Techniques to Guide the Mandible to Centric Relation- A Systematic Review

Introduction: Centric Relation (CR) is the only physiological position which is repeatable, recordable and reproducible for prosthodontic rehabilitation. A missed CR can give rise to faulty occlusal relationships leading to a life time of trauma to the temporomandibular joints. Literature has various methods outlined to locate and record the CR but it’s confusing as to which method is best suited to take the condyles into CR position. Hence, this systematic review was conducted to find an answer to this very question. Aim: To find a reliable clinical technique to guide the mandible to a recordable, repeatable and reproducible CR position. Materials and Methods: The present systematic review was conducted from July 2019 to October 2019 at School of Dental Sciences, KIMSDU, Maharashtra. A 20-year comprehensive literature review was undertaken aiming to arrive at a reliable and repeatable method to guide the mandible to CR following the Preferred Reporting Items for Systematic Reviews and Meta Analyses (PRISMA) and Patient Intervention Comparison Outcome (PICO) guidelines to the highest possible extent. The research material was sifted through MEDLINE (PubMed)- {(“CR technique”) (MeSH terms) AND/OR (Retruded mandibular position”) (MeSH terms)}, Cochrane library “CR techniques” and Google Scholar “CR techniques OR Retruded mandibular position” search engines. Cochrane collaboration tool was used to assess the risk of bias for the Randomised Controlled Trial, Methodological I index for non RCTs (MINOR). Quality and strength of the existing evidence was appraised by both the authors through Grading of Recommendations Assessment, Development and Evaluation (GRADE) system. Results: Online database search was conducted from January 1998 to September 2019 resulting in a total of 950 articles being shortlisted. Post-screenings, using the exclusion criteria, nine articles of the total articles were reviewed. These were reviewed individually by both the authors and discussed for various techniques to guide the mandible to CR. The ultimate outcome of the review was that the clinicians are required to fall back on time tested models, scientifically sound and technically correct and uncomplicated to execute methods which have proven to yield the most excellent outcomes at zero or minimal cost. One such method is undoubtedly Dawson’s Bimanual Technique. Bimanual technique in supine position coupled with a simple anterior deprogrammer has consistently resulted in a physiological CR position that is recordable, repeatable and reproducible. Conclusion: The primary outcome of this systematic review is that Dawson’s bimanual manipulation technique is superior to other techniques; primarily when carried out in supine position.

Evaluation of the Efficacy of G32 (Commercially Available Ayurvedic Preparation) in Reducing Halitosis - A Randomized Controlled Trial

INTRODUCTION

Oral malodour is a social malady affecting people of all the age groups. Effective management of oral malodour is the key to improve the quality of life of such people.

AIM

To evaluate the effectiveness of ayurvedic medication, G32 in controlling oral malodour and comparing the effects with Chlorhexidine (CHX).

MATERIALS AND METHODS

This was a single blind randomized controlled trial with parallel study design conducted at a hospital in the city of Udupi in Southern India. A total of 40 patients suffering with oral malodour, aged 17-35 years, were included in this trial. After inclusion into the study, the subjects were examined twice, with a one-week interval between both examinations. Volatile Sulphur Compounds (VSCs), gingival, plaque and tongue coating scores were assessed at both examinations. Subjects were randomly allocated to G32 group - ayurvedic formulation (intervention group) and CHX group (control group), and were provided with the respective formulations enough to be used twice daily for a period of one week. The difference between the mean scores of VSCs, plaque, and gingivitis and tongue coating were compared within the intervention and control groups, respectively, using paired t-test.

RESULTS

Both test and control groups showed a significant reduction in VSCs, plaque and gingivitis levels. The percentage reductions in VSCs, plaque and gingivitis were found to be similar among the two groups. There was no significant difference between the preintervention and postintervention scores in both the groups.

CONCLUSION

G32, an ayurvedic medication, can be an effective tool to deal with oral malodour.

Personality and psychological factors: effects on dental beliefs

BACKGROUND

Dental treatment can be highly unpleasant for anxious patients. Despite all advancements, dental anxiety continues to upset the dentist-patient relationship. The psychological factors like individual personality and familial and peer influence may alter the dental beliefs of a patient.

AIM

A cross-sectional questionnaire study was conducted among young adolescents to investigate the relationship among various psychological factors and the dental beliefs of an individual.

MATERIALS AND METHODS

A self-administered questionnaire was distributed among higher secondary school children, aged 15-17 years in Udupi district. The dental anxiety of the participants was measured using Modified Dental Beliefs scale and the personality traits were assessed using the Ten-Item Personality Inventory. Pearson's correlation and chi-square analysis were performed among these scales. Independent t-test was performed to compare dental anxiety scores with different socio-demographic and psychological characteristics.

RESULTS

In all 198 students, with a mean age of 16.6 years, completed the questionnaire. A majority of the participants had lower MDBS scores. The personality traits like Emotional Stability and Openness to New Experiences showed a negative correlation with the Dental Belief scores. Apart from these, the experience at first dental visit and peer support also affected the dental beliefs of the adolescents.

CONCLUSION

Various psychological traits of adolescents influence their dental anxiety.

Dental practitioners self reported performance of tobacco cessation counseling interventions: a cross sectional study

BACKGROUND

The objective of the study was to determine the knowledge, attitude and behaviors of the practicing dentists regarding tobacco cessation counseling (TCC) in Chhattisgarh state and also the barriers that prevent them from doing so.

MATERIALS AND METHODS

The study was conducted among dental practitioners of Raipur district, Chhattisgarh state (India). The sampling frame was registration with the State Dental Council and practicing in Raipur district. A questionnaire was personally administered and the practitioners were given explanations regarding how to complete it. Only descriptive statistics were calculated (SPSS version 16 for Windows).

RESULTS

Based on the responding dentists' self reports, 76% were not confident in TCC, 48% did not assume TCC to be their responsibility, 17% considered that it might have a negative impact on their clinical practice, whereas 24% considered it might take away precious time from their practice, 25% considered TCC by dentists to be effective to a considerable extent and 80% considered TCC activities are not effective due to lack of formal training, 69% considered dental clinics as an appropriate place for TCC but 82% thought there must be separate TCC centre and 100% of the dentists wanted TCC training to be a part of practice and that it should be included in dental curriculum. Some 95% of them were of the view that tobacco products should be banned in India and 86% responded that health professionals must refrain from tobacco habits so to act as role models for society.

CONCLUSIONS

Dental professionals must expand their armamentarium to include TCC strategies in their clinical practice. The dental institutions should include TCC in the curriculum and the dental professionals at the primary and the community health care level should also be trained in TCC to treat tobacco dependence.

Studies of coagulation and platelet functions in heparin-free hemodialysis

Hematologic and coagulation studies were carried out during 12 heparin-free hemodialysis in 9 maintenance hemodialysis patients. Treatment employed a C-DAK 4000 cellulose acetate membrane hemodialyzer. Both hemodialyzer and blood tubing were periodically flushed with physiologic saline. No significant clotting of the hemodialyzers was encountered in uneventful dialyses. Platelet counts, platelet aggregation with ADP and epinephrine, antithrombin III and fibrinogen/fibrin degradation products were not significantly changed compared with pre-dialysis values. Fibrino-peptide A levels, elevated pre-treatment, demonstrated additional rise during dialysis. These findings support clinical experience that this anticoagulation-free method can be used safely and effectively to dialyze patients at risk for bleeding.