International Journal of Medical Science and Dental Research

Volume 7 Issue 3 (May-June 2024)

    • Classifications of Gingival Recession- A Review
      Abstract:
      Gingival recession is defined as “displacement of marginal tissue apical to the Cementoenamel junction(CEJ) [1].Various classification has been proposed to classify gingival recession Classification of gingival recession is an important factor for correct understanding and determining of diagnosis, prognosis, and treatment planning for root coverage of the exposed root surface. Recent evidence has raised many questions on the use of currently popular classification system[2].The purpose of this systemic review is to assess various classification systems in the light of the current scientific literature[2].The occurrence and severity of the gingival recession present considerable differences between populations[3] . To prevent gingival recessions from from occuring, it is essential to detect the underlying etiology[3] This is fairly common clinical condition, research indicates it present in at least one or more tooth surfaces in 23% of U.S adults between 30 to 90 years of age . This paper reviews various causes and classification based on their clinical presentation. The prevalence, extent, severity of gingival recession increase with age, and this condition is more prevalent among males. The severity of recession is determined by the actual position of the gingiva and not by its apparent position From 1985 to till date, Miller's classification system is the most frequently used and popular classification system[2].This paper reviews etiology, classification and conclusion.





    • “Assessing the Influence of Glycated Hemoglobin levels on Periodontal Status of Diabetic Patients- A Clinical and Radiographic Study”
      ABSTRACT: OBJECTIVES: To evaluate theinfluence of glycated hemoglobin levelson the periodontal status of diabetic patients by assessing clinical parameters and radiographic bone loss.
      METHODOLOGY: A total of 30diabetic patients were selected. Patients were divided into three groups,Group1: 10systemically healthy patients withperiodontitis,Group2:10 adequately-controlled diabetic subjects with HbA1c<7 %, and Group3:10 inadequately-controlled diabetic subjects with HbA1c>7%.Clinicalparameters [Plaqueindex, Gingival index, and Probing Pocketdepth] and radiographic bone loss were assessed.
      RESULT: The averageplaque index and gingival index score were higher in the chronic periodontitis group, while AT2D and IT2D had no significant difference whereas Probing pocket depth and bone loss considering the number of sites was higher in systemically healthy chronic periodontitis patients compared to diabetic groups, whereas between two diabetic groups, AT2D had slightly more average scores than IT2D.
      CONCLUSION The analysis between the two diabetic groups states that there is no significant difference in average pocket depth and bone loss, proving that an increase in levels of HbA1C alone is not a determining factor in assessing the periodontal status.

      Keywords: Alveolar bone loss ,Chronic periodontitis, Diabetes mellitus, Glycated Hemoglobin, Probing pocket depth.



    • Historical Aspects of Congenital Inguinal Hernia in Children
      Abstract
      Congenital inguinal hernia is one of the most common surgical conditions in infants and one of the most discussed topics in pediatric surgery. Despite numerous descriptions in the literature on the subject of inguinal hernias, the main principle of treatment in infants and children has been insufficiently considered, with most descriptions devoted to inguinal hernias in adults. We present the first methods of resolving inguinal hernias in children that underlie contemporary treatment.

      Keywords: inguinal hernia in children



    • Effects of Delayed Spinal Anaesthesia Induction after Preloading on the Maternal Blood Pressure During Caesarean Deliveries
      Abstract: Background: Unreported cases of severe hypotension and cardiac arrest had occurred in a few patients in our centre. This severe hypotension was traceable to delayed induction of spinal anaesthesia for more than one hour after crystalloid prealoding has been administered.
      Objectives:The study tested the hypothesis that hypotension during spinal anaesthesia becomes more severe when surgery and anesthesia are delayed for an hour after initial administration of crystalloid preloading during spinal anaesthesia for caesarean section.
      Methods:All the 100 parturients received 15ml/kg crystalloid preload within 15 minutes before induction of spinal anaesthesia, immediately parturients in group N (n=50) had spinal anaesthesia and10 ml/kg normal saline infusion within 15 minutes following induction of subarachnoid block. Parturients in group D (n=50) had their induction of spinal anaesthesia deliberately delayed by one hour after crystalloid preloading had been administered, they also received 10 ml/kg normal saline infusion within 15 minutes following induction of subarachnoid block. Maternal haemodynamics, total rescue fluid and ephedrine used were documented.
      Results:AT 25th minute a significant amount of patients (45/90% versus 9/18%) in group D had hypotension compared to patients in group N, the difference was statistically significant (P<0.001). Total average rescue dose of fluid administered to manage hypotension was significantly higher in patients in group D than the one administered to patients in group N. The mean total dose of ephedrine that was consumed is significantly higher in parturients in group D (16.4±1.8 mg) than in patients in group N (5.0±1.9 mg).
      Conclusion:This study showed that incidence of hypotension during spinal anaesthesia becomes more severe when surgery and anesthesia are postponed for one hour after initial administration of crystalloid preloading during spinal anaesthesia for caesearian section.

      Keywords: spinal anaesthesia, preload, coload, hypotension



    • Minimally Invasive Management of Enamel Hypoplaisa- A Case Report
      Abstract: Introduction: Enamel hypoplasia is a deviation in enamel development resulting from disruptions in the amelogenesis process. Manifesting clinically as either diminished enamel thickness or complete absence, this condition presents with a surface that may exhibit a white, yellow, or brownish hue, along with a textured appearance such as roughness or pitting. Bilaterally observed, it frequently occurs in the central third region of the crown, with the severity of the defect directly correlating with its size (both in depth and extent). The approach to manage enamel hypoplasia is determined by the extent of it’s severity.

      Objective: To delineate the characteristics and address the treatment of a case involving enamel hypoplasia leading to aesthetic concerns.

      Case Report: A 21-year-old male presented to the Conservative Dentistry Department at Yenepoya Dental College, expressing dissatisfaction with the esthetics of his upper anterior jaw region. Clinical examination revealed brown lesions and irregularly formed enamel on the labial surface of the maxillary anterior teeth. The diagnosis established was enamel hypoplasia type III (as per Silberman et al.), and the proposed treatment plan involves restoration using a composite resin.

      Conclusion: Enamel hypoplasia is amenable to a minimally invasive approach through direct restoration using composite resin. This procedure aims to restore the natural color and appearance of the affected teeth.

      Keywords: Enamel Hypoplasia, Minimally invasive ,Composite, Build up,Esthetics



    • Experience of Periodontics Counter-Referrals Through the Continuity of Care Platform (8 Months)
      Abstract: The Continuity of Care Platform (PCA) was created as part of the commitment by High Public Management (ADP). The PCA has evolved through various clinical meetings between Primary Health Care (APS) specialists from the Metropolitan South Health Service (SSMS) and secondary level specialists, aiming to reduce re-hospitalization rates due to complications of chronic diseases in prioritized users listed in the PCA Manual. Additionally, the PCA is integrated with the electronic record Tracker®; since January 1, 2023, counter-referrals from the secondary level (Barros Luco Assistance Complex) to APS have been actively coordinated. Before the implementation of the PCA, the completion rate of follow-ups for counter-referrals was 40% in epicrisis.

      Keywords: Health Information Interoperability, Public Health Informatics, Continuity of Patient Care, Electronic Health Records, Periodontics



    • TOXICITY TESTING OF CINNAMON BARK (Cinnamomi burmannii Cortex) ESSENTIAL OIL AS A MOUTHWASH ON FIBROBLAST CELL CULTURE
      Abstract: Essential oils are the active ingredient found in cinnamon which has the main ingredient of cinnamaldehyde. Previous research has revealed that cinnamon essential oils with a certain concentration have antibacterial and antifungal effects. In addition, cinnamon essential oil has been shown to have benefits as an anti-inflammatory and analgesic. With its variety of benefits, cinnamon essential oil has the potential as a mouthwash ingredient. However, to be used as a mouthwash ingredient, it needs to go through a toxicity test first. Purpose: To determine the toxicity concentration of Essential oils of Cinnamomiburmannii Cortex on fibroblast cells. Methods: This research was an experimental laboratory research using Post Test Only Control Group design. The research treatment used the administration of essential oils of Cinnamomiburmannii Cortex with 0.5%, 0.25%, 0.125%, 0.0625%, and 0.0312% concentration on fibroblast cells with 6 replications. Results: The fibroblast cell life percentage in 0.5%, 0.25%, 0.125%, 0.0625%, and 0.0312% concentrations respectively were 51%, 57%, 61% 69%, and 80%. The toxicity results were obtained using the MTT assay technique after 24 hours. The optical density absorbency values were read by an ELISA reader and represent life cell viability. Conclusion: Essential oils of Cinnamomiburmannii Cortex have no toxicity for fibroblast cells to a concentration of 0.5%.

      Keywords: Cytotoxicity, Cinnamomi burmannii Cortex, fibroblast cells, Mouthwash



    • Evaluation of Serum and GCF Calcium Levels in Healthy and Periodontal Disease Patients: A Clinico-Biochemical Study
      Abstract: Introduction:The elemental analysis of human blood serum and GCF is noteworthy in routine clinical practice as well as in medical research. Gingival Crevicular Fluid (GCF) and blood serum have been referred to as a promising medium for the detection of markers for periodontal disease activity. Analysis of GCF, blood serum shows minute changes in biomarker levels well before the onset of clinical signs and symptoms;which helps to even predict a person’s predisposition towards periodontal disease occurrence.

      Aim:The aim of this study was to evaluate the correlation between Serum and GCF Calcium levels in Healthy and Periodontal disease patients.

      Materials &Methods:The present study was conducted to evaluate the Serum and GCF Calcium levels in 24 sampleswith age groups of 25-60 years including males and females, which were divided into two groups of 12 each. Group I-Control-Healthy, Group II-Experimental -Chronic Periodontitis. All subjects underwent for clinical examination including Plaque Index, Gingival Index, Gingival Bleeding Index, Probing Pocket Depth, and Clinical Attachment Level using a UNC 15 Probe. Blood and GCF samples were collected from each patient and Serum and GCF Calcium levels were estimated.

      Results:All samples were screened for the levels of Serum and GCF Calcium from both groups. The experimental chronic periodontitis group showed a mean of 6.25mg/dl Serum Calcium and 6.01mg/dl GCF Calcium levels respectively, while the healthy group showed a mean of 8.97 mg/dl Serum Calcium and 9.00 mg/dl GCF Calcium levels respectively.The Serum and GCF Calcium levels were highly significant in healthy subjects compared to chronic periodontitis patients, P<0.01, respectively.

      Conclusion:This study concludes that there is a decrease in Serum and GCF Calcium levels in periodontitis patients.Serum and GCF Calcium levels may be a useful tool to assess the periodontal host response and disease progression.

      Keywords: Serum Calcium, GCF Calcium, Periodontitis, Healthy patients