Elimination Of Etiological Factors Research Articles

Evaluation of Alterations That May Occur on Root Surfaces after Root Planing Procedures with a Scanning Electron Microscope

Background: The aim of root debridement procedures in non-surgical periodontal treatment is the elimination of etiologic factors that cause periodontal disease, as well as the removal of cement affected by the disease. However, root debridement procedures for the treatment of periodontal diseases produce root surface irregularities that can adversely affect the healing of periodontal tissues. The objective of the present study is to evaluate the surface texture of a root after instrumentation, including an ultrasonic instrument, a Gracey curette, or a double Gracey curette. Methods: A total of 26 single-rooted teeth were used in this study; two specimens were used as controls, and the remaining 24 specimens were equally divided into three groups. Specimens from each group were then subjected to root planing using one of the following instruments: (1) an ultrasonic instrument; (2) a Gracey curette; or (3) a double Gracey curette. The control group was treated with no instrumentation. The extracted teeth were analyzed under a scanning electron microscope and graded in terms of the “roughness and loss of tooth substance index” and the “exposed dentin tubule index.” The SPSS (Statistical Package for Social Sciences) V.21 program was used to conduct a statistical analysis of the data obtained in this study. While evaluating the data, in addition to descriptive statistical methods (mean and standard deviation), a one-way analysis of variance (one-way ANOVA) was carried out to compare the quantitative data and evaluate normally distributed parameters between groups, while a post hoc multiple comparison test was carried out for subgroup comparisons. Results: There was no statistically significant difference between the roughness and material loss on the root surfaces in the samples treated with the ultrasonic instrument or the Gracey curette, and no exposed dentine tubules were observed. Meanwhile, it was observed that the double Gracey curette caused more roughness and material loss on the root surface, and exposed dentine tubules were observed in some samples. The time required for treatment using a double Gracey curette was significantly shorter than that required with the Gracey curette and ultrasonic instruments. Conclusions: The double Gracey curettes produced a relatively rougher root surface than the Gracey curettes or the ultrasonic instrument.

Role of Kushthaghna, Kandughna, and Varnya yoga in Vicharchika (allergic contact dermatitis): A case report

Abstract: Contact Dermatitis (CD) is the reactive eczematous inflammation of the skin. CD is caused by various daily substances such as shampoos, cleansers, moisturizers, nail polish, dye gloves, and different shoe materials. Allergic Contact Dermatitis (ACD) is a type of dermatitis caused by allergic substances. It has symptoms such as itching and redness with flaky rashes. In conventional systems of medicine, topical applications and systematic use of steroids and anti-allergics are the main treatment modalities for relief. However, these interventions are associated with certain limitations and side effects. In Ayurveda, most of the skin diseases are narrated under the umbrella of Kushtha (~various skin diseases). Among different varieties of Kushtha, Vicharchika (~form of dermatitis) has comparable symptoms with ACD that include Kandu (~itching), Srava (~discharge), Pidaka (~vesicles), and Shyava varna (~blackish discoloration). A 47-year-old female having swelling with small ulcers in the bilateral foot on the contact area of slipper straps for 15–20 days visited the outpatient department, she was diagnosed as Vicharchika considering the clinical presentation. On the basis of Ayurveda principles, she was treated with a combination of Kushthaghna, Kandughna, and Varnya yoga (~formulations) of Ayurveda including Panchatikta guggulu ghrita, Arogyavardhini vati, Punarnavasava, Gandhaka rasayana, Haridra khanda along with Nidana parivarjana (~elimination of etiological factors) of ACD. The patient got complete relief within 37 days of treatment without any side effects. It reflects that Ayurvedic formulations having anti-inflammatory, anti-allergic, anti-bacterial, and blood purifier potential are effective in the management of ACD.

Case Report: Interstitial-intralesional laser therapy and laser-assisted new attachment procedure for the treatment of alveolar bone loss provoked by an aggressive pyogenic granuloma

A pyogenic granuloma (PG) is a common benign vascular lesion found in the oral cavity. The gold standard treatment of this lesion, comprising surgical excision and the elimination of etiological factors, cannot avoid tooth loss in the case of an aggressive pyogenic granuloma. Because of the prominent properties of 980 nm and 635 nm diode lasers in photocoagulation and photobiomodulation, we applied these wavelengths in the treatment of a large pyogenic granuloma with alveolar bone loss. Our objective was to use a combination of interstitial-intralesional laser therapy, photocoagulation and laser-assisted new attachment procedure (LANAP) to preserve the teeth and periodontal tissue in a case of an aggressive pyogenic granuloma. The patient was a 13-year-old Thai male with a pyogenic granuloma involving the interdental papilla and lingual gingiva of the lower left first and second molars. The teeth were also displaced by the lesion. After treatment with three sessions of photocoagulation, three sessions of interstitial-intralesional laser therapy and two sessions of LANAP, the lesion was completely resolved. The periodontal status of the teeth was improved at the six-month follow-up. The combination of interstitial-intralesional laser therapy, photocoagulation and LANAP was able to treat an aggressive pyogenic granuloma with tooth preservation.

Therapeutic effect of two fluoride varnishes on remineralisation of white spot lesions evaluated by laser fluorescence

Background / Aim: The presence of white spot lesion (WSL) is considered the first stage of dental caries. The early detection and diagnosis of WSL is of crucial importance, since caries can be prevented at this stage, reversed and/or controlled by elimination of etiological factors and by use of fluorides. The aim of this study was to compare the efficacy between the two fluoride varnishes on WSL remineralisation evaluated by laser fluorescence. Methods: A total of 30 children and 60 WSL cases (2 per each child) were included in this study. The selected WSL were randomly divided into two groups in each child: G1 applying Fluor Protector S®, Vivadent, Lichenstein (n = 30) and G2 applying MI varnish®, GC, Tokyo, Japan (n = 30). The fluoride varnishes were submitted to three applications: at baseline, four weeks and eight weeks following the baseline, according to the manufacturer's recommendations. Mineral density of the enamel was measured using laser fluorescence (DIAGNOdent® 2095, KaVo, Biberach, Germany) for each WSL. Laser fluorescence (LF) measurements were performed at baseline and at fourth, eighth and twelfth week after starting the treatment and LF scores were calculated. Results: By comparing LF scores at each measurement after treatment initiation, it was found that the scores were significantly lower in all groups when compared to baseline. Conclusion: The results of this study indicate that both fluoride varnishes used were capable of remineralising WSL as evaluated by LF measurements. No difference was noted in the remineralising efficacy of the varnishes despite their different compositions. The main limitations of this study are small sample size and short follow up period. Therefore, further studies with large sample size and a longer follow up are, however, necessary.

Management of internal inflammatory root resorption with the aid of cone beam computed tomography: A case report

Managing a case of internal root resorption is a tedious task.Mostly it is detected in anterior teeth where trauma is mainly responsible for its occurrence. It is a chronic pulpal inflammation condition where signs and symptoms are elicited in due course of time. Successful treatment can be rendered only after proper diagnosis and elimination of etiological factors. In this article a case report of internal root resorption is presented where treatment was instituted after thorough analysis of CBCT sections. Keywords: Internal root resorption, Composite, CBCT.

Expression of Fibronectin and Tenascin after Direct Capping of the Pulp with Mineral Trioxide Aggregate and Biodentine®

BACKGROUND: Caries is a destructive process leading to progressive demineralization of the inorganic part of the tooth, accompanied by enzyme disintegration of the organic component of the tooth tissue. Considering the fact that caries activity can be stopped if the demineralization process is stopped, it is clear that the objectives of caries treatment are focused toward elimination of etiological factors and stimulation of regeneration of the dental tissues. That is why in the last years treatment of the caries disease is targeted to remineralization of the initial carious lesions, as well as on the biological behavior of the pulp-dentine complex after application of certain medications.
 AIM: The aim of this study is to evaluate impact of the two materials for direct capping, mineral trioxide aggregate (MTA) and Biodentine®, on the expression of glycoproteins fibronectin (FN), and tenascin (TN), responsible for dentinogenesis.
 METHODS: In the tests were used materials MTA and Biodentine, as agents for direct capping of pulp exposure. From 60 extracted teeth included in this in vitro study, tissue cuts were made. Each of them was then analyzed on a light microscope to determine the amount of two extracellular matrix glycoproteins, FN-C, and TN-C.
 RESULTS: Our study show that there is an expressed immunoreactivity for FN and for TN in the fibronectin bridge under MTA and Biodentine® after 8, and even after 30 days of their application.
 CONCLUSION: Based on this study, we can conclude that both materials – MTA and Biodentine – may induce reparative dentinogenesis, in which FN and TN have certainly a major role in the formation of the fibronectin matrix.

Peripheral Cemento-ossifying Fibroma: A Report of Two Cases

ABSTRACT Peripheral cemento-ossifying fibroma (PCOF) is an osteogenic neoplasm of odontogenic origin with uncertain pathogenesis, which presents as a localized growth manifesting predominantly in adolescent and young adults. Early diagnosis by thorough radiographic and histologic examination is crucial for positive identification of lesions. Proper surgical excision with aggressive curettage of adjoining tissues and complete elimination of etiological factors is extremely important for prevention of recurrence. This clinical report presents two cases of patients who reported with localized gingival overgrowth, diagnosed as PCOF after histological examination. The clinical, radiographic, and histologic features of the two cases are discussed, and postsurgery, the patients have been followed up for a 1-year period with no recurrence. In conclusion, it is difficult clinically to differentiate between the various gingival lesions. Therefore, this article emphasizes that though recurrence rate of PCOF is high, most of these cases can be adequately managed with sound periodontal treatment. How to cite this article Guru SR, Singh SS, Guru RC. Peripheral Cemento-ossifying Fibroma: A Report of Two Cases. J Health Sci Res 2016;7(2):71-75.

Modifiable Etiological Factors and the Burden of Stroke from the Rotterdam Study: A Population-Based Cohort Study

Stroke prevention requires effective treatment of its causes. Many etiological factors for stroke have been identified, but the potential gain of effective intervention on these factors in terms of numbers of actually prevented strokes remains unclear because of the lack of data from cohort studies. We assessed the impact of currently known potentially modifiable etiological factors on the occurrence of stroke. This population-based cohort study was based on 6,844 participants of the Rotterdam Study who were aged ≥55 y and free from stroke at baseline (1990-1993). We computed population attributable risks (PARs) for individual risk factors and for risk factors in combination to estimate the proportion of strokes that could theoretically be prevented by the elimination of etiological factors from the population. The mean age at baseline was 69.4 y (standard deviation 6.3 y). During follow-up (mean follow-up 12.9 y, standard deviation 6.3 y), 1,020 strokes occurred. The age- and sex-adjusted combined PAR of prehypertension/hypertension, smoking, diabetes mellitus, atrial fibrillation, coronary disease, and overweight/obesity was 0.51 (95% CI 0.41-0.62) for any stroke; hypertension and smoking were the most important etiological factors. C-reactive protein, fruit and vegetable consumption, and carotid intima-media thickness in combination raised the total PAR by 0.06. The PAR was 0.55 (95% CI 0.41-0.68) for ischemic stroke and 0.70 (95% CI 0.45-0.87) for hemorrhagic stroke. The main limitations of our study are that our study population comprises almost exclusively Caucasians who live in a middle and high income area, and that risk factor awareness is higher in a study cohort than in the general population. About half of all strokes are attributable to established causal and modifiable factors. This finding encourages not only intervention on established etiological factors, but also further study of less well established factors. Please see later in the article for the Editors' Summary.

A case of successful management of class III gingival recession using subepithelial connective tissue graft

Marginal tissue recession presents a common condition in Periodontology. Recession defects around teeth are usually treated to achieve patient-centered outcomes such as reduction in root sensitivity, ease in plaque control, and aesthetic concerns regarding excessive tooth length and abnormal gingival contour. It is believed that cases of recession in which the etiological factors are well diagnosed and eliminated show a great percentage of recession coverage. According to Miller, Class I and II show complete recession coverage whereas cases with class III are only capable of partial coverage. A variety of surgical procedures have been described for recession coverage. The present case report presents a clinical case classified as Miller's class III recession which was treated using coronally advanced partial thickness flap with subepithelial connective tissue graft to obtain root coverage and also eliminate the aesthetic deficiency. Clinical Relevance To Interdisciplinary Dentistry Thorough knowledge of anatomy of donor and recipient site is important for success of coronally advanced partial thickness flap with subepithelial connective tissue graft. Proper case selection and elimination of etiologic factors is key to successful management of gingival recession. Subepithelial connective tissue graft if used.

Langzeitergebnisse nach mikrolaryngoskopischer Abtragung von Reinke-Ödemen

In the case of Reinke's edema, the usual aim of microlaryngoscopic vocal fold stripping is an improvement of voice quality. Long-term results concerning functional voice quality in the literature vary widely. Whether and to what degree surgical intervention leads to the desired postoperative results is therefore still an open question. Therefore we conducted a follow-up study to review our own treatment results. We questioned 88 patients treated for Reinke's edema, either orally or by means of a written questionnaire, 6 months to 7 years (mean: 3.5 years) after the operation (longitudinal incision, removal of the edema by suction, resection of surplus vocal cord mucosa), asking about postoperative voice quality and subjective impression of how successful the operation had been. In all 63 patients answered the questionnaire; 16 agreed to undergo follow-up laryngostroboscopy. 51 patients (81%) reported a postoperative improvement in voice quality, 8 patients (13%) rated their voice quality as unchanged, and 4 patients (6%) complained of deterioration in their voice quality. Among the patients whose voices were subject to professional strain (n=27) a lower proportion experienced successful results (voice quality improved: 71%; unchanged: 21%; worse: 8%) than among patients without vocal strain (n=36; improved: 86%; unchanged: 11%; worse: 3%). Postoperative elimination or restriction of such etiological factors as smoking and vocal strain also improved the long-term results. Follow-up examination in 16 patients revealed a good correlation between the patients' subjective reports and the stroboscopic and auditory findings. Patients should be selected very carefully for surgical treatment of Reinke's edema. The elimination of etiological factors is of highly significant in terms of the prognosis. Before surgery patients should be fully informed of how uncertain the prognosis is.

Correction of Periodontal Abnormalities as a Preliminary Phase of Oral Rehabilitation*

The elimination of etiological factors and the correction of periodontal abnormalities are often a necessary preliminary phase of oral reconstruction. The development of optimal gingival and bony qualities using the surgical procedures outlined when indicated improves the prognosis of prospective abutment teeth and additionally may improve esthetics, retention, and maintenance of a fixed restoration.