Comparing the effectiveness of water flosser and dental floss in plaque reduction among adults: A systematic review

Introduction

Interdental aids such as dental floss and water flossers have been found to be effective in removing interdental plaque. This systematic review aimed to compare the available data on the efficacy of dental floss and water flossers in plaque removal among adults.

Materials and Methods

Five databases: PubMed, Scopus, Cochrane, ScienceDirect, Lilac, and Google Scholar were searched from January 1, 2002, to October 31, 2022, to obtain the relevant articles. Based on the search strategy, the titles of the studies were screened independently by two reviewers. Randomized controlled trials were included in the review, in which the study participants were given either dental floss or water flosser. Reduction in plaque scores was the outcome that was assessed. Seven articles met the eligibility criteria and were further processed for qualitative analysis.

Results

The majority of the studies favored water flossers over dental floss in plaque reduction. Water flosser was also found to be effective in removing plaque from inaccessible interproximal areas of the tooth surfaces as compared to dental floss.

Conclusion

Based on the scope of this review, results suggest that water flossers can be used as an effective alternative to dental floss in patients with manual dexterity, patients undergoing orthodontic treatment, and patients with dental prostheses.

Awareness about Importance of Clinical and Radiological Details for Histopathological Reporting among Practicing Oral Pathologists in Kerala, India

Introduction: Clinical history and examination, radiography and histopathology are the three pillars of accurate diagnosis. The decisive nature of histopathology reporting has made it the cornerstone of modern medical science, thus making it extremely important to render timely and well-elaborated reports with utmost diagnostic accuracy. Inadequate communication between the clinician/surgeon, radiologist and the histopathologist hampers the delivery of correct and complete diagnosis on time. Aim: To assess the awareness among practicing Oral pathologists from Kerala, India about importance of clinical and radiographic details for histopathological reporting. Materials and Methods: A population-based, cross-sectional questionnaire study was conducted from January 2022 to April 2022. Kerala was divided into four zones-North, South, East and West. An online questionnaire containing eight questions was devised and circulated among 75 practicing Oral Pathologist from each zone through digital messenger platforms or e-mail. Descriptive statistics (frequency and percentage) was calculated using Microsoft Excel 2020. Results: A total of 220 responses were received. Among the participants, 100 (45.5.%) stated that their clinician or surgeon did not provide them with adequate clinical and radiographic details. It was found that 140 (63.6%) participants opined that their clinicians or surgeons used to specify the clinical details and in 188 (85.5%) cases the surgeon or clinician mentioned the demographic data. Conclusion: It was concluded that there was a good awareness among practicing Oral Pathologists from Kerala, India, regarding the importance of clinical and radiographic details for histopathological reporting.

Salivary Aspartate Aminotransferase, Alanine Aminotransferase and IgA as biomarkers for Type I Diabetes Mellitus: A Systematic Review

Introduction:

Type I diabetes mellitus (T1DM) is an autoimmune disorder characterized by absolute insulin deficiency, which is caused by progressive destruction of the β-islet cells of the pancreas. Aminotransferases participate in the interconversion of amino acids and oxalic acids by transfer of amino groups. Organ damage leads to leakage of transaminases into the blood. IgA is the only immunoglobulin that is found in saliva and forms the first line of defense. Alteration in the levels of secretory IgA often indicates a local or systemic disease. The aim of this systematic review is to evaluate the role of salivary aspartate aminotransferase (AST), alanine aminotransferase (ALT), and IgA as biomarkers for T1DM patients.

Materials and Methods:

An electronic literature search was conducted by two independent reviewers using PubMed, Medline and Google scholar without any date filter. The inclusion criteria included case control and cross-sectional studies. Publications in languages other than English, review articles, letters to the editor, and studies done on animal models were excluded from the review. The difference in the levels of salivary AST, ALT, or IgA in T1DM patients and in healthy individuals were compared. Risk of bias assessment was done using the ROBINS-I tool.

Results:

A total of eight relevant articles were assessed, out of which three studies showed elevated salivary AST and ALT levels and five studies showed elevated salivary IgA levels in patients with T1DM.

Conclusion:

Our review reflected that salivary AST, ALT, and IgA were elevated in T1DM patients, and they can be used for monitoring these patients. Further studies are needed to establish the diagnostic accuracy of these parameters for clinical application.

Renal support in acute kidney injury

Acute kidney injury requiring renal replacement therapy (RRT) is associated with an unacceptably high mortality rate. Despite the identification of the modality, timing and intensity of dialysis, membrane biocompatibility, hollow fiber and catheter properties as potential modifying factors, there is little convincing evidence for the superiority of one over the other. However, the available data suggest that the early initiation of RRT may be beneficial. A focused review of clinical trials and meta-analysis of clinical trials of RRT is provided.

Eagle' syndrome. Anatomy of the styloid process

The observations made on the angulations and the length of styloid processes from a hundred skulls are presented. Morphometrical data compiled is correlated to those available in literature. The dimension and angularity of the process when in extreme is known to produce symptoms classified as Eagle's syndrome. This paper discusses the probable incidence of dysphagia due to predisposition of the elongated styloid process in Indian context. Most statistics on the metrics of the process are called from radiographic studies done in western centres. Osteometry of the styloid with reference to the risk factors in causation of the syndromes probably, presented in this paper for the first time in this part of the world. It is hoped that despite the rarity of the syndrome, this brief study will spur research into the osteological basis for the peculiar clinical condition.

Multibacillary nerve histology in clinically diagnosed borderline tuberculoid leprosy patients

The classification of leprosy into multibacillary (MB) and paucibacillary (PB) patients in almost all clinics is entirely dependent on clinical examination. In a study of 21 patients clinically classified as borderline tuberculoid (BT) and, therefore, belonging to the PB group, skin smears and skin and nerve biopsies were examined. Four patients did not have any histopathological evidence of leprosy. Skin smears showed that 1 patient was positive for acid-fast bacilli (AFB), 2 skin biopsies belonged to the borderline lepromatous (BL) category and showed AFB in their lesions, and AFB were present in 10 nerve biopsies classified as BL. It is possible that reported relapses among PB patients may be in those patients with demonstrable AFB in the lesions, including nerves. A careful follow-up study of this particular group of patients after PB multidrug therapy is suggested to resolve this question.