Efficacy of a Commercially Available Herbal Formulation for the Disinfection of Elastomeric Heavy Body Impression Materials

Introduction: Cross infection refers to the transfer of harmful microorganisms from one person to another. Dental impressions are considered semi-critical as it directly comes in contact with patient’s saliva and oral mucosa. Improper handling of these dental impressions can potentially have the risk of transmitting infections especially to the dentist. The role of herbal preparation in disinfecting the dental impressions is sparse in the literature. Aim: To evaluate and compare the disinfection ability of a commercially available herbal formulation (HiOra®) with chlorhexidine digluconate solution (0.2%) and 1% sodium hypochlorite on dental impressions made using condensation silicone. Materials and Methods: A cross-sectional study was conducted in Outpatient Department of Periodontology and Implantology at Sri Ramachandra Institute of Higher Education and Research, Chennai, Tamil Nadu, India, between June 2019 and November 2019. Sixty maxillary and mandibular dental impressions using condensation silicone material were obtained from 30 systemically healthy volunteers. The impressions were divided into three groups and were subjected to three antimicrobial agents for 10 minutes: 1% Sodium Hypochlorite (group I); 0.2% chlorhexidine digluconate (group II); HiOra® (group III), respectively. Following this, microbial culturing was performed to detect the presence of Streptococcal and Staphylococcus species in samples obtained both prior and after impression disinfection. One-way Analysis of Variance (ANOVA) was performed to assess the significance of the difference in microbial reduction between the groups. Results: Antimicrobial efficacy was similar against both Streptococcus spp., and Staphylococcus spp., for the three disinfectants tested. No statistically significant difference in the microbial colony count reduction between the three disinfectants tested was observed (Streptococcus spp, p-value=0.064, Staphylococcus spp., p-value=0.337). Conclusion: The herbal mouthwash was found to have an equivalent efficacy as chlorhexidine, sodium hypochlorite for disinfection of impressions made from condensation silicone.

An interdisciplinary approach to management of diastemas: A novel classification and a case report

Diastema between the teeth negatively affects the patients' smile, psychology and daily activities by creating a disharmony in the patients' face. The development of diastema has been attributed to several factors such as labial frenulum, microdontia, mesiodens, peg-shaped lateral incisors, agenesis, cysts, habits such as finger sucking, tongue thrusting, or lip sucking, dental malformations, genetics, proclinations, dental-skeletal discrepancies, and imperfect coalescence of interdental septum. Patients often present with complex problems that require a multidisciplinary treatment approach which includes determination of the aetiological factors, soft tissue morphology, occlusion, patient demands and aesthetic consideration to achieve satisfactory outcomes. Lack of current literature on classification of diastemas and multi-disciplinary approach of management led to the proposal of a new classification the ATAC (Anatomic and Therapeutic Classification) for management of the diastema. This case report highlights the use of the proposed classification for management of diastemas, requiring a perio-restorative intervention using a Chu's proportion gauge to achieve ideal aesthetics.

Clinical efficacy of amniotic membrane with biphasic calcium phosphate in guided tissue regeneration of intrabony defects- a randomized controlled clinical trial

BACKGROUND

The concept of periodontal regeneration has been revolutionised since the introduction of growth factors and bioactive bone substitutes which ensures optimal regeneration of the diseased periodontium. The aim of the present study was to evaluate the efficacy of Amniotic membrane + Biphasic Calcium phosphate as compared to Collagen membrane + Biphasic Calcium phosphate for the management of periodontal intrabony defects.

METHODS

50 systemically healthy patients with localised moderate to severe periodontitis, sites which had a Probing Pocket Depth (PPD) ≥ 6 mm and an intrabony component of ≥ 3 mm as detected on Intra oral periapical radiographs (IOPAR) and bone sounding were recruited based on specific inclusion and exclusion criteria. They were randomly allocated by computer generated tables to Collagen membrane + Biphasic Calcium phosphate and Amniotic membrane + Biphasic Calcium phosphate groups. The amount of bone fill and changes in Probing Pocket Depth, Clinical Attachment Level were measured at baseline and six months.

RESULTS

The results of the present study showed a mean reduction in the PPD of 2.89 ± 0.69 mm in the Collagen membrane + Biphasic Calcium phosphate group and 2.95 ± 0.57 mm in the Amniotic membrane + Biphasic Calcium phosphate group and CAL gain of 2.60 ± 1.43 mm in Collagen membrane + Biphasic Calcium phosphate group 3.18 ± 1.13 mm in the Amniotic membrane + Biphasic Calcium phosphate group at 6 months follow-up with no statistical significance between the groups. In terms of Defect resolution, 98.62 ± 6.51 % was achieved in Collagen membrane + Biphasic Calcium phosphate group and 98.25 ± 7.21 % in Amniotic membrane + Biphasic Calcium phosphate group.

CONCLUSIONS

Within the limitations of the present study, it can be concluded that AM can be used as a barrier membrane, in conjunction with Biphasic calcium phosphate, and provides comparable results to Collagen membrane with Biphasic calcium phosphate when used in the management of periodontal intrabony defects.

The effect of fennel seeds on pH of saliva - A clinical study

Context

Saliva is an oral fluid that gives a protective effect against dental caries. Chewing of fennel seeds after food is a common culture in the Indian Sub-continent. A review of previous studies on fennel seeds showed that some of them have an anti-microbial efficacy, but there are no extensive data available on the effect of chewing fennel seeds on the pH of saliva.

Aim

The aim of the study was to record the baseline pH of saliva and to record the changes in salivary pH after chewing fennel seeds.

Setting and Design

The study was carried out in the Department of Public Health Dentistry, Sri Ramachandra University, Chennai, prior to which a pilot study was carried out.

Subjects and Methods

Voluntary enrolment of 30 individuals was done. A written and informed consent was obtained from the individuals prior to the study. The pH of the saliva was recorded by placing the standardized salivary strip below the tongue in the oral cavity and colour changes were matched with the pH scale colour chart within about 15 sec. The subjects were asked to chew fennel seeds for 5 min. Salivary pH was measured immediately after chewing (SP2) at 0 min and the experiment was repeated for 5 min (SP3), 10 min (SP4), 15 min (SP5) and 30 min (SP6).

Statistical Analysis

The data was gathered and analysed using paired t test.

Results

There was an increase in salivary pH from baseline (SP1) to 0 min (SP2) was found to be highly significant (P = 0.000). The mean salivary pH reduced to 7.64 ± 0.06, 5 min after chewing the seeds (SP3) and the drop in pH was found to be highly significant (P = 0.000). The subsequent drop in pH from 10 min (SP4), 7.50 ± 0.05 to 15 min (SP4), 7.38 ± 0.05 to 30 min (SP4), 7.24 ± 0.05 were found to be highly significant as well (P = 0.000).

Conclusion

Chewing of fennel seeds increases the pH of saliva, thus making it a suitable anti-cariogenic agent.