Comparative Evaluation of Periodontal Osseous Defects Using Direct Digital Radiography and Cone-Beam Computed Tomography

OBJECTIVES

To evaluate and compare the accuracy of Direct Digital Radiography (DDR) and cone-beam computed tomography (CBCT) in determination and diagnosis of periodontal osseous defects.

METHODS

A nonrandomized in vivo study was conducted to compare the two imaging modalities, DDR and CBCT, for the diagnosis of periodontal osseous defects. Comparison was made between the linear measurements of DDR and CBCT images with the actual measurements of various osseous defects during surgical exposure (Gold standard).

RESULTS

The results of the present study demonstrated the difference in the mean values of the DDR and surgical exposure measurements of periodontal osseous defects, whereas comparable mean values were found between the CBCT and surgical exposure measurements, with no statistically significant difference (P > 0.05) being found between each modality.

CONCLUSION

CBCT proved to be an indispensable imaging tool in detecting and quantifying periodontal defects and furcation involvement more precisely and could provide additional benefits over the traditional radiography for clinical and postsurgical evaluation.

Comparative evaluation of tooth surface roughness caused by three different powered toothbrushes and a novel manual toothbrush -An SEM and AFM study

Background

Toothbrush is the most frequently used tool for mechanical plaque control. Variety of manual and powered toothbrushes are available in the market, and it is often a dilemma for a common man that which one to choose among the wide range. Thus, the purpose of the present study was to evaluate and compare the tooth surface roughness caused by three different powered toothbrushes.

Method

In total, 160 samples comprising of 80 enamel and cementum each were equally and randomly divided into four groups: Group 1 multi-directional powered toothbrushing; Group 2 oscillating/rotating/pulsating powered tooth brushing; Group 3 sonic powered tooth brushing; and Group 4 manual tooth brushing. They were further sub-divided equally into Control and Test. The Test samples were brushed for 2 min every day for a period of 1 month. The prepared samples were evaluated for surface roughness using scanning electron microscope at 1000 × magnification and atomic force microscope at the nanoscale.

Result

A statistically significant difference was seen in the enamel and cementum roughness between multi-directional tooth brush group and sonic (P = 0.00); multi-directional tooth brush group and manual tooth brush group (P = 0.00); oscillating tooth brush group and sonic group (P = 0.00); oscillating tooth brush group and manual tooth brush group (P = 0.00); and sonic group and manual tooth brush group (P = 0.00).

Conclusion

The surface microroughness caused by tooth brushing was found to be least using multi-directional and oscillating/rotational/pulsating powered toothbrush, followed by sonic powered toothbrush and maximum in manual toothbrush.

Short communication: Molecular markers for epithelial cells across gastrointestinal tissues and fecal RNA in preweaning dairy calves

The objective of this study was to compare the transcription of gene markers for gastrointestinal (GI) epithelial cells, including fatty acid binding protein 2 (FABP2) and cytokeratin 8 (KRT8), and tight junction complex genes (TJP1, CLDN1, CLDN4) in fecal RNA against several GI tract tissue sections in dairy calves. Eight healthy Jersey calves were euthanized at 5 wk of age, and postmortem samples were collected from rumen, duodenum, jejunum, ileum, large intestine, cecum, and feces for total RNA isolation. Tissues and fecal samples were immediately frozen in liquid nitrogen until RNA isolation. A real-time quantitative PCR analysis was performed using a single standard curve composited of equal amounts of all samples, including cDNA from fecal and GI tract tissues. The mRNA expression of the tight junctions TJP1, CLDN1, and CLDN4 was greater in fecal RNA compared with lower GI tract tissues (i.e., duodenum, jejunum, ileum, large intestine, and cecum). Similar to fecal RNA, rumen tissue had greater expression of tight junctions CLDN1 and CLDN4 than lower GI tract tissues. Similarly, rumen tissue had greater expression of TPJ1 than all lower GI tract tissues except duodenum. The expression of TJP1 and CLDN4 was greater in fecal RNA than in rumen tissue; in contrast, CLDN1 mRNA expression was greater in rumen tissue than in the fecal RNA. The expression of FABP2 was greater in duodenum in comparison to all tissue except ileum. The mRNA expression of FABP2 in fecal samples was similar to jejunum and ileum. The expression of KRT8 in fecal samples was similar to duodenum, large intestine, and cecum. The fecal RNA had a greater expression of KRT8 in comparison to jejunum and ileum. The rumen tissue had the lowest mRNA expression of KRT8. The expression levels of FABP2, KRT8, and tight junction genes observed in fecal transcripts suggest that a considerable amount of RNA derived from GI tract epithelial cells can be detected in fecal RNA, which is in agreement with previous data in neonatal dairy calves and other biological models including humans, rodents, and primates. The greater expression of tight junctions in fecal RNA in comparison to sections of the low GI remains to be understood, and due to the importance of tight junctions in GI physiology, further clarification of this effect is warranted. The similarities in mRNA expression of FABP2 and KRT8 between fecal RNA and intestinal sections add up to the accumulating evidence that fecal RNA can be used to investigate molecular alterations in the GI tract of neonatal dairy calves. Further research in this area should include high-throughput transcriptomic analysis via RNA-seq to uncover novel molecular markers for specific sections of the GI tract of neonates.

Medium term results following heart transplantation for end stage heart failure: A single center experience of 257 patients

OBJECTIVE

End stage heart failure is a lethal disease with a dismal 5 year survival. Heart transplantation has proven to be a highly effective modality of treatment in appropriately selected group of such patients. This is a retrospective analysis of medium term outcomes of heart transplantation in the setting of a private health facility in India. The objective of this study was two fold.

METHODS

The outcome of 257 heart transplants done at a single centre from October 2012 to October 2019 was analyzed. Patients with combined Heart and lung transplants and those whose complete medical records were unavailable were excluded from the study. Survival was tracked at 60 days, 90 days, one year and beyond for a maximum of 7 years. Preoperative patient risk profiles were characterized on the basis of INTERMACS category.

RESULTS

There were 176 male and 81 female patients. The age range was from 8 months to 78 years with a mean of 32.9 years. Survival at 2 months was 87%, at 90 days was 83%, at one year was 81%, 2 years was 75%, at 3 years was 72% and at 5 years and beyond was 62% for the whole series. Strong predictors of 90 day mortality included INTERMACS category (odd's ratio 0.289, p = 0.000) and creatinine more than 1.5 mg/dl (odd's ratio 2.48, p = 0.056). Recipient pulmonary vascular resistance and donor organ ischemic times were not found to be statistically significant factors affecting outcome. Medium term survival was influenced by INTERMACS category (Hazard ratio > 3 for INTERMACS category 1 compared to INTERMACS 4 or 5, p < 0.0001) and creatinine > 1.5 mg/dl (Hazard ratio 2.15, p = 0.003). This effect of creatinine was related to the age of the recipient. Hazard ratio 1.4, p = 0.524 if age <30 and Hazard ratio 4.78, p = 0.006, if age was >50.

CONCLUSION

Satisfactory medium term outcome is possible after heart transplantation even in resource constrained environment of a developing country.

Comparison of microsurgical and macrosurgical technique using bioactive synthetic bone graft and collagen membrane for an implant site development: A randomized controlled clinical trial

Background:

Implant site development can be effective in minimizing postextraction alveolar ridge resorption in the esthetic region. Microsurgical approach has demonstrated substantial improvement in soft-tissue architecture.

Aim and Objectives:

The aim of the present study was to evaluate and compare the efficacy of microsurgical technique with conventional one for implant site development utilizing biphasic hydroxyapatite/beta-tricalcium phosphate bone graft substitute and collagen membrane.

Materials and Methods:

Thirty extraction sites were planned for implant placement and randomly divided into control (macrosurgical/conventional) and test (microsurgery) sites. Clinical measurements were recorded at four different points of extraction socket, i.e., mesiobuccal, midbuccal, distobuccal, and midlingual/palatal at baseline, 3, 6, and 9 months. Postoperative neovascularization at control and test site was evaluated by ultrasound Doppler flowmetry at baseline, 10^th day, and 1 month. Radiological assessment of bone density (Hounsfield units) was measured at control and test sites at baseline, 6 and 9 months by computed tomography. Data was subjected to statistical analysis.

Results:

Significant socket fill at all the four different sites was observed and found to be statistically significant at test as compared to control group with better tissue contour after 3, 6, and 9 months. Test group demonstrated better neovascularization (P < 0.05) with significantly higher bone density (P = 0.000) at different time intervals.

Conclusions:

The results indicate that the augmentation of extraction sockets, not only improved the quality of bone in both the techniques but the utilization of microsurgical instruments and microsutures under magnification definitely enhanced the quality of soft tissues which is imperative for successful implant placement and its survival.

Prevalence of periodontitis in patients with pulmonary disease: A cross-sectional survey in the industrial district of India

Background

Evidence state that periodontitis may have a contributory role in the onset and progression of pulmonary diseases. However, very limited data are available till date, studying the coexistence of both the conditions.

Aim and Objective

The aim and objective of this study are to determine the prevalence of periodontitis among patients affected with various pulmonary diseases in Moradabad District, Uttar Pradesh, India.

Materials and Methods

A total of 700 patients suffering from pulmonary diseases including tuberculosis (TB), chronic obstructive pulmonary disease, or pneumonia within the age group of 12-70 years were selected for the study. A detailed case-history for both pulmonary and periodontal status was taken. Periodontal Disease Index and Periodontal Index for Risk of Infectiousness were recorded for all patients. The scores were calculated and subjected to statistical analysis.

Results

Individuals with pulmonary diseases showed a statistically significant prevalence of periodontal disease with higher values of periodontal disease index (31%) and periodontal index for risk of infectiousness (55%) at P < 0.05. Patients suffering from TB within the age group of 51-60 (42%) showed the highest prevalence of periodontitis with a more number of males (43%) being affected as compared to females at P < 0.01.

Conclusion

Most of the study population was diagnosed with periodontitis with a higher proportion categorized under high-risk category as per PIRI scores.

Parastyle cusp: A rare morphologic variant of maxillary second molars

Human jaws and teeth show a high diversity in the morphology, which varies from individual to individual. The variation in the morphologic feature is of great importance in the forensic field for identification. A tubercle or an accessory cusp is rare but is usually seen in the mandibular molar buccal aspect. From a forensic odontologist's point of view, the features though rare and unusual are useful for identification of the victim as well as criminal. The article presents three cases showing this rarest morphologic variation, i.e., the presence of a parastyle on a permanent maxillary second molar.