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Aim: This study compares and evaluates the efficacy of ozonated water irrigation (OZI) and powered toothbrushing on the oral health and microbial status of mentally challenged individuals. Materials and Methods: Thirty individuals of age range 15–30 years with a mild-to-moderate level of mental retardation (MR) and gingival inflammation participated in this double-blind randomized controlled clinical trial. Total duration of the study was 45 days consisting of two clinical phases (phase I, i.e., aided) and phase II, i.e. unaided) of the duration of 21 days in each phase, with a washout period of 3 days between the two phases. With a split-mouth design, sites from each subject were randomly allocated into two treatment groups: Powered Toothbrushing (PB) and OZI were randomly done for each half side of the mouth of each subject. Subgingival plaque samples were collected from sites of both the treatment groups and sent for microbial analysis. Clinical and microbial parameters were measured before and after the treatment. Results: Significant improvement of the clinical and microbial parameters was found in both treatment groups. However, intergroup differences in the parameters were statistically nonsignificant. Conclusion: OZI could serve as an alternative or adjunct to powered toothbrushes for people with MR.

Over the past 30 years, research has validated the success of osseointegrated implants as a viable alternative to fixed or removable prosthetic restorations. Placement of endosseous implants has become an option in comprehensive periodontal treatment plans for both fully and partially edentulous patients.' In the late 1970s, Branemark established the use of extensive surgical flaps to visualize the surgical field during implant surgery. According to this protocol, an incision in the mucosa or the mucobuccal fold was made, and then a flap was reflected to expose the underlying bone. The implants were then placed and the flaps repositioned with sutures.' Since the beginning of impIantology, the technique has been gradually modified and refined to the one or two stage procedures most frequently used today. Despite these modifications, the surgical process has remained remar~ably constant. Initial bone loss seems to be caused by interrupted blood supply that follows removal ofthe periosteum.'

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