Background: Pain perception is a complex sensory experience which is perceived by different individuals in different manners. The pain perceived by the patient after periodontal surgery may vary based on different parameters. Aim: This observational study was conducted to evaluate the perception of pain after periodontal therapies. Materials and Methods: A total of 63 surgeries were carried out in 50 patients and the surgeries were divided into three categories: open flap debridement, resective and regenerative surgeries, and periodontal plastic surgeries. The pain experienced by the patient was recorded on the visual analog scale that ranged from 0 to 10. Results: The mean VAS score for different periodontal surgeries was 2.49. The study showed highest mean VAS in open flap debridement (2.74) followed by periodontal plastic surgery (2.5) and the lowest in resective and regenerative procedures (2.13). Among various variables such as age, sex, periodontal dressing, arch, amount of local anaesthesia and time duration, the data showed statistical difference between VAS score and sex (p = 0.04) and between VAS score and amount of local anaesthesia (p = 0.012). Conclusion: The study showed there is low pain perception after different periodontal surgeries as measured by VAS. Proper understanding of the variables that affect pain is important as they may produce emotional responses that could influence compliance and the therapy result. Inadvertent use of large dose of anaesthetics beforehand assuming high anticipation of pain should be discouraged as the increase in volume relates to increased pain.
Introduction: Different bracket systems are available in the market claiming to have some advantage over the other. Conventional brackets and the self-ligating brackets are the most common. Though both the systems work basically similarly, the difference between the two system is principally in the ligating technique. The advantage of conventional brackets claimed are faster tooth movements and improved oral health of the patient. Materials & Method: A total number of 20 patients were shorted from the waiting list meeting the selection criteria. With the help of random number generator, two groups with 10 subjects each were created for conventional brackets (0.022 Slot MBT brackets) and self-ligating brackets (0.022 Slot DAMON prescription) respectively. The patients were blinded regarding the selection of the brackets. The brackets were bonded according to the random number allocation. After the bonding, the periodontal parameters i.e. gingival index (GI), plaque Index (PI) were measured again at an interval of 60 (T1) and 120 days (T2). Periodontal indices were calculated by summing the mean score of each examined tooth and dividing by the number of the evaluated teeth. Data collection was done with the help of a periodontal probe. All the records were taken by the same periodontist to avoid inter-examiner variability. To reassure that there is no any intra-examiner variation for periodontal status, the same periodontist re-measured the periodontal parameters again of 10 individuals selected randomly after 7 days from the initial measurements. To examine the intra-examination variability, Dahlberg’s formula was used between the two readings taken at a span of 7 days of the same subjects. The mean value of Plaque index and Gingival index was checked for normal distribution applying Kolmogorov- Smirnov test. One-way ANOVA test was applied for comparison between and within groups for plaque index and Gingival index during three different period in Conventional brackets and Self-ligating brackets. Post hoc Bonferroni test was applied for multiple comparison. Independent t-test was applied for comparison between conventional brackets and self-ligating brackets to compare the plaque index and gingival index. All data were test were analyzed at P<0.05. Result: There was no any significant difference between T0 and T1 and between T1 and T2 in both the conventional brackets and self-ligating brackets. However, there was statistical difference between the time period from T0 to T2. There was also no any significant difference between conventional bracket and self-ligating brackets in terms of plaque index and gingival index. Conclusion: There are no advantages of self-ligating brackets over conventional brackets in terms of periodontal status.
An increase in size of gingiva is a common clinical condition termed as gingival overgrowth. The definite aetiology is unknown. It is classified on the basis of aetiologic factors and pathologic changes. Both localised and generalised overgrowth are encountered commonly and patients are aesthetically, socially, psychologically and functionally disturbed until they revert back to the original contour. Localised gingival enlargement frequently is inflammatory and can also be associated with systemic diseases/condition (hormonal, nutritional, allergic, nonspecific conditioned) or neoplasic and sometimes false enlargement. DIGO is a well documented side effect with the use of anticonvulsant, immunosuppressant, and calcium channel blockers. Total 3% to 84.5% of subjects taking these drugs seem to have significant enlargement. Localised overgrowth are managed by proper diagnosis followed by controlling inflammation and other causative factors before surgical excision. DIGO is managed by drug replacement and surgical excision if required after nonsurgical treatment. Gingivoplasty of gingival margin is necessary to create self-cleansing and aesthetic architecture.
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