Aryl Hydrocarbon Receptor (AhR) as a Potential Therapeutic Target in Oral Diseases
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:2] [Pages No:1 - 2]
DOI: 10.5005/jp-journals-10015-2144 | Open Access | How to cite |
Evaluation of Salivary Galectin-3 Level and its Potential Role in Increasing the Severity of COVID-19 Infection in Patients with Periodontitis
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:6] [Pages No:3 - 8]
Keywords: Acute phase proteins, Coronavirus disease 2019, Galectin-3, Periodontitis, Severe acute respiratory syndrome coronavirus 2
DOI: 10.5005/jp-journals-10015-2169 | Open Access | How to cite |
Aim: To evaluate and compare the salivary galectin-3 (Gal-3) level in chronic periodontitis patients, coronavirus disease 2019 (COVID-19) patients, and patients with COVID-19 + periodontitis and thus determining the risk of periodontitis in increasing the severity of COVID-19 infection. Materials and methods: For the present study, a total of 77 participants were recruited to the study with 20 healthy controls (group I), 20 patients with chronic generalized periodontitis (group II), 19 COVID-19 patients (group III), and 18 with COVID-19 and periodontitis (group IV). Demographic characteristics and periodontal clinical parameters like plaque index (PI), probing pocket depth (PPD), and clinical attachment level (CAL) were recorded for all patients. Saliva samples were collected and Gal-3 levels were assessed using enzyme-linked immunosorbent assay (ELISA) kit. One-way analysis of variance (ANOVA) analysis and Tukey's honest significant difference post hoc tests were carried out for data analysis. Results: Group IV patients had a higher concentration of salivary Gal-3 (15.50 ng/mL) than that of group III (10.247 ng/mL) and group II (12.340 ng/mL), and the mean difference in Gal-3 level was statistically significant with the p-value 0.000. The mean PPD, CAL, and PI were significantly high in groups II and IV compared to groups I and II with a p-value of 0.000. Conclusion: The result of the present study showed that patients with periodontitis and periodontitis + COVID-19 presented significant higher salivary Gal-3 levels in comparison with COVID-19 patients and healthy subjects. Thus periodontitis can be a risk factor in increasing the severity of COVID-19 infection. Clinical significance: This study was carried out to evaluate whether periodontitis is a risk factor for increasing the severity of COVID-19 infection. This study also highlights the importance of maintaining good oral hygiene and periodontal health in preventing COVID-19 severity.
Evaluation of Marginal Fit and Flexural Strength of Screw-retained Casted One-piece Metal Framework Postsectioning and Welding: An In Vitro Study
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:7] [Pages No:9 - 15]
Keywords: Casting, Flexural strength, Laser welding, Marginal fit
DOI: 10.5005/jp-journals-10015-2175 | Open Access | How to cite |
Aim: This in vitro study was done to evaluate and compare the effect of sectioning and laser welding on the marginal fit and flexural strength of non-hex full-arch screw-retained casted framework. Materials and methods: Five implants were placed parallel to each other in a styrofoam master model. A total number of 20 conventionally casted screw-retained implant-supported frameworks were fabricated, the samples were divided into group I (one-piece nonsectioned and welded) and group II (sectioned and welded). To evaluate the marginal fit, a screw resistance test and one screw test were used. Data were submitted to an unpaired t-test. After evaluating the frameworks for fit, the flexural strength of both types of frameworks was calculated using universal testing machine (UTM). Results: The data was analyzed using an unpaired t-test. On evaluating the frameworks using one screw test, the mean vertical misfit value at the terminal implant for the group I was 293.23 ± 7.82 µm, and for group II was 78.43 ± 1.49 µm, whereas the average misfit values at four implants on applying screw resistance test were 226.70 ± 9.29 (group I) and 71.26 ± 13 (group II), respectively. The average misfit values on two implants using the screw resistance test were 173.14 ± 10.80 and 37.26 ± 2.18 for groups I and II, respectively. The mean value of flexural strength of frameworks after laser welding was 1529.6 MPa, which was statistically nonsignificant when compared to nonsectioned frameworks. Conclusion: Within the limitations of the study, it was concluded that the passivity and vertical fit of the casted one-piece implant framework improved significantly upon sectioning and laser welding. The flexural strength of the laser welded joint was comparable to nonsectioned frameworks. Clinical significance: The laser welding techniques used in this study demonstrated to be able to improve the clinical conditions of a conventionally casted screw-retained prosthesis by lowering the misfit and producing adequate flexural resistance.
Assessment of the Effectiveness of Two Different Dentin Biomodifiers on Shear Bond Strength of Dentin and Resin Interface: A Comparative Study
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:5] [Pages No:16 - 20]
Keywords: Collagen cross-linkers, Dentin biomodifiers, Matrix metalloproteinase inhibitors, Shear bond strength
DOI: 10.5005/jp-journals-10015-2168 | Open Access | How to cite |
Aim: The aim of the current study was to appraise the efficiency of two different dentin biomodifiers on the shear bond strength of the dentin-resin interface. Materials and methods: A total of 60 human deciduous molars without dental caries were utilized for the purpose of this research. Individual teeth were subjected to mounting on self-curing acrylic resin, uncovering them 1 mm beneath the cementoenamel junction (CEJ). Preparation of class V cavities was performed on the buccal surface of the teeth with the occlusal edge in the enamel while the cervical borders were positioned 0.75 mm apical to the CEJ. After the cavity preparations were made using consistent proportions, the specimens were allocated at random to one of the three groups (n = 20)—the Group I—control group, Group II—casein phosphopeptide-amorphous calcium phosphate (CPP-ACP), and group III—chitosan nanoparticles (CNPs). The universal single-bond adhesive system was subjected to application on the specimens. Each of the finished specimens was tested for its shear bond strength by employing the universal testing machine. Results: Casein phosphopeptide-amorphous calcium phosphate (CPP-ACP) group at 161.32 ± 5.220 showed the highest shear bond strength, in pursuit by the CNPs group at 158.18 ± 5.148 and finally, the control group at 124.98 ± 7.246. A statistically noteworthy dissimilarity was noted among the three groups. On multiple contrast assessments of dentin biomodifiers on shear bond strength, a greatly significant disparity was noted amid the control vs CPP-ACP and control vs CNPs (p < 0.001). Conclusion: Amid the confines of the limitations that this research had, it can be inferred that the utility of dentin biomodifiers like CPP-ACP as well as CNPs have the potential to improve the enduring steadiness of the dentin bond, thus improving the durability of the tooth-restoration composite. However, the CPP-ACP cohort exhibited somewhat improved shear bond strength vs CNPs. Clinical significance: Multiple dentin biomodifiers are presently accessible to decrease the degradation of collagen by enzymes as well as enhance their mechanical strength and steadiness. Biomodifying dentin utilizes inhibiting agents for matrix metalloproteinases (MMPs) in addition to the use of dentinal collagen cross-linkers. Such biomodification of dentin seems to be a competent move toward the stabilization of the resin-dentin bond.
In Vitro Evaluation of Incorporation of Zirconium Oxide Nanoparticle and Antibiotics on the Physical Properties of Glass Ionomer Cement
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:6] [Pages No:21 - 26]
Keywords: Antibiotics, Compressive strength, Fluoride release, Glass ionomer cement, Zirconium oxide nanoparticles
DOI: 10.5005/jp-journals-10015-2159 | Open Access | How to cite |
Aims and objectives: To evaluate and compare the compressive strength and fluoride release of conventional glass ionomer cement (GIC) with zirconium oxide (ZrO2) nanoparticle and antibiotic-enriched glass ionomer cement. Materials and methods: A total of 30 specimens in three groups comprising group I (control): Fuji IX GIC, group II A: 3% ZrO2 nanoparticles + GIC, group II B: 1.5% ZrO2 nanoparticles + GIC, group III A: 3% (ciprofloxacin + cefuroxime = 1:1) + GIC, and group III B: 1.5% (ciprofloxacin + cefuroxime = 1:1) + GIC were prepared in a transparent polyethylene tubing of 10 × 4 mm dimension. All the prepared specimens were stored in distilled water (37°C) for 24 hours. Compressive strength and fluoride release were evaluated using the universal testing machine (UTM) and Orion 940 ion analyzer, respectively. Then the values were compared. To test the statistical significance of the comparison of compressive strength and fluoride release between the groups, the Kruskal–Wallis test and Bonferroni multiple-comparison tests were used. Results: The mean compressive strength was observed to be highest with group II A (94.13 MPa ± 1.81) and least with group III A (62.80 MPa ± 1.53). The highest and lowest mean fluoride releases after 24 hours were observed in group II A (18.40 ppm ± 1.32) and group I (10.10 ± 0.36), respectively. However, the difference in the amount of fluoride released from group II A was not statistically significant at the end of 7 days. Conclusion: Zirconium oxide enriched GIC (3% w/w) has added fluoride release and compressive strength than antibiotic enriched GIC and conventional GIC. Clinical significance: Modifications of GIC have substantially improved the physio-mechanical properties. The application of ZrO2 nanoparticles significantly increased the compressive strength and fluoride release of GIC.
Angular Relationship between the Palatal Plane and the Anterior Cranial Baseline in Different Sagittal Skeletal Relationships: A Cephalometric Study
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:5] [Pages No:27 - 31]
Keywords: Angular Relationship, Cephalometry, Sagittal skeletal relationship, Sella-nasion plane
DOI: 10.5005/jp-journals-10015-2171 | Open Access | How to cite |
Aim: The objective of this investigation was to quantify the relation between the anterior cranial base and the palatal plane [PP-sella-nasion (SN)] in subjects having different sagittal skeletal relationships. Materials and methods: Pretreatment cephalometric radiographs of 106 subjects were obtained. The cephalograms were then traced using the Facad software. The β angle measurement was done to evaluate the sagittal skeletal relationship of the subject. The cephalograms were then grouped into three based on the β angle measurements—groups I, II, and III. The angle formed by the palatal plane (PP) and cranial base intersecting was then measured and tabulated. The data was statistically evaluated using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) software. Results: The tabulated data was distributed normally. The overall mean angle between the PP and the cranial base of the included participants was 6.34° ± 4.51°. The difference in the PP-SN angle between groups was not statistically significant. There was no gender disparity observed. Conclusion: Although individual variability exists, the difference in PP-SN angle among the groups and between both genders was not significant statistically (p > 0.05). Clinical significance: The role of the PP-SN angle as a diagnostic and prognostic tool in the management of malocclusion has to be explored further. Quantification of the PP-SN angle for the South Indian population is a first step in this direction. With the rising popularity of the use of temporary anchorage devices (TADs) and orthognathic surgical interventions, the PP-SN angle could be a key determinant factor in the selection of either.
Analysis of Palatal Rugae Pattern between Male and Female Population in Bangladesh: A Cross-sectional Study
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:4] [Pages No:32 - 35]
Keywords: Odontology, Palate, Palatal forms, Rugae count
DOI: 10.5005/jp-journals-10015-2166 | Open Access | How to cite |
Aim: The study aims to evaluate the palatal rugae patterns in Bangladeshi males and females and to examine the differences in the rugae pattern between males and females within each group. Materials and methods: This cross-sectional study was conducted on 50 males and 50 females whose palatal impression models were obtained. The rugae patterns were observed by using the magnifying glass. Evaluation and assessment of the rugae count were performed between the left and right horizons in both male and female individuals. The shape and placement of rugae were also observed in both populations. The data were recorded and tabulated. The Student's t-test and Chi-squared test were used for statistical analysis through Statistical Package for the Social Sciences (SPSS) V21. Results: The results showed a significance on the right side rather than on the left side number of rugae between males and females. The shape of the rugae pattern was found insignificant. The variation in the form of rugae and the comparison between male and females study participants were observed as insignificant. Conclusion: The study found a distinctive pattern in the population, with a statistically significant difference in the rugae on the right side of the palate between men and women. Curved rugae were more common in women than in men. However, an insignificant difference in gender was observed. Therefore, this result suggests that identifying the population using rugae patterns became difficult since similar patterns were observed in the distinct population. Clinical significance: Palatal rugae is a unique anatomical structure having significant forensic, anthropological, and as well as clinical aspects. No quantitative significance was found among genders. Significance showed only based on rugae patterns.
Assessment of Mental Health in Medical and Dental College Students in Jazan Province to See the Delayed Psychological Impact of COVID-19 Pandemic: An Online Survey
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:5] [Pages No:36 - 40]
Keywords: Anxiety, COVID-19, Dental, Depression, GAD-7, Medical, PHQ-9, Student
DOI: 10.5005/jp-journals-10015-2105 | Open Access | How to cite |
Aim: The present study aimed to assess the depression and anxiety among medical and dental students of Jazan University, Jazan, Saudi Arabia, during the COVID-19 pandemic using the Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder (GAD-7). Materials and methods: An online descriptive cross-sectional survey was conducted among 117 students of Jazan University. Depression and anxiety among the students were assessed using the PHQ-9 and GAD-7. Descriptive statistics were calculated. Association between independent variables and questionnaire scores was calculated using the Chi-square test. Statistical significance was considered at a p-value less than 0.05. Results: Eighty-one students (69.2%) and 72 (61.5%) who participated in the survey were suffering from depression and anxiety, respectively. The medical students had significantly more severe anxiety (p = 0.028) than dental students. No significant association of gender with the presence of depression and anxiety was observed (p > 0.05). Conclusion: Two-thirds of the participants were suffering from some form of depression or anxiety. Medical students reported higher levels of anxiety than dental students. No association was found between depression and anxiety with gender. Clinical significance: COVID-19 had an impact on the mental health of the students and proper counseling from time to time should be provided.
Evaluation of Characteristics of Gingival Stippling in Adult Population. A Clinical Study
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:6] [Pages No:41 - 46]
Keywords: Gingiva, Interpapillary, Interradicular, Keratinization, Stippling
DOI: 10.5005/jp-journals-10015-2174 | Open Access | How to cite |
Aim: The present study aims to describe stippling patterns in terms of number, size and location and evaluate their gender-specific differences. Materials and methods: Around 250 subjects aged between 10 and 35 years were recruited for the study. The gingival examination included the evaluation of stippling patterns in different areas of attached gingiva followed by impression making that was done with custom-made trays and variation in impression making was standardized with stone casts and photographs made with digital single-lens reflex camera (DSLR) camera. The characteristics of stippling were analyzed and subjected to statistical analysis. Results: According to size, the fine form was more in occurrence to bulbous and there was no significant difference between sexes. Based on the number, sparse was more prevalent when compared to numerous and moderate and between the sexes, there was a significant difference in the number of stippling in the maxillary labial (p < 0.03) and palatal (p < 0.01) and mandibular lingual region (p < 0.01). Based on the quantity, the light form was more occurrence than heavy and between sexes, significant differences were found for the quantity of stippling only in the maxillary palatal region (p < 0.05). In both arches, stippling was most prevalent in the interpapillary (84.2%) compared to interradicular (74.65%), and radicular (23.3%) regions. Conclusion: The characteristics of gingival stippling based on the size, number and quantity showed significant variation between sexes and this variation might be attributed to factors such as keratinization and the relative position of teeth. So, accessing the stippling with a larger study population would consider stippling as a valuable diagnostic aid. Clinical significance: Gingival stippling seems to be a unique characteristic of every individual. It varies in terms of number, size, and quantity. Rugae and fingerprints are utilized in forensic sciences for the identification of age, sex, and individuals, along with dental and osseous characteristics. If the stippling pattern and its reliability are further studied, then in the future, it might be used as a major diagnostic aid and as a valuable identification marker in forensic dentistry.
Awareness and Pragmatic Use of Respirators among Dental Healthcare Professionals during COVID-19 Pandemic: A Cross-sectional Study
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:5] [Pages No:47 - 51]
Keywords: Awareness, Coronavirus disease 2019, Dentists, Health personnel, Masks, N95 respirators
DOI: 10.5005/jp-journals-10015-2177 | Open Access | How to cite |
Osteogenic Potential of Tooth as Autogenous Bone Graft in Dental Extraction Sites: A Split-mouth Randomized controlled Human Trial
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:10] [Pages No:52 - 61]
Keywords: Autogenous bone grafting, Grinder, Implants, Teeth
DOI: 10.5005/jp-journals-10015-2172 | Open Access | How to cite |
Aim: The aim of the study was to evaluate the osteogenic potential of autologous tooth graft used in dental extraction sites. Materials and methods: This study was an in vivo, split-mouth, and randomized control trial comparing the effectiveness of autologous tooth grafts in bone formation. A total of 11 patients undergoing bilateral extractions of the analogous teeth were selected after obtaining informed consent and ethical clearance. The atraumatic extraction site allowed to heal normally served as the control (group I) and the extraction site grafted with tooth autologous material served as the intervention (group II). The outcome measures were postoperative pain, discomfort, and qualitative and quantitative bone formation assessed by histological and tomographic methods. Results: The mean total bone formation assessed histomorphometrically was 4.45 ± 2.77 and 21.69 ± 14.6 parts per hundred (PPH) for groups I and II, respectively. The mean total bone formation assessed using the tomographic scale was 0.63 ± 0.48 and 3.27 ± 0.44 for groups I and II, respectively. Statistically significant bone formation was observed in the intervention group (p < 0.01). Conclusion: Tooth as an autologous bone graft can be a viable option for grafting in regions of inadequate bone which is substantiated by the results of this study. Clinical significance: The autologous tooth graft obtained demonstrated excellent osteogenic potential in dental extraction sites, as revealed by definitive histomorphometric and imaging evidence. This can be used as an effective, economical, and potent graft material in conditions requiring osseous repair and reconstruction.
Comparison of Postoperative Healing Using Commercially Available Fibrin (Reliseal®) and Vicryl Suture Following Periodontal Flap Surgery: A Split-mouth Study
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:5] [Pages No:62 - 66]
Keywords: Commercially available fibrin glue, Periodontal flap, Vicryl suture
DOI: 10.5005/jp-journals-10015-2173 | Open Access | How to cite |
Aim: To evaluate commercially available fibrin glue (Reliseal®) as an alternative material for absorbable Vicryl sutures in closing non-tension flaps after periodontal flap surgery. Materials and methods: In this split-mouth study, six patients were selected from the Department of Periodontics. After getting consent from the patients, they were randomly allocated into two groups. The test group (group I) is a commercially available fibrin glue (Reliseal®), and the control group (group II) is an absorbable Vicryl suture. On the 2nd day and 7th day, clinical parameters like plaque index (PI), gingival index (GI), early wound healing index (EWHI), visual analog score (VAS), and patient compliance were evaluated. Results: The test group (Reliseal®) has shown statistically significant improvement in PI, GI, patient compliance, and decreased postoperative (post-op) pain when compared to the control group (absorbable Vicryl sutures). However, in terms of EWHI, there were no statistical differences noted. Conclusion: This result showed that commercially available fibrin glue could be used as an alternative to absorbable Vicryl sutures in the approximation of non-tension periodontal flaps following periodontal flap surgery. Clinical significance: The use of fibrin glue in surgical procedures has significantly increased as it helps to achieve hemostasis following flap surgery, acceptable patient compliance, and improved wound healing process.
Role of Collagen Fibers in Predicting the Biologic Behavior of Dentigerous Cyst, Normal Dental Follicle, and Hyperplastic Dental Follicle Using Special Stains
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:7] [Pages No:67 - 73]
Keywords: Collagen Fibers, Dentigerous cyst, Hyperplastic dental follicle, Normal dental follicle, Picrosirius red, Masson's trichrome
DOI: 10.5005/jp-journals-10015-2179 | Open Access | How to cite |
Background: Extracellular matrix is predominantly made of collagen that shows variation in structure and nature in different pathologies. There are overlapping histopathological features in dentigerous cyst (DC), normal dental follicle (NDF), and hyperplastic dental follicle (HDF), leading to diagnostic ambiguity. The distinction between the three lesions is important as they vary in biologic behavior. The efficacy of Masson's trichome (MT) and picrosirius red (PR) to distinguish dental follicles from DC has been minimally investigated. Aim: To determine the nature of collagen fibers in DC, NDF, and HDF using MT and PR stains, and to estimate the staining efficacy. Methodology: A total of 30 histopathologically diagnosed archival tissue sections each of NDF, HDF, and DC were chosen and subjected to routine and special stains, namely MT and PR. The resultant data was analyzed statistically using the chi-squared test. Results: The arrangement and orientation of collagen fibers differed significantly between NDF, HDF, and DC. The significant difference in the staining efficacy with respect to orientation, organization, arrangement, differentiation, and specificity suggests that PR is superior to MT and hematoxylin and eosin (H and E) in the detection of collagen as it has the potential to differentiate mature and immature collagen fibers. Conclusion: Picrosirius red (PR) and MT can be used to differentiate NDF, HDF, and DC, suggesting their role in determining the behavior of these lesions.
Effectiveness of Nonsurgical Periodontal Therapy on Salivary Visfatin: A Clinical and Biochemical Analysis
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:5] [Pages No:74 - 78]
Keywords: Adipokines, Biomarker, Periodontitis, Visfatin
DOI: 10.5005/jp-journals-10015-2176 | Open Access | How to cite |
Aim: To assess the effectiveness of nonsurgical periodontal therapy (NSPT) on salivary visfatin (VF) levels in chronic periodontitis patients. Materials and methods: A total of 40 individuals with body mass index (BMI) of 18.5–24.9, aged between 30 and 50 years (group I—n = 20, periodontally healthy and group II1—n = 20, generalized chronic periodontitis patients) were enrolled in this experimental study. Clinical parameters such as periodontal probing depth (PPD) and clinical attachment level (CAL) were recorded. Unstimulated salivary samples were collected and assayed for VF using a human VF enzyme-linked immunosorbent assay (ELISA) kit. After clinical examination and saliva collection at baseline, scaling, and root planing (SRP) was done for generalized chronic periodontitis patients, and after 3 months, clinical examination and saliva collection was done (group II2). The results were analyzed using Statistical Package for Social Sciences (SPSS) software, version 23.0. Within-group comparison between different time frames was made by paired t-test, and intergroup comparison was made by independent t-test. Pearson correlation was done to assess the relationship between variables. Results: The salivary VF level was higher in group II1 (37.96 ± 1.74 ng/mL) as compared to group I (19.23 ± 1.33 ng/mL). Between groups II1 (before NSPT) and II2 (after NSPT), there was a reduction in PPD from baseline (4.65 ± 0.36) to 3 months (2.73 ± 2.77), and there was a reduction in CAL from baseline (5.04 ± 0.55) to 3 months (2.98 ± 2.22). Also, there was a reduction of VF from baseline (37.96 ± 1.74) to 3 months (19.04 ± 0.34). Pearson correlation in groups II1 and II2 revealed the correlation between VF and clinical parameters (PPD and CAL) was strongly positive and statistically significant. Conclusion: The present study suggests that there was a significant reduction in salivary VF levels among periodontitis patients after NSPT. Also, there exists a positive correlation between salivary VF and periodontal parameters. Clinical significance: Salivary VF may be used as a potential diagnostic biomarker in the detection of periodontal diseases. Furthermore, it can be used to monitor the efficacy of the treatment during the course of the management of periodontitis.
Traditional and Modern Approaches in the Treatment of Skeletal Class II Malocclusion associated with a Severe Skeletal Open Bite: A Case Report
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:9] [Pages No:79 - 87]
Keywords: Headgear, Miniscrew, Orthodontic treatment, Skeletal class II, Skeletal open bite
DOI: 10.5005/jp-journals-10015-2170 | Open Access | How to cite |
Aim: This case report presents the correction of skeletal class II malocclusion associated with a severe skeletal open bite. Background: Using different mechanics in the same case is always challenging, especially when using class II mechanics augmented by molars intrusion. Case description: In this case report, NM, a healthy 13-year-old girl complaining chiefly of her unpleasant smile, esthetics, speech, and masticatory problems. Clinical and radiographic examination revealed a complex tongue thrust swallowing associated with a skeletal class II and severe vertical discrepancy in the form of a skeletal open bite (mandibular retrusion and clockwise mandibular rotation). The molars relationship was full unit class II bilaterally with an increased overjet of 7 mm associated with the anterior open bite of −9 mm and posterior open bite extended to the first molars. Transversely, the maxillary and mandibular midlines were shifted 1 and 2 mm to the right side, respectively. The patient had total enamel hypoplasia involving all teeth, which was more aggressive in the restored maxillary and mandibular first molars and periodontally compromised lower right central incisor. In this case, traditional (headgear) and modern (miniscrew) approaches were used to get the maximum benefits of each. The treatment involved two phases: the first was to control the habit through fixed habit-breaking appliances and occipital headgear to correct the full unit molars class II malocclusion. The second phase involved maxillary molars intrusion by miniscrew-supported intrusion mechanics with fixed appliances for the upper and lower arches, utilizing preadjusted edgewise appliances with a Roth prescription. The total treatment duration was 3 years and 2 months. A vacuum-formed retainer for both arches and a Hawley retainer with a posterior bite plane for the maxillary arch was delivered to maintain the corrected skeletal and dental malocclusions. Conclusion: The case was provided with a pleasant smile, stable occlusion, and harmonized soft tissue profile using headgear and miniscrew-supported mechanics. Clinical significance: Correction of combined anterioposterior and vertical skeletal malocclusions required proper planning and controlled orthodontic mechanics supported with patient compliance.
Efficacy of Subgingival Glycine Powder Air-polishing in Nonsurgical Therapy of Periodontitis Patients: A Systematic Review of Randomized Controlled Trials
[Year:2023] [Month:January] [Volume:14] [Number:1] [Pages:9] [Pages No:88 - 96]
Keywords: Air-polishing, Glycine air powder polishing, Mechanical debridement, Nonsurgical periodontal therapy, Periodontitis
DOI: 10.5005/jp-journals-10015-2165 | Open Access | How to cite |
Objectives: To evaluate the efficacy of subgingival glycine powder air polishing (subGPAP) in nonsurgical periodontal therapy in systemically healthy periodontitis patients. Materials and methods: Scopus, Web of Science, and PubMed databases were searched using predetermined keywords for randomized controlled clinical trials published between 1st January 2000 and 31st August 2022 in the English language. Probing depth (PD) was considered the primary outcome. The risk of bias was assessed using the Cochrane Collaboration's Tool for Assessing Risk of Bias Version 2.0, and the certainty of the evidence was evaluated using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) assessment tool. The recorded data were subjected to narrative synthesis as meta-analysis was not possible due to the heterogeneity of the data. Results: Seven randomized controlled trials were selected from 45 studies obtained in the electronic search, including a total of 232 participants. The risk of bias for six studies was rated as having some concerns, and one had a low risk of bias. The overall quality of evidence was determined to be low as per GRADE guidelines. There was a significant reduction in clinical parameters, especially pocket PD, between baseline and after treatment in both test and positive control groups in all of the studies. However, subGPAP and conventional scaling and root planning (SRP) demonstrated similar results in six of the seven studies, and only one study reported subGPAP to be more effective. The total microbial count and reduction in Porphyromonas gingivalis (Pg) counts were seen to be more significant after subGPAP. Conclusion: Subgingival glycine powder air polishing (subGPAP) was observed to be equally effective as SRP in reducing periodontal clinical parameters. Total microbial count and reduction in gingival crevicular fluids (GCF) volume levels were seen to be more significant after subGPAP. However, large, multicentric randomized controlled trials with standard diagnostic protocols evaluating the efficacy of subGPAP alone versus other standard treatment modalities are required before formulating clinical guidelines. Clinical significance: Subgingival glycine powder air polishing (subGPAP) has been reported to reduce the amount of tooth structure lost during conventional SRP and causes less patient discomfort and pain. The present review highlights its effectiveness in improving periodontal clinical parameters. Even though the outcomes with subGPAP were comparable with SRP, clinical variables such as pocket PD and clinical attachment level were seen to improve significantly with subGPAP in all of the seven studies included in this review.