Tarun Nanda

Vaccine against Dental Caries- An Urgent Need

Dental caries, the disease that causes tooth decay, is infectious, and the mutans streptococci bacteria have long been identified as the primary disease-causing agents. Most treatments are now aimed at either elimination of this bacterium or suppression of its virulence. Thanks to numerous scientific advances, tooth decay is not as rampant as it once was, but it is still five times more common in children than asthma and seven times more common than hay fever. And about 25% of the population (in the United States) carries about 80% of the disease burden. So it is still a serious problem, especially for those populations who are very young, very old, economically disadvantaged, chronically ill, or institutionalized. Contemporary research is aimed at evolving a potent and effective caries vaccine to prevent dental caries. Various experimental trials have been conducted utilizing rat and primate models with protein antigens derived from S. mutans or S. sobrinus to prevent oral colonization by S. mutans and subsequent dental caries. Numerous strategies have been developed to induce high levels of salivary antibodies that can persist for prolonged periods and to establish immune memory by through different routes of administration. Therefore elimination of caries is the main objective of the health professionals. Still more clinical trials are needed to evaluate the safety of these vaccines so that potential risks are eliminated.

Impact of school based oral health education programmes in India: a systematic review.

The teaching of Oral Health Education aims at preventing the dental disease and promoting dental health at early stages. Schools are powerful places to shape the health, education and well-being of our children. The objective of this study was to determine the impact of school dental health education programmes conducted in various parts of India. A systematic review from available literature was carried out. The study examined papers relating to oral health interventions which were published between 1992 and 2012. Ten articles were selected and included in the review. All the studies were found to contain the required information on the outcomes of school dental health programmes in India. Different methods were used to deliver oral health education. All the studies reported significant improvement in oral hygiene of school children after imparting dental health education. In some studies, school teachers were also trained to impart oral health education. Decreased level of awareness was found in children coming from low income families. Longer duration studies are needed to improve the results. School dental education programmes should be more focused on north-eastern Indian population.

Comparison of Nano-Sized Hydroxyapatite and β-Tricalcium Phosphate in the Treatment of Human Periodontal Intrabony Defects

BACKGROUND Since the advent of nanotechnology, various materials have been introduced for the treatment of the bone defects which have shown promising results. AIM The purpose of this study was to compare the effect of nano-sized Hydroxyapatite (NHA) and β-Tricalcium Phosphate (β-TCP) in the treatment of human periodontal defects. MATERIALS AND METHODS Tweleve patients with a total of 24 sites which were almost identical as determined clinically and radiographically were selected for the study. The selected sites were treated with access flap surgery were divided into two groups: Group I was treated with NHA and Group II treated with β-TCP. Following clinical and radiographic parameters were recorded at baseline, 3 months and 6 months post operatively: 1) Probing pocket depth (PPD); 2)Clinical attachment level (CAL); 3) Gingival recession (GR); 4) Radiographic Defect Depth. RESULTS Groups showed statistically significant improvements in soft and hard tissue parameters after 3 months and 6 months. Greater reduction in PPD, gain in CAL and Radiographic Defect Fill (RDF) was seen in Group I after three months whereas after six months were no statistically significant difference was seen with regard to soft and hard tissue measurements. CONCLUSION Within limits of the study, both NHA and β-TCP have proved to be beneficial in the management of periodontal defects. Treatment of intrabony periodontal defects with NHA leads to significant improvement in early clinical and radiographic outcomes as compared to β-TCP.

Root conditioning in periodontology - Revisited

Objective: Root surfaces of periodontitis-affected teeth are hypermineralized and contaminated with cytotoxic and other biologically active substances. To achieve complete decontamination of the tooth surfaces, various methods including root conditioning following scaling and root planning are present. The main objective of this article is to throw light on the different root conditioning agents used and the goals accomplished by root conditioning in the field of periodontology. Materials and Methods: 20 human maxillary anterior teeth indicated for extraction due to chronic periodontitis were collected and root planned. The teeth were sectioned and specimens were divided into two groups — Group I and II. Group I dentin specimens were treated with EDTA and group II specimens were treated with tetracycline HCl solution at concentration of 10% by active burnishing technique for 3 minutes. The root surface samples were then examined by scanning electron microscope (SEM). Results: The results of the study showed that EDTA and tetracycline HCl were equally effective in removing the smear layer. It was observed that the total and patent dentinal tubules were more in number in teeth treated with tetracycline as compared to EDTA group. However, EDTA was found to be much more effective as root conditioning agent because it enlarged the diameter of dentinal tubules more than that of tetracycline HCl. Conclusion: Results of in-vitro study showed that both the agents are good root conditioning agents if applied in addition to periodontal therapy. However, further studies are required to establish the in-vivo importance of EDTA and tetracycline HCL as root conditioners.

Complications and Failures of Implants

Although the high predictability and long-term success rate of dental implants is well documented, complications and failures do occur. Some complications may be relatively minor and easy to correct, while others will be major and result in the loss of the implant or prosthesis. The aim of this paper is to discuss complications and failures of dental implants.

Peripheral ossifying fibroma: A clinico-histopathological report

The gingiva is often the main site of localized reactive overgrowths occurring in the oral cavity. The peripheral ossifying fibroma (POF) is one of them occurring frequently in the anterior maxilla of females usually in the second to third decade of life. This case report describes a case of POF present in the left upper maxillary anterior region obliterating the vestibule occurring in a 70-year-old female. The lesion was surgically excised down to the periosteum to prevent any chances of recurrence as the recurrence rate of POF is quite high.

Bone platform switching: Perpetuating crestal bone preservation - A pilot study

Background: The purpose of this study was to clinically evaluate the peri-implant soft tissue health and to radiographically evaluate the bone height mesial and distal to the Alpha-bio ® SFB platform switched implants for 1 year; post-prosthesis insertion at 3 month regular intervals. Materials and Methods: A total of 2 Alpha-bio ® SFB platform switched implants were placed on selected patients during this study. A two-stage surgical approach was used for healed or immediate extraction sites - for implant insertion and prosthetic rehabilitation under strict aseptic conditions. The patients were subjected to clinical parameters like plaque index, gingival index, and sulcular bleeding index. Standardized radiographs were taken at different intervals and subjected to computer assisted image analysis for assessment of bone loss mesial and distal to the implant. Results: Implant sites of both patients showed an increase in the plaque, gingival, and bleeding scores at each interval compared to the baseline, followed by a decrease in the average plaque, gingival, and bleeding scores in all patients for teeth as well as implants, indicating that neither of the sites had an increased tendency for soft tissue inflammation. No mobility was associated with any of the implants. Width of keratinized mucosa remained constant throughout the study for either of the patients. The total bone loss was lesser for immediate post-extraction implants. Conclusion: This short-term study showed that Alpha-Bio SFB ® implants could be effectively used for single tooth replacement both in conventional healed ridges or immediately post-extraction in fresh extraction sockets.