electron microscopic study showed completely obliterated dentinal tubules in the HAP-treated specimens, whereas the other groups showed predominantly open or partially occluded tubules. CONCLUSIONS HAP shows definite potential as an effective and permanent desensitizer when used as an in-office procedure. However, further long-term studies and comparative clinical trials with other popular desensitizing methods need to be carried out to prove its superiority.

Effect of Environmental Tobacco Smoke From Smoker Parents on Gingival Pigmentation in Children and Young Adults: A Cross-Sectional Study

BACKGROUND Non-smokers exposed to environmental tobacco smoke (ETS) absorb nicotine and other compounds just as smokers do, and as the exposure to ETS increases, the level of these harmful compounds in the body also increases. The ill effects of ETS range from gingival pigmentation to lung cancer and death. The exposure to ETS is difficult to quantitatively measure and has been approximated by self-reported estimates, primarily of the smoking history of spouses. However, the documentation of gingival pigmentation in non-smokers is meager and has remained contentious. We aimed to assess the effects of ETS from smoker parents on gingival pigmentation in children and young adults and assess the urine cotinine levels in these individuals. METHODS A total of 153 non-smoking participants with ≥1 smoker parent were randomly selected from the outpatient Department of Periodontics, Bangalore Institute of Dental Sciences and Postgraduate Research Center, Bangalore, India. These participants were divided into three groups based on age, and the smoking history of parents was established by an interview with participants and parents. The degree of gingival pigmentation of participants was assessed by using the gingival pigmentation index and a standardized digital oral photograph. A urine analysis was conducted to assess levels of cotinine. The κ statistic was performed for interexaminer agreement, and χ(2) and Fisher exact tests were used for statistical analyses. RESULTS The prevalence of gingival pigmentation in passive smokers was statistically significant (P <0.05). Increased levels of urinary cotinine were observed in all three groups with the highest levels in group 3 (19 to 24 years old). CONCLUSION This study depicts the effects of ETS on gingival melanin pigmentation.

Gingival Blood Glucose Estimation With Reagent Test Strips: A Method to Detect Diabetes in a Periodontal Population

BACKGROUND Periodontal disease is considered the sixth complication of diabetes. Therefore, as a foremost responsibility of the periodontist, the present study was carried out to screen an unsuspecting periodontal population for the presence of diabetes with the help of gingival blood glucose and reagent test strips. METHODS A total of 356 patients with no known medical history of diabetes visiting the outpatient Department of Periodontics, at the Government Dental College and Hospital, Nagpur, Maharashtra, India, were divided into 3 groups: group 1 included patients with a healthy periodontium; group 2, patients with gingivitis; and group 3, patients with periodontitis. Gingival blood, formed by puncturing the interdental papilla of the upper anterior teeth with a lancet, was allowed to fall onto a test reagent strip, where the color change was noted, and corresponding glucose values recorded. Patients with glucose values >120 gm% (per manufacturer provided chart) were sent for glucose tolerance tests to confirm their glycemic status. Patients with abnormal glucose tolerance values were further referred to a physician for the confirmation of diabetes. RESULTS Diabetes was detected in 19.1% of the survey population, of which 3.9% of patients belonged to group 1, 7.8% of patients belonged to group 2, and 7.3% of patients belonged to group 3. Diabetes was detected in 40.8% of patients with hyperglycemia, of which 8.4% of patients belonged to group 1, 16.8% of patients belonged to group 2, and 15.6% of patients belonged to group 3. A total of 10.11% of the survey population who tested positive for diabetes were females and 8.99% were males. CONCLUSIONS The use of reagent strips for the estimation of gingival blood glucose seemed to be a suitable option for the screening of an unsuspecting periodontal population for the presence of diabetes; however, additional studies in a larger population are needed to confirm their suitability.

Schizophrenia and periodontal disease: An oro-neural connection? A cross-sectional epidemiological study

Background: Schizophrenia is a psychosis characterized by delusions and hallucinations occurring in clear consciousness. Studies have shown that the cytokines may modulate dopaminergic metabolism and schizophrenic symptomatology in schizophrenia. Cytokine involvement in periodontal disease is also well documented. To date, however, there has been relatively little research assessing periodontal status of patients with schizophrenia. The present study was therefore mainly intended to understand the exact link, if any, between periodontal disease and schizophrenia. Materials and Methods: A total of 250 schizophrenic patients (140 males and 110 females), between 25 and 55 years of age, were selected from the out patient department of National Institute of Mental Health and Neural Sciences, Bangalore and their periodontal status was assessed as part of this cross-sectional epidemiological survey. Results: ANOVA showed that there was increased evidence of poor periodontal condition, as evidenced by gingival index and plaque index in patients who had been schizophrenic for a longer duration of time (P < 0.001). So also, higher probing pocket depths were found in schizophrenics suffering from a longer period of time than others (P < 0.001). Conclusions: Although oral neglect might be a cause of poor periodontal health in schizophrenics, the possible link between periodontal diseases giving rise to schizophrenia cannot be overlooked due to the presence of cytokine activity which is present both in schizophrenia and periodontal disease.

Facial Measurements as Predictors of the Length of the Maxillary Central Incisor in a Cross Section of the Indian Population-A Clinical Study

Introduction: The maxillary central incisor in particular holds the key in creating a highly esthetic frontal profile and therefore appropriate selection of the tooth is of utmost importance in the restoration of the anterior segment of teeth in completely or partially edentulous patients. Although a number of studies have suggested various reference guides towards estimation of the width of central incisor, there have been no suitable guides to ascertain the length of the incisor in the absence of pre-extraction records. Purpose of the study: The present study attempted to arrive at a correct proportion for determining as far as possible the correct length of the maxillary central incisor with the help of facial measurements in the absence of pre-extraction records in a small proportion of the subcontinent Indian population. Materials and methods: The distance from the bridge of the nose to the base was compared to the length (actual and calculated by regression) of the maxillary central incisor in 400 patients of both sexes between the age groups of 20-35 years. Results: The length of the maxillary central incisor by calculated measurement ratios of facial measurements and regression equation showed variations between 0.2 to 0.4 mm in males and females respectively which was statistically significant (p<0.01). Conclusion: The distance from the bridge of the nose to base of the nose may be used as a reference to estimate the length of the central incisor in the subcontinent Indian population, although regression equation may be more accurate.

Comparative Evaluation of Hydroxyapatite, Potassium Nitrate and Sodium Monofluorophosphate as in Office Desensitising AgentsâÂÂA Double Blinded Randomized Controlled Clinical Trial

Background: The search for an agent that would predictably and permanently occlude the tubules, and blend with them led to the discovery of HYDROXYAPATITE (HAP). The present double blinded randomsed controlled clinical trial aimed to compare the desensitizing effects of two forms of HAP with 2 other popular agents, potassium nitrate and potassium nitrate with sodium monofluorophosphate. Methods: Clinical study: 716 hypersensitive teeth in 50 patients with hypersensitive symptoms, confirmed by visual analogue scale (VAS) and verbal rating scale (VRS), were randomly divided into 4 groups (A,B,C and D) treated with HAP dry sol gel and liquid precipitate form, potassium nitrate and sodium monofluorophosphate respectively. The responses were evaluated at 0, 1 day, 1, 2, 4 and 8 weeks respectively for all groups and later statistically analysed. Results: HAP treated teeth showed statistically significant reduction in hypersensitive symptoms (p<0.001) requiring fewer applications compared to other groups at the end of 1st day, 2 and 8 weeks respectively. At the end of 8 weeks, all 4 groups showed significant change from baseline scores (p<0.001). Conclusion: HAP showed definite potential as an effective permanent desensitizer when compared to potassium nitrate and sodium monofluorophosphate when used as an in-office procedure. However, its efficacy when used as part of dentifrice like the other 2 agents needs further research.

A clinical and radiographic evaluation of the management of periodontal osseous defects with alloplast and platelet rich plasma

Abstract Background and objectives: Tissue engineering is fast gaining popularity in the field of periodontics, as periodontal disease is a complex condition, involving destruction of vital tooth supporting structures.

Comparative Evaluation of the Effect of a Herbal Dentifrice and a Regular Dentifrice on Beneficial Oral Microflora - A Clinico- Microbiologic Study

Background and Objectives Herbal dentifrices are fast gaining popularity in most parts of Asia and Europe. Although effects of dentifrices on pathogenic plaque microorganisms has been documented, little or no evidence exists with regard to their effects on the useful microflora, which help to keep the pathogenic strains at bay. The present study was attempted to evaluate and compare these effects of herbal and conventional dentifrice. Methods 60 student participants in the age group of 18 to 28 years with good oral hygiene (OHI score = 0) were randomly divided into two groups, test and control. The test group used herbal dentifrice and the control group, a regular dentifrice. Plaque and saliva samples were collected at baseline, immediately after brushing, 12 hours after brushing, at 1 week and at 1 month, and cultured. The Streptococcus mitis and Lactobacillus counts along with total microbial counts were estimated at the various time intervals. Results Day 1 showed no significant difference between test and control groups with regard to Streptococcus mitis and Lactobacillus counts as well as total CFU (P>0.05), but at one week control group showed significant increase in streptococcus count in plaque and saliva(P>0.01). Whereas, the test group showed significant increase in L. bacillus and total CFU count in saliva, 12 hrs after brushing, when evaluated at one month (p>0.01). Conclusion Herbal dentifrices may be slightly more effective in preservation of beneficial oral microflora when compared to regular dentifrices, although both are equally effective in inhibiting the pathogenic microorganisms.

A Comparative Evaluation of Clinical Efficacy and Salivary and Gingival Crevicular Fluid Interleukin - 6 Levels with Herbal and Probiotic Host Modulation Therapy in Chronic Periodontal Disease

Background Host modulation is fast gaining popularity as one of the most safe and effective therapeutic modalities in a number of systemic ailments and also periodontal disease. Of these, herbal agents and probiotics have emerged as popular therapeutic agents. The present study was attempted to comparatively evaluate for the first time the effects of both these agents on chronic periodontitis. Materials and methods In this double blinded randomized controlled clinical trial, 96 systemically healthy patients with chronic periodontitis between the ages of 25-55 years were randomly divided into 3 groups. Following scaling and root planing, group 1 was administered the herbal immunomodulator tablets twice daily for 2 weeks, group 2, probiotic tablets twice daily for 2 weeks and group 3 was not administered any agent. Changes in gingival index, gingival bleeding index, pocket depth and interleukin - 6 (IL-6) levels in saliva and GCF were assessed at day 0, at 1 month, at 3 months and 6 months following which statistical analysis was done. Results Statistically significant reduction (p<0.001) in clinical parameters and GCF IL-6 levels at 1, 3 and 6 months respectively within all 3 groups was observed. However, there was a significant reduction in salivary IL-6 levels within group 3 only. Group 1 showed better clinical results and salivary IL-6 reduction compared to group 2 and 3. Conclusion