Maintenance Of Good Oral Hygiene Research Articles

Multiple Odontogenic Keratocysts: A Case Report

Multiple odontogenic keratocysts are a rare, but well recognized condition that characteristically affects the jaws of middle-aged women. The radiographic appearance can vary from areas of radiolucency to mixed lesions and to opaque masses which are often bilaterally. This condition has been classified as sclerosing osteitis, multiple enostoses, diffuse chronic osteomyelitis and gigantiform cementoma. The lesion is usually benign and requires no treatment unless cosmetically concerning or becomes symptomatic. For the asympto- matic patient the best management consists of regular recall examination with prophylaxis and maintenance of good oral hygiene According to the recent review of literature, only five patients of florid cemento-osseous dysplasia from India have been reported (less than 2%). Here presentsuch a rare case occurring in a 38 year – old female who came with dull pain in upper right back teeth region since 6 months. Radiographically, it showed mixed radiolucent / radio-opaque mass in both right and left premolar to molar region.

Multiple Odontogenic Keratocysts: A Case Report

Multiple odontogenic keratocysts are a rare, but well recognized condition that characteristically affects the jaws of middle aged women .The radiographic appearance can vary from areas of radiolucency to mixed lesions and to opaque masses which are often bilaterally. This condition has been classified as sclerosing osteitis, multiple enostoses, diffuse chronic osteomyelitis and gigantiform cementoma. The lesion is usually benign and requires no treatment unless cosmetically concerning or becomes symptomatic. For the asymptomatic patient the best management consists of regular recall examination with prophylaxis and maintenance of good oral hygiene According to the recent review of literature, only five patients of florid cemento-osseous dysplasia from India have been reported (less than 2%). Here present such a rare case occurring in a 38 year –old- female who came with dull pain in upper right back teeth region since 6 months. Radiographically, it showed mixed radiolucent / radio-opaque mass in both right and left premolar to molar region.

Evaluation of Primary Stability in Immediate Loading of Dental Implants

Study Design: With the patient’s desire to shorten the treatment time and to avoid an edentulous condition, immediate loading of implants has emerged as an alternative approach as compared to delayed loading implants for replacing missing natural teeth. The aim of this study is to evaluate the primary stability in immediate loading of dental implants. Objective: To evaluate primary stability and postoperative complications clinically and radiographically. Method: Total 50 patients were treated with immediate loading dental implants. Withdrawal criteria includes patients not returning for checkup, follow-up, or documentation, and patients not following postoperative instruction. Result: Primary stability increases in immediate loading protocol; mean stability was 57 which was adequate at the time of surgery and during healing period. Conclusion: Our study concludes that under appropriate circumstances, medical condition and maintenance of good oral hygiene provide better primary stability in immediate loading protocol.

Antimicrobial and Anti-Biofilm Effect of an Electrolyzed Superoxidized Solution at Neutral-pH against Helicobacter pylori.

The presence of Helicobacter pylori in the oral cavity has been associated to the failure of antimicrobial therapy in patients with gastrointestinal infection and the development of oral diseases. However, it has been reported that the maintenance of good oral hygiene can improve the therapeutic success rates, where the use of mouthwashes with anti-Helicobacter activity would help to achieve it. The aim was to evaluate the antimicrobial activity of OxOral® mouthwash against H. pylori and its effect on biofilm formation. The minimum inhibitory concentration (MIC) of OxOral® (pH = 6.4–7.5, ORP = 650–900 mV) against H. pylori was calculated testing serial dilutions 0.117–15 ppm against 1 × 108 CFU/mL of H. pylori (ATCC® 700824™) by broth microdilution method using 96‐well plates. The H. pylori biofilm formation was determined by the optical density measurement at 600 nm from coverslips stained with 0.1% crystal violet. The gene expression of ureA, luxS, flaA, omp18, and lpxD were analyzed by RT‐qPCR. OxOral® cytotoxicity was evaluated in a human gingival fibroblast cell line by MTT assay. MIC was of 3.75 ppm, with 99.7 ± 7.7% bacterial growth inhibition. In the negative control, the biofilm formation was observed, whereas when bacteria were treated with OxOral® at 0.234, 0.469, and 0.938 ppm, an inhibition of 35.5 ± 0.9%, 89.1 ± 1.2%, and 99.9 ± 5.5% were obtained, respectively. The gene expression analysis showed that flaA, omp18, and lpxD genes were down‐regulated with OxOral® compared with control (p < 0.05). Low cytotoxicity of 16.5 ± 7.6% was observed at the highest dose (15 ppm); no significant differences were observed from 15 to 0.469 ppm compared to the control of untreated cells (p > 0.05). Our results reveal an important anti-Helicobacter activity of OxOral® and open the possibility of its therapeutic use new studies, which would increase the success rate of conventional therapies against H. pylori.

OBTURATOR TREATMENT- BACTERIAL INFECTION RISK ASSESSMENT

Background: Consequences after oncological operations of the upper jaw are varying degrees of eating, swallowing and breathing disorders, from which the patient suffers biologically. Speaking is also affected in varying degrees, which makes the patient socially inferior as well. Often the newly formed communication between the oral and nasal cavity takes away the possibility of normal nasal breathing, food residue pass through the resulting opening, its decomposition result in chronic inflammation of the nose and paranasal sinuses. Patients maxillary resection post-surgery stage require maintaining of good oral hygiene and appropriate materials usage for laboratory development of obturators.Objective: The purpose of this study is to review the literature data assessing the risk of bacterial infection in the treatment of patients with maxillary defects treated by different types of obturators.Discussion: Surgical treatment of cancer and other pathological conditions in the maxillofacial area lead to different size, location and type of defects of soft and hard tissues that impair appearance and aesthetic look of the face of the operated patients. Changes that occur in appearance and functional disorders are directly dependent on the size and type of defect after the operation. The problems after maxillary resection are often exacerbated by concomitant radiotherapy, and leads to dry mouth, difficulty swallowing and impaired speech intelligibility.The prosthetic treatment of patients after maxillary resection is accompanied by many difficulties and problems. Patients maxillary obturators after the bone resection can cause risk of bacterial infection. This is more commonly observed because of silicone materials and buccal flange sealers application. The acrylic and light-curing plastics usage significantly reduces the risk of infection. Nevertheless, disinfectant solutions irrigation and good oral hygiene maintenance are mandatory. Their use is considered to significantly reduce the risk of bacterial infection during all stages of prosthetic treatmentConclusion: Prosthetic rehabilitation of patients with maximal resection requires the specific treatment modalities usage. The type and shape of prosthetic structures, as well as the choice of materials for their construction, must ensure good oral hygiene. The use of disinfectants significantly reduces the risk of bacterial infection, especially when silicone materials are applied.

Inter-rater reliability of the Oral Assessment Guide for oral cancer patients between nurses and dental hygienists: the difficulties in objectively assessing oral health.

Perioperative oral care is effective for the prevention and reduction of complications following surgery. However, oral cancer patients' oral health is often poor. During hospitalization, oral cancer patients frequently receive oral care from ward nurses as well as professional oral care from dental hygienists. Maintenance of good oral hygiene in these patients ideally requires cooperation between nurses and dental hygienists. Consequently, communication tools used to share information about the status of patients' oral health are needed. One such tool is the Oral Assessment Guide (OAG). However, the inter-rater reliability of the OAG has not been consistently reported; therefore, we examined this between nurses and dental hygienists. Participants comprised 76 patients hospitalized for oral cancer treatment. After surgery, a nurse and a dental hygienist performed oral assessments using the OAG. Comparative statistical analyses were conducted to examine differences and consistencies in the scores of nurses and dental hygienists. Although almost all patients' oral health status was poor, none were given the worst score in the mucous membrane or gingiva categories. Further, the tongue, saliva, mucous membrane, gingiva, and teeth/denture categories had low κ coefficients, indicating poor nurse-dental hygienist inter-rater reliability. In contrast, the κ coefficients and agreement rates for voice and swallowing were high. Dental hygienists' scores were significantly higher for the tongue, gingiva, and teeth/denture categories than were nurses' scores. This study showed low nurse-dental hygienist inter-rater reliability for the OAG and highlighted the difficulties in objectively assessing patients' symptoms and oral health conditions. Therefore, rather than only relying on an objective assessment of symptoms by a clinician, assessments should also include patients' subjective reporting of symptoms. OAG will likely be used until a new assessment tool is developed. Objective assessment training and/or user manual development may be required to improve the reliability of OAG. The present training of one lesson a year is insufficient, and efforts should be made to improve this to get more reliable outcomes.

The role of patients education in the hygiene of removable dentures – a case report

Prosthetic treatment with removable dentures is long- lasting process, which requires from patients motivation and awareness about oral hygiene and proper maintantenance of dental prosthesis. Removable prosthesis wearers are much more susceptible to fungal and bacterial infections than people who do not use any dentures. Knowledge of negative influence of dental plaque, denture plaque and intraoral infections on oral and whole organism health is essential. Forcing patients, the role of oral hygiene and the need for follow- up care is an integral part of the treatment. Realization of this conditions enable specialists to get positive therapeutic effects. In addition, availability of numerous hygiene products provides effective protection against the negative effects of microbial infections. This paper presents cases of prosthetic rehabilitation of patients with unsatisfactory hygiene of removable prosthetic appliances. New dentures were prepared and focused on thorough education about appropriate handling and good oral hygiene maintenance. Improved hygiene and patients’ health awareness were observed.

A cohort study on risk factors for preterm births in rural Gujarat

Prematurity is one of the leading causes of neonatal and under-five mortalities globally and also in India. It is an important determinant of short- and long-term morbidities in infants and children. Unfortunately, risk factors of majority of preterm births (PTBs) remain unexplained which calls for appropriate action. There is a dearth of community-based research on PTB and its risk factors, especially in high burden countries like India. The objective of the study was to explore different risk factors for PTB. A cohort of 1977 antenatal mothers was enrolled at household level by trained field investigators and was followed up in four districts of Gujarat, India, to document the outcome of pregnancy. Pretested and structured questionnaires were used to collect information. A hierarchical regression model was used to analyze the risk factors for PTB. Proportion of PTB was 9% among the enrolled cohort. Risk factors which were found to be significant on applying the hierarchical model were periodontal disease, long sleep duration, and sex during any trimester. The study suggests an urgent need for strengthening of existing guidelines for effective, evidence-based, and culturally appropriate interventions for prevention of PTB. Maintenance of good oral hygiene should find a place in routine recommendations for pregnant women, and antenatal examinations should include screening for oral hygiene also.

Evaluation of Plaque Index in Patient Receiving Multi-Bracket Fixed Appliance

Objective: To compare the plaque index in patients receiving multi-bracket fixed orthodontic treatment for various factors like gender, brushing practices, meal habits, types of brackets, types of ligations, and use of mouthwash. Study Design: Cross-sectional analytical study. Socio-demographic and clinical modalities were defined and recorded for 40 patients having multi-bracket fixed appliances. The plaque index of subjects were recorded according to the modified Silness and Loe plaque index method. The data were checked for normality and simple summary statistics were generated. Independent sample t-test was applied to determine the difference in plaque index in factors such as gender, timing of brushing, use of mouthwash, type of brackets, type of ligation ,diet and brushing practice. Result: The results of this study showed significant difference in Plaque Index for the factors such as type of brushing technique, frequency of brushing, type of brush used and usage of dental auxillaries. The other factors like gender, meal habits, type of brackets, and type of ligation were statistically insignificant. Conclusion In conclusion, it proves that the maintenance of good oral hygiene during fixed orthodontic treatment is more dependent of the brushing practices and less on the clinical practices. The subjects who comply with the use of normal and interdental brushing, the timing of brushing and frequency of brushing is less prone to plaque accumulation. Therefore, patients education on oral hygiene maintenance must be a part of the orthodontic treatment. For these reasons, proper methods of instructions in the form of verbal, brochures and video tapes must be devised and incorporated in clinical practice.

Etiology of Deep Neck Infection and Determination of their Predisposing Factors and Microbial Pattern

Deep neck infection is an infection in the potential spaces and fascial planes of either with abscess formation or cellulitis .However some of may still result in fatal complications. This paper described the etiology of deep neck infection, their predisposing factors and microbial pattern. More than 50% subject of this study were of younger age group ( below 40 years) with male predominance (65%). Regarding the neck space submandibular space was the most commonly involved(32%). Etiology of neck abscess showed that odontogenic cause was the most common (60%) among the respondent, then come infected cyst, tumour. Among the predisposing factors of deep neck infection, Anaemia comprises the highest percentage (45.2%). Then comes diabetes and Liver disease, Oral hygiene, index relates with the odontogenic cause. Among the odontogenic cause patient (71.8%) had poor oral hygiene index. Regarding microbial pattern streptococcus was the highest predominance followed by Staphylococcus and E coli. This results correlates with the common dental infective microorganism which also stands for odontogenic cause of deep neck abscess. This study concluded that maintenance of good oral hygiene can prevent deep neck abscess and their devastating effect of Bangladeshi people.Update Dent. Coll. j: 2016; 6 (2): 13-20

Community analysis of dental plaque and endotracheal tube biofilms from mechanically ventilated patients

PurposeMechanically ventilated patients are at risk for developing ventilator-associated pneumonia, and it has been reported that dental plaque provides a reservoir of respiratory pathogens that may aspirate to the lungs and endotracheal tube (ETT) biofilms. For the first time, metataxonomics was used to simultaneously characterize the microbiome of dental plaque, ETTs, and non-directed bronchial lavages (NBLs) in mechanically ventilated patients to determine similarities in respective microbial communities and therefore likely associations. Material and methodsBacterial 16S rRNA gene sequences from 34 samples of dental plaque, NBLs, and ETTs from 12 adult mechanically ventilated patients were analyzed. ResultsNo significant differences in the microbial communities of these samples were evident. Detected bacteria were primarily oral species (e.g., Fusobacterium nucleatum, Streptococcus salivarius, Prevotella melaninogenica) with respiratory pathogens (Staphylococcus aureus, Pseudomonas aeruginosa, Streptococcuspneumoniae, and Haemophilus influenzae) also in high abundance. ConclusionThe high similarity between the microbiomes of dental plaque, NBLs, and ETTs suggests that the oral cavity is indeed an important site involved in microbial aspiration to the lower airway and ETT. As such, maintenance of good oral hygiene is likely to be highly important in limiting aspiration of bacteria in this vulnerable patient group.

Oral and Radiographic Findings of a Patient with Osteopetrosis: A Rare Case Report

Oral and Radiographic Findings of a Patient with Osteopetrosis: A Rare Case Report Rita Khounganian(BDS, MSc, PhD), Abdul Aziz Al Wakeel (BDS), Bhari Manjunatha(BDS, MSc) Abstract Osteopetrosis is a group of rare hereditary skeletal disorders with variable clinical features which are characterized by a marked increase in bone density and reduction of marrow spaces. This disease has been generally reported in three clinical forms: severe malignant infantile autosomal recessive inheritance form; intermediate mild autosomal recessive form with clinical manifestations similar to malignant form and having the lowest incidence rate; and benign/adult osteopetrosis with autosomal dominant inheritance and with fewer symptoms. This report presents a case of osteopetrosis in a 27 year old Syrian female patient who was referred by her physician for dental checkup. The best therapeutic approach for this patient was preventive management and maintenance of good oral hygiene by regular brushing of her teeth twice a day and intake of a balanced diet and reduce the amount of sugar and carbohydrate to prevent dental caries. Full Text: PDF DOI: 10.15640/ijmp.v5n2a3

Assessment of Changes in Nickel and Chromium Levels in the Gingival Crevicular Fluid during Fixed Orthodontic Treatment.

Various components of appliances used in fixed orthodontic treatment are fabricated from materials that are highly resistant in nature and have high strength and biocompatibility. Corrosion of materials occurs inside the oral cavity due to numerous environmental or oral factors that act on them. These factors include temperature, pH variation, salivary conditions, mechanical loads, microbiological and enzymatic activity, and various food components. Gingival crevicular fluid (GCF) is the material obtained from the gingival sulcus and might act as a potential source for various biomarkers in the orthodontic setup because inflammatory-induced response is directly related to orthodontic forces in GCF. In the light of above-mentioned data, we planned this study to assess and evaluate the changes occurring in nickel and chromium levels in the GCF during fixed orthodontic treatment. This study included assessment of 30 patients who underwent fixed orthodontic treatment. Three samples were taken from the GCF of the patients giving a total of 90 samples. The samples were collected at the following time intervals: At baseline (pretreatment time), 1 month after the start of orthodontic treatment, and at 6 months after the commencement of orthodontic treatment. Cellulose strips were used for isolation of the tooth region. For GCF collection, a standardized cellulose acetate absorbent strip was used. Placement of the strips was done in the sulcus for 60 seconds for the collection of the samples. Refrigeration of the specimen bottles was done for a minimum of 7 days and was then sent to a laboratory where specimens were transferred for atomic absorption spectrophotometry. All the results were analyzed by Statistical Package for the Social Sciences software. At 1 month, the mean value of nickel and chromium in GCF was found to be 4.5 and 4.9 ug/gm of GCF respectively. While comparing the mean nickel levels between 1 and 6 months and between baseline and 6 months, significant results were obtained. Significant results were also obtained while comparing the mean values of chromium in GCF between baseline and 6 months and between 1 and 6 months. Gingival health index of the patients was found to be associated with increased inflammation with the progression of time of orthodontic treatment. Levels of nickel and chromium might show considerable elevation in the GCF with time along with an increase in the severity of inflammation in the gingival health in patients undergoing fixed orthodontic treatment. Regular oral prophylaxis of the patients undergoing orthodontic treatment should be done to avoid tox-icities caused by the release of nickel and chromium and for maintenance of good oral hygiene and oral health.

Tooth abnormalities in pediatric patients submitted to antineoplastic treatment for central nervous system neoplasms

Objective: The aim of this study was to evaluate the frequency of tooth abnormalities in pediatric patients treated for central nervous system neoplasms. Material and methods: This cross-sectional study assessed thirty-one patients, median age 14.2 years (range 5 - 25), who were off therapy for at least one year, comparatively with a control group of thirty-one healthy patients matched for age with the study group. Tooth abnormalities were evaluated by panoramic radiographs. Results: There was no statistical significant evidence that patients of the study group (age range 5 - 25 years) have more frequency of tooth abnormalities comparatively with controls. However, in children who were diagnosed before 5 years of age, microdontia was the most common abnormality with statistically significant difference (P=0.037). Root shortening grade III was observed in patients over 10 years of age at the time of radiographic examination, also with statistical significance (P=0.046). Conclusions: Tooth abnormalities frequency in patients treated for central nervous system neoplasms is directly related to the age of diagnosis and stage of odontogenesis. Microdontia and reduced root surface areas, the most common abnormalities observed, can lead to future oral health impairment due to malocclusion and less periodontal support. It is important to give parents and patients early orientation about maintenance of good oral hygiene and proper treatment by orthodontics or dentofacial orthopedics.

Ultrasonic vs. hand instrumentation in periodontal therapy: clinical outcomes.

Periodontal disease is the most common oral disease in adults. Traditional nonsurgical periodontal therapy involves subgingival removal of hard and soft deposits on the root surface, along with maintenance of good oral hygiene. Nonsurgical periodontal therapy can either be definitive or part of the initial phase before surgical therapy. Mechanical therapy, either with hand or ultrasonic instrumentation, is the keystone of nonsurgical periodontal therapy. This requires considerable amounts of time and a high level of operator skill. The use of appropriate instruments greatly increases clinical efficiency. This article discusses the use of ultrasonic and hand instrumentation, along with recent advances, and the benefits of adjunctive therapy during nonsurgical periodontal therapy.

The Impact of Oral Hygiene Maintenance on the Association Between Periodontitis and Osteoporosis: A Nationwide Population-Based Cross Sectional Study.

Both periodontitis and osteoporosis have similar sign of bone resorption in nature. However, the relationship of the severity between these 2 bone-loss diseases is still uncertain.The aim of this study was to investigate the association between the severity of osteoporosis and periodontitis regarding the impact of oral hygiene maintenance. In total, 35,127 osteoporosis patients and 50,498 comparisons were derived from the Longitudinal Health Insurance Database of Taiwan between 2000 and 2010. The population was subdivided into groups according to the different level oral hygiene maintenance and the severity of periodontitis and osteoporosis. The association between osteoporosis and periodontitis was estimated by multinomial logistic regression and rank correlation by Kendall rank correlation test, presented by odds ratio (OR), and 5% confidence intervals (CIs).After controlling the age, sex, and comorbidities, variables in the good oral hygiene maintenance population, we found that periodontitis raised 1.29-fold risk of osteoporosis (95% CI = 1.12–1.49); the risk of osteoporosis was increased with the elevated severity of periodontitis from 1.27 (95% CI = 1.08–1.48) to 1.38 (95% CI = 1.01–1.89). There is a positive correlation between the severity of periodontitis and osteoporosis occurrence in this population (OR = 1.27–1.46; Kendall rank correlation test P = 0.0003). In the poor oral hygiene maintenance population, periodontitis patients had 6.02-fold risk of osteoporosis than those who without periodontitis (95% CI = 4.65–7.81); the risk of osteoporosis was increased with periodontitis severity from 5.96 (95% CI = 4.48–7.92) to 6.37 (95% CI = 3.36–12.1).This result indicated the periodontitis and osteoporosis are conjunctive. The sudden periodontal breakdown of those who with good oral hygiene maintenance might be an indicator for the risk of osteoporosis; if those who were diagnosed as osteoporosis must pay more attention to their periodontal health. Good oral hygiene maintenance might be a crucial factor for preventing the deterioration of osteoporosis progressing; the oral hygiene maintenance plays a significant influence on the association between periodontitis and osteoporosis.

Position paper on medication-related osteonecrosis of the jaw (MRONJ)

It is now 12 years since the first article on medication-related osteonecrosis of the jaw (MRONJ) was reported in 2003. The recognition of MRONJ is still inconsistent between physicians and dentists but it is without doubt a severe disease with impairment of oral health-related quality of life. This position paper was developed by three Austrian societies for dentists, oral surgeons and osteologists involved in this topic. This update contains amendments on the incidence, pathophysiology, diagnosis, staging and treatment and provides recommendations for management based on a multidisciplinary international consensus. The MRONJ can be a medication-related side effect of treatment of malignant and benign bone diseases with bisphosphonates (Bp), bevacizumab and denosumab (Dmab) as antiresorptive therapy. The incidence of MRONJ is highest in the oncology patient population (range 1-15 %), where high doses of these medications are used at frequent intervals. In the osteoporosis patient population, the incidence of MRONJ is estimated to be 0.001-0.01 %, marginally higher than the incidence in the general population (< 0.001 %). Other risk factors for MRONJ include glucocorticoid use, maxillary or mandibular bone surgery, poor oral hygiene, chronic inflammation, diabetes mellitus, ill-fitting dentures as well as other drugs, including antiangiogenic agents. Prevention strategies for MRONJ include elimination or stabilization of oral disease prior to initiation of antiresorptive agents, as well as maintenance of good oral hygiene. In those patients at high risk for the development of MRONJ, including cancer patients receiving high-dose BP or Dmab therapy, consideration should be given to withholding antiresorptive therapy following extensive oral surgery until the surgical site heals with mature mucosal coverage. Management of MRONJ is based on the stage of the disease, extent of the lesions and the presence of contributing drug therapy and comorbidity. Conservative therapy includes topical antibiotic oral rinses and systemic antibiotic therapy. Early data have suggested enhanced osseous wound healing with teriparatide in those patients without contraindications for its use. The MRONJ related to denosumab may resolve more quickly with a drug holiday than MRONJ related to bisphosphonates. Localized surgical debridement is indicated in advanced nonresponsive disease and has proven successful. More invasive surgical techniques are becoming increasingly more important. Prevention is the key for the management of MRONJ. This requires a close teamwork for the treating physician and the dentist. It is necessary that this information is disseminated to other relevant health care professionals and organizations.

Impact of verbal, Braille text, and tactile oral hygiene awareness instructions on oral health status of visually impaired children.

Visually impaired children face limitations in interacting with the environment, as they cannot see the facial expression of parents, teachers and cannot perceive social behavior. These children are challenged every day in learning basic life skills and maintenance of oral hygiene being one among them. To evaluate the impact of verbal, braille text, and tactile oral hygiene awareness instructions on oral health status of visually impaired children. One hundred and twenty institutionalized visually impaired children aged 6-16 years were selected and divided into three groups (40 children each). Group I: Verbal and tactile, Group II: Verbal and braille, Group III: Verbal, braille, and tactile. Instructions regarding maintenance of good oral hygiene and brushing technique were explained to all the children, and oral health status of these children using plaque index (Silness and Loe) and gingival index (Loe and Silness) was evaluated at 1, 3, and 6 months interval. ANOVA test was used to analyze the intra- and inter-group comparisons and Tukey post-hoc test for multiple group comparisons. Children in all the groups showed reduction in plaque and gingival scores. There was the highest percentage of reduction in plaque scores in Group III (70.6%), and the decrease in gingival scores was the highest in Group II (84%). Severity of dental plaque and gingivitis in visually impaired individuals can be reduced by a controlled and supervised educational program. The combination of all three, i.e., verbal, braille, and tactile mode of oral health educational aids proved to be effective.

Thermoplastics: An Unexpendable biomaterial in Orthodontics-A systematic review

Thermoplastic materials are indicated for fabrication of various appliances such as retainers, night guards, temporomandibular joint splints, bleaching trays, minor tooth movements. These appliances are transparent, visually more appealing, comfortable, disposable and above all maintenance of good oral hygiene is possible. In order to expand the clinical indications of thermoplastic appliances, it is important to understand the mechanical properties such as hardness and elastic modulus of the materials and the method of their fabrication.

Idiopathic gingival enlargement: A case report

Idiopathic gingival fibromatosis is a relatively rare condition characterized by the proliferation of the gingival tissues resulting in masticatory, esthetics, phonetics and psychological disturbances. We present a case with generalized diffuse gingival enlargement involving the maxillary and mandibular arches extending on buccal and lingual/palatal surfaces and covering incisal/occlusal third of the tooth in the left maxillary region. Gingivectomy was carried out in all four quadrants. Periodic recalls showed maintenance of good oral hygiene and one year follow-up revealed no recurrence.JCMS Nepal. 2015;11(1): 26-28