Recall Visits Research Articles

Mobile Phone Text Message Reminders to Improve Vaccination Uptake: A Systematic Review and Meta-Analysis.

Mobile phone text message reminders (MPTMRs) have been implemented globally to promote vaccination uptake and recall rates. This systematic review evaluated the effectiveness of MPTMRs on vaccination recall rates. We included randomized controlled trials of caregivers of children, adolescents, or adults who received MPTMRs for improving vaccine uptake and recall visits. We searched the Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, and Scopus to identify relevant studies published up to 24 January 2024. We used Cochrane's Risk of Bias tool to assess the included studies and reported the results as risk ratios with 95% confidence intervals, using a random effects model. We identified 25 studies for inclusion. All studies were assessed as having a low risk of bias. The evidence supports MPTMRs for improving vaccination uptake compared to usual care (RR = 1.09 [95%CI: 1.06, 1.13], I2 = 76%). Intervention characteristics, country setting, country economic status, and vaccination type had no bearing on the effectiveness of the intervention. MPTMRs have a positive effect, albeit relatively small, on vaccination uptake. These findings may assist public health practitioners, policymakers, and vaccine researchers in evidence-based decision making that focuses on MPTMRs and their impact on vaccination coverage.

Poly-Ether-Ether-Ketone versus dead-soft coaxial bonded retainers: a randomized clinical trial. Part 2: periodontal health and microbial biofilm assessment.

Retainers have the potential to detrimentally impact periodontal health and contribute to tooth decay. To investigate periodontal health and bacterial biofilm related to Poly-Ether-Ether-Ketone (PEEK) fixed retainers as compared to Dead-soft coaxial fixed retainer (DSC). A two-arm parallel groups single-centre randomized clinical trial. The trial included patients whose orthodontic treatment was completed and required retainers. Participants were randomly assigned into two retainer groups: PEEK retainers, prepared by computer-aided design and manufacturing into 0.8mm wire form, and DSC retainers. The objectives included assessing periodontal health through plaque accumulation index (PI), bleeding on probing (BOP), periodontal pocket depth (PPD), gingival index (GI), calculus index (CI), and alveolar bone height (ABH) assessment. Biofilm assessment involved bacteriological screening of aerobic, facultative anaerobic, mutans streptococci, and lactobacilli. The periodontal indices and microbiological screening as well as were assessed at the debonding stage (T0), 1-month (T1), 3-month (T3), and 6-month (T6) after the commencement of the trial, except for the ABH, which was recorded using periapical radiograph at T0 and T6. Single blinding of participants in addition to the bacteriological specialist. Initially, the trial enrolled 46 participants, aged between 12 and 28 years, and were randomly assigned to two groups, with 23 participants in each group. Subsequently, one participant withdrew from the trial, resulting in a total of 45 participants whose data were analysed. Assessment of the periodontal indices, excluding the CI (P = .480), revealed statistically but not clinically significant differences between groups after 6-month of retention (P = .016 of PI, P = .020 of BOP, P = .05 of PPD, and P = .01 of GI). There was slight plaque accumulation, normal PPD (approximately 1mm), healthy to mild gingivitis with a GI of less than 1 and BOP was around 10%. Concerning the ABH, there was a noticeable reduction in its score after 6 months, particularly in the PEEK group, although the difference was not statistically significant (P = .102). Furthermore, the bacteriological viable count did not show any significant difference between the groups during the recall visits. There have been no reported negative consequences. Blinding the assessor of periodontal indices was not feasible due to the nature of the intervention. The trial follow-up duration was limited. Both the PEEK and DSC retainers have comparable impacts on periodontal health and bacterial accumulation and composition during the retention period. NCT05557136.

Two-Step Periosteal Releasing Incision for Tension-Free Flap Closure After Implant Placement With Simultaneous Guided Bone Regeneration.

We evaluated the effect of periosteal-releasing incisions on flap displacement in anterior maxillary sites following implant placement and simultaneously guided bone regeneration. Thirty patients, each requiring a single dental implant and guided bone regeneration in the maxillary esthetic zone, were recruited. After full-thickness flap elevation, the displacement of the flap was measured under a standardized tension of 1 Ncm. Then, a 2-step periosteal releasing incision was placed in the internal aspect of the flap, and the displacement was remeasured using the same standardized tension. Keratinized tissue width and mucosal thickness at the surgical site were recorded. Patient-reported outcomes were assessed at the 7- and 14-day recall visits. Flap displacement (primary outcome) was calculated before and after periosteal-releasing incisions. Multivariable linear regression models were used to evaluate the influence of mucosal thickness on flap displacement and adjusted for Keratinized tissue width. Primary wound closure was achieved in all patients. The mean difference in flap coronal displacement before and after the periosteal-releasing incisions was 8.2 mm (p < .0001). Adjusted regression models showed no association between mucosal thickness and keratinized tissue width with the amount of flap displacement (p = .770). Patient-reported outcome measures for pain, swelling, and bleeding amounted to 1.28 ± 1.93, 1.36 ± 1.87, and 0.0 ± 0.0 at 7 days and 0.11 ± 0.57, 0.56 ± 1.03, and 0.0 ± 0.0 at 14 days, respectively. Periosteal-releasing incisions using the 2-step procedure described here are a predictable technique to obtain coronal flap displacements >8 mm without increased surgical complications.

Influence of mucosal tissue height on implant crestal bone: A 10-year follow-up of a controlled clinical trial

ObjectiveTo evaluate the 10-year influence of soft tissue height (STH) on crestal bone level changes (CBC) in bone-level implants with non-matching internal conical connections. Material & MethodsFrom the initial 97 patients, 59 (19 men, 40 women, age 55.86 ± 9.5 years) returned for the recall visit. Based on baseline STH, they were categorized into T1 (thin STH ≤2 mm, n = 33), T2 (thin STH augmented with allogenic tissue matrix (ATM), n = 32), and C (thick STH >2 mm, n = 32). Implants were placed in the posterior mandible using a one-stage approach and received single screw-retained restorations. Clinical (PPD, BOP, PI) and radiographic examinations were conducted after 10 years, with CBC calculated mesial and distal to each implant. ResultsAfter 10 years, implants in surgically thickened (T2) or naturally thick STH (C) showed bone gains of 0.57 ± 0.55 mm and 0.56 ± 0.40 mm, respectively (p < 0.0001) shifting from an initial CBC of -0.21 ± 0.33 mm to 0.36 ± 0.29 mm in the thick STH group and -0.2 ± 0.35 mm to 0.37 ± 0.29 mm in the surgically thickened STH group. Implants in naturally thin STH yielded a non-significant trend of bone loss (-0.12 ± 0.41 mm; p > 0.05). ConclusionsImplants in thin STH (≤2 mm) exhibited greater CBC over the study period. Significant bone gains were observed in thick STH cases, indicating that naturally thick STH or STH augmentation with ATM may contribute to maintain CBC in long-term around implants. Clinical significanceThis is the first long-term follow-up study suggesting that adequate soft tissue height around implants helps maintain stable peri‑implant bone levels. While tissue thickness plays a key role, other factors also interact with peri‑implant tissue height to sustain crestal bone stability over time.

An Insight into Supportive Periodontal Therapy and Maintenance Care

Abstract: Periodontitis is a painless destructive disease of the tooth supporting structures that progresses silently, hence it’s a big challenge for clinicians to motivate the patients for therapy. Several factors influence the treatment outcome such as genetic variations, smoking, systemic complications, stress, trauma from occlusion, iatrogenic dentistry, etc. There is ever-growing evidence that recall visits are prerequisites for the success of therapy. At the personal level, maintenance is difficult for an average patient as this demands frequent elimination of soft and hard deposits from all the possible surfaces, hence highlighting the significance of repeated professional care at regular intervals. An effective outcome of the therapy can be achieved by a fruitful combination of both active and supportive periodontal therapy, hence reducing the possibility of re-infection and arresting the disease progression. Keywords: Supportive Periodontal therapy; an extended trimeric model; compliance; risk assessment.

Effectiveness of an Ayurvedic Gel for Tooth Pain Relief Due to Dental Caries: A Randomized Controlled Trial

Aim: To evaluate the effectiveness of an ayurvedic gel in tooth pain reduction due to dental caries. Materials and methods: This in vivo cross-over design study enrolled adults with at least one tooth with caries and a symptom of pain after the application of an ice stimulus. Two hundred patients were screened and eligible patients were enrolled in the study. Forty-five subjects completed washout phases before each recall visit. During each recall visit, subjects evaluated pain relief following an ice bar stimulus and one random finger-tip application of a treatment i.e. Ayurveda Herbal gel containing clove oil, camphor, and menthol (Ayurveda Herbal Gel Group), and two control formulations: a gel without active ingredients and commercial olive oil as a surrogate of home remedy. At each assessment, subjects used a stopwatch to record the onset of pain relief and tooth pain using visual analog scores (VAS), dental pain scores (DPS), and relief from tooth pain by dental pain relief scores (DPRS). After each treatment, subjects recorded their satisfaction with the provided treatment using a four-point satisfaction index. Data were tabulated and statistical analysis was performed with (ANCOVA) and two-way ANOVA with a p - value of 0.05 considered statistically significant. Results: Forty-five subjects (28 males and 17 females) completed the entire study without any adverse events. Application of the Ayurveda gel resulted in a significantly faster onset of pain relief (2.47 min) in comparison to the onset of pain relief after 4 minutes recorded with the controls (p &lt; 0.05). Subjects reported lower VAS and DPS scores over the study period of evaluation when using the Ayurveda gel compared to the application of each control formulation. Subjects also reported greater relief of pain and greater satisfaction after the application of the Ayurveda gel as compared to the controls. Conclusion: Significantly better tooth pain relief from caries was observed from an Ayurveda Herbal gel than from controls.

Peri-implant mucositis and peri-implantitis: key features and differences

Peri-implant diseases are frequent complications that occur around osseointegrated endosseous implants and are the result of an imbalance between the bacterial challenge and host response. Peri-implant diseases may affect the peri-implant mucosa only (peri-implant mucositis) or also involve the supporting bone (peri-implantitis). Early detection of peri-implant diseases and timely treatment is important for the success of dental implant treatment. Peri-implant probing is essential to assess the peri-implant health status and should be done at each recall visit. Dental practitioners should be familiar with the clinical and radiological features of both conditions in order to make an accurate diagnosis and determine the appropriate treatment required. This article aims to provide clinicians with an understanding of the key differences between peri-implant health, peri-implant mucositis and peri-implantitis.

Outcomes of nonsurgical endodontic treatment under general anesthesia in special health care needs: An observational study

Background and aimThe alarming rise in the number of people with special health care needs (SHCNs) necessitates a paradigm shift in how to approach their oral health needs. General anesthesia (GA) is a valuable technique for facilitating dental procedures in patients with SHCNs who may not be able to tolerate treatment without it. The aim was to assess nonsurgical endodontic treatment and outcomes in patients with SHCNs performed under GA.MethodSeventy-eight permanent teeth in 33 patients who received nonsurgical endodontic treatment under GA were included between 2018 and 2022 in SHCNs hospital clinics. The demographic data, types of SHCNs, pulpal and periapical diagnosis, type of treatment, and material used were analyzed. All patients were recalled for clinical and radiographic examinations. Pre-treatment and recall periapical radiographs were evaluated and scored using the Periapical Index (PAI).ResultsAutism and Attention deficit hyperactivity disorder were 39.4% of patients treated. Most treatments delivered were primary nonsurgical root canal treatment (95%). Warm vertical compaction of gutta-percha for obturation accounted for 88% of cases treated. Single cone obturation technique was used in 9 cases (12%) utilizing tricalcium silicate sealer. At the recall visits, 98.7% of teeth treated had survived. Twelve teeth have pre-treatment periapical lesions, and all healed except one. Female patients were found to have higher scores of PAI compared to male patients (23.7% vs 7.5%), yet insignificant. Only 10 patients with nonsurgical root canal treatment reported recurrent caries.ConclusionThis study demonstrates a high survival rate for nonsurgical endodontic treatment performed under GA in a cohort of patients with SHCNs. Interestingly, patients with social and communication disorders received the highest proportion of treatments under GA. These findings highlight the potential of GA-facilitated endodontics for this population. However, further research is warranted to explore additional methods for optimizing oral health outcomes in SHCNs.

Strategic approaches in oral squamous cell carcinoma diagnostics using liquid biopsy.

Liquid biopsy is a noninvasive diagnostic technique used for monitoring cancer utilizing specific genetic biomarkers present in bodily fluids, such as blood, saliva, or urine. These analyses employ multiple biomolecular sources including circulating tumor DNA (ctDNA), circulating tumor cells (CTCs), and exosomes (that contain DNA fragments) to detect genetic biomarkers that can predict, disclose, and/or monitor cancers. Levels of these biomarkers can inform on the presence of cancer, its genetic characteristics, and its potential treatment response and also provide predictive genetic predisposition information for specific cancers including oral squamous cell carcinomas (OSCC). Liquid biopsies can aid cancer management as they offer real-time dynamic information on the response to say chemotherapy or radiotherapy and recurrence following surgical excision. Unlike traditional tissue biopsies, which are invasive with a degree of morbidity and require specific tumor location sampling, liquid biopsies are noninvasive and can be repeated frequently. For oral squamous cell carcinoma, on which this review focuses, liquid biopsy of blood or saliva can be valuable in predicting susceptibility, providing early detection, and monitoring the disease's progression and response to therapy. This review gives a general narrative overview of the technology, its current medical usage, and advantages and disadvantages compared with current techniques and discusses a range of current potential biomarkers for disclosing OSCC and predicting its risk. Oral squamous cell carcinoma is all too often detected in the late stages. In future, liquid biopsy may provide an effective screening process such that cancers including OSCC will be detected in the early stages rather than later when prognosis is poor and morbidity and debilitation are greater. In this screening process, periodontists and hygienists have a critical role in that they are adept in examining mucosa, they see patients with shared risk factors for periodontitis and OSCC, namely smoking and poor oral hygiene, and they see patients frequently such that OSCC examinations should be a routine part of the recall visit. With this additional screening manpower, oral medicine and oral surgery colleagues will detect OSCC earlier and this coupled with new techniques such as liquid biopsy may greatly decrease global morbidity in OSCC.

Outcome Assessment of Three Different Methods of Root-end Preparation and Filling Materials in Endodontic Surgery: A Comparative Clinical Prospective Study

Introduction: The technique of endodontic surgery had evolved tremendously in the recent years with introduction of new instruments and materials. Aim: This study aims to compare the clinical outcome of endodontic microsurgery using three different techniques with three different root-end filling materials for 16 months. Materials and Methods: A total of 45 maxillary incisors indicated for root-end surgery were selected for the study. They were enrolled into three groups, i.e. Group A (traditional [TRS]/heat burnished gutta-percha), Group B (concave [CON]/Retroplast), and Group C (cavity/DiaRoot BioAggregate), of 15 teeth each. The clinical and radiographic outcome was recorded at 1, 6, 12, and 16 months using various criteria. Statistical Analysis: The data were analyzed by one-way analysis of variance and Tukey’s post hoc test using SPSS V. 21 software (IBM Corp., Somers, NY, USA). Results: All patients had uneventful healing at the final follow-up. Radiological intratime analysis concluded a highly high significant (P &lt; 0.0001) decrease in the size of radiolucency between the three groups at the third recall visit. Intertime analysis recorded no significant decrease in radiolucency between Groups A and B, a significant decrease in B and C, and a highly significant decrease between Groups A and C at 12 months. Conclusions: There was no significant difference in the clinical outcome after endodontic surgery when comparing TRS/heat burnished gutta-percha, CON/Retroplast, and cavity/DiaRoot BioAggregate techniques at 16 months. However, cavity/DiaRoot BioAggregate resulted in significantly rapid and predictable healing at 12 months.

Evaluation of Risk Factors associated with Caries Development after Full-mouth Rehabilitation for Early Childhood Caries Under General Anesthesia.

To evaluate the risk factors associated with caries development after full-mouth rehabilitation for early childhood caries (ECC) under general anesthesia. A total of 100 children diagnosed with ECC requiring full-mouth rehabilitation under general anesthesia were recruited for the study. At baseline, caries status, plaque index, Streptococcus mutans count, and Lactobacillus count were evaluated. The risk assessment for caries was evaluated using a cariogram. Children were recalled after 12 months for evaluation. All children returned for the recall and data was recorded at the recall visit. Children were grouped into caries-free or caries recurrent based on the absence or presence of caries. Chi-square tests and student's t-test were used for statistical analysis using the statistical package for the social sciences (SPSS), version 23. All 100 children returned for follow-up. 76% of the children developed new carious lesions in a period of 1 year. A statistically significant association between caries recurrence and S. mutans count and caries risk assessment (CRA) score was found (p < 0.001). No significant associations were seen between parental education levels and the oral health practices of the child. Children treated under full-mouth rehabilitation for ECC under general anesthesia are at risk for developing new carious lesions after treatment. New carious lesions are strongly correlated with the presence of S. mutans, and high cariographic risk scores serve as an indication of future caries. Early childhood caries may be avoided if children are more diligent in practicing good dental hygiene. Relapse of caries after full-mouth rehabilitation under general anesthesia can affect the quality of life of children. Preventive measures should be initiated and reinforced to prevent the occurrence of new carious lesions after full-mouth rehabilitation. How to cite this article: Mathew MG, Jeevanandan G, Maganur PC, et al. Evaluation of Risk Factors associated with Caries Development after Full-mouth Rehabilitation for Early Childhood Caries Under General Anesthesia. J Contemp Dent Pract 2024;25(1):85-91.

Six-Year Outcomes in Subjects with Polypoidal Choroidal Vasculopathy in the EVERESTII Study.

The EVERESTII study previously reported that intravitreally administered ranibizumab (IVR) combined with photodynamic therapy (PDT) achieved superior visual gain and polypoidal lesion closure compared to IVR alone in patients with polypoidal choroidal vasculopathy (PCV). This follow-up study reports the long-term outcomes 6years after initiation of the EVERESTII study. This is a non-interventional cohort study of 90 patients with PCV from 16 international trial sites who originally completed the EVERESTII study. The long-term outcomes were assessed during a recall visit at about 6years from commencement of EVERESTII. The monotherapy and combination groups contained 41 and 49 participants, respectively. The change in best-corrected visual acuity (BCVA) from baseline to year6 was not different between the monotherapy and combination groups; - 7.4 ± 23.0 versus - 6.1 ± 22.4 letters, respectively. The combination group had greater central subfield thickness (CST) reduction compared to the monotherapy group at year6 (- 179.9 vs - 74.2µm, p = 0.011). Fewer eyes had subretinal fluid (SRF)/intraretinal fluid (IRF) in the combination versus monotherapy group at year6 (35.4% vs 57.5%, p = 0.032). Factors associated with BCVA at year6 include BCVA (year2), CST (year2), presence of SRF/IRF at year2, and number of anti-VEGF treatments (years2-6). Factors associated with presence of SRF/IRF at year6 include combination arm (OR 0.45, p = 0.033), BCVA (year2) (OR 1.53, p = 0.046), and presence of SRF/IRF (year2) (OR 2.59, p = 0.042). At 6years following the EVERESTII study, one-third of participants still maintained good vision. As most participants continued to require treatment after exiting the initial trial, ongoing monitoring and re-treatment regardless of polypoidal lesion status are necessary in PCV. ClinicalTrials.gov identifier, NCT01846273.

Clinical Evaluation of Impact of Acrylic Partial Dentures on the periodontal conditions of abutments

Aim: To evaluate the impact of wearing removable partial dentures on the periodontal health of abutments and find outtheage and gender association. Study design: Descriptive case series. Place and duration: Prosthodontic department of Lahore Medical and Dental College Lahore, from15th January till 15thJuly 2023. Methodology: A total of 70 patients of both genders participated in the study. Removable dentures were delivered to the patients and they were recalled after one month of denture insertion to evaluate the abutment health, gingival recession was checked in terms of its presence or absence, plaque and gingival health index assessment were done using Loe and Silness index. Tooth mobility was checked by using Millar’s classification. Mean and SD was computed for quantitative data. Age and gender correlation was assessed using Pearson Chi -square test. Significant level was set to p&lt;0.05. Results: A total 41.4%males and 58.6% females were selected. A total of 68.6% maxillary partial dentures whereas 31.4% mandibular partial dentures were inserted. Gingival health index showed maximum patients with good health 57.1%. Dental plaque index of maximum patients 77.1% fell under zero score. Tooth mobility score of zero was frequently found in abutments 78.6%. Gingival recession around the abutments after one month of denture insertion was found in 15.7%whereas 84.3% abutments remained healthy. Association of Gingival index, plaque index, tooth mobility and gingival recession with gender did not show statistical significance however with respect to age significant results were obtained. Tooth mobility had no association with age. Conclusion: Removable partial dentures use does not disturb the periodontal health of abutments if well fabricated dentures are provided and good oral hygiene maintenance protocolsare followed. Patients’ education regarding denture use along with regular recall visits are of utmost importance. Keywords: Abutment, Acrylic dentures, dental plaque, Removable partial dentures, Periodontal health, periodontal diseases.

Indian Society of Periodontology Good Clinical Practice Recommendations for Peri-implant Care.

Current implant therapy is a frequently employed treatment for individuals who have lost teeth, as it offers functional and biological advantages over old prostheses. Concurrently, active exploration of intervention strategies aims to prevent the progression of peri-implant diseases and manage the existing peri-implant tissue damage. Indian Society of Periodontology has recognized the need for systematic documents to update the everyday clinical practice of general dental practitioners and has provided evidence-based consensus documents, namely good clinical practice recommendations from time to time to raise the oral health-related awareness and standards of oral health-care delivery across the country. The current clinical practice recommendations focused on peri-implant care to bridge the gap between academic theory and clinical practice by compiling evidence-based suggestions for preventing and treating peri-implant diseases. Twenty-eight subject experts across the country prepared these recommendations after a thorough literature review and group discussions. The document has been prepared in three sections covering peri-implant health and maintenance, peri-implant mucositis, and peri-implantitis. It will be a quick and concise reference for oral implant practitioners in patient management. The guidelines provide distinct definitions, signs, and symptoms, treatment required; recall visit specifications for plausible clinical case situations, and home-care recommendations regarding maintaining peri-implant health. The document advocates combined efforts of oral implant practitioners and the population at large with evidence-based, integrated, and comprehensive peri-implant care. By providing accessible, applicable guidance, these guidelines would empower dental professionals to uphold the well-being of implant patients and ensure the long-term success of implant therapy.

Stability of anterior open bite cases treated with upper and lower extrusion arches in adults: a follow-up study.

To investigate the post-treatment stability of anterior open bite (AOB) cases treated with upper and lower extrusion arches in adults. 23 patients with AOB were treated with extrusion arches and evaluated for dentoskeletal changes using lateral cephalometric radiographs before treatment (T0), after treatment (T1), and 12 months post-treatment (T2). Patients received bondable tongue spurs and vacuum-formed retainers as post-treatment retention/stability measures for 12 months. Post-treatment stability was further assessed qualitatively by the Photographic Openbite Severity Index. All the cases showed positive overlap between the anterior teeth at the end of orthodontic treatment, and 20 of 23 treated patients attended the recall visit after 12 months. A total of 85% of the cases maintained positive overlap at least 1 year post-treatment, 10% showed edge-to-edge bite, and only 5% showed no overbite. Treatment of AOB in adults with extrusion arches proved to be stable 1 year post-treatment. Changes in the overbite after 1 year of follow-up were not significant.

EVALUATION OF TRAUMATIC ULCERATIONS FREQUENCY AND SITE IN POST-INSERTION ADJUSTMENT RECALL VISITS IN COMPLETE DENTURE PATIENTS VISITING A DENTAL COLLEGE IN CHITWAN

Background: During the initial days after complete denture insertion, patients can face various difficulties like traumatic ulcerations, loss of retention, unstable denture, difficulty in mastication and speech etc. The aim of the study was to assess the site and number of traumatic ulcerations in maxillary and mandibular denture bearing area in post-insertion adjustment recall visits and also to find out the total number of adjustments recall visits required until the patients become comfortable with the denture. Methods: A cross-sectional study was conducted among 75 complete denture patients to look for the number and site of traumatic ulcerations and the number of post-insertion recall visits required until they became symptom free. Descriptive (frequency and percentage) statistical analysis was done using SPSS Statistical Software Package (version 21.0). Results: In the mandibular arch 49.33% (N=34) and in the maxillary arch 12.5% (N=9) patients required adjustment visits for traumatic ulcerations. In the first recall visit after 24 hrs, 34 patients showed traumatic ulcerations on mandibular arch while only 6 patients experienced traumatic ulcerations on the maxillary arch. Conclusions: The patients required more post insertion adjustments for traumatic ulcerations in the mandibular arch in comparison to maxillary arch. Traumatic ulcerations was most frequently found in distobuccal sulcus area in the maxillary arch and labial sulcus in the mandibular arch.

Well-being, postoperative pain and outcome after clinical application of a novel root canal irrigation fluid-RISA-in teeth with apical periodontitis: A first-in-human study.

The aim of the study was to assess the tolerance to the new root canal irrigation fluid RISA after root canal treatment (RCT) by evaluating the subject's postoperative well-being, postoperative pain (PP) and treatment outcome. A single-arm prospective study with 16 subjects (17 teeth) diagnosed with asymptomatic apical periodontitis. Endodontic treatment in one session performed using RISA for root canal irrigation. Well-being was assessed on the same day and after 24 h by telephone. For pain intensity, a visual analogue scale was used at 0-5 days. Clinical and radiographic evaluations were performed at ≥12 months. Well-being, occurrence of PP and outcome were qualitatively reported. Friedman test for paired samples and Spearman correlation coefficient were used. Significance was set at p < .05. At the same day and after 24 h, 14/16 subjects felt 'good'. 9/16 presented intra- or extra-oral swelling. The frequency of PP ≥36 (weak) was 82.4%. On the same day, 1 and 2 days postoperatively, there was more pain compared with preoperative pain p < .05. At Day 3, PP equalled preoperative pain (p > .05). 62.5% of subjects needed analgesics Day 0-2. The recall rate was 94.1%, and resolution of apical periodontitis was observed in 87.5%. The well-being of subjects was good, and the overall PP intensity was low. However, postoperative intra- and extra-oral swelling occurred often. At the recall visit, the effectiveness of the RCT with RISA appeared high (87.5%). The encouraging outcome results plus the fact that RISA has a broader action range than NaOCl in vitro, justify further work on the RISA solution. To reduce postoperative swelling, it is advised to further investigate the optimal way of application of RISA in the laboratory before clinical application is recommended.

Effect of Intraoral Appliance on Oral Health Status and Streptococcus mutans Count: A Longitudinal Study

Abstract Objective Appliances used in preventive and interceptive orthodontics, which are often provided to correct or intercept a specific malocclusion or habit, may be detrimental. to a child's oral health. The objective of this study was to evaluate the effect of intra oral appliance wear on the plaque index, gingival index, bleeding on probing, and on levels of salivary Streptococcus mutans. Materials and Methods A total of 60 children requiring any preventive or interceptive orthodontic treatment (appliance therapy) were randomly divided into two groups, as fixed orthodontic appliance group (n = 30) and removable appliance group (n = 30). Preoperative and post operative assessments of patients were done before and after wearing appliances. Assessment was done by determining oral hygiene status and microbiological evaluation of saliva for S. mutans count. S. mutans colonies were counted from saliva cultured on mitis-salivarius-bacitracin (MSB) agar. Statistical Analysis Data that are continuous in nature were summarized as standard deviation and mean. For “within group” comparisons, paired t-tests were used to analyze the continuous data. For “between group” comparisons, unpaired t-tests and Fisher's exact test were used to analyze the continuous data. Results Appliance treatment increases plaque and gingival indices. Plaque and gingival index changes 1 month after deployment of both fixed and removable appliances were essentially the same and statistically non-significant with p-values of 0.412 and 0.965. Bleeding on probing after insertion of both appliances was not statistically significant (p=0.423). S. mutans numbers increased following removable and fixed orthodontics. Fixed appliances had more S. mutans than removable appliances (p=0.014). Conclusion The inherent levels of these microorganisms are related with plaque accumulation due to fixed or removable appliances. Increase in the level of plaque and microorganisms after fixed and removable appliance therapy can hamper optimum oral health and thus is a concern for pedodontists. During orthodontic therapy, cariogenic pathogens should be reviewed, and to prevent cariogenic pathogens from increasing and to maintain oral hygiene during orthodontic treatment, proper recall visits, patient and parent education, and regular fluoride application are essential.

Comparison of Marginal Fracture Between Conventional and Bonded Amalgam Restorations in Posterior Permanent Molar Teeth.

Background/objectives Dental amalgam has been a successful restoration for over a century. However, restoration failures due to secondary caries, fractured teeth or restorations, marginal deficiencies, tooth wear, and secondary caries remain significant concerns. Amalgam-bond, known for its ability to bond amalgam to the tooth structure and prevent percolation, forms a strong bond with vital dentin. This study aimed to compare the outcome of marginal fractures in bonded amalgam and conventional amalgam posterior restorations among patients at a tertiary care dental hospital. Materials and methods Sixty consecutive patients aged 25-35 years, meeting the inclusion and exclusion criteria, participated in this study. A thorough history, clinical examination, and standardized periapical radiographs were conducted. Patients were divided randomly into two equal groups, group A and group B. Group A received bonded amalgam restorations, while group B received conventional amalgam restorations. Polishing was performed at a recall visit after seven days, and a follow-up evaluation was done after two months. The final assessment of marginal fractures was recorded after six months. Results After six months, 28 (46.7%) patients showed no marginal fractures, including 11 males and 17 females. On the other hand, 32 (53.3%) patients exhibited marginal fractures, comprising 17 males and 15 females. The clinical success rate of group A was better than group B (p = 0.001). Conclusion Bonded amalgam demonstrates a high success rate and should be a routine choice for treating carious permanent molars in dental practice.

Evaluating the Clinical Efficacy of Maxillary Labial Frenectomy Procedure Using Diode Laser (980 nm) and Conventional Scalpel: An Observational Study.

This is an era of minimally invasive and least traumatic surgical interventions being focused on. The traditional scalpel frenectomy technique offers an increase in post-operative sequelae. To unravel this scenario a comparative evaluation is carried out to find out the clinical outcomes and quality of life after maxillary labial frenectomy using a conventional scalpel and diode laser frenectomy of 980 nm. Thirty-six subjects age ranging between 18 and 45 years reported to the Department of Oral and Maxillofacial Surgery, MES Dental College, Perinthalmanna with an aberrant frenal attachment of maxillary labial frenum were randomly assigned into two groups. Group A underwent the conventional scalpel technique and group B for the diode laser-assisted (980 nm) frenectomy technique. The post-operative parameters of ooze from the surgical site, pain, wound healing, and discomfort or acceptance of the procedure were assessed on day 1, day 7, and day 14, respectively. The diode laser group exhibited statistically significant clinical and healing outcomes. Less pain, minimal or absent ooze, increased healing, and better acceptance of the procedure with diode laser at 1, 7, and 14 days recall visit. Surgical interventions involving needle puncture and the associated post-operative sequelae are the most dreaded experiences that make patients indifferent toward surgical treatments. Thus in terms of better clinical outcomes and improved quality of life diode laser frenectomy is an excellent alternative wherein a needleless anesthetic success followed by minimal surgical intervention and less post-operative sequelae with fast recovery is possible.