Background: Repeated abutment replacements may insults the soft tissue (mucosal) barrier mechanic... more Background: Repeated abutment replacements may insults the soft tissue (mucosal) barrier mechanically, that might initiate other toxic irritants and bacteria into the mucosal-implant barrier that may affect the strength of the tissues around implants. The development of the “definitive abutment,” might minimize the chances of peri-implant soft and hard tissue loss. Therefore, the study was designed to assess peri-implant tissue dimensions in dental implants with definitive abutment (Test group) and repeated abutment replacements (Control group). Materials and Methods: Twenty edentulous sites from systemically healthy participants were selected for the study. Parameters registered were bleeding on probing, Sulcus probing depth, peri-implant marginal bone loss (PMBL) and additionally, two parameters were measured both clinically and radiographically, which included distance of cement enamel junction to alveolar crest (CEJ-AC) and distance of CEJ to gingival margin (CEJ-GM). At the time of surgery, sites were allocated randomly to either test group or control group. All the measurements were recorded at baseline, 3 and 6 months. Results: The PMBL increased from baseline to 3 months in control (1.05 ± 0.28 mm) and test groups (0.65 ± 0.41 mm). When the clinical values of CEJ-AC and CEJ-GM were compared with their respective radiographic values, no substantial differences were noticed between both the groups. The soft-tissue margins in both the groups remained comparatively stable across all the time points. Conclusion: The findings of this study point toward the use of implants with definitive abutment are more beneficial in achieving better maintenance in terms of marginal peri-implant tissue health.
Purpose: Direct observation of procedural skills (DOPS) is widely used on the basis of workplace-... more Purpose: Direct observation of procedural skills (DOPS) is widely used on the basis of workplace-based assessments, which consist of direct observation and feedback. The DOPS covers all related professional qualities including knowledge, clinical perception, communication skills, ethics, the rights of patients, and the speed and accuracy of the task. However, the use of DOPS in dental treatment, especially in the field of periodontics is limited. Objective: The aim of the study was to find the utility of DOPS as assessment tool for the periodontal procedure. Methodology: The departmental faculty and postgraduate (PG) students were sensitized to the DOPS concept. A total of 12 PG students performed the periodontal procedure and were assessed on the basis of the DOPS rating scale for the 4 encounters each. The student's clinical skills were assessed by faculty members and then both students and faculty members were asked to give feedback for the procedure and overall experience. Results: Faculty and students both were comfortable in giving the feedback. Improvements in the knowledge of different clinical skills like relevant anatomy, technique of procedure were observed from 1st encounter to 4th encounter from 70% to 73.33%. Taking informed consent was improved from 53.33% to 90% from 1st encounter to 4th. Moreover, it helped the student to develop and improve their clinical skills, patient examination, and decision-making and treatment. Conclusion: The present study finding shows that faculty and students both were comfortable in giving the feedback and it helped the student to develop and improve their clinical skills. Our experience indicates that DOPS is an appropriate and functional tool in PG setup to enhance the clinical competencies.
Journal of Esthetic and Restorative Dentistry, Jul 19, 2023
BackgroundTo evaluate and compare efficacy of pinhole surgical technique (PST) alone and with adv... more BackgroundTo evaluate and compare efficacy of pinhole surgical technique (PST) alone and with advanced platelet rich fibrin (A‐PRF) in the management of bilateral multiple adjacent gingival recession defects (MAGRD).MethodsOne hundred and sixty five MAGRD were randomly assigned to control group (treated with PST) and test group (PST with A‐PRF). Clinical parameters of gingival recession depth (GRD), gingival recession width (GRW), width of keratinised gingiva (WKG), complete root coverage (CRC) and gingival thickness (GT) on ST‐CBCT was measured at 2, 4 and 6 mm apically from the gingival margin. Also, root coverage aesthetic score and patient satisfaction ratings were recorded at baseline, 6 and 12 months postoperatively.ResultsSubstantial reduction in GRD (Test: 1.29 ± 0.69 mm and Control 0.98 ± 0.30 mm) (p < 0.001) and GRW (Test: 2.03 ± 0.90 mm and control 1.73 ± 0.99 mm) (p < 0.05) with associated gain in WKG and GT was observed (p < 0.001). Mean GT values were increased in both the groups at 2, 4 and 6 mm from the crest. Comparison of Test and Control groups yielded significant reductions in GRD (−0.17 ± 0.56 mm) and WKG (0.73 ± 1.07 mm) favoring the Test group (p < 0.05). Similar increase in GT was observed with better results in Test than control group. (p < 0.001).ConclusionBoth groups exhibited sound clinical outcomes with test group offering better resolution of MAGRD in comparison to control group. Also, it enhances clinical and therapeutic end results in terms of attaining reduction in GRD and GRW along with greater gain in KTW and GT.Clinical SignificancePST as a minimally invasive approach has numerous benefits, some of which include the absence of scarring and improved aesthetics linked to faster wound healing. The addition of A‐PRF enhances the intended therapy outcomes, which is beneficial for both patients and professionals in the field of periodontics.
Objective: The present study aimed to evaluate the gender-based association of gingival exhibit w... more Objective: The present study aimed to evaluate the gender-based association of gingival exhibit with lip dimensions, intercommissural width (ICW), interdental smile line (ISL), and gingival smile line (GSL) in periodontally healthy patients. Materials and methods: 120 patients aged between 20 and 40 years were divided equally into two groups based on gender. The parameters of lip length (LL) at rest and on smiling, ICW, and the intraoral parameters of gingival exhibit in ISL and GSL were measured on digitized photographs in the maxillary anterior teeth. Results: The LL positions at rest and on smiling differed significantly: 23.50 ± 3.31 mm and 19.89 ± 1.91 mm, and 16.53 ± 2.94 mm and 13.91 ± 1.93 mm for males and females, respectively. The gingival exhibit of the interdental papillae in ISL was 3.01 ± 1.85 mm for males and 4.26 ± 1.85 mm for females, while the midfacial exhibit in GSL was 0.62 ± 1.01 mm for males and 1.24 ± 1.44 mm for females; both the differences were statistically significant. Conclusion: The gender variability in LL, the interdental papillae exhibit in ISL, and the midfacial exhibit in GSL can provide constructive guidelines that can be implemented in the esthetic zone.
Background: The aim of the present systematic review was to assess the effectiveness of simultane... more Background: The aim of the present systematic review was to assess the effectiveness of simultaneous placement of implant in osteotome-mediated sinus floor elevation (OMSFE) procedure with and without bone augmentation. Materials and methods: An exploration of randomized clinical trials (RCTs) was systematically done in three databases comprising PubMed, Cochrane, and Google Scholar complemented by a thorough manual search of periodontology/implantology-related journals. A final inclusion of 6 RCTs (2010-2020) was done to investigate the efficiency of simultaneous implant placement with OMSFE in conjunction with bone augmentation. A meta-analysis was further conducted with comparable studies which assisted in attaining a final conclusion regarding the survival rate, endosinus bone gain (ESBG), and marginal bone loss (MBL). Results: Data synthesis was performed on the basis of 6 trials and further meta-analysis was performed to statistically validate the clinical and radiographic outcomes. Meta-analysis on the parameters indicated greater ESBG (mean difference [MD]: 0.82; [95% confidence interval [CI]: 0.72-0.91, P ≤ 0.0001]), which was also associated with minimal MBL (MD: -1.11; [95% CI: -1.53-0.68, P ≤ 0.0001)] in the bone augmentation group. However, the parameter of implant survival rate (risk ratio: 1.04; [95% CI: 0.83-1.31, P = 0.6849)] failed to reveal significant difference between the two groups. Conclusions: In the restoration of masticatory apparatus, simultaneous placement of implant in OMSFE with bone augmentation can be considered as successful and predictable treatment approach in deficient posterior maxillary ridges. It contributes toward bone neoformation resulting in greater ESBG as well as a substantial decrease in MBL.
Background: The aim of the present study was to evaluate and compare the patient-reported experie... more Background: The aim of the present study was to evaluate and compare the patient-reported experience and outcome measures (PREMS and PROMS) and three-dimensional augmentation efficacy of the autogenous and allogenic bone block grafts in deficient alveolar ridges through cone beam computed tomography (CBCT). Materials and methods: Twenty patients were equally divided into Groups I and II treated with autogenous and allogenic bone block grafts for ridge augmentation, respectively. The radiographic parameters including the apico-coronal defect height (DH) as well as buccolingual defect depth (DD) and mesiodistal defect width (DW) at apical, middle, and cervical zone were measured using CBCT at baseline, 6 months and 1 year. The PREMS and PROMS were evaluated using Visual analogue scale (VAS) scale and questionnaire method. Results: The mean DH, apical DD and DW, middle and cervical zone DW were significantly different between two study groups (P < 0.05). The mean apical 11.6 ± 1.91 and middle zone 9.43 ± 0.89 DD were significantly higher (in Group I as compared to Group II, with P values 0.016 and 0.004, respectively). The mean bone gains in apico-coronal DH and mesio-distal DW dimension in the apical and middle zone was significantly higher in Group I (P < 0.0001). The comparison of PROM revealed better patient satisfaction in Group II as depicted by significantly higher VAS score (P < 0.0001). Conclusion: Superior bone gain and reduced graft resorption was observed in Group I when compared to Group II. On the contrary, better PROMs and PREMs were obtained with the allogenic bone block augmentation.
Objective: The present study was formulated as a gender-based evaluation of the vertical apicocor... more Objective: The present study was formulated as a gender-based evaluation of the vertical apicocoronal (VAC), horizontal mesiodistal (HMD), and horizontal faciopalatal (HFP) dimensions of the interproximal area and their influence on the presence of interdental papillae and gingival thickness (GT) in maxillary anterior teeth. Materials and methods: A total of 120 patients in an age range of 20 to 40 years, divided equally into two groups based on gender, were evaluated for interproximal VAC, HMD, and HFP dimensions through radiovisiographic (RVG) images. Additionally, the existence of interdental papillae and GT were assessed clinically in the maxillary anterior sextant. Results: The overall mean VAC dimensions in between the central incisors were greater in females than in males, with maximum mean values of 5.91 ± 0.33 mm and 5.03 ± 0.23 mm, respectively. The mean values for HMD and HFP showed a reverse trend, being greater in males than in females, with the differences being statistically significant. Similarly, the mean GT was greater in males than in females (P < 0.0001). It was also shown that as the VAC dimension increased, the existence of complete papillae in the interproximal areas reduced. Conclusions: The gender variability of intraoral characteristics such as VAC and GT dimensions and their influence on the existence of interdental papillae provide valuable guidelines that can be implemented in procedures in the maxillary anterior sextant. The associations between HMD and HFP dimensions and interdental papillae were not clearly evident, and further exploration in participants of different age groups would be useful and informative.
DOAJ (DOAJ: Directory of Open Access Journals), Mar 20, 2018
Background: Osteoporosis is particularly high in females, the early identification of which remai... more Background: Osteoporosis is particularly high in females, the early identification of which remains a challenge. Panoramic radiographs are routinely advised to detect periodontal diseases and can be used to predict low bone mineral density (BMD). Hence, this investigation was aimed to identify the risk of osteoporosis in pre- and postmenopausal periodontally healthy and chronic periodontitis women with digital panoramic radiographs. Materials and Methods: The study population consisted of 120 patients equally divided as Group I - Premenopausal periodontally healthy, Group II - Premenopausal periodontitis, Group III - Postmenopausal periodontally healthy, and Group IV - Postmenopausal periodontitis. Clinical parameters were recorded, and digital panoramic radiographs were used to record the mental index (MI), panoramic mandibular index (PMI), and mandibular cortical index (MCI) scores. Results: MI was found to be varied, and the differences were highly significant among Group III and IV (P = 0.0003) and Group II and IV (P = 0.0007), and significant difference was found between Group I and Group II (P = 0.0113). MCI evaluation showed a greater prevalence of C2 and C3 patterns among postmenopausal women. MCI correlation with MI (P < 0.0001), PMI (P < 0.0001) and age (P = 0.0029) indicated a highly significant variance. Conclusion: The positive association between MCI and chronic periodontitis in postmenopausal women confirms the high risk of osteoporosis in them. Furthermore, an increased percentage of patients with undetected decrease in BMD may be identified by screening with digital panoramic radiographs which are done on a routine basis for periodontal and other dental diseases and thus could be used as an effective aid to quantify bone density in future.
Purpose: Direct observation of procedural skills (DOPS) is widely used on the basis of workplace-... more Purpose: Direct observation of procedural skills (DOPS) is widely used on the basis of workplace-based assessments, which consist of direct observation and feedback. The DOPS covers all related professional qualities including knowledge, clinical perception, communication skills, ethics, the rights of patients, and the speed and accuracy of the task. However, the use of DOPS in dental treatment, especially in the field of periodontics is limited. Objective: The aim of the study was to find the utility of DOPS as assessment tool for the periodontal procedure. Methodology: The departmental faculty and postgraduate (PG) students were sensitized to the DOPS concept. A total of 12 PG students performed the periodontal procedure and were assessed on the basis of the DOPS rating scale for the 4 encounters each. The student's clinical skills were assessed by faculty members and then both students and faculty members were asked to give feedback for the procedure and overall experience. Results: Faculty and students both were comfortable in giving the feedback. Improvements in the knowledge of different clinical skills like relevant anatomy, technique of procedure were observed from 1st encounter to 4th encounter from 70% to 73.33%. Taking informed consent was improved from 53.33% to 90% from 1st encounter to 4th. Moreover, it helped the student to develop and improve their clinical skills, patient examination, and decision-making and treatment. Conclusion: The present study finding shows that faculty and students both were comfortable in giving the feedback and it helped the student to develop and improve their clinical skills. Our experience indicates that DOPS is an appropriate and functional tool in PG setup to enhance the clinical competencies.
Journal of Indian Dental Association, Oct 24, 2019
Aim: The aim was to evaluate the knowledge, attitude and behaviour of dental students concerning ... more Aim: The aim was to evaluate the knowledge, attitude and behaviour of dental students concerning infection control measures and to check the correlation, if any, among knowledge, attitude and behaviour of dental students concerning infection control measures in dental setups. Materials and Methods: A total of 1200 students from first to final year and interns from three different colleges were included in the study. Results: A total of 95.83% think isolation is important. Only 4.1% have been vaccinated with hepatitis B vaccine and 95% with tetanus vaccine. Conclusion: The level of knowledge and behaviour of infection control measures was average, for which the reasons could be inadequate training, supply of protective equipments and mainly carelessness. Key Words- Infection control, Vaccination, Isolation.
Objectives: Emerging evidence suggests that inflammation due to periodontal diseases may not be l... more Objectives: Emerging evidence suggests that inflammation due to periodontal diseases may not be limited to adjacent oral tissues but may have influence on systemic diseases such as chronic kidney diseases (CKD) and cardiovascular diseases. Hence, this study was aimed to evaluate and compare left ventricular mass (LVM) in patients with CKD undergoing hemodialysis (CKDH) in periodontally healthy, chronic gingivitis, and chronic periodontitis. Methodology: A total of 60Â patients diagnosed with CKDH were divided equally into three groups based on periodontal status as CKDH patients with healthy periodontium (Group I), CKDH patients with chronic gingivitis (Group II), and CKDH patients with chronic periodontitis (Group III). These patients were assessed clinically, biochemically, and echocardiographically. LVM in each of these patients was calculated according to Devereux formula and was indexed to height. Results: Group II and Group III patients exhibited higher mean LVM of 199.51 ± 40.17 g and 200.35 ± 65.04Â g, respectively, as compared to Group I of 161.56 ± 27.99Â g. Similarly, LVM index (LVMI) was found to be more in Group II and Group III at 59.36 ± 13.14Â g/m2.7 and 57.83 ± 19.94Â g/m2.7, respectively, while it was 45.99 ± 11.87 g/m2.7 for Group I patients. Conclusion: Increasing the severity of periodontal diseases in CKDH patients is associated with increase in LVM and LVMI. Periodontal screening and intervention would enable the clinician to refine cardiovascular risk assessment in such patients.
OBJECTIVE The gingival tissues surrounding the maxillary anterior teeth play a pivotal role in fo... more OBJECTIVE The gingival tissues surrounding the maxillary anterior teeth play a pivotal role in fostering a beautiful smile. The gingival zenith position (GZP) and its spatial orientation in the mesiodistal and apicocoronal direction can provide a valuable reference point. The present study was undertaken to evaluate the GZP and gingival zenith line (GZL) in maxillary anterior teeth in different age groups and genders. METHOD AND MATERIALS The study population comprised 124 periodontally healthy patients equally divided into 21 to 40 years (Group I) and 41 to 60 years (Group II) age groups and gender distribution. The parameters of vertically bisected midline (VBM), GZP, and GZL were evaluated for all the teeth. RESULTS The GZP was distally placed in 54.68% and 78.12% of the central incisors for males and females in Group I, while in Group II it was 65.62% and 75.00% respectively. The majority of lateral incisors and canines had coincidence of the GZP and VBM. The GZL was found to be at an apical position with reference to the GZP of lateral incisors. CONCLUSION A distal deviation of GZP was observed for central incisors, while the GZP coincided with the VBM for lateral incisors and canines. The GZL was apically placed in relation to the GZP of lateral incisors. These elements can be taken up as reference points in periodontal and restorative procedures.
BackgroundThe present study aimed to investigate the serum and salivary ghrelin and cortisol leve... more BackgroundThe present study aimed to investigate the serum and salivary ghrelin and cortisol levels in smokers and non‐smokers with Stage III Periodontitis.MethodsThe present study comprised of a total of 90 systemically healthy patients categorized in three groups: Group I‐ Periodontally healthy patients; Group II‐Non‐smokers with Stage III Periodontitis and Group III‐Smokers with Stage III periodontitis. Clinical parameters of Probing pocket depth (PPD), Clinical attachment levels (CAL), Plaque Index (PI), Gingival Index (GI) and Papillary Bleeding Index (PBI) were recorded and biochemical parameters of serum and salivary ghrelin and cortisol levels were analyzed via Enzyme Linked Immunosorbent Assay (ELISA). Stress levels were assessed using Zung's self‐rating depression scale.ResultsSerum and salivary ghrelin values were found to be higher in Group II (620.25 ± 260.86 pg/mL, 892.40 ± 271.65 pg/mL respectively) as compared to Group III. Similarly, salivary as well as serum cortisol levels were higher in Group III (20.78 ± 9.23 pg/mL, 399.37 ±189.21 pg/mL respectively) as compared to Group II (16.36 ± 8.88 pg/mL, 320.68 ± 107.01 pg/mL respectively). In Group III, a direct correlation was observed between stress, serum and salivary cortisol levels while an inverse correlation was found between stress, serum and salivary ghrelin levels. Group III showed a greater number of depressed patients followed by Group II and I.ConclusionAs per the results smokers with Stage III Periodontitis exhibit an elevated stress and cortisol levels, lower serum and salivary ghrelin levels as compared to the non‐smokers.
Background: A strong bilateral relationship between cardiovascular disease (CVD) and chronic peri... more Background: A strong bilateral relationship between cardiovascular disease (CVD) and chronic periodontitis has been established for decades. However, a knowledge gap regarding this association still persists among patients. The main objective of the present study was to assess the knowledge, awareness, and attitude among patients with CVD about its association with chronic periodontitis (CP). Materials and Methods: This observational cross-sectional survey consisted of 500 patients with CVD. Along with information on demographic characteristics, data were collected on knowledge, awareness, and attitude of the interrelationships between periodontal disease and CVD, using a 5-point Likert scale, with 4 and 5 representing “agree” and “strongly agree,” respectively. Results: A significant number of the study population had no knowledge regarding the bilateral association CVD and CP. Other questions revealed limited awareness and ignorant attitude of the patients. Conclusion: Within the limitations of the study, it can be concluded that there is a lack of awareness and an ignorant attitude about the bidirectional relationship between CVD and periodontitis among the CVD patients. Special efforts should be taken by dental as well as medical professionals to increase the awareness in this regard and thereby deliver quality health-care services at earlier stages.
BackgroundInterleukins are the markers of inflammation and the lipid profile reveals the likeliho... more BackgroundInterleukins are the markers of inflammation and the lipid profile reveals the likelihood of arising cardiovascular disease (CVD). The present study aimed to assess and correlate the influence of non‐surgical periodontal therapy (NSPT) on serum lipid profile and Interleukin‐6 (IL‐6) and Interleukin‐8 (IL‐8) in patients with Stage III periodontitis.MethodsSixty patients with the age range of 35–60 years with Stage III periodontitis were included by evaluating for periodontal parameters such as Probing pocket depth (PPD) and clinical attachment levels (CAL). NSPT was performed at baseline, 3 and 6 months. Biochemical parameters like serum lipid parameters of total cholesterol (TC), triglycerides (TG), low‐density lipopolysaccharide (LDL), high‐density lipopolysaccharide (HDL), and IL‐6 and IL‐8 serum levels were assessed at baseline and 6 months' post‐NSPT.ResultsThe results indicated a significant reduction (p < 0.0001) in the PPD (2.75 ± 0.41), CAL (3.23 ± 0.56), li...
Background: Repeated abutment replacements may insults the soft tissue (mucosal) barrier mechanic... more Background: Repeated abutment replacements may insults the soft tissue (mucosal) barrier mechanically, that might initiate other toxic irritants and bacteria into the mucosal-implant barrier that may affect the strength of the tissues around implants. The development of the “definitive abutment,” might minimize the chances of peri-implant soft and hard tissue loss. Therefore, the study was designed to assess peri-implant tissue dimensions in dental implants with definitive abutment (Test group) and repeated abutment replacements (Control group). Materials and Methods: Twenty edentulous sites from systemically healthy participants were selected for the study. Parameters registered were bleeding on probing, Sulcus probing depth, peri-implant marginal bone loss (PMBL) and additionally, two parameters were measured both clinically and radiographically, which included distance of cement enamel junction to alveolar crest (CEJ-AC) and distance of CEJ to gingival margin (CEJ-GM). At the time of surgery, sites were allocated randomly to either test group or control group. All the measurements were recorded at baseline, 3 and 6 months. Results: The PMBL increased from baseline to 3 months in control (1.05 ± 0.28 mm) and test groups (0.65 ± 0.41 mm). When the clinical values of CEJ-AC and CEJ-GM were compared with their respective radiographic values, no substantial differences were noticed between both the groups. The soft-tissue margins in both the groups remained comparatively stable across all the time points. Conclusion: The findings of this study point toward the use of implants with definitive abutment are more beneficial in achieving better maintenance in terms of marginal peri-implant tissue health.
Purpose: Direct observation of procedural skills (DOPS) is widely used on the basis of workplace-... more Purpose: Direct observation of procedural skills (DOPS) is widely used on the basis of workplace-based assessments, which consist of direct observation and feedback. The DOPS covers all related professional qualities including knowledge, clinical perception, communication skills, ethics, the rights of patients, and the speed and accuracy of the task. However, the use of DOPS in dental treatment, especially in the field of periodontics is limited. Objective: The aim of the study was to find the utility of DOPS as assessment tool for the periodontal procedure. Methodology: The departmental faculty and postgraduate (PG) students were sensitized to the DOPS concept. A total of 12 PG students performed the periodontal procedure and were assessed on the basis of the DOPS rating scale for the 4 encounters each. The student's clinical skills were assessed by faculty members and then both students and faculty members were asked to give feedback for the procedure and overall experience. Results: Faculty and students both were comfortable in giving the feedback. Improvements in the knowledge of different clinical skills like relevant anatomy, technique of procedure were observed from 1st encounter to 4th encounter from 70% to 73.33%. Taking informed consent was improved from 53.33% to 90% from 1st encounter to 4th. Moreover, it helped the student to develop and improve their clinical skills, patient examination, and decision-making and treatment. Conclusion: The present study finding shows that faculty and students both were comfortable in giving the feedback and it helped the student to develop and improve their clinical skills. Our experience indicates that DOPS is an appropriate and functional tool in PG setup to enhance the clinical competencies.
Journal of Esthetic and Restorative Dentistry, Jul 19, 2023
BackgroundTo evaluate and compare efficacy of pinhole surgical technique (PST) alone and with adv... more BackgroundTo evaluate and compare efficacy of pinhole surgical technique (PST) alone and with advanced platelet rich fibrin (A‐PRF) in the management of bilateral multiple adjacent gingival recession defects (MAGRD).MethodsOne hundred and sixty five MAGRD were randomly assigned to control group (treated with PST) and test group (PST with A‐PRF). Clinical parameters of gingival recession depth (GRD), gingival recession width (GRW), width of keratinised gingiva (WKG), complete root coverage (CRC) and gingival thickness (GT) on ST‐CBCT was measured at 2, 4 and 6 mm apically from the gingival margin. Also, root coverage aesthetic score and patient satisfaction ratings were recorded at baseline, 6 and 12 months postoperatively.ResultsSubstantial reduction in GRD (Test: 1.29 ± 0.69 mm and Control 0.98 ± 0.30 mm) (p &lt; 0.001) and GRW (Test: 2.03 ± 0.90 mm and control 1.73 ± 0.99 mm) (p &lt; 0.05) with associated gain in WKG and GT was observed (p &lt; 0.001). Mean GT values were increased in both the groups at 2, 4 and 6 mm from the crest. Comparison of Test and Control groups yielded significant reductions in GRD (−0.17 ± 0.56 mm) and WKG (0.73 ± 1.07 mm) favoring the Test group (p &lt; 0.05). Similar increase in GT was observed with better results in Test than control group. (p &lt; 0.001).ConclusionBoth groups exhibited sound clinical outcomes with test group offering better resolution of MAGRD in comparison to control group. Also, it enhances clinical and therapeutic end results in terms of attaining reduction in GRD and GRW along with greater gain in KTW and GT.Clinical SignificancePST as a minimally invasive approach has numerous benefits, some of which include the absence of scarring and improved aesthetics linked to faster wound healing. The addition of A‐PRF enhances the intended therapy outcomes, which is beneficial for both patients and professionals in the field of periodontics.
Objective: The present study aimed to evaluate the gender-based association of gingival exhibit w... more Objective: The present study aimed to evaluate the gender-based association of gingival exhibit with lip dimensions, intercommissural width (ICW), interdental smile line (ISL), and gingival smile line (GSL) in periodontally healthy patients. Materials and methods: 120 patients aged between 20 and 40 years were divided equally into two groups based on gender. The parameters of lip length (LL) at rest and on smiling, ICW, and the intraoral parameters of gingival exhibit in ISL and GSL were measured on digitized photographs in the maxillary anterior teeth. Results: The LL positions at rest and on smiling differed significantly: 23.50 ± 3.31 mm and 19.89 ± 1.91 mm, and 16.53 ± 2.94 mm and 13.91 ± 1.93 mm for males and females, respectively. The gingival exhibit of the interdental papillae in ISL was 3.01 ± 1.85 mm for males and 4.26 ± 1.85 mm for females, while the midfacial exhibit in GSL was 0.62 ± 1.01 mm for males and 1.24 ± 1.44 mm for females; both the differences were statistically significant. Conclusion: The gender variability in LL, the interdental papillae exhibit in ISL, and the midfacial exhibit in GSL can provide constructive guidelines that can be implemented in the esthetic zone.
Background: The aim of the present systematic review was to assess the effectiveness of simultane... more Background: The aim of the present systematic review was to assess the effectiveness of simultaneous placement of implant in osteotome-mediated sinus floor elevation (OMSFE) procedure with and without bone augmentation. Materials and methods: An exploration of randomized clinical trials (RCTs) was systematically done in three databases comprising PubMed, Cochrane, and Google Scholar complemented by a thorough manual search of periodontology/implantology-related journals. A final inclusion of 6 RCTs (2010-2020) was done to investigate the efficiency of simultaneous implant placement with OMSFE in conjunction with bone augmentation. A meta-analysis was further conducted with comparable studies which assisted in attaining a final conclusion regarding the survival rate, endosinus bone gain (ESBG), and marginal bone loss (MBL). Results: Data synthesis was performed on the basis of 6 trials and further meta-analysis was performed to statistically validate the clinical and radiographic outcomes. Meta-analysis on the parameters indicated greater ESBG (mean difference [MD]: 0.82; [95% confidence interval [CI]: 0.72-0.91, P ≤ 0.0001]), which was also associated with minimal MBL (MD: -1.11; [95% CI: -1.53-0.68, P ≤ 0.0001)] in the bone augmentation group. However, the parameter of implant survival rate (risk ratio: 1.04; [95% CI: 0.83-1.31, P = 0.6849)] failed to reveal significant difference between the two groups. Conclusions: In the restoration of masticatory apparatus, simultaneous placement of implant in OMSFE with bone augmentation can be considered as successful and predictable treatment approach in deficient posterior maxillary ridges. It contributes toward bone neoformation resulting in greater ESBG as well as a substantial decrease in MBL.
Background: The aim of the present study was to evaluate and compare the patient-reported experie... more Background: The aim of the present study was to evaluate and compare the patient-reported experience and outcome measures (PREMS and PROMS) and three-dimensional augmentation efficacy of the autogenous and allogenic bone block grafts in deficient alveolar ridges through cone beam computed tomography (CBCT). Materials and methods: Twenty patients were equally divided into Groups I and II treated with autogenous and allogenic bone block grafts for ridge augmentation, respectively. The radiographic parameters including the apico-coronal defect height (DH) as well as buccolingual defect depth (DD) and mesiodistal defect width (DW) at apical, middle, and cervical zone were measured using CBCT at baseline, 6 months and 1 year. The PREMS and PROMS were evaluated using Visual analogue scale (VAS) scale and questionnaire method. Results: The mean DH, apical DD and DW, middle and cervical zone DW were significantly different between two study groups (P < 0.05). The mean apical 11.6 ± 1.91 and middle zone 9.43 ± 0.89 DD were significantly higher (in Group I as compared to Group II, with P values 0.016 and 0.004, respectively). The mean bone gains in apico-coronal DH and mesio-distal DW dimension in the apical and middle zone was significantly higher in Group I (P < 0.0001). The comparison of PROM revealed better patient satisfaction in Group II as depicted by significantly higher VAS score (P < 0.0001). Conclusion: Superior bone gain and reduced graft resorption was observed in Group I when compared to Group II. On the contrary, better PROMs and PREMs were obtained with the allogenic bone block augmentation.
Objective: The present study was formulated as a gender-based evaluation of the vertical apicocor... more Objective: The present study was formulated as a gender-based evaluation of the vertical apicocoronal (VAC), horizontal mesiodistal (HMD), and horizontal faciopalatal (HFP) dimensions of the interproximal area and their influence on the presence of interdental papillae and gingival thickness (GT) in maxillary anterior teeth. Materials and methods: A total of 120 patients in an age range of 20 to 40 years, divided equally into two groups based on gender, were evaluated for interproximal VAC, HMD, and HFP dimensions through radiovisiographic (RVG) images. Additionally, the existence of interdental papillae and GT were assessed clinically in the maxillary anterior sextant. Results: The overall mean VAC dimensions in between the central incisors were greater in females than in males, with maximum mean values of 5.91 ± 0.33 mm and 5.03 ± 0.23 mm, respectively. The mean values for HMD and HFP showed a reverse trend, being greater in males than in females, with the differences being statistically significant. Similarly, the mean GT was greater in males than in females (P < 0.0001). It was also shown that as the VAC dimension increased, the existence of complete papillae in the interproximal areas reduced. Conclusions: The gender variability of intraoral characteristics such as VAC and GT dimensions and their influence on the existence of interdental papillae provide valuable guidelines that can be implemented in procedures in the maxillary anterior sextant. The associations between HMD and HFP dimensions and interdental papillae were not clearly evident, and further exploration in participants of different age groups would be useful and informative.
DOAJ (DOAJ: Directory of Open Access Journals), Mar 20, 2018
Background: Osteoporosis is particularly high in females, the early identification of which remai... more Background: Osteoporosis is particularly high in females, the early identification of which remains a challenge. Panoramic radiographs are routinely advised to detect periodontal diseases and can be used to predict low bone mineral density (BMD). Hence, this investigation was aimed to identify the risk of osteoporosis in pre- and postmenopausal periodontally healthy and chronic periodontitis women with digital panoramic radiographs. Materials and Methods: The study population consisted of 120 patients equally divided as Group I - Premenopausal periodontally healthy, Group II - Premenopausal periodontitis, Group III - Postmenopausal periodontally healthy, and Group IV - Postmenopausal periodontitis. Clinical parameters were recorded, and digital panoramic radiographs were used to record the mental index (MI), panoramic mandibular index (PMI), and mandibular cortical index (MCI) scores. Results: MI was found to be varied, and the differences were highly significant among Group III and IV (P = 0.0003) and Group II and IV (P = 0.0007), and significant difference was found between Group I and Group II (P = 0.0113). MCI evaluation showed a greater prevalence of C2 and C3 patterns among postmenopausal women. MCI correlation with MI (P < 0.0001), PMI (P < 0.0001) and age (P = 0.0029) indicated a highly significant variance. Conclusion: The positive association between MCI and chronic periodontitis in postmenopausal women confirms the high risk of osteoporosis in them. Furthermore, an increased percentage of patients with undetected decrease in BMD may be identified by screening with digital panoramic radiographs which are done on a routine basis for periodontal and other dental diseases and thus could be used as an effective aid to quantify bone density in future.
Purpose: Direct observation of procedural skills (DOPS) is widely used on the basis of workplace-... more Purpose: Direct observation of procedural skills (DOPS) is widely used on the basis of workplace-based assessments, which consist of direct observation and feedback. The DOPS covers all related professional qualities including knowledge, clinical perception, communication skills, ethics, the rights of patients, and the speed and accuracy of the task. However, the use of DOPS in dental treatment, especially in the field of periodontics is limited. Objective: The aim of the study was to find the utility of DOPS as assessment tool for the periodontal procedure. Methodology: The departmental faculty and postgraduate (PG) students were sensitized to the DOPS concept. A total of 12 PG students performed the periodontal procedure and were assessed on the basis of the DOPS rating scale for the 4 encounters each. The student's clinical skills were assessed by faculty members and then both students and faculty members were asked to give feedback for the procedure and overall experience. Results: Faculty and students both were comfortable in giving the feedback. Improvements in the knowledge of different clinical skills like relevant anatomy, technique of procedure were observed from 1st encounter to 4th encounter from 70% to 73.33%. Taking informed consent was improved from 53.33% to 90% from 1st encounter to 4th. Moreover, it helped the student to develop and improve their clinical skills, patient examination, and decision-making and treatment. Conclusion: The present study finding shows that faculty and students both were comfortable in giving the feedback and it helped the student to develop and improve their clinical skills. Our experience indicates that DOPS is an appropriate and functional tool in PG setup to enhance the clinical competencies.
Journal of Indian Dental Association, Oct 24, 2019
Aim: The aim was to evaluate the knowledge, attitude and behaviour of dental students concerning ... more Aim: The aim was to evaluate the knowledge, attitude and behaviour of dental students concerning infection control measures and to check the correlation, if any, among knowledge, attitude and behaviour of dental students concerning infection control measures in dental setups. Materials and Methods: A total of 1200 students from first to final year and interns from three different colleges were included in the study. Results: A total of 95.83% think isolation is important. Only 4.1% have been vaccinated with hepatitis B vaccine and 95% with tetanus vaccine. Conclusion: The level of knowledge and behaviour of infection control measures was average, for which the reasons could be inadequate training, supply of protective equipments and mainly carelessness. Key Words- Infection control, Vaccination, Isolation.
Objectives: Emerging evidence suggests that inflammation due to periodontal diseases may not be l... more Objectives: Emerging evidence suggests that inflammation due to periodontal diseases may not be limited to adjacent oral tissues but may have influence on systemic diseases such as chronic kidney diseases (CKD) and cardiovascular diseases. Hence, this study was aimed to evaluate and compare left ventricular mass (LVM) in patients with CKD undergoing hemodialysis (CKDH) in periodontally healthy, chronic gingivitis, and chronic periodontitis. Methodology: A total of 60Â patients diagnosed with CKDH were divided equally into three groups based on periodontal status as CKDH patients with healthy periodontium (Group I), CKDH patients with chronic gingivitis (Group II), and CKDH patients with chronic periodontitis (Group III). These patients were assessed clinically, biochemically, and echocardiographically. LVM in each of these patients was calculated according to Devereux formula and was indexed to height. Results: Group II and Group III patients exhibited higher mean LVM of 199.51 ± 40.17 g and 200.35 ± 65.04Â g, respectively, as compared to Group I of 161.56 ± 27.99Â g. Similarly, LVM index (LVMI) was found to be more in Group II and Group III at 59.36 ± 13.14Â g/m2.7 and 57.83 ± 19.94Â g/m2.7, respectively, while it was 45.99 ± 11.87 g/m2.7 for Group I patients. Conclusion: Increasing the severity of periodontal diseases in CKDH patients is associated with increase in LVM and LVMI. Periodontal screening and intervention would enable the clinician to refine cardiovascular risk assessment in such patients.
OBJECTIVE The gingival tissues surrounding the maxillary anterior teeth play a pivotal role in fo... more OBJECTIVE The gingival tissues surrounding the maxillary anterior teeth play a pivotal role in fostering a beautiful smile. The gingival zenith position (GZP) and its spatial orientation in the mesiodistal and apicocoronal direction can provide a valuable reference point. The present study was undertaken to evaluate the GZP and gingival zenith line (GZL) in maxillary anterior teeth in different age groups and genders. METHOD AND MATERIALS The study population comprised 124 periodontally healthy patients equally divided into 21 to 40 years (Group I) and 41 to 60 years (Group II) age groups and gender distribution. The parameters of vertically bisected midline (VBM), GZP, and GZL were evaluated for all the teeth. RESULTS The GZP was distally placed in 54.68% and 78.12% of the central incisors for males and females in Group I, while in Group II it was 65.62% and 75.00% respectively. The majority of lateral incisors and canines had coincidence of the GZP and VBM. The GZL was found to be at an apical position with reference to the GZP of lateral incisors. CONCLUSION A distal deviation of GZP was observed for central incisors, while the GZP coincided with the VBM for lateral incisors and canines. The GZL was apically placed in relation to the GZP of lateral incisors. These elements can be taken up as reference points in periodontal and restorative procedures.
BackgroundThe present study aimed to investigate the serum and salivary ghrelin and cortisol leve... more BackgroundThe present study aimed to investigate the serum and salivary ghrelin and cortisol levels in smokers and non‐smokers with Stage III Periodontitis.MethodsThe present study comprised of a total of 90 systemically healthy patients categorized in three groups: Group I‐ Periodontally healthy patients; Group II‐Non‐smokers with Stage III Periodontitis and Group III‐Smokers with Stage III periodontitis. Clinical parameters of Probing pocket depth (PPD), Clinical attachment levels (CAL), Plaque Index (PI), Gingival Index (GI) and Papillary Bleeding Index (PBI) were recorded and biochemical parameters of serum and salivary ghrelin and cortisol levels were analyzed via Enzyme Linked Immunosorbent Assay (ELISA). Stress levels were assessed using Zung's self‐rating depression scale.ResultsSerum and salivary ghrelin values were found to be higher in Group II (620.25 ± 260.86 pg/mL, 892.40 ± 271.65 pg/mL respectively) as compared to Group III. Similarly, salivary as well as serum cortisol levels were higher in Group III (20.78 ± 9.23 pg/mL, 399.37 ±189.21 pg/mL respectively) as compared to Group II (16.36 ± 8.88 pg/mL, 320.68 ± 107.01 pg/mL respectively). In Group III, a direct correlation was observed between stress, serum and salivary cortisol levels while an inverse correlation was found between stress, serum and salivary ghrelin levels. Group III showed a greater number of depressed patients followed by Group II and I.ConclusionAs per the results smokers with Stage III Periodontitis exhibit an elevated stress and cortisol levels, lower serum and salivary ghrelin levels as compared to the non‐smokers.
Background: A strong bilateral relationship between cardiovascular disease (CVD) and chronic peri... more Background: A strong bilateral relationship between cardiovascular disease (CVD) and chronic periodontitis has been established for decades. However, a knowledge gap regarding this association still persists among patients. The main objective of the present study was to assess the knowledge, awareness, and attitude among patients with CVD about its association with chronic periodontitis (CP). Materials and Methods: This observational cross-sectional survey consisted of 500 patients with CVD. Along with information on demographic characteristics, data were collected on knowledge, awareness, and attitude of the interrelationships between periodontal disease and CVD, using a 5-point Likert scale, with 4 and 5 representing “agree” and “strongly agree,” respectively. Results: A significant number of the study population had no knowledge regarding the bilateral association CVD and CP. Other questions revealed limited awareness and ignorant attitude of the patients. Conclusion: Within the limitations of the study, it can be concluded that there is a lack of awareness and an ignorant attitude about the bidirectional relationship between CVD and periodontitis among the CVD patients. Special efforts should be taken by dental as well as medical professionals to increase the awareness in this regard and thereby deliver quality health-care services at earlier stages.
BackgroundInterleukins are the markers of inflammation and the lipid profile reveals the likeliho... more BackgroundInterleukins are the markers of inflammation and the lipid profile reveals the likelihood of arising cardiovascular disease (CVD). The present study aimed to assess and correlate the influence of non‐surgical periodontal therapy (NSPT) on serum lipid profile and Interleukin‐6 (IL‐6) and Interleukin‐8 (IL‐8) in patients with Stage III periodontitis.MethodsSixty patients with the age range of 35–60 years with Stage III periodontitis were included by evaluating for periodontal parameters such as Probing pocket depth (PPD) and clinical attachment levels (CAL). NSPT was performed at baseline, 3 and 6 months. Biochemical parameters like serum lipid parameters of total cholesterol (TC), triglycerides (TG), low‐density lipopolysaccharide (LDL), high‐density lipopolysaccharide (HDL), and IL‐6 and IL‐8 serum levels were assessed at baseline and 6 months' post‐NSPT.ResultsThe results indicated a significant reduction (p < 0.0001) in the PPD (2.75 ± 0.41), CAL (3.23 ± 0.56), li...
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Papers by Rajashri Kolte