Bleeding Gums Research Articles

Pemberian SABU (Serum Anti-Bisa Ular) untuk Kasus Gigitan Ular Awitan Lama dengan Komplikasi Disseminated Intravascular Coagulation (DIC)

Background: Snakebite is a neglected disease in subtropical and tropical countries in Asia, Africa, and Latin America. Snakebite is one of the most common venomous animal bites in the world. Case: A 34-year-old male presented with a history of snakebite two days before with a swollen left gluteus and spontaneous gum bleeding. At the emergency room, the patient was fully conscious with blood pressure of 120/80 mmHg, temperature of 36.8oC, pulse rate of 80 beats per minute, and respiration rate of 18 times per minute. Blood studies showed prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT), leucocytosis, thrombocytopenia, low hemoglobin, and elevated renal function test. The patient's condition was improved after administration of anti-snake venom, vitamin K injection, transfusion of fresh frozen plasma and packed red cells. He was discharged after three days of hospital stays. Conclusion: Antivenom is the only specific antidote to snake venom; in Indonesia, there is only one local antivenom, commonly known as SABU (serum anti-bisa ular). Inappropriate use of antivenom should be strongly discouraged. Administration of the antivenom should be accompanied by preparedness for anaphylaxis risk.

Correlation between Oxidative Stress Markers and Periodontal Disease in Dogs.

In dogs, periodontal disease (PD) is a highly common condition whose prevalence rises significantly with age. Studies on rats with experimentally induced PD and human clinical trials have found an association between oxidative stress (OS) and PD, as has been observed in many other inflammatory disorders. The objective of this research was to assess the main indicators of oxidative stress detected in the saliva of dogs and to compare them to the degree of inflammation and tartar amount on their teeth and gums. By identifying these correlations, we intended to identify early-stage PD markers that would allow us to diagnose the condition in dogs without requiring for invasive or traumatic procedures. The antioxidant enzyme superoxide dismutase (SOD), total antioxidant capacity (TAC), malondialdehyde (MDA) and 8-hydroxyguanosine (8OHG), matrix metalloproteinase-8 (MMP8), and the quantity of total proteins are the markers that have been investigated in order to accomplish these objectives. The appearance of specific forms of periodontal disease has been confirmed by an increase in the saliva concentration of MMP8, a marker commonly used in the diagnosis of these pathologies in humans. The study was carried out on 22 dogs divided in a control group (C) and study groups (S), the second one being divided into three subgroups according to the severity of the gum inflammation and the presence or absence of tartar: S1-small accumulation of tartar, lack of infection-related signs; S2-moderate accumulation of tartar, gums swollen, red, and bled easily; S3-significant accumulation of tartar; gums bright red and bleeding; marked pain and halitosis. A correlation between the concentration of the tested parameters and the severity of the local appearance of the gum and teeth was noted. In comparison to the results of individuals from the control group, MMP8 reported increases of 1.2, 2, and 3.7 times, respectively, in the case of individuals from subgroups S1, S2, and S3. Oxidative stress is caused by inflammatory processes in the oral cavity. The presence of oxidative stress was demonstrated by the evaluation of different indicators in the saliva: an increase in the general antioxidant status, which was associated with an increase in SOD activity; intensification of the lipid peroxidation processes, as demonstrated by the accumulation of the MDA peroxidation product; and an increase in the DNA oxidation processes, as demonstrated by the accumulation of the oxidation product 8OHdG. In consequence, it was observed that there were up to 2-fold increases in protein levels, total antioxidant activity, SOD, and MDA, and up to 8.6-fold increases in the case of 8-OHdG when comparing dogs from the S3 group (significant tartar accumulation; bright red and bleeding gums; marked pain and halitosis) to those in the control group.

Genetic evidence strengthens the bidirectional connection between oral health status and psychiatric disorders: A two-sample Mendelian randomization study

BackgroundObservational studies cannot accurately infer the causal associations between oral health status and psychiatric disorders. MethodsWe conducted univariate and multivariate Mendelian randomization (MR) analyses using single nucleotide polymorphisms (SNPs) associated with eight oral health statuses (periodontitis, DMFS, Nteeth, toothache, loose teeth, painful gums, bleeding gums, and mouth ulcers) and four psychiatric disorders (Schizophrenia, Major Depressive Disorder (MDD), anxiety and stress-related disorder (ASRD), and Bipolar Disorder (BIP)) as instrumental variables. Genetic data were sourced from the Gene-lifestyle interactions in dental endpoints (GLIDE), UK Biobank, Psychiatric Genomics Consortium (PGC), and Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH). The inverse variance-weighted (IVW) approach, supported by a comprehensive sensitivity analysis, was employed. ResultsGenetically predicted mouth ulcers were significantly linked to higher MDD (OR = 2.17, 95 % CI: 1.33‐–3.54, P< 0.01) and BIP risks (OR = 2.25, 95 % CI: 1.22–4.15, P = 0.01). BIP heightened bleeding gums risk (OR = 1.01, 95 % CI: 1.00–1.01, P < 0.01). These associations were adjusted for smoking status and alcohol consumption. Painful gums were significantly associated with MDD risk (OR = 96.48, 95 % CI: 2.66–3495.28, P = 0.01), while MDD raised periodontitis risk (OR = 2.15, 95 % CI: 1.24–3.75, P = 0.01), both confounded by smoking and alcohol. Relatively small effects between several variables, while others could not withstand correction for multiple tests. LimitationsThe sample size and limitation to European populations limits the study generalizability. ConclusionsThis study provide evidence of possible causal relationships between several oral health conditions and mental illness. Focusing on oral health and valuing mental health are important for each other and overall health.

Development of reverse genetics system for Guanarito virus: substitution of E1497K in the L protein of Guanarito virus S-26764 strain changes plaque phenotype and growth kinetics.

Guanarito virus (GTOV) is the causative agent of Venezuelan hemorrhagic fever. GTOV belongs to the genus Mammarenavirus, family Arenaviridae and has been classified as a Category A bioterrorism agent by the United States Centers for Disease Control and Prevention. Despite being a high-priority agent, vaccines and drugs against Venezuelan hemorrhagic fever are not available. GTOV S-26764, isolated from a non-fatal human case, produces an unclear cytopathic effect (CPE) in Vero cells, posing a significant obstacle to research and countermeasure development efforts. Vero cell-adapted GTOV S-26764 generated in this study produced clear CPE and demonstrated rapid growth and high yield in Vero cells compared to the original GTOV S-26764. We developed a reverse genetics system for GTOV to study amino acid changes acquired through Vero cell adaptation and leading to virus phenotype changes. The results demonstrated that E1497K in the L protein was responsible for the production of clear plaques as well as enhanced viral RNA replication and transcription efficiency. Vero cell-adapted GTOV S-26764, capable of generating CPE, will allow researchers to easily perform neutralization assays and anti-drug screening against GTOV. Moreover, the developed reverse genetics system will accelerate vaccine and antiviral drug development.IMPORTANCEGuanarito virus (GTOV) is a rodent-borne virus. GTOV causes fever, prostration, headache, arthralgia, cough, sore throat, nausea, vomiting, diarrhea, epistaxis, bleeding gums, menorrhagia, and melena in humans. The lethality rate is 23.1% or higher. Vero cell-adapted GTOV S-26764 shows a clear cytopathic effect (CPE), whereas the parental virus shows unclear CPE in Vero cells. We generated a reverse genetics system to rescue recombinant GTOVs and found that E1497K in the L protein was responsible for the formation of clear plaques as well as enhanced viral RNA replication and transcription efficiency. This reverse genetic system will accelerate vaccine and antiviral drug developments, and the findings of this study contribute to the understanding of the function of GTOV L as an RNA polymerase.

Potential effects of specific gut microbiota on periodontal disease: a two-sample bidirectional Mendelian randomization study.

Periodontal disease (PD) presents a substantial global health challenge, encompassing conditions from reversible gingivitis to irreversible periodontitis, often culminating in tooth loss. The gut-oral axis has recently emerged as a focal point, with potential gut microbiota dysbiosis exacerbating PD. In this study, we employed a double-sample bidirectional Mendelian randomized (MR) approach to investigate the causal relationship between specific gut microbiota and periodontal disease (PD) and bleeding gum (BG) development, while exploring the interplay between periodontal health and the gut microenvironment. We performed genome-wide association studies (GWAS) with two cohorts, totalling 346,731 (PD and control) and 461,113 (BG and control) participants, along with data from 14,306 participants' intestinal flora GWAS, encompassing 148 traits (31 families and 117 genera). Three MR methods were used to assess causality, with the in-verse-variance-weighted (IVW) measure as the primary outcome. Cochrane's Q test, MR-Egger, and MR-PRESSO global tests were used to detect heterogeneity and pleiotropy. The leave-one-out method was used to test the stability of the MR results. An F-statistic greater than 10 was accepted for instrument exposure association. Specifically, Eubacterium xylanophilum and Lachnoclostridium were associated with reduced gum bleeding risk, whereas Anaerotruncus, Eisenbergiella, and Phascolarctobacterium were linked to reduced PD risk. Conversely, Fusicatenibacter was associated with an elevated risk of PD. No significant heterogeneity or pleiotropy was detected. In conclusion, our MR analysis pinpointed specific gut flora with causal connections to PD, offering potential avenues for oral health interventions.

Assessment of oral health awareness and hygiene practice in hemophilic patients in Indore: A cross-sectional study

: Haemophilia is a genetic X linked recessive bleeding disorder characterized by a deficiency or absence of certain clotting factors in the blood, primarily factors VIII (haemophilia A) or factor IX (haemophilia B). Dental caries and periodontal diseases are two main oral diseases affecting majority of population, but their effects are enhanced in hemophiliacs and medically compromised patients. There is a lack of epidemiological studies regarding oral health and oral hygiene of hemophilic patient especially in central India. This study therefore, aimed to evaluate the oral hygiene awareness and hygiene practices of patients with hemophilia in Indore district. This cross-sectional study was conducted on 30 hemophilic patients who were selected via snow ball sampling technique. The patients who were ready to participate voluntarily in the study were included. A study questionnaire in Hindi and English was given to the patients to obtain their knowledge about oral hygiene and dental health awareness.: Thirty hemophilic patients participated in the study with a mean age of 20 ±15 years. All the participants were male. Although hemophilic patients were conscious of oral hygiene, the study found most of them had poor dental practices. The majority of participants (56.67%) reported of using soft-bristled brushes. Only 56.67% of the participants reported cleaning their mouths after meals and having seen gum bleeding. The majority of hemophilia patients (46.15%) reported using Factor VIII, while some also used Tranexamic acid (15.39%).: Oral hygiene is crucial for everyone, but it holds particular importance for individuals with hemophilia. Good oral hygiene reduces the need for invasive dental treatments, minimizing potential complications.

Periodontal Health Knowledge and Oral Health-Related Quality of Life in Caribbean Adults.

To identify the relationship between periodontal health knowledge and oral health-related quality of life among Caribbean adults. A cross-sectional study was conducted in a representative sample from 3 Caribbean cities (weighted N = 1805). Participants completed a questionnaire on oral health knowledge, hygiene habits, and other practices, as well as the Oral Health Impact Profile-14 (OHIP-14) questionnaire. The associations between knowledge and habits and OHIP-14 score and its tertiles were evaluated using negative binomial and multinomial logistic regression models, respectively, adjusting for confounders. Odds ratios and regression coefficients were reported. Participants reporting none, little, and adequate knowledge about gum health had higher odds of being in the worst tertile for OHRQoL, compared to those reporting "good knowledge" (ORnone vs good = 2.38, 95% CI: 1.59-3.54; ORlittle vs good = 1.82, 95% CI: 1.19-2.78; ORadequate vs good = 1.68, 95% CI: 1.11-2.57). Participants reporting toothbrushing ≥ twice/day were less likely to be in the worst tertile for OHRQoL, compared to those brushing less often (OR = 0.67, 95% CI: 0.48-0.92). Self-reported gum bleeding was associated with double the odds of being in the worse tertile (OR = 2.03, 95% CI: 1.60-2.58). According to the findings of this study, periodontal health knowledge is associated with reduced OHRQoL in Caribbean Adults. In addition, the frequency of brushing and the self-reported gum bleeding was related to a worse quality of life (QoL) level.

Changes in dental visits and oral health for children by race and ethnicity during the COVID-19 pandemic

BackgroundThe COVID-19 pandemic created new barriers to oral health care, which may worsen oral health and exacerbate disparities. The authors quantified changes in children’s dental care receipt and oral health outcomes during the pandemic and examined differences among racial and ethnic groups. MethodsUsing the National Survey of Children’s Health (163,948 child observations from 2017-2021), the authors used weighted modified Poisson models to examine caregiver-reported receipt of a dental visit (for any reason and for preventive care) and adverse oral health outcomes (teeth in fair or poor condition; difficulty with toothaches, cavities, or bleeding gums) from 2017 through 2019 (prepandemic) compared with 2020 and 2021. The authors examined outcomes within and across racial and ethnic groups. ResultsChildren from all racial and ethnic groups experienced declines in receipt of dental visits, but there were limited changes in adverse oral health outcomes during 2020 and 2021. Prepandemic disparities in receipt of dental visits persisted for Black children and Asian children compared with White children. Hispanic children experienced larger increases in risk of experiencing both adverse oral health outcomes compared with White children in 2020 and in having teeth in fair or poor condition in 2021. ConclusionsThe pandemic did not create new disparities in receipt of dental visits or oral health outcomes, but disparities in care persisted, and the oral health of Hispanic children was affected differentially. Practical ImplicationsContinued monitoring of dental visits and adverse oral health outcomes by race and ethnicity is critical to ensuring all children have access to oral health care. This information can help develop targeted interventions to improve children’s oral health, including for minoritized racial and ethnic groups.

Effectiveness of theory-based educational interventions of promoting oral health among elementary school students

BackgroundThe aim of the present study was to determine the effect of oral health education programs on the oral health of primary school students.MethodsIn this randomized controlled trial study, 190 elementary fifth-grade female students were chosen using the multistage cluster sampling method. In this study, the Plaque Index (PI), Simplified Oral Hygiene Index (OHI-S), Community Periodontal Index (CPI), tooth brushing using fluoride toothpaste, dental flossing frequency and factors affecting them were determined according to social cognitive theory (SCT). Interventions were implemented using the play method and with the help of three pamphlets, five posters, a celebration of oral health, and the creation of a Telegram group. Data were analyzed using descriptive statistics indexes, t tests, paired sample t tests, chi-square tests, and Pearson correlation tests.ResultsThe results showed that 3 months after the intervention, compared to before the intervention, the percentage of participants in the intervention group who brushed their teeth twice or more per day increased by 48.5%, and the percentage of participants who used dental floss at least once per day increased by 64.2%. The rate of gum bleeding decreased by 6.3%. The good OHI-S rate increased by 44.4%. Dental plaque decreased by 38.1%.ConclusionThe results demonstrated that a gamification design can be effective and useful in promoting the oral health of students.Trial registrationregistration timing: retrospective, registration date: 18/10/2022, registration number: IRCT20141128020129N2.

Analysis of Correlation of Periodontal Disorders with Hepatitis C Virus Infection

Background: Periodontal disease is caused by pathological damage to periodontal tissues, evident through increased gingival sulcus depth and bleeding gums. Its etiology includes local factors such as plaque, calculus, cavities, and poor dental hygiene, as well as systemic causes like hormonal shifts, diabetes, and blood disorders. Objective: This study aims to correlate periodontal disorders with Hepatitis C infection. Methods: A descriptive cross-sectional study was conducted at the Institute of Dentistry, LUMHS Jamshoro. Two hundred participants were selected using non-probability convenient sampling, comprising 100 cases infected with the Hepatitis C virus and 100 controls without Hepatitis C. Data analysis was performed using SPSS version 26.0, employing Student's t-test and Chi-square test for evaluating continuous and categorical variables, respectively. Results: The Mean± SD of cases and controls was 41.7±7.31 and 40.9±5.6 years respectively (p=0.076). Of the 100 cases, 57% were male and 43% female, while in the control group, 61% were male and 39% female. Seventy-one percent of cases reported not brushing their teeth. The frequency of brushing techniques such as straight, circular, and up-down motions was observed in 34% and 45%, 54% and 47%, &amp; 12% and 8% of cases and controls, respectively (p=0.001). Conclusion: This study indicates a high prevalence of periodontal disease among individuals infected with Hepatitis C. Given the prevalence of Hepatitis C infection in the population, further research is recommended regarding the oral health of HCV-infected patients.

Systemic bevacizumab for treatment of recurrent respiratory papillomatosis.

To characterize treatment response of recurrent respiratory papillomatosis (RRP) including adult-onset RRP (AORRP) and juvenile-onset RRP (JORRP) to systemic bevacizumab (bev), and share our treatment regimen experience. Patients were enrolled in bev treatment based on a pathologically confirmed diagnosis of squamous papilloma. According to lesion characteristics and medical history, systemic bev was used as preoperative adjuvant therapy, postoperative adjuvant therapy, or primary therapy. The assessment of treatment response relied on the morphological changes of lesions. Vocalization and voice-related quality of life were evaluated using the voice handicap index-30 (VHI-30) for adults and the pediatric VHI (pVHI) for children. Adverse effect was monitored through patient self-reported symptoms and regular follow-ups. This study included 24 patients, comprising nine AORRP and 15 JORRP cases. In AORRP, all patients (100%) exhibited various degrees of response to systemic bev, with 5 (55.56%) achieving complete response (CR). Among JORRP patients, 14 (93.33%) showed a response to systemic bev, with 8 (53.33%) achieving CR and currently being followed up. No instances of aggravation were observed during systemic bev treatment. A total of 21 patients (21/24, 87.50%) reported voice improvement, accompanied by reduced VHI-30 or pVHI scores across all aspects, including total, functional, physical, and emotional dimensions. No grade 3 or higher adverse events occurred. The most common adverse events were grade 1 gum bleeding (n = 4, 16.67%) and grade 1 proteinuria (n = 4, 16.67%). Systemic bev can be used as a powerful therapy for both AORRP and JORRP. The findings provide a reference to the systemic bev treatment for RRP.

A case of unusual hemorrhage as a complication of dengue fever in a tertiary hospital in Dhaka

Common bleeding complications of dengue hemorrhagic fever are epistaxis, gum bleeding, gastrointestinal bleeding, menorrhagia, hematuria.1 Major hemorrhage like intracranial hemorrhage have been documented but rare. We present here a case of a 24 year old man with complaints of high grade intermittent fever for 5 days, upper abdominal discomfort for 3 days and swelling of right upper limb for same duration. Laboratory investigations revealed a positive dengue serology, thrombocytopenia and elevated transaminases. USG of the hand revealed a hematoma involving the right upper arm. The patient was managed conservatively with elevation and immobilization of the upper limb and recovered gradually. J MEDICINE 2024; 25: 100-101

Cuprorivaite/hardystonite/alginate composite hydrogel with thermionic effect for the treatment of peri-implant lesion.

Peri-implant lesion is a grave condition afflicting numerous indi-viduals with dental implants. It results from persistent periodontal bacteria accumulation causing inflammation around the implant site, which can primarily lead to implant loosening and ultimately the implant loss. Early-stage peri-implant lesions exhibit symptoms akin to gum disease, including swelling, redness and bleeding of the gums surrounding the implant. These signs indicate infection and inflammation of the peri-implant tissues, which may result in bone loss and implant failure. To address this problem, a thermionic strategy was applied by designing a cuprorivaite-hardystonite bioceramic/alginate composite hydrogel with photothermal and Cu/Zn/Si multiple ions releasing property. This innovative approach creates a thermionic effect by the release of bioactive ions (Cu2+ and Zn2+ and ) from the composite hydrogel and the mild heat environment though the photothermal effect of the composite hydrogel induced by near-infrared light irradiation. The most distinctive advantage of this thermionic effect is to substantially eliminate periodontal pathogenic bacteria and inhibit inflammation, while simultaneously enhance peri-implant osseointegration. This unique attribute renders the use of this composite hydrogel highly effective in significantly improving the survival rate of implants after intervention in peri-implant lesions, which is a clinical challenge in periodontics. This study reveals application potential of a new biomaterial-based approach for peri-implant lesion, as it not only eliminates the infection and inflammation, but also enhances the osteointegration of the dental implant, which provides theoretical insights and practical guidance to prevent and manage early-stage peri-implant lesion using bioactive functional materials.

YouTube as an information source for bleeding gums: A quantitative and qualitative analysis.

Gum bleeding is a common dental problem, and numerous patients seek health-related information on this topic online. The YouTube website is a popular resource for people searching for medical information. To our knowledge, no recent study has evaluated content related to bleeding gums on YouTube™. Therefore, this study aimed to conduct a quantitative and qualitative analysis of YouTube videos related to bleeding gums. A search was performed on YouTube using the keyword "bleeding gums" from Google Trends. Of the first 200 results, 107 videos met the inclusion criteria. The descriptive statistics for the videos included the time since upload, the video length, and the number of likes, views, comments, subscribers, and viewing rates. The global quality score (GQS), usefulness score, and DISCERN were used to evaluate the video quality. Statistical analysis was performed using the Kruskal-Wallis test, Mann-Whitney test, and Spearman correlation analysis. The majority (n = 69, 64.48%) of the videos observed were uploaded by hospitals/clinics and dentists/specialists. The highest coverage was for symptoms (95.33%). Only 14.02% of the videos were classified as "good". The average video length of the videos rated as "good" was significantly longer than the other groups (p <0.05), and the average viewing rate of the videos rated as "poor" (63,943.68%) was substantially higher than the other groups (p <0.05). YouTube videos on bleeding gums were of moderate quality, but their content was incomplete and unreliable. Incorrect and inadequate content can significantly influence patients' attitudes and medical decisions. Effort needs to be expended by dental professionals, organizations, and the YouTube platform to ensure that YouTube can serve as a reliable source of information on bleeding gums.

A cross-sectional observational study to evaluate the acceptability of the clove mouthwash in Delhi NCR population

ABSTRACT Aim: The aim of this study was to assess customer satisfaction premarket launch of the newly developed mouthwash; the present survey has been conducted to evaluate the taste, texture, their effectiveness in treating sensitivity, and bad breath. Materials and Methods: The survey was conducted for a sample size of 480. Participants received a questionnaire consisting of questions on oral health, sensitivity, bleeding gums, and bad breath. Results: Eighty-two percentage of the population found the clove mouthwash to be effective and claimed that their sensitivity was significantly reduced. Conclusion: Since the clove mouthwash gained acceptance from the majority of the population as evidently supported by the results of our current survey, it is stated that within the confines of the survey, clove mouthwash can be launched in the market.

Clinical Diagnosis and Treatment of Scurvy in a Young Adult With Poor Dietary Habits: A Case Report and Literature Review

Scurvy, once prevalent among sailors, is now rare due to improved access to fresh fruits and vegetables yet persists in individuals with poor dietary habits. We report a case of a 35‐year‐old male presenting with month‐long, nonpainful, nonitchy lower extremity lesions. A dermatological examination revealed follicular hyperkeratosis, perifollicular bleeding, corkscrew hairs, bleeding gums, and hemorrhagic purpura. Despite unavailable plasma vitamin C testing, scurvy was diagnosed based on clinical features and dietary history. Treatment with vitamin C resulted in significant improvement within 10 days. Inadequate intake of fruits and vegetables causes vitamin C deficiency, impairing collagen synthesis and leading to typical scurvy symptoms. This case underscores the importance of considering scurvy in patients with compatible symptoms, focusing on clinical diagnosis and treatment response when testing is unavailable. Management includes vitamin C supplementation and dietary changes, emphasizing healthcare providers’ role in promoting sufficient fruit and vegetable consumptions to prevent nutritional deficiencies.

Intoxication in a Colombian mercury mine: Aranzazu, 1948-1975.

This study analyzes the activities, poisoning, and medical treatment of the "La Esperanza" mercury mine workers in Aranzazu (Caldas, Colombia) between 1948 and 1975. The mining work there was difficult due to the geological instability of the area and the use of inappropriate mining technology, which generated a high occurrence of poisoning manifested in tremors of limbs, bleeding gums, loss of teeth, and bad mouth odor. The mine was the first Colombian company to treat its poisoned workers with dimercaprol and penicillamine. Occupational toxicology in Colombia was thus born during one of the most significant occupational health disasters in the country.

Тимчасові незнімні ортопедичні конструкції виготовлені із використанням CAD/CAM системи методом фрезерування, як альтернатива постійним на тривалий термін

Relevance. Prevalence of partial loss of teeth in the population of Ukraine is from 62.3% to 84.5%. The war in Ukraine significantly affected the provision of timely and high-quality dental care. However, the restoration of the destroyed crown part of the tooth and the integrity of the tooth rows must take place in a timely manner, as it leads to the development of secondary deformations of the dental and jaw system. One of the options for solving the problem of timely orthopedic treatment, in these conditions, can be the use of temporary fixed orthopedic structures made using the CAD/CAM system by the milling method. The aim is to investigate the possibility of using non-removable temporary orthopedic structures made using the CAD/ CAM system by the milling method and cements for their temporary fixation for a period exceeding that established by the general protocols of orthopedic treatment and declared by the manufacturer. Materials and methods. The study was conducted in the period from September 2022 to April 2024 at the Department of Orthopedic Stomatology of the National Medical University named after O.O. Bogomolets For the study, 60 patients aged 25-59 years were selected, with the destruction of the crown part of the tooth, which required replacement with a fixed orthopedic structure and included dentition defects of various lengths. All supporting elements were divided into groups, depending on the cement used for fixation: Group I – Freegenol (GC, Japan), Group II – Provicol (Voco, Germany), Group III – RelyX Temp NE (3M ESPE, Germany), IV group – Temp-Bond NE (KERR, USA). Re-examinations of patients were carried out in periods from two weeks to six months. Results. Depending on the selected cement for temporary fixation of a non-removable orthopedic structure, the percentage of decementing of temporary single crowns, in terms of two weeks to six months, was from 2.22% to 32.65%, structures with support on two elements from 5.55% to 52.94% and based on three elements from 7.14% to 77.78%. A direct relationship was established between the appearance of mobility of the temporary fixed orthopedic structure, the sensitivity of the vital tooth and bleeding gums in all groups of subjects. Conclusions. Temporary non-removable orthopedic structures made using the CAD/CAM system by the milling method, depending on the selected cement for temporary fixation, can be used to restore the crown part of the tooth and included defects of the dentition for a period that exceeds that established by the general protocols of orthopedic treatment and declared by the manufacturer. Key words: temporary non-removable orthopedic structures, CAD/CAM systems, milling, cements for temporary fixation.

Emicizumab Prophylaxis in Patients with Severe Hemophilia A: Insights from A Resource Limited Country.

In this prospective study, severe HA patients were recruited from January 2022 to June 2023. Inhibitor positive and inhibitor negative patients with annual bleeding rate (ABR) 8 or greater and past histories of bleeding like intra-cranial, intra-abdominal, and pseudo-tumors were included. Emicizumab loading dose was 3 mg/kg in the first 4 weeks, and the maintenance dose was started at week 5 at 6 mg/kg/month. Patients' detailed bleeding history and demographics were recorded. The five-level EuroQol five-dimensional questionnaire (EQ-5D-5L) was used to evaluate patients' HRQoL. Furthermore, Hemophilia Joint Health Score (HJHS) and Functional Independence score in Hemophilia (FISH) were applied for the assessment of joints at different time points. Results were analyzed by SPSS version 21. A total of 36 HA male patients with the mean age of 19.7 ± 14.42 years were recruited in the study; among them, 19 patients were inhibitor positive, while 17 were negative. Patients clinically presented with bleeding symptoms which included: hemarthrosis 95%, GI bleeding 13.8%, and bruises and gums bleeding 13.8%. Significant reduction was observed in the bleeding episodes after the therapeutic intervention, and joints assessment and Euro-Quality-of-life Visual Analog Scale showed a significant improvement in health after treatment. Similarly, there was a remarkable reduction in bleeding episodes and improved quality of life among HA patients. The ABR decreased from 53.6% episodes per year prior to treatment to 2.4% during Emicizumab therapy. Prior to initiating Emicizumab therapy, participants exhibited an average FISH score of 16 and HJHS score of 10, indicating moderate limitations due to joint-related issues. After treatment, the mean FISH score improved to 9 and HJHS score to 4 reflecting a substantial enhancement in participants' ability to perform daily activities (P < 0.057). Our results showed that HA patients on prophylactic treatment with Emicizumab were less restricted and had improved quality of life due to marked decrease in bleeding episodes which resulted in improved health and social lives. In addition, it was well tolerated, and no participant discontinued treatment because of adverse events.

Nonsurgical management of puberty-associated gingival enlargement in an adolescent female: a case report with a follow-up of 6 months

Sex hormones have long been thought to have an impact on periodontal tissue, bone turnover, wound healing, and the development of periodontal disease. In adolescence, hormonal changes may affect both male and female gingival tissues, altering the tissues’ response to dental plaque and perhaps causing conditioned gingival growth. Such overgrowths may cause several issues, including speech difficulties, gum bleeding, and even aesthetic problems. The ability to deal with hormonal factors linked to the reproductive process is well understood by oral health-care experts. In the current case study, we have covered how to treat gingival inflammatory overgrowth associated with puberty through a nonsurgical approach. The present case report leads us to conclude that nonsurgical treatment for puberty-induced gingival enlargement is the best alternative treatment option than surgical intervention.