Background:The purpose of this 2-year prospective survival analysis study is to determine a statistically validated periodontal prognostic score for diseased molars in smokers using the Miller-McEntire Periodontal Prognostic Index (MMPPI).Materials and Methods:Two hundred molars were evaluated from 25 patients who were smokers with moderate-to-severe chronic periodontitis. The factors evaluated included age, probing depth, mobility, furcation involvement, smoking, and molar type. A modified, 5 level, scoring criterion for smoking based on smoking-dose was adopted. MMPPI was computed as the sum of scores for all six prognostic factors. Appropriate periodontal treatment and supportive periodontal therapy were provided. All patients were evaluated at baseline and 2 years posttreatment. Hazard risk ratio (HR) was computed for each prognostic factor.Results:A total of 3 (1.5%) teeth of the 200 molars were extracted over the 2-year follow-up duration, with a mean of 0.015 teeth lost. The HR was found as significantly higher for three individual prognostic factors: mobility (HR = 5.57, P = 0.02), smoking (HR = 3.35, P = 0.04), and furcation involvement (HR = 7.30, P = 0.01). Significant and positive HR (HR = 1.70, P = 0.01) was noted for the total MMPPI score, validating its prognostic value for molar survival at 2 years prospectively.Conclusions:The findings of the current study demonstrate the prognostic validity of MMPPI incorporating a more detailed smoking score criterion. The factors smoking, furcation involvement, and mobility significantly impacted the likelihood of survival of periodontally diseased molars. Further studies with a larger sample size and longer follow-up are required to confirm these findings.
Aim and Objective:The aim of this study was to prospectively determine and establish the periodontal prognosis of diseased molars in diabetic patients using the Miller–McEntire Periodontal Prognostic Index (MMPPI) with an additional criterion for diabetes (changes in glycosylated hemoglobin levels), at 2-year postperiodontal therapy.Materials and Methods:A sample of 200 molars in 25 patients with diabetes mellitus (DM) and chronic periodontitis were evaluated. The prognostic parameters evaluated include age, probing depth (PD), mobility, furcation involvement, diabetes, and molar type. The total score calculated from all parameters was used considered prognosis score for each molar. All patients were evaluated at baseline and 2-year posttreatment.Results:The results of this study suggest that following prognostic factors, DM (hazard ratio [HR] =5.2), age (HR = 0.4), and molar type (HR = 0.6) were clinically significant at the end of the 2-year posttherapy from baseline. A total of 4 (2%) teeth were extracted from the 200 teeth with a mean of 0.02 for the tooth lost during 2-year posttreatment. Significant improvements (P < 0.05) in the frequency PD, furcation, and mobility scores were noted at 2 years.Conclusions:These findings demonstrate that score for DM as prognostic criterion is a valid addition to MMPPI. The factors such as DM, age, and molar type can impact the prognosis of molar survival. Studies with a larger sample size and longer follow-up are required to affirm the findings of this preliminary study.
Background: Oral cancer mainly affects individuals in the 6 th and 7 th decades of life with a history of risk factors like, smoking, tobacco chewing and alcohol consump tion. Early recognition and referral is essential for higher cure rates and better quality of life. Nursing staff provides the oral health care for patients in hospital. Admission to hospital provides a ''window of opportunity'' for oral cancer screening via an oral health checkup during nursing care. Objective: To measure awareness of risk factors, clinical signs and screening service for oral cancer among nursing students. Materials and Methods: A cross-sectional questionnaire survey was conducted in two Nursing Colleges of Davangere city. The questionnaire consisted of 17 closed ended questions. The questionnaire was pre-tested and validated before administering. Results: Among 300 nursing students, 231 were females and 69 were males. Over 90% thought oral health checkups were important although only 69% performed oral examination regularly; approximately 90% identifi ed smoking and use of tobacco products as a risk factor but very few identifi ed other associated factors like alcohol. Only 55% of the respondents were aware about the most common site of occurrence of oral cancer. Only 49% recognized a non healing ulcer as a sign of oral cancer. Over 90% of the students felt that a nursing student needs more education about screening for oral cancer and were willing to participate in a network to promote early screening for oral cancer. Conclusion: This study revealed that nurses' awareness of oral cancer risk factors and clinical signs, in the group under study was, however, poor. This study highlights a need for improved education of nurses on oral cancer to make the oral health checkup on admission viable for oral cancer screening.
Fetal intracranial calcification (ICC) noted during antenatal imaging poses a diagnostic challenge. Although this presentation is most commonly associated with intrauterine infection, non-infectious causes of fetal ICC have been reported and include metabolic, genetic, or hemodynamic conditions. We report on a patient with antenatally detected extensive ICC, in whom postnatal imaging revealed a distinctive band-like ICC with abnormal gyral pattern and a negative serology for TORCH infections. Such a constellation of findings have been previously described under the terminology of "pseudo-TORCH phenotype," and we posit that our patient represents this entity. Our patient had unreported dysmorphic features, which expands the phenotypic spectrum of this recently described heterogenous condition. In addition we report on the progression of the phenotype both clinically and radiologically. In view of the limited information available for the differential diagnosis of fetal ICC, we also review the available literature on this topic.
Aim: The aim of the present study was to assess the knowledge and practice of, and attitudes toward, pulp therapy in deciduous dentition among pediatric dentists. Methods:A cross-sectional, observational survey was conducted using a closedended, multiple-choice questionnaire evaluating the knowledge and practice of, and attitudes toward, pulp therapy in deciduous dentition, which was formulated and sent to 360 pediatric dentists across India. Descriptive statistics were done, followed by χ 2 -test to test the association between years of experience and the questionnaire items.Results: A total of 3.5% of pediatric dentists performed their treatment using a rubber dam in all cases; 30% preferred to use local anesthesia prior to indirect pulp therapy (IPT). Traditional indirect pulp capping was preferred to IPT, and only 48% of them believed in not removing it completely. Pulpotomy was preferred over IPT (70%) when there was a probability of pulp exposure following complete caries excavation. Calcium hydroxide, along with iodoform, was the material of choice for the obturation of primary teeth (73.5%). A stainless steel crown was placed after pulp therapy in the primary tooth (86.3%). Most dentists believed requested immediate and 3-month follow up. Conclusion:The survey helps in assessing whether our views or approaches are in line with recent trends. K E Y W O R D Sindirect pulp capping, primary teeth, pulp therapy, pulpectomy, pulpotomy
Introduction:The proposed new index by Dr. Frencken: Caries Assessment Spectrum and Treatment (CAST) Index. It addresses the assessment of clinical stages of carious lesion progression in enamel, dentine, pulp and cavity restored under 9 codes. Content validity as a part of psychometric testing was conducted by Frencken in Brazil, which included 15 countries and India was not included. Hence, the aim of this study was to assess the face and content validity of CAST Index in India. Materials and Methods: Face and content validity of CAST Index was conducted amongst dentists with post-graduate degree qualification (Conservative and Endodontics, Pediatric Dentistry, Public Health Dentistry and Oral Medicine and Radiology) in India. The proforma for content and face validation containing the description of the index along with the original article was given in person to 20 Subject Matter Experts (SME's) through convenience sampling. Results: The SME's concluded that face validity of CAST Index seemed to be a reasonable way of recording dental caries, and it was feasible and appropriate with certain modifications to use in the Indian population. The content validity ratio of all the codes of CAST Index showed that the "ACCEPTABLE" codes were 0, 2, 3, 5, 6, 7 and 8. Conclusion:The CAST Index could be used for epidemiological surveys in India but with a few modifications of the original index. Furthermore, its application can be justified due to a varied population with different socio-economic and cultural backgrounds in India and it also covers the entire spectrum of dental caries.
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