Aims: The present study was conducted to determine correlation between peri‑implantitis and periodontitis in adjacent teeth. Materials and Methods: The present study was conducted on 58 patients with 84 dental implants. They were divided into two groups, group I (50) was with peri‑implantitis and group II (34) was without it. In all patients, probing depth (PD), gingival recession (GR), and clinical attachment loss (CAL) was calculated around implant, adjacent to implant and on contralateral side. Obtained data were statistically analyzed using statistical software IBM SPSS Statistics for Windows, Version 21.0. Armonk, NY: IBM Corp with one‑way analysis of variance. Results: Males were 30 with 52 dental implants and females were 28 with 32 dental implants. CAL was 5.82 ± 0.52 in group I and 3.62 ± 0.63 in group II (P = 0.001) around implants. PD was 4.28 ± 1.26 in group I and 2.20 ± 0.52
in group II around adjacent teeth (P = 0.002). PD around contralateral teeth was significant (P = 0.05) in group I (3.18 ± 1.01) and group II (2.71 ± 0.73). Conclusion: Periodontitis has negative effect on implant success. Teeth adjacent to dental implant plays an important role in deciding the success or failure of implant. Maintenance of periodontal health is of paramount importance for successful implant therapy.
Assesment of Self Evaluation Of Dental Appearance Among Non-Dental Undergradu...Dr. Prathamesh Fulsundar
Orthodontist routinely evaluate patients and prescribe treatment plans in order to satisfy the often stated goals of good dental function, stability of teeth & jaw position & dental aesthetics. however aesthetics has variability in individual judgments, it can differ for patients and dentists making it difficult to make generalized statements hence the aim of this study was to assess the self evaluation and satisfaction of dental appearance among non dental undergraduate students and their attitude towards orthodontic treatment.
Assessment of Survival Rate of Dental Implants in Patients with Bruxism: A 5-...Dr. Anuj S Parihar
Background: Dental implants are associated with failure such as early or late failure. Systemic conditions such as diabetes, hypertension, and bruxism affect the success rate. The
present study was conducted to assess complications in dental implants in bruxism patients.
Materials and Methods: This 5‑year retrospective study was conducted on 450 patients (640 dental implants) who received implants during the period and followed up for 5 years from June 2010 to June 2015. Among these patients, 124 had bruxism habit. Dental radiographs or patients’ recalled records were evaluated for the presence of complications such as fracture of implant, fracture of ceramic, screw loosening, screw fracture, and decementation of unit. Results: In 240 males
and 210 females, 380 implants and 260 implants were inserted, respectively. The difference was statistically nonsignificant (P = 0.1). A total of 145 screw‑type and 130 cemented‑type fixations
had complications. The difference was statistically nonsignificant (P = 0.5). Complications were seen in single crown (45), partial prostheses (125), and complete prostheses (105). The difference was statistically significant (P = 0.012). The common complication was fracture of ceramic (70) in cemented‑type fixation and fracture of ceramic (85) in screw‑type fixation. The difference was statistically significant (P = 0.01). Forty‑two single crowns showed decementation, 85 partial prostheses had fracture of ceramic/porcelain, and 50 complete prostheses showed fracture of ceramic/porcelain. The failure rate was 42.9%. Survival rate of dental implants in males with bruxism habit was 90% after 1 year, 87% after 2 years, 85% after 3 years, 75% after 4 years, and 72% after 5 years. Survival rate of dental implants in females with bruxism habit was 92% after 1 year, 90% after 2 years, 85% after 3 years, 75% after 4 years, and 70% after 5 years. The difference among
genders was statistically nonsignificant (P = 0.21).
Conclusion: Bruxism is a parafunctional habit which affects the survival rate of dental implants. There is requirement to follow certain specific protocols in bruxism patients to prevent the developing complications.
Assesment of Self Evaluation Of Dental Appearance Among Non-Dental Undergradu...Dr. Prathamesh Fulsundar
Orthodontist routinely evaluate patients and prescribe treatment plans in order to satisfy the often stated goals of good dental function, stability of teeth & jaw position & dental aesthetics. however aesthetics has variability in individual judgments, it can differ for patients and dentists making it difficult to make generalized statements hence the aim of this study was to assess the self evaluation and satisfaction of dental appearance among non dental undergraduate students and their attitude towards orthodontic treatment.
Assessment of Survival Rate of Dental Implants in Patients with Bruxism: A 5-...Dr. Anuj S Parihar
Background: Dental implants are associated with failure such as early or late failure. Systemic conditions such as diabetes, hypertension, and bruxism affect the success rate. The
present study was conducted to assess complications in dental implants in bruxism patients.
Materials and Methods: This 5‑year retrospective study was conducted on 450 patients (640 dental implants) who received implants during the period and followed up for 5 years from June 2010 to June 2015. Among these patients, 124 had bruxism habit. Dental radiographs or patients’ recalled records were evaluated for the presence of complications such as fracture of implant, fracture of ceramic, screw loosening, screw fracture, and decementation of unit. Results: In 240 males
and 210 females, 380 implants and 260 implants were inserted, respectively. The difference was statistically nonsignificant (P = 0.1). A total of 145 screw‑type and 130 cemented‑type fixations
had complications. The difference was statistically nonsignificant (P = 0.5). Complications were seen in single crown (45), partial prostheses (125), and complete prostheses (105). The difference was statistically significant (P = 0.012). The common complication was fracture of ceramic (70) in cemented‑type fixation and fracture of ceramic (85) in screw‑type fixation. The difference was statistically significant (P = 0.01). Forty‑two single crowns showed decementation, 85 partial prostheses had fracture of ceramic/porcelain, and 50 complete prostheses showed fracture of ceramic/porcelain. The failure rate was 42.9%. Survival rate of dental implants in males with bruxism habit was 90% after 1 year, 87% after 2 years, 85% after 3 years, 75% after 4 years, and 72% after 5 years. Survival rate of dental implants in females with bruxism habit was 92% after 1 year, 90% after 2 years, 85% after 3 years, 75% after 4 years, and 70% after 5 years. The difference among
genders was statistically nonsignificant (P = 0.21).
Conclusion: Bruxism is a parafunctional habit which affects the survival rate of dental implants. There is requirement to follow certain specific protocols in bruxism patients to prevent the developing complications.
A 10 years retrospective study of assessment of prevalence and risk factors o...Dr. Anuj S Parihar
Aim: The present study was conducted to determine the prevalence rate of dental implants failure and risk factors affecting dental implant outcome.
Materials and Methods: The present retrospective study was conducted on 826 patients who received 1420 dental implants in
both genders. Length of implant, diameter of implant, location of implant, and bone quality were recorded. Risk factors such as habit of smoking, history of diabetes, hypertension, etc., were recorded.
Results: In 516 males, 832 dental implants and in 310 females, 588 dental implants were placed. Maximum dental implant failure was seen with length <10 mm (16%), with diameter <3.75 mm, and with type IV bone (20.6%). The difference found to be significant (P < 0.05). Maximum dental implant failures were seen with smoking (37%) followed by
hypertension (20.8%), diabetes (20.3%), and CVDs (18.7%). Healthy patients had the lowest failure rate (4.37%).
Conclusion: Dental implant failure was high in type IV bone, dental implant with <3.75 mm diameter, dental implant with length <10.0 mm, and among smokers..
Central Park Periodontics - A Quarterly UpdateAlan Winter
Central Park Periodontics is pleased to announce the installation of a 3D cone beam CT imaging scanner for better outcomes, improved diagnoses, and reduced risk to patients.
68.Dr. Afreen Kauser; Dr. Rahul VC Tiwari; Dr. Ankita Khandelwal; Dr. Heena Tiwari; Dr. Sourabh Ramesh Joshi; Dr. Fawaz Abdul Hamid Baig; Dr. Anil Managutti. "Preference Of Orthodontic Treatment Versus Orthognathic Surgery In Class Iii Malocclusion Cases: A Research Survey". European Journal of Molecular & Clinical Medicine, 8, 1, 2021, 1271-1276.
Prevalence,riskfactors and treatment needs of traumatic dental injuries to an...Dr. Anuj S Parihar
Aims and Objectives: Traumatic dental injuries (TDIs) of the permanent anterior teeth among the
school children are quite prevalent but often the neglected problem. The objective of the present
study was to assess the prevalence of the TDIs of the permanent anterior teeth among 6-15 years
schoolchildren attending government and private schools of Bhopal city.
Dr. Rahul VC Tiwari - Fellowship In Orthognathic Surgery - Jubilee Mission Medical College Hospital and Research Center, Thrissur, Kerala - 30th publicationJAMDSR 6TH name
A retrospective study in a comprehensive assessment of the various systemic f...AI Publications
In this study, 220 patients from different hospitals in Iraq and distribution Lost follow-up implants and Failed implants of the patient's study for four years, 300 implants. Study showed 220 participants were included, and the average age ranged between 40-60 years with a mean value and standard deviation of 48±7.8.0 This study was designed by adopting an analysis approach for all factors affecting dental implants, and the results were analysed according to the statistical analysis program IBM SPSS Soft. The quality of life (WHO QOL-BREF) was also measured for the purpose of conducting a comprehensive assessment of the various systemic factors of Iraqi patients receiving dental implants. The results which found to be distributed according to gender for 130 male patients with 59.09%, females for 90 patients with 40.09%, Implant insertion torque range achieved in no. of cases (Maxillary dental implants with No. of implants placed 30 for 30±4.9 N and 40 No. of implants placed with Implant insertion torque range achieved in no. of cases 45±7.7 N), (Mandibular dental implants with No. of implants placed for 40 (Implant insertion torque range achieved in no. of cases 34±3.4), (Mandibular dental implants with No. of implants placed 175 and Implant insertion torque range achieved in no. of cases 47±6.6) The effect of dental implants on the quality of life of patients was also identified, and a statistically significant relationship was found at a p-value < 0.05
Evaluation of effect of gestational diabetes mellitus on composition of the i...Dr. Anuj S Parihar
Background: Gestational diabetes mellitus (GDM) is one of the commonly occurring high‑risk obstetric complications that accounts for 4%–9% of total pregnancies. The present study
was an attempt to assess the effect of GDM on composition of the neonatal oral microbiota.
Materials and Methods: In this study, oral samples from 155 full‑term vaginally delivered newborns were collected with sterile swabs. Seventy‑five mothers diagnosed with GDM group and 80 were nondiabetic mothers (control). The oral microbiota was evaluated and analyzed by SPSS software.
Results: The mean gestational age in Group I was 38.1 weeks and in Group II was 39.6 weeks. Firmicutes was present in 38.1% in Group I versus 77.6% in Group II patients, Actinobacteria was seen in 15.2% in Group I and 7.4% in Group II, Bacteroidetes in 27.6% in Group I and 7.9% in Group II, Proteobacteria in 9.5% in Group I and 3.8% in Group II, and Tenericutes in 9.6% in Group I and 3.3% in Group II. There was a significant difference in major genera Prevotella, Bacteroidetes, Bifidobacterium, Corynebacterium, Ureaplasma, and Weissella in both groups (P < 0.05).
Conclusion: There was increased bacterial microbiota in neonates born to mothers with GDM as compared to neonates born to nondiabetic mothers. Assessment of initial oral microbiota of neonates could help in assessing the early effect of GDM on neonatal oral microbial flora.
Comparative Evaluation of Serum Tumor Necrosis Factor a in Health and Chronic...Dr. Anuj S Parihar
Background: Tumor necrosis factor‑alpha (TNF‑α), a “major inflammatory cytokine,” not only plays an important role in periodontal destruction but also is extremely toxic to the host. Till date, there are not many studies comparing the levels of TNF‑α in serum and its relationship to periodontal disease.
Aim: Our study aimed to compare the serum TNF‑α among the two study groups, namely, healthy controls and chronic periodontitis patients and establish a correlation between serum TNF‑α and various clinical parameters. Hence, an attempt is made to estimate the level of TNF‑α in serum, its relationship to periodontal disease and to explore the possibility of using the level of TNF‑α in serum as a biochemical “marker” of periodontal disease. Materials and Methods: Forty individuals
participated in the study and were grouped into two subgroups. Group A – 20 systemically and periodontally healthy controls. Group B – twenty patients with generalized chronic periodontitis.
The serum samples were assayed for TNF‑α levels by enzyme‑linked immunosorbent assay method.
Results: The mean serum TNF‑α cytokines for Group B Generalized chronic periodontitis (GCP) was 2.977 ± 1.011, and Group A (healthy) was 0.867 ± 0.865. The range of serum TNF‑α was from (0.867 to 2.977). Serum TNF‑α cytokines had highly significant correlation with all clinical parameters (plaque index, probing pocket depth, clinical attachment loss, and gingival index) among all study participants (P = 0.001). Conclusion: These observations suggest a positive association
between periodontal disease and increased levels of TNF‑α in serum. It can be concluded that there is a prospect of using the estimation of TNF‑α in serum as a “marker” of periodontal disease in future. However, it remains a possibility that the absence or low levels of TNF‑α in serum might indicate a stable lesion and elevated levels might indicate an active site but only longitudinal studies taking into account, the disease “activity” and “inactivity” could suggest the possibility of using
TNF‑α in serum as an “Indicator” of periodontal disease.
Oral Health–Related Quality of Life in Children and Adolescents of Indian pop...Dr. Anuj S Parihar
Background: Kids and teenagers are more prone to oral diseases. Poor oral health has a significant impact on oral well-being–associated quality of life. Thus, we performed an investigation to examine the outcome of oral health status on
the quality of life of children and adolescents in Indian population, by using the Oral Health Impact Profile-14 (OHIP-14).
Materials and Methods: A total of 100 children, ranging between 1 and 19 years of age who attended Indian hospitals from November 2016 to October 2019, were included in the study. The DMFT Index (Decayed, Missing, and Filled Teeth) and OHIP-14 were used as data collection tools. Association of the total OHIP-14 score and seven subscales associated with it was evaluated using Spearman’s correlations.
Results: The results showed statistically noteworthy association between the toothbrushing regularity, number of dental appointments, history of oral trauma, smoking, and subdomains of OHIP-14 (P < 0.05)
Conclusion: Dental and oral health of an individual has a great impact on their quality of life.
Evaluation of Microleakage and Microgap of Two Different Internal Implant–Abu...Dr. Anuj S Parihar
Aim: The higher success rate (>90%) of dental implants over 5 years has made this treatment option favorable for dental surgeons as well as for patients. The present in vitro study was conducted to assess microleakage and microgap of two dissimilar internal implant–abutment associations.
Materials and methods: Forty dental implants were divided into two groups: trilobe internal connection fixtures in group I and internal hexagonal geometry fixtures in group II. For the immersion of implant abutment assemblies, sterilized tubes containing 4 mL of Staphylococcus aureus broth culture were incubated at 37°C for 2 weeks. Gram’s stain and biochemical reactions were used for identification of colonies.
Results: The mean log10 colony-forming unit (CFU) in group I was 8.6 and was 9.3 in group II. The disparity among two groups was found to be significant (p < 0.05). The mean microgap in group I was 7.2 μm and was 10.4 μm in group II. The disparity among the two groups was found
to be significant (p < 0.05).
Conclusion: Authors found that microscopic space between implant and abutment may be the site of penetration of bacteria. There was significant higher log10 CFU in dental implant fixtures with an internal hexagonal geometry compared to the dental implant fixtures with a trilobe internal connection.
A must read seminar on Dental Implants for Under-Graduates and Post-Graduates.
If you have any doubts regarding Dental Implants or any topic if you are unable to understand then do feel free to contact me on my Email address: Dr.anujparihar@gmail.com
Periodontally accelerated osteogenic orthodontics: A perio-ortho ambidextrous...Dr. Anuj S Parihar
The interdisciplinary collaboration of periodontics and orthodontics has allowed teeth to be moved 2–3 times faster, reducing the time required for traditional orthodontic therapy considerably. Periodontally accelerated osteogenic orthodontics (PAOO), also known as Wilckodontics, is a combination of a selective decortication facilitated orthodontics and alveolar augmentation. With this technique, there is no dependence on the pre‑existing alveolar volume. This case report describes the treatment of permanent mandibular molar protraction in a 14‑year‑old patient undergoing orthodontic therapy using PAOO with piezosurgery.
Evaluation of role of periodontal pathogens in endodontic periodontal diseasesDr. Anuj S Parihar
Aim: This study aimed to correlate periodontal pathogens in endodontic periodontal diseases. Methodology: This study was conducted on 40 patients of both genders. All the participants were obtained from department of endodontics and periodontology with history of endo‑perio lesion in same teeth. Polymerase chain reaction was performed and correlation was established. Results: This study included 18 males and 22 females. The mean age of male was 42.5 years and female was 41.3 years. Specimens of Tannerella forsythia were isolated from 94% endodontium and 92% periodontium, Porphyromonas gingivalis from 71% endodontium and 55% periodontium,
Aggregatibacter actinomycetemcomitans from 12% endodontium and 58% periodontium. The difference was significant (P < 0.05). Bacteria in endodontic‑periodontal infection confirmed statistically significant correlation between absolute quantitation of T. forsythia and P. gingivalis (r = 0.412, P < 0.05), P. gingivalis and A. actinomycetemcomitans (r = 0.524, P < 0.05), and T. forsythia and A. actinomycetemcomitans (r = 0.427, P < 0.05). Conclusion: There was correlation between targeted bacterial species levels from concurrent endodontic‑periodontal diseases. Thus, it can be suggested that dentinal tubules may be the pathway for spread of bacteria.
Crestal bone loss around dental implants after implantation of Tricalcium pho...Dr. Anuj S Parihar
Background and Aims: Bone loss around dental implants is generally measured by monitoring changes in marginal bone level using radiographs. After the first year of implantation, an implant should have <0.2 mm annual loss of marginal bone level to satisfy the criteria of success. However, the success rate of dental implants depends on the amount of the crestal bone around the implants. The main aim of this study was to evaluate and compare the crestal bone loss around implants placed with particulate β‑Tricalcium Phosphate Bone Graft and platelet concentrates. Methods: 50 individuals received hundred dental implants. Each individual received one dental implant in the edentulous site filled with β‑Tricalcium Phosphate Bone Graft along (β‑TCP) with Platelet‑ Rich Plasma (PRP)
(Group A) and another in edentulous site filled only with β‑Tricalcium Phosphate Bone Graft (Group B) in the posterior edentulous region. All the 100 implants were prosthetically loaded after a healing period of three months. Crestal bone loss was measured on mesial, distal, buccal and lingual side of each implant using periapical radiographs 3 months, 6 months and 9 months after implant placement. Results: The average crestal bone loss 9 months after the implants placement in Group A and Group B was 2.75 mm and 2.23 mm respectively, the value being statistically significant (P < 0.05). In both Group A and Group B, the average crestal bone loss was maximum on the lingual side followed by buccal, distal and mesial sides. Conclusion: β‑TCP is a promising biomaterial for clinical
situations requiring bone augmentation. However, the addition of PRP results in decreased bone loss around the dental implants.
Assessment of Lingual Concavities in Submandibular Fossa Region in Patients r...Dr. Anuj S Parihar
Aim: The present study was aimed at assessing the lingual concavities in the submandibular fossa region in patients requiring dental implants with the help of cone beam computed tomography (CBCT). Materials and methods: The present study included 140 patients who visited the department with the missing mandibular posterior teeth. CBCT images were obtained using planmeca machine. Cross sections of 1 mm of submandibular fossa in the region of 1st and 2nd molar were studied and Type I to III lingual concavities were analyzed by a radiologist. Results: Type I lingual concavity (< 2 mm) was seen in 23%, type II (2-3 mm) in 62% and Type III (> 3 mm) in 15% of patients. The difference was significant (p < 0.05). Males had slightly higher mean ± S.D value at 1st molar (2.6 mm ± 0.94) and 2nd molar (2.8 mm ± 0.90) on the left side and (2.7 mm ± 0.92) at 1st molar and (2.9 mm ± 0.93) at 2nd molar on the right side. The difference was nonsignificant (p > 0.05). Females had mean ± S.D value at 1st molar (2.3 mm ± 0.90) and (2.5 mm ± 0.92) at 2nd molar on the left side and (2.4 mm ± 0.91) at 1st molar and (2.8 mm ± 0.93) at 2nd molar. The difference was nonsignificant (p > 0.05. The difference between both genders was statistically nonsignifi-cant (p > 0.05). Conclusion: Type I bone is the best for placing an implant. The chances of complications are more in type II and III bone. CBCT provides necessary information before planning implant in the edentulous area. Clinical significance: Cone beam computed tomography (CBCT) is the best radiographic aid which is effective in delin-eating different types of bone in the mandibular posterior region.
Correlation of Clinical Attachment Level (CAL) and C - Reactive Protein (CRP)...Dr. Anuj S Parihar
Periodontal disease, caused mainly by bacteria, is characterized by inflammation and destruction of the attachment apparatus of the teeth. Periodontitis is a multi-factorial disease with microbial dental plaque as the initiator of periodontal disease. Studies indicate that the periodontal lesion is not strictly a localized process but may lead to systemic alterations in the immune function. The present study intends to evaluate the correlation of clinical attachment level and C-reactive protein levels in
smoker and non-smoker patients with chronic generalized periodontitis. A total of fifty patients were included in the study, and they were divided into two group. Group A consisting of 25 patients who are smokers and they are having chronic generalized periodontitis, while Group B consist of 25 patients who are nonsmokers and having chronic generalized periodontitis. In the study clinical parameters we checked were Oral hygiene index – Simplified (OHI-S), Gingival Index (GI), Probing pocket depth (PPD) and Clinical Attachment level (CAL). Furthermore, CRP was evaluated as well between
Group-A (Smokers with chronic generalized periodontitis) and Group-B (Nonsmokers with chronic generalized periodontitis). The results showed higher OHI – S, PPD, CAL and CRP levels in Group - A (Smokers having chronic generalized periodontitis) than Group - B (Nonsmokers having chronic generalized periodontitis). GI score was higher in Group - B as compared to Group - A. Increased levels of clinical attachment level
(CAL) were seen in smokers suffering from chronic periodontitis. Significantly an increased level of C - reactive protein (CRP) was seen in smokers suffering from chronic periodontitis. Correlation between Clinical attachment level (CAL) and Creactive protein levels (CRP) was very strongly positive and significant. Suggesting, as value of CAL increases, CRP also increases.
Healing Effects of Hydroalcoholic Extract of Guava (Psidium guajava) Leaf on ...Dr. Anuj S Parihar
Oral mucositis (OM) is a common inflammatory complication among cancerous patients as an adverse effect of chemotherapy and radiotherapy. The aim of this study is to evaluate the healing effects of hydroalcoholic extract of Psidium
Guajava leaf on oral induced mucositis induced by 5-fluorouracil using histopathologic and tissue antioxidative markers assessment in male dark brown rats. In a prospective randomized double blind animal study, OM was induced in 64 male dark brown rats that allocated in 4 groups by 5-FU (60 mg/kg) on days 0, 5, and 10 of the study. The cheek pouch was scratched with a sterile needle on once daily on days 3 and 4. Starting from day 12, gel base, topical form and 600 mg/kg dietry form of hydroalcoholic extract of Psidium Guajava leaf were administered per day. Pouch histopathology score, superoxide dismutase, glutathione peroxidase, total antioxidant capacity were evaluated on day 14 and 18. DPPH scavenging activity and total phenolic content also were measured. Histopathology scores of mucositis were lower in the systemic and topical treatment groups than the gel base and control groups (P<0.05). Higher activities of SOD, GPX and TAC were detected in the topical and systemic treatment groups in comparison to the others (P<0.05). The extract was rich in total phenolic content as antioxidant. The use of extract of Psidium Guajava leave may be associated with reduced intensity of OM, increased concentration of SOD, GPX and TAC on induced
OM in dark brown rats undergoing 5-FU consumption.
Gingival crevicular fluid turnover markers in premenopausal vs postmenopausal...Dr. Anuj S Parihar
Orthodontic treatment is one of the commonly
used dental treatments. Orthodontic forces act on the bone by
modulating the biomolecules, chiefly the osteoprotegerin (OPG),
osteopontin (OPN), receptor activator of nuclear factor kappa-B
(RANK), and RANK ligand (RANKL) (OPG ligand). Hormonal
changes are known to cause marked alteration in the levels of
these biomolecules. Hence, we planned this study to evaluate the
response of bone biomarkers in the gingival crevicular fluid (GCF)
in postmenopausal women undergoing fixed orthodontic therapy.
Local Drug Delivery Modalities in Treatment of Periodontitis: A ReviewDr. Anuj S Parihar
Periodontitis is an inflammatory disease that causes destruction of
tooth supporting tissues, characterized by multifactorial etiology
with pathogenic bacteria being the primary etiologic agents that
dwells the subgingival area. Local drug delivery system consists of
antimicrobial dosages that produces more constant and prolonged
concentration profiles within the subgingival tissue and provides
better access into the periodontal pockets. It addresses the critical
distress of exposing the patient to adverse effects of systemic
administration. This article reviews the literature and presents
novel trends such as osteoblast activators, growth factors, and
herbal products in the local drug delivery system.
Dental Plaque
Soft deposits that form the biofilm adhering to the tooth surface or other hard surfaces in the oral cavity, including removable & fixed restorations”
Bowen , 1976
Bacterial aggregations on the teeth or other solid oral structures
Lindhe, 2003
Relationship between Severity of Periodontal Disease and Control of Diabetes ...Dr. Anuj S Parihar
Background: Both diabetes mellitus (DM) and periodontitis
are chronic diseases affecting large number of the population
worldwide. Changes in human behavior and lifestyle over the
last century have resulted in a dramatic increase in the incidence
of diabetes in the world. This study was designed to evaluate the
relationship between severity of periodontal disease and control of
diabetes (glycated hemoglobin [HBA1c]) in patients with Type 1
DM in a hospital based study.
Materials and Methods: Fifty patients (n = 50) with Type 1
diabetes were enrolled in the study. They were divided into three
groups based on the degree of glycemic control by measuring
HbA1c levels as: “Good” (HBA1c ≤7) Group A, fair (HBA1c = 7-8)
Group B and poor (HBA1c >8) Group C. All enrolled patients
underwent detailed history and dental checkup. Evaluation for
periodontal disease was done by measuring dental plaque (plaque
index), inflammation of gums (gingival index), probing pocket
depth (PPD), and clinical attachment level.
Results: Type 1 diabetics with poor glycemic control had
increased gingival inflammation (P < 0.05), more dental plaque
(P < 0.05), increased PPDs (P < 0.05) and attachment loss
(P < 0.05) as compared to those with fair and good glycemic
control, respectively.
Conclusion: Severity of periodontal disease increases with poor
glycemic control in patients with Type 1 DM.
Key Words: Glycated hemoglobin levels, periodontal disease,
Type 1 diabetes mellitus
Peripheral ossifying fibroma (POF) is a non-neoplastic enlargement of the gingival, which is one of the main
benign, reactive hyperplastic inflammatory lesions of the gingiva occurring in young adults. It has a very high
recurrence rate of around 7-45%. For this reason, a longer patient follow-up is very important in POF. Peripheral
ossifying fibroma comprises about 9% of all gingival growths. POF has similar clinical presentations with different
lesions which makes it difficult to reach at a correct diagnosis. In this article, we are reporting a case of peripheral ossifying fibroma (POF) in a 16-year-old female patient.
Key Words: Fibrous hyperplasia, Peripheral ossifying fibroma,
The presence of furcation involvement is one clinical finding that can lead to a diagnosis of advanced periodontitis and potentially to a less favourable prognosis for the affected tooth or teeth. Furcation involvement therefore presents both diagnostic and therapeutic dilemmas. This review explains the vast aspects of furcation involvement in form of etiology, classification, diagnosis and different treatment modalities in detail.
Key Words: Furcation, periodontitis, plaque.
The term probiotics is a relatievly new word meaning “for life” and is currently used to name bacteria associated with beneficial effects for humans and animals. The development of resistance to range of antibiotics by some important pathogen has raised a possibility of return to pre antibiotic dark ages. So there was need of new treatment paradigm to be introduced to treat periodontal diseases. This need was fulfilled by the introduction of probiotics. Probiotics are counterparts of antibiotics thus are free from concerns for developing resistance, further they are body’s own resident flora hence are most easily adapted to host. The buzz about probiotics has become a roar but despite great promises, probiotics work is limited to gut. Periodontal works are sparse and need validation by large randomized trials. It can be said probiotics are still in “infancy” in terms of periodontal health benefits, but surely have opened door for a new paradigm of treating disease on a nano molecular mode. Novel species are likely to be added in the future as research data
accumulate. In-depth understanding of the intrinsic microbial ecological control of commensal microbiota may introduce new putative species to this discussion.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
Anti ulcer drugs and their Advance pharmacology ||
Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
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This document describes the acute management of AV block.
The prostate is an exocrine gland of the male mammalian reproductive system
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Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
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NYSORA Guideline
2 Case Reports of Gastric Ultrasound
2. Achanur, et al.: Periodontitis and peri‑implantitis
Journal of Family Medicine and Primary Care 244 Volume 9 : Issue 1 : January 2020
Materials and Methods
The present retrospective study was conducted on 58 patients
of both genders with 84 dental implants in Department of
Implantology from March 2011 to September 2017. Written
informed consent was obtained from all participating subjects.
Ethical clearance was taken from the institutional ethical
committee letter no. PDA/Rese: 128/2017-18. Ethical approval
was obtained on 16th
August 2017.
Inclusion criteria was patients with dental implants, evidence of
periodontitis with bleeding on probing, >4.5 mm pocket depth,
clinical and radiographic presence of bone loss, presence of
atleast one teeth adjacent to implant (either mesial or distal), and
in opposing and contralateral arch. Patients who received dental
implants on posterior ridge in either of the arch in the last 6 years
were enrolled in the study. Information of patient home care
and smoking habit was recorded. Patients with prior periodontal
surgery, history of systemic conditions like diabetes, patients
under medications, edentulous opposing, and contralateral arch
were excluded from the study.
Depending upon presence or absence of peri‑implantitis,
patients were divided into two groups. Group I (50) was with
peri‑implantitis and group II (34) was without peri‑ implantitis.
In all patients, William graduated periodontal probe was used
to calculate the probing depth (PD) around the implant as well
as around the teeth adjacent to the implant. Teeth adjacent to
implant site were evaluated for bone and periodontal condition.
Gingival recession (GR) was calculated by measuring the distance
from gingival margin to the Cemento-enamel (CE) junction.
The clinical periodontal parameters included PD. In all patients,
the mean of parameters was considered which were measured
at six sites such as buccal, mesiobuccal, distobuccal, lingual,
mesiolingual, and distolingual around the dental implant and
teeth adjacent to implant and on the contralateral site using a
manual probe.
Clinical attachment loss (CAL) was calculated by adding GR and
PD. All measurements were performed around 84 implant sites,
84 adjacent teeth, and 84 contralateral teeth. Intraoral periapical
radiographs (IOPARs) were taken to evaluate peri‑implantitis.
All the evaluation was done by single trained investigator.
Results thus obtained were subjected to statistical analysis
using statistical software IBM SPSS Statistics for Windows,
Version 21.0. Armonk, NY: IBM Corp with one‑way analysis
of variance (ANOVA). P value less than 0.05 was considered
significant.
Results
Out of 58 patients, males were 30 and females were 28. In
30 males, 52 dental implant and in 28 females, 32 dental implants
were present. The difference was significant (P = 0.01) [Table 1].
Table 2 shows PD (mean ± S.D) around implant (4.24 ± 1.15),
adjacent teeth (3.20 ± 1.08), and contralateral teeth (3.04 ± 0.26).
The difference was significant (P = 0.01). GR showed significant
difference (P = 0.02) around implants (0.55 ± 0.92), adjacent
teeth (0.83 ± 1.02), and contralateral teeth (0.80 ± 0.96). CAL
was found to be 4.79 ± 1.46, 4.03 ± 1.32 and 3.84 ± 1.17
around implant, adjacent teeth, and contralateral teeth, which
showed nonsignificant difference (P = 0.07). CAL was highly
significant (P = 0.001) among group I (5.82 ± 0.52) and
group II (3.62 ± 0.63) around implants. PD was 4.28 ± 1.26
in group I and 2.20 ± 0.52 in group II around adjacent
teeth which showed significant difference (P = 0.002). CAL
around adjacent teeth to implant also showed significant
difference (P‑ =0.001). PD around contralateral teeth was
3.18 ± 1.01 in group I and 2.71 ± 0.73 in group II. The difference
was significant (P = 0.05) [Tables 3-5].
Discussion
The successful dental implant therapy may be judged by its ability
to free from complications such as peri‑implantitis, fracture of
Table 1: Distribution of patients and dental implants
Gender Dental implants P
Male 30 52
Female 28 32
Table 2: Assessment of periodontal & peri‑ implant
status in 84 implants
Parameters
(Mean±S.D)
Implants Adjacent teeth Contralateral teeth
PD 4.24±1.15 3.20±1.08 3.04±0.26
GR 0.55±0.92 0.83±1.02 0.80±0.96
CAL 4.79±1.46 4.03±1.32 3.84±1.17
P<0.05 test used: One way ANOVA
Table 3: Periodontal status around implants in both
groups
Parameters Group I (50) (Mean±S.D) Group I (34) (Mean±S.D)
PD 5.28±1.27 3.20±0.75
GR 0.54±0.82 0.42±0.58
CAL 5.82±0.52 3.62±0.63
P<0.05 test used: One way ANOVA
Table 4: Periodontal status around adjacent teeth
Parameters Group I Group II
PD 4.28±1.26 2.20±0.52
GR 0.91±0.80 0.86±0.75
CAL 5.19±1.42 2.06±1.27
Table 5: Periodontal status in contralateral teeth in both
groups
Parameters Group I Group II
PD 3.18±1.01 2.71±0.73
GR 0.82±0.85 0.86±0.95
CAL 4.00±0.81 3.57±0.77
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3. Achanur, et al.: Periodontitis and peri‑implantitis
Journal of Family Medicine and Primary Care 245 Volume 9 : Issue 1 : January 2020
implant, and prosthetic part. The presence of peri‑implantitis
can be evaluated by taking radiographs in recalled visits and the
amount of bone loss and mobility of implant determines the
survival rate of implant.[5]
The present study was conducted to
evaluate the effect of periodontitis in dental implants in terms
of peri‑implantitis.
Zitzmann and Berglundh[6]
in their study found 28‑56% of
prevalence of peri‑implant diseases among patients and 12‑43%
around dental implants. They suggested that the chances of
peri‑implantitis are higher among those who have periodontal
diseases as compared to healthy one. Peri‑implant mucositis and
peri‑implantitis are two peri‑implant diseases which affects the
treatment outcome. Peri‑implant mucositis is inflammation of
mucosa adjacent to implant and peri‑implantitis is inflammation
around implant characterized by bone loss.[7]
Klokkevold et al.[8]
in
their systemic review revealed that periodontitis is among various
risk factors for peri‑implantitis and periodontitis has a negative
influence on survival rate of dental implants.
We found that CAL was higher in patients with peri‑implantitis
than those without it. Thus, it may be suggested that risk of
peri‑implantitis is more in patient with periodontal diseases
than those with healthy periodontium. Similarly, PD and CAL
were significantly higher in adjacent teeth group I as compared
to group II.
Wang et al.[9]
evaluated the relation between peri‑implant
conditions and periodontal conditions and found that 58% of
patients with 120 dental implants had more peri‑implantitis
with modified gingival index score >3. They concluded that
periodontal health adversely affects the implant health in patient.
We found that although GR and CAL on contralateral side
in group I was higher than group II but the difference was
statistical nonsignificant (P > 0.05). Chrcanovic et al.[10]
in
their meta‑ analysis of dental implants and periodontically
compromised and periodontically healthy subjects found that
5.37% implant failures were seen out of 10, 927 dental implants
inserted in periodontically compromised patients as compared
to 3.84% failure rate in periodontically healthy subjects. They
suggested that periodontitis exaggerate the bone loss around
dental implant, ultimately leading to implant loss.
Sung et al. evaluated the relationship between peri‑implantitis and
the periodontal health of the adjacent tooth to the implants with
and without peri‑implantitis and concluded that the presence of
peri‑implantitis was significantly associated with the periodontal
measurements of the remaining teeth.[11]
Dinzin et al. in a systemic
review conclude that diagnosis or history of periodontitis
was associated with the occurrence of peri‑implantitis and
determining the potential factors associated with peri‑implantitis
is fundamental for preventive strategies.[12]
Sabanci and Eltas evaluated the microbiological findings obtained
from implants and teeth of individuals with dental implants in
function for at least 3 years with respect to presence of smoking
and concluded that peri‑implant and periodontal microflora
composition was similar at long‑term implants in smoking and
non‑smoking individuals.[13]
Kandasamy et al. evaluated various
clinical parameters during implant maintenance phase and
conclude that etiological factors should be considered in success
of implant due to possibility of peri‑implantitis.[14]
Muhammad Irshad in his review article stated that knowledge of
risk factors for developing peri‑implantitis is necessary for the
clinicians to provide detailed counseling to the high‑risk patients
and stress the need for good personal and clinical care for the
implants.[15]
Sarmast et al. suggested that endodontic evaluation
of teeth adjacent to the implant site should be performed for
primary prevention of RPI.[16]
Mumcu and Taqi Fadhil in a review article suggested that risk
factors for peri‑implantitis include periodontitis, dental plaque,
bad oral hygiene, smoking, alcohol consumption, and diabetes
mellitus.[17]
From the present study, we observed that periodontal health
strongly affects the outcome of dental implant therapy. Teeth
adjacent to dental implant also play an important role in deciding
the success or failure of implant. Primary preventive care by
home oral hygiene, early treatment of periodontal condition,
treating systemic condition, and avoiding smoking habit can help
in the better prognosis.
Limitation of the study was smaller sample size in particular
geographic area. Further long‑term study on larger sample size
with inclusion of various other factors is needed.
Conclusion
Periodontal health strongly affects the outcome of dental implant
therapy. Teeth adjacent to dental implant also plays an important
role in deciding the success or failure of implant. Contralateral
teeth have no strong relationship between peri‑implantitis and
periodontitis.
Declaration of patient consent
The authors certify that they have obtained all appropriate
patient consent forms. In the form the patient (s) has/have
given his/her/their consent for his/her/their images and other
clinical information to be reported in the journal. The patients
understand that their names and initials will not be published and
due efforts will be made to conceal their identity, but anonymity
cannot be guaranteed.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
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4. Achanur, et al.: Periodontitis and peri‑implantitis
Journal of Family Medicine and Primary Care 246 Volume 9 : Issue 1 : January 2020
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