Category: Nevin Manimala

J Contemp Dent Pract. 2022 Dec 1;23(12):1260-1266. doi: 10.5005/jp-journals-10024-3451.

ABSTRACT

AIM: To assess and record periodontal and dentition status among psychiatric patients using modified WHO Oral Health Assessment form 1997.

MATERIALS AND METHODS: A descriptive cross-sectional study was conducted at Sri Aurobindo Institute of Medical Sciences and PG Institute, Indore, among the inpatients and outpatients. Ethical approval for the study was obtained from Institutional Review Board of Sri Aurobindo College of Dentistry. Statistical analysis was done using SPSS, IBM version 20.0. Descriptive statistics was used to find the frequencies, mean, and standard deviation of variables considered in the study.

RESULTS: Among all the disorders, schizophrenia subjects had shallow pockets 28 (25.2%) and deep pockets 55 (49.5%). Only 2 (2.6%) study subjects who had major depressive disorder had more than 12 mm loss of attachment (LOA). The highest mean DMFT score was recorded for schizophrenia patients (13.0 ± 7.09).

CONCLUSION: The results reveal an unmet need of projecting effective planning and implementation strategies toward the improvement of periodontal and dentition status health of the psychiatric patients.

CLINICAL SIGNIFICANCE: The study highlights the importance of incorporating dental health education to psychiatric rehabilitation programs.

PMID:37125525 | DOI:10.5005/jp-journals-10024-3451

J Contemp Dent Pract. 2022 Dec 1;23(12):1245-1254. doi: 10.5005/jp-journals-10024-3454.

ABSTRACT

AIM: This prospective randomized clinical trial was designed to compare the apical U-shape splitting technique (AUST) combined with guided bone regeneration (GBR) vs GBR alone for horizontal bone augmentation in maxillary labial undercut areas.

MATERIALS AND METHODS: The study included twelve patients with labial undercuts that made their alveolar ridges not able to compass dental implants. They received a total of 14 dental implants in the anterior maxilla where 7 (group I) were placed after AUST with GBR and the other 7 (group II) after the conventional GBR. The clinical and radiographic evaluations were done preoperatively, after surgery, and 6 months later. Facial flap fracture, peri-implant health, ridge width (RW) gain and loss, marginal bone loss (MBL), and implant esthetics were measured. Data were analyzed and compared and for any of the used tests, results were considered statistically significant if p-value ≤ 0.05.

RESULTS: For group I, no fracture of the bone flap happened and the gain in RW was significantly higher at 6 months postoperatively. Marginal bone loss was similar for both groups. The total pink esthetic score was significantly higher in group I vs group II (p = 0.024).

CONCLUSION: Within the limitations of this study, it was concluded that AUST combined with GBR was more effective in RW gain than GBR alone and it provided a merit approach for restoring function and esthetics if labial fenestration was unavoidable during implant placement.

CLINICAL SIGNIFICANCE: Apical U-shape splitting technique for horizontal ridge augmentation is a valuable option for the benefit of patients in clinics who need dental implants and have anterior undercut areas that may lead to fenestration and usually requires onlay bone grafting which is less successful in maintaining the RW.

PMID:37125523 | DOI:10.5005/jp-journals-10024-3454

J Contemp Dent Pract. 2022 Dec 1;23(12):1237-1244. doi: 10.5005/jp-journals-10024-3442.

ABSTRACT

AIM: The aim of this study was to evaluate the efficacy of grape seed extract (GSE) on remineralization of surface and subsurface enamel lesions compared to that of sodium fluoride (NaF).

MATERIALS AND METHODS: A total of 20 intact bovine incisor crowns were separated from their roots and immersed in a demineralizing solution for 96 hours at 37°C to create artificial enamel lesions. The specimens were randomly divided into two groups (n = 10): 6.5% GSE solution and 1000 ppm NaF solution. The specimens were subjected to six daily pH cycles for 8 days. The microhardness test was carried out at three different stages: baseline, after artificial caries formation, and after pH cycling. Raman spectroscopy was used to evaluate the depth of enamel remineralization. Surface morphology and elemental analysis were assessed using a scanning electron microscope (SEM) and an energy dispersive X-ray (EDX) spectroscope, respectively. Statistical analysis was performed using SPSS 22.0 at a significance level of p ≤ 0.05.

RESULTS: There was a significant increase in the mean values of enamel surface microhardness after pH cycles in the two groups compared to after artificial caries formation, but there was no significant difference between both groups. The B-type carbonate/phosphate (Ca/P) ratio at 10 and 40 µm depth revealed no significant difference between the two groups. Scanning electron microscope micrograph revealed occlusion of porosities and particle precipitation on the enamel surface of the two groups, while EDX results for the Ca/P ratio of the GSE and NaF groups were 1.59 and 1.60, respectively.

CONCLUSION: Grape seed extract and NaF are equally effective in remineralizing surface and subsurface artificial enamel lesions.

CLINICAL SIGNIFICANCE: Grape seed extract can be considered a promising herbal material and a safe alternative to traditional NaF for the noninvasive treatment of enamel lesions.

PMID:37125522 | DOI:10.5005/jp-journals-10024-3442

J Contemp Dent Pract. 2022 Dec 1;23(12):1211-1217. doi: 10.5005/jp-journals-10024-3443.

ABSTRACT

AIM: This randomized controlled trial evaluated the efficacy of platelet-rich fibrin (PRF) and concentrated growth factor (CGF) as scaffolds in the regenerative endodontic procedure (REP) using clinical and radiographic parameters along with cone-beam computed tomographic (CBCT) analysis.

MATERIALS AND METHODS: The apexogenesis procedure was performed in 16 teeth. They were randomly divided into two groups of eight teeth each: group I and group II. In group I PRF was used as the scaffold and in group II CGF was used as the scaffold. They were evaluated for pain, pulpal vitality, tenderness on percussion, and mobility, and also evaluated using digital radiographs at 3, 6, 12, and 18 months interval. The response of the teeth was graded using Chen and Chen criteria. Increase in root length, reduction in the apical foramen dimension, and reduction in periapical lesion volume were evaluated using CBCT scans taken preoperatively and at 18 months.

RESULTS: At the end of 3 months, 50% of teeth without periapical pathology were found to be vital in both groups. At the end of 18 months, 60% of the teeth in both groups showed increase in root length, all teeth showed closure of apical foramen, and reduction in the volume of periapical lesion. However, there was no statistically significant difference between the groups (p < 0.05).

CONCLUSION: The clinical and radiographic features reported in this study revealed that both PRF and CGF act as effective scaffolds in REP for regeneration of pulp-dentin complex with promising results.

CLINICAL SIGNIFICANCE: Apexogenesis by revascularization has not been used regularly for the treatment of nonvital teeth with open apex because the results are not reliable. Since platelet concentrates like PRF and CGF are rich in growth factors; when apexogenesis is performed by REP using these platelet concentrates, desirable results can be achieved in a short duration of time. They also accelerate the healing of periapical lesions present in such cases. With the increased success rate of apexogenesis with REP, many clinicians would prefer to use REPs as a treatment option for teeth with open apex.

PMID:37125518 | DOI:10.5005/jp-journals-10024-3443

J Contemp Dent Pract. 2022 Dec 1;23(12):1199-1202. doi: 10.5005/jp-journals-10024-3449.

ABSTRACT

AIM: To evaluate the effectiveness of gelatin sponge [Abgel] with injectable platelet-rich fibrin (i-PRF) in the surgical treatment of mandibular Grade II furcation defects in endodontically involved teeth.

MATERIALS AND METHODS: The present study was a single-center clinical trial wherein 20 mandibular grade II furcation defects were treated with gelatin sponge combined with i-PRF results were compared both clinically and radiographically at baseline, 3, and 6 months postoperatively. Statistical analysis was done using Statistical package for social sciences (SPSS) we software. For pre and post comparison, paired t-test, analysis of variance (ANOVA) and Wilcoxon test were used.

RESULTS: There was a statistically highly significant improvement seen in all the clinical parameters vertical clinical attachment level (V-CAL), horizontal clinical attachment level (H-CAL) and probing pocket depth (PPD) and radiographic parameters at baseline and 6 months postoperatively p < 0.01.

CONCLUSION: Open flap debridement along with Abgel combined with i-PRF is an effective treatment modality in reducing the horizontal and vertical component of grade II furcation defects.

CLINICAL SIGNIFICANCE: Gelatin sponge with i-PRF is a cost-effective treatment modality in achieving periodontal regeneration.

PMID:37125516 | DOI:10.5005/jp-journals-10024-3449

J Contemp Dent Pract. 2022 Dec 1;23(12):1190-1194. doi: 10.5005/jp-journals-10024-3452.

ABSTRACT

AIM: The aim of the present study was to assess the occlusal stress on the implant-abutment junction and implant-bone interface of a long-span implant-supported prosthesis made of two different prosthetic materials.

MATERIALS AND METHODS: A computerized tomography of the mandible was used to get the finite element model of the bone. The comparative groups were made as follows: S1 and S2 – 3.7 × 11 mm (44 region) and 4.5 × 11 mm (47 region), S1A and S2A – screw-retained porcelain-fused-to-metal prosthesis, S1B and S2B – cement-retained porcelain-fused-to-metal prosthesis, S1C and S2C – screw-retained zirconia prosthesis, and S1D – cement-retained zirconia prosthesis. Maximum stress generated on the implant-abutment interface of all the prostheses under vertical and oblique load was assessed.

RESULTS: For all the comparative groups, maximum level of stress was generated at the cervical level of the implant-bone interface in comparison to the apical and middle-third level under both vertical and oblique load. No statistically significant difference between zirconia and porcelain-fused-to-metal prosthesis was seen at the implant-abutment interface and the cervical third of the implant-bone interface. A significant difference was found between all screw-retained and cement-retained groups.

CONCLUSION: The present study concluded that the short implants in combination with standard-length implants using either porcelain-fused-to-metal or zirconia as prosthetic material in the form of long-span implant-supported prosthesis can be a viable treatment option in the posterior mandible.

CLINICAL SIGNIFICANCE: The accuracy of the diagnosis, examination, and knowledge of the site where the implant must be inserted, and the choice of superstructure is important for the stability and lifespan of the implant prosthesis.

PMID:37125514 | DOI:10.5005/jp-journals-10024-3452

Clin Infect Dis. 2023 May 1;76(Supplement_2):S210-S214. doi: 10.1093/cid/ciad097.

ABSTRACT

There is a crucial need for novel antibiotics to stem the tide of antimicrobial resistance, particularly against difficult to treat gram-negative pathogens like Acinetobacter baumannii-calcoaceticus complex (ABC). An innovative approach to addressing antimicrobial resistance may be pathogen-targeted development programs. Sulbactam-durlobactam (SUL-DUR) is a β-lactam/β-lactamase inhibitor combination antibiotic that is being developed to specifically target drug-resistant ABC. The development of SUL-DUR culminated with the Acinetobacter Treatment Trial Against Colistin (ATTACK) trial, a global, randomized, active-controlled phase 3 clinical trial that compared SUL-DUR with colistin for treating serious infections due to carbapenem-resistant ABC. SUL-DUR met the primary noninferiority endpoint of 28-day all-cause mortality. Furthermore, SUL-DUR had a favorable safety profile with a statistically significant lower incidence of nephrotoxicity compared with colistin. If approved, SUL-DUR could be an important treatment option for infections caused by ABC, including carbapenem-resistant and multidrug-resistant strains. The development program and the ATTACK trial highlight the potential for pathogen-targeted development programs to address the challenge of antimicrobial resistance.

PMID:37125468 | DOI:10.1093/cid/ciad097

J Neurotrauma. 2023 Apr 26. doi: 10.1089/neu.2022.0419. Online ahead of print.

ABSTRACT

Hyperventilation (HV) therapy uses vasoconstriction to reduce intracranial pressure (ICP) by reducing cerebral blood volume. However, as HV also lowers cerebral blood flow (CBF), it may provoke misery perfusion (MP) where the decrease in CBF is coupled with increased oxygen extraction fraction (OEF). MP may rapidly lead to the exhaustion of brain energy metabolites, making it vulnerable to ischemia. MP is difficult to detect at the bedside, which is where transcranial hybrid, near-infrared spectroscopies are promising since they noninvasively measure OEF and CBF. We have tested this technology during HV (∼30 minutes) with bilateral, frontal lobe monitoring to assess MP in twenty-seven sessions in eighteen patients with traumatic brain injury. In this study, HV did not lead to MP at a group level (p>0.05). However, a statistical approach yielded eighty-nine events with a high probability of MP in nineteen sessions. We have characterized each statistically significant event in detail and their possible relation with clinical and radiological status (decompressive craniectomy and presence of a cerebral lesion), without detecting any statistically significant difference (p>0.05). However, MP detection stresses the need for personalized, real-time assessment in future clinical trials with HV, in order to provide an optimal evaluation of the risk-benefit balance of HV. Our study provides pilot data demonstrating that bedside transcranial hybrid near-infrared spectroscopies could be utilized to assess potential MP.

PMID:37125452 | DOI:10.1089/neu.2022.0419

J Neurotrauma. 2023 Apr 26. doi: 10.1089/neu.2022.0507. Online ahead of print.

ABSTRACT

Data supporting the benefits of early surgical intervention in acute spinal cord injury (SCI) is growing. For early surgery to be accomplished, understanding the causes of variabilities that effect the timing of surgery is needed to achieve this goal. The purpose of this analysis is to determine factors that affect the timing of surgery for acute cervical SCI within the North American Clinical Trials Network (NACTN) for SCI registry. Patients in the NACTN SCI registry from 2005 to 2019 with a cervical SCI, excluding Acute Traumatic Central Cord Syndrome, were analyzed for time elapsed from injury to arrival to the hospital, and time to surgery. Two categories were defined: 1) Early Arrival with Early Surgery commenced within 24 hours of injury (EAES) and 2) Early Arrival but Delayed Surgery (EADS) with surgery occurring between 24 to 72 hours post-injury. Patients’ demographic features, initial clinical evaluation, medical comorbidities, neurological status, surgical intervention, complications, and outcome data were correlated with respect to the two arrival groups. Of the 222 acute cervical SCI patients undergoing surgery, 163 (73.4%) were EAES, and 59 (26.6%) were EADS. There was no statistical difference in arrival time between the EAES and EADS groups. There was a statistical difference in the median arrival time to surgery between the EAES group (9 hours) compared to the EADS group (31 hours) (p<0.05). There was no statistical difference in race, sex, age, mechanism of injury, APACHE II scores, or medical comorbidities between the two groups but the EAES group did present with a significantly lower systolic blood pressure (p<0.05). EADS patients were more likely to present as an AIS D than EAES (p<0.05). Early surgery was statistically more likely to occur if the injury occurred over the weekend (p<0.05). There were variations in the rates of early surgery between the 8 NACTN sites within the study, ranging from 57% to 100%. Of the 114 patients with 6-month outcome data, there was no significant change between the two groups regarding AIS grade change and motor/pin prick/light touch score recovery. A trend towards improved motor scores with early surgery was not statistically significant (p=0.21). Although there is data that surgery within 24 hours of injury improves outcomes and can be performed safely, there remain variations in care outside of clinical trials. In the present study of cervical SCI, NACTN achieved its goal of early surgery in 73.4% of patients from 2005-2019 who arrived within 24 hours of their injury. Variability in achieving this goal was related to severity of neurological injury, the day of the week, and the treating NACTN center. Evaluating variations within our network improves understanding of potential systemic limitations and our decision-making process to accomplish the goal of early surgery.

PMID:37125447 | DOI:10.1089/neu.2022.0507

Dent Mater J. 2023 Apr 28. doi: 10.4012/dmj.2022-273. Online ahead of print.

ABSTRACT

This study investigated the effect of 10-methacryloyloxydecyl dihydrogen phosphate (MDP) in methyl methacrylate (MMA) monomer on the adhesion of tri-n-butylborane (TBB)-initiated resins (MDP/MMA-TBB resins) to human enamel. Enamel surface conditions were either polished only or phosphatized surfaces. The 1.0, 1.7, and 2.0 mol% MDP/MMA-TBB resins, 4-methacryloxyethyl trimellitate anhydride (4-META)/MMA-TBB resin and MMA-TBB resin were prepared as luting materials. The shear bond strength was determined before and after thermocycles, and the results were compared using non-parametric statistical analyses (each, n=15). The MDP/MMA-TBB resins showed significantly better bond durability to enamel than other resins with or without etching. The 1.7 and 2.0 mol% MDP/MMA-TBB resins were suggested to be the optimum MDP concentrations from pre- and post-thermocycling results for the non-etched specimens. The TBB initiator resin including MDP was shown to be effective in bonding to human enamel, and this effect was enhanced in combination with phosphate treatment.

PMID:37121735 | DOI:10.4012/dmj.2022-273