Backgrounds Oral submucous fibrosis (OSMF) is a chronic, insidious disease and is said to have a ... more Backgrounds Oral submucous fibrosis (OSMF) is a chronic, insidious disease and is said to have a multifactorial origin with varied clinical manifestation of repeated oral ulcers, intolerance to spicy food, mucosal blanching resulting in stiffness of the oral mucosa and formation of taut bands leading to reduced mouth opening. We designed this study to systematically review the literature on QOL in OSMF and hope to make recommendations for future course of QOL assessment in OSMF. Methods An electronic bibliographic search of studies was done from year 1900–2019 using specified keywords. The following databases were searched: PubMed, Ovid, Google Scholar and manual search were done from references of relevant articles. Of the screened 156 articles, finally 10 studies were included after screening for inclusion/exclusion criteria. Quality assessment of studies was completed using the Effective Public Health Practice Project (EPHPP) criteria for quantitative studies. Results Most instruments used in the studies were not disease specific for OSMF except one study. Six types of questionnaires were used. The heterogeneity in study population, study designs, QOL instruments and outcome measures made it difficult for a comparison. Therefore, a quantification analysis was not possible. Also pure OSMF data without the involvement of other lesions were less in number. Conclusions OSMF not only physically debilitates a patient, it has its repercussions on the social, physical, psychological domains as well. Another aspect is that apart from trismus, which is the most common and evident symptom associated with OSMF, a substantial part of the suffering that ensues is also because of the ulcerations, burning sensation and worsening of dental health. Another focus was the association of worse QOL with a higher grade of disease, longer and higher tobacco abuse contact duration. This review is unable to give a confident answer to the evidence on QOL in OSMF but definitely showers light on the evident lack of robust data on the same. Robust Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation methodological and adequately powered studies on assessing QOL in OSMF using only a reliable disease specific questionnaire is the need of the hour. Clinical Trial Registration PROSPERO Registration: CRD42018102874.
Analysing Level of Evidence (LOE) provides an insight to evidence-based medicine (EBM). The aim o... more Analysing Level of Evidence (LOE) provides an insight to evidence-based medicine (EBM). The aim of our study was to evaluate and analyse trends in Levels of Evidence (LOE) in Journal of Maxillofacial and Oral Surgery (MAOS) since inception, i.e. December 2009 along with categorization into subtopics. LOE for each article was determined according to modified American Society of Plastic Surgeons (ASPS) scale and National Health and Medical Research Council (NHMRC) Evidence Hierarchy. A total of 1264 articles were included in the final analysis, out of which high-quality evidence (Level A) accounted for 7% of the journal. The percentage of Level I/II (Level A) has increased from 2.09% in 2009/2010 to 12.74% in 2019/2020, representing a promising trend toward higher-quality research in just 10 years. Case reports and narrative reviews with Level of Evidence value “D” account the highest number (36%) of all the published articles. The majority of articles fell under Class 2 (Maxillofacia...
Oral and Maxillofacial Surgery for the Clinician, 2020
In the modern day’s Oral and Maxillofacial surgical practice, complex surgical and aesthetical pr... more In the modern day’s Oral and Maxillofacial surgical practice, complex surgical and aesthetical procedures are being carried out associated with an increased risk of infectious complications. Therefore, to ensure better outcomes of the surgical procedures, it is absolutely necessary that appropriate measures must be taken to decrease the incidence of associated infections. The practices to be carried out for infection control include proper scrubbing procedures for both patient and the operator, specific protocols to be followed by the operating personnel at the time of procedures, proper handling of the instruments and maintaining an aseptic environment throughout the procedure. The main aim of this chapter is to provide information on the preoperative, operative and post-operative protocols that should be adhered to improve the safety of the patients undergoing surgical procedures.
To compare the onset, duration and depth of anesthesia, postoperative pain, duration of analgesia... more To compare the onset, duration and depth of anesthesia, postoperative pain, duration of analgesia and adverse reaction between 0.5% ropivacaine and 2% Lignocaine hydrochloride with adrenaline (1:80,000) in 40 patients having bilaterally impacted mandibular third molars. A prospective, randomized, single blind study was carried out among 40 patients requiring surgical removal of bilaterally impacted mandibular third molars having similar “difficulty index.” The onset of action, duration and depth of anesthesia, duration of analgesia, postoperative pain and adverse reactions of 0.5% ropivacaine and 2% lignocaine hydrochloride with 1:80,000 adrenaline were evaluated. All patients were infiltrated intradermally with 0.5 ml of 0.5% ropivacaine as test dose to rule out any allergic reaction. The surgical extractions of the impacted third molars were done using the standard surgical procedure. 0.5% Ropivacaine had higher depth of anesthesia, longer duration of action and postoperative anal...
The Journal of the American Dental Association, 2021
BACKGROUND Results from several randomized controlled trials have shown a beneficial effect of oz... more BACKGROUND Results from several randomized controlled trials have shown a beneficial effect of ozone in reducing postsurgical complications after impacted mandibular third-molar surgery, but the literature is lacking a systematic review and meta-analysis. METHODS The authors conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines after exclusion and inclusion criteria were applied and the following outcome parameters were evaluated: pain, swelling, trismus, quality of life, number of analgesics consumed, and adverse events. RevMan Cochrane Collaboration software, Version 5.3, was used to perform meta-analysis and the Grading of Recommendation Assessment, Development and Evaluation approach was used to rate the certainty of evidence. RESULTS Patients who underwent adjuvant ozone application reported lower pain scores than patients in the control group at 24 hours after surgery (95% CI, -3.94 to -1.56) and at 7 days (95% CI, -1.67 to -0.78). Pooled analysis of all 4 included trials revealed a standardized mean difference (SMD) in swelling of -0.44 at 24 hours, 0.63 at 72 hours, and -0.87 at 7 days after surgery in the experimental group. Higher mean estimates in mouth opening were experienced by patients who received ozone at 24 hours (SMD, 2.74; 95% CI, -1.93 to 7.41; 4 studies, 133 patients), 72 hours (SMD, 2.77; 95% CI, -0.63 to 6.17; 4 studies, 133 patients), and 7 days after surgery (SMD, 1.42 SMD; 95% CI, -1.34 to 4.18; 4 studies, 133 patients). PRACTICAL IMPLICATIONS Evidence suggests that adjuvant ozone application can offer some benefit for reducing pain, improving quality of life, and decreasing mean intake of analgesics after impacted mandibular third-molar surgery, but it is not effective in reducing facial swelling and trismus, which paves the way for future research.
Purpose The purpose of this study is to compare the suture versus sutureless surgery in impacted ... more Purpose The purpose of this study is to compare the suture versus sutureless surgery in impacted mandibular third molar and to evaluate the morbidity and complications associated with each technique. Materials and Methods A total of 50 patients with asymptomatic impacted mandibular third molars were randomly divided into two groups of 25 patients each. Radiographs were taken to assess the angulation and degree of eruption in the third molar. A small modified Szmyd, V-shaped flap was raised in all cases, and teeth were extracted. In Group I-Suture group (suture was used to close the flap), and in Group II-Sutureless group (no suture used to close the flap). The post-operative pain, swelling, trismus, haemorrhage, periodontal pocket, and alveolar osteitis were evaluated at 24 h, 48 h, 5th days, 7th days, and 2 weeks after surgery. The statistical analysis was done using the Chi-square ''t'' test and Independent Samples ''t'' test. Observations and Results Pain, swelling, and trismus were found to be significantly reduced especially in the immediate post-operative period in the sutureless group as compared to the suture group (p \ 0.001). There were no incidences of intra-operative and post-operative haemorrhage in any case. Follow-up of all the patients showed that there was no difference in periodontal sequelae and alveolar osteitis Conclusions Sutureless surgery with small flap was found to be less invasive, time-saving, and also a cost-effective method. This technique significantly reduced the early crucial phase of patient discomfort and demonstrates good results.
Background Oral submucous fibrosis (OSMF) is a chronic disease of the oral cavity which presents ... more Background Oral submucous fibrosis (OSMF) is a chronic disease of the oral cavity which presents clinically with burning sensation, leathery consistency of oral mucosa with palpable fibrous bands leading to reduced mouth opening. Though the evaluation of quality of life (QOL) in health care is gaining importance, researches regarding the evaluation of QOL in OSMF individuals are very sparse. Aim The aim of the present study is to evaluate the QOL assessment in OSMF patients through WHOQOL-BREF questionnaire. Methodology The study includes a total of 300 participants recruited from the outpatient department. The quality of life was assessed using the WHOQOL-BREF questionnaire. The raw scores for the physical health, psychological health, social relationships and environmental health domains were done on 4-20 scale suggested by the WHOQOL procedural manual. The analysis of variance (ANOVA) was used for the simultaneous comparison of mean scores for the four domains, and independent t test was used for the comparison of two means of domain scores. Results The participants with OSMF have a significant negative impact on the quality of life when compared with the participants without OSMF (P = 0.002). The environmental factors in the WHOQOL-BREF have shown a significant difference in the QOL of participants with OSMF than without OSMF (P = 0.001). Conclusion The oral submucous fibrosis has a negative impact on the quality of life in participants with OSMF specifically in social and environmental domains of the WHOQOL-BREF questionnaire. Keywords Oral submucous fibrosis Á Quality of life Á WHOQOL-BREF Á Oral premalignant condition Á Environmental health
Occupational exposures to blood borne pathogens can occur as a result of percutaneous injuries du... more Occupational exposures to blood borne pathogens can occur as a result of percutaneous injuries during periodontal procedures. Detailed attention to the pattern of injuries could help in developing improved strategies to further minimize their incidence. We surveyed 12 residents enrolled in the Master of Dental Surgery (MDS) course for one year to find out how many percutaneous injuries occurred during periodontal procedures. Survey questionnaire inquired in detail about the circumstances, site and the nature of injury. We also noted the risk status of patient and device which caused the injury. A total of 48 percutaneous injuries (7.84%) were received in 612 periodontal interventions consisting of 265 surgical and 670 non surgical procedures in the 1 year survey. the injury rate was 4/year/resident and individual residents suffered from 2-7 injuries during the study. the difference in number of percutaneous injuries sustained in surgical periodontal procedures (41/265) was highly significant statistically (p<0.0001) when compared to those in non surgical interventions (7/670). Most injuries occurred from suture needle followed by Castroviejo and injection needle. there is a low probability of occupational transmission of blood borne diseases in periodontal procedures. The findings of this study could possibly contribute further in efforts to reduce the incidence of percutaneous injuries during periodontal procedures.
Objective To compare the efficacy of CRP and TLC as markers for monitoring the course of odontoge... more Objective To compare the efficacy of CRP and TLC as markers for monitoring the course of odontogenic space infections (OSI) in 50 patients. Methods A Clinical severity scale (CSS) was developed to grade the severity of infections in patients. Blood samples were taken preoperatively and postoperatively at day 1, day 2, day 3 and day 7 for measuring the levels of CRP and TLC. The trends of CRP and TLC were analysed against the CSS. The data was subjected to paired ''t'' test, ANOVA, Spearman rank correlation, Pearson's bivariate correlation as appropriate. Results The CRP values were elevated in all 50/50 (100 %) patients as compared to TLC which were elevated in 32/50 (64 %) patients only. The CSS displayed a high internal consistency and reliability (Cronbach a = 0.748). A significant strong positive correlation (q = 0.754) was found between CRP and CSS as compared to a moderate correlation (q = .607) between TLC and CSS. Conclusion CRP displayed a more consistent relation with clinical severity of the infection than TLC. Hence it could be more reliably employed to judge the progress in a patient with OSI.
Life-threatening infections of odontogenic or upper airway origin may extend to potential spaces ... more Life-threatening infections of odontogenic or upper airway origin may extend to potential spaces formed by fascial planes of the lower head and upper cervical area. Complications include airway obstruction, mediastinitis, necrotizing fascitis, cavernous sinus thrombosis, sepsis, thoracic empyema, Lemierre&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome, cerebral abscess, orbital abscess, and osteomyelitis. The incidence of these &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;space infections&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; has been greatly reduced by modern antibiotic therapy. However, serious morbidity and even fatalities continue to occur. This study reviews complications of odontogenic infections. The search done was based on PubMed and Google Scholar, and an extensive published work search was undertaken. Advanced MEDLINE search was performed using the terms &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;odontogenic infections,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;complications,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;risk factors.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;
International journal of oral and maxillofacial surgery, Jan 20, 2015
The aim of this study was to evaluate the incremental improvement in mouth opening following coro... more The aim of this study was to evaluate the incremental improvement in mouth opening following coronoidectomy. Twenty-three patients with unilateral temporomandibular joint (TMJ) ankylosis (Sawhney types I-III) were assessed preoperatively; physical and radiological examinations were done (panoramic radiography and computed tomography). Data including demographic and clinical parameters were recorded. Patients with bilateral ankylosis, recurrent cases, and those with Sawhney type IV TMJ ankylosis were not included. The improvement in mouth opening was measured after ostectomy, after ipsilateral coronoidectomy, and after contralateral coronoidectomy. The improvements in mouth opening at each stage were analysed using the Student's t-test and Pearson's correlation coefficient. There was a marked improvement in maximal incisal opening (MIO) from 5.7±4.2mm to 23.7±5.9mm after removal of the ankylotic bony mass. MIO was significantly increased after ipsilateral coronoidectomy (31.6...
Journal of investigative and clinical dentistry, 2011
Prion diseases are a group of fatal neurodegenerative diseases that are rapidly progressive and f... more Prion diseases are a group of fatal neurodegenerative diseases that are rapidly progressive and fatal, with no definite cure. There are no reported cases of prion disease transmission arising from dental procedures. Nevertheless, there is a theoretical but real risk of transmission of prion disease from dental instruments. A review was made of studies up to 2008 to provide an update of the characteristics, risk of transmission, and the infection-control implications of prions in the field of dentistry. As the prions are resistant to conventional sterilization methods, highly-specific, cross-infection control measures are required when managing patients infected with these.
Backgrounds Oral submucous fibrosis (OSMF) is a chronic, insidious disease and is said to have a ... more Backgrounds Oral submucous fibrosis (OSMF) is a chronic, insidious disease and is said to have a multifactorial origin with varied clinical manifestation of repeated oral ulcers, intolerance to spicy food, mucosal blanching resulting in stiffness of the oral mucosa and formation of taut bands leading to reduced mouth opening. We designed this study to systematically review the literature on QOL in OSMF and hope to make recommendations for future course of QOL assessment in OSMF. Methods An electronic bibliographic search of studies was done from year 1900–2019 using specified keywords. The following databases were searched: PubMed, Ovid, Google Scholar and manual search were done from references of relevant articles. Of the screened 156 articles, finally 10 studies were included after screening for inclusion/exclusion criteria. Quality assessment of studies was completed using the Effective Public Health Practice Project (EPHPP) criteria for quantitative studies. Results Most instruments used in the studies were not disease specific for OSMF except one study. Six types of questionnaires were used. The heterogeneity in study population, study designs, QOL instruments and outcome measures made it difficult for a comparison. Therefore, a quantification analysis was not possible. Also pure OSMF data without the involvement of other lesions were less in number. Conclusions OSMF not only physically debilitates a patient, it has its repercussions on the social, physical, psychological domains as well. Another aspect is that apart from trismus, which is the most common and evident symptom associated with OSMF, a substantial part of the suffering that ensues is also because of the ulcerations, burning sensation and worsening of dental health. Another focus was the association of worse QOL with a higher grade of disease, longer and higher tobacco abuse contact duration. This review is unable to give a confident answer to the evidence on QOL in OSMF but definitely showers light on the evident lack of robust data on the same. Robust Powered by Editorial Manager® and ProduXion Manager® from Aries Systems Corporation methodological and adequately powered studies on assessing QOL in OSMF using only a reliable disease specific questionnaire is the need of the hour. Clinical Trial Registration PROSPERO Registration: CRD42018102874.
Analysing Level of Evidence (LOE) provides an insight to evidence-based medicine (EBM). The aim o... more Analysing Level of Evidence (LOE) provides an insight to evidence-based medicine (EBM). The aim of our study was to evaluate and analyse trends in Levels of Evidence (LOE) in Journal of Maxillofacial and Oral Surgery (MAOS) since inception, i.e. December 2009 along with categorization into subtopics. LOE for each article was determined according to modified American Society of Plastic Surgeons (ASPS) scale and National Health and Medical Research Council (NHMRC) Evidence Hierarchy. A total of 1264 articles were included in the final analysis, out of which high-quality evidence (Level A) accounted for 7% of the journal. The percentage of Level I/II (Level A) has increased from 2.09% in 2009/2010 to 12.74% in 2019/2020, representing a promising trend toward higher-quality research in just 10 years. Case reports and narrative reviews with Level of Evidence value “D” account the highest number (36%) of all the published articles. The majority of articles fell under Class 2 (Maxillofacia...
Oral and Maxillofacial Surgery for the Clinician, 2020
In the modern day’s Oral and Maxillofacial surgical practice, complex surgical and aesthetical pr... more In the modern day’s Oral and Maxillofacial surgical practice, complex surgical and aesthetical procedures are being carried out associated with an increased risk of infectious complications. Therefore, to ensure better outcomes of the surgical procedures, it is absolutely necessary that appropriate measures must be taken to decrease the incidence of associated infections. The practices to be carried out for infection control include proper scrubbing procedures for both patient and the operator, specific protocols to be followed by the operating personnel at the time of procedures, proper handling of the instruments and maintaining an aseptic environment throughout the procedure. The main aim of this chapter is to provide information on the preoperative, operative and post-operative protocols that should be adhered to improve the safety of the patients undergoing surgical procedures.
To compare the onset, duration and depth of anesthesia, postoperative pain, duration of analgesia... more To compare the onset, duration and depth of anesthesia, postoperative pain, duration of analgesia and adverse reaction between 0.5% ropivacaine and 2% Lignocaine hydrochloride with adrenaline (1:80,000) in 40 patients having bilaterally impacted mandibular third molars. A prospective, randomized, single blind study was carried out among 40 patients requiring surgical removal of bilaterally impacted mandibular third molars having similar “difficulty index.” The onset of action, duration and depth of anesthesia, duration of analgesia, postoperative pain and adverse reactions of 0.5% ropivacaine and 2% lignocaine hydrochloride with 1:80,000 adrenaline were evaluated. All patients were infiltrated intradermally with 0.5 ml of 0.5% ropivacaine as test dose to rule out any allergic reaction. The surgical extractions of the impacted third molars were done using the standard surgical procedure. 0.5% Ropivacaine had higher depth of anesthesia, longer duration of action and postoperative anal...
The Journal of the American Dental Association, 2021
BACKGROUND Results from several randomized controlled trials have shown a beneficial effect of oz... more BACKGROUND Results from several randomized controlled trials have shown a beneficial effect of ozone in reducing postsurgical complications after impacted mandibular third-molar surgery, but the literature is lacking a systematic review and meta-analysis. METHODS The authors conducted this systematic review according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines after exclusion and inclusion criteria were applied and the following outcome parameters were evaluated: pain, swelling, trismus, quality of life, number of analgesics consumed, and adverse events. RevMan Cochrane Collaboration software, Version 5.3, was used to perform meta-analysis and the Grading of Recommendation Assessment, Development and Evaluation approach was used to rate the certainty of evidence. RESULTS Patients who underwent adjuvant ozone application reported lower pain scores than patients in the control group at 24 hours after surgery (95% CI, -3.94 to -1.56) and at 7 days (95% CI, -1.67 to -0.78). Pooled analysis of all 4 included trials revealed a standardized mean difference (SMD) in swelling of -0.44 at 24 hours, 0.63 at 72 hours, and -0.87 at 7 days after surgery in the experimental group. Higher mean estimates in mouth opening were experienced by patients who received ozone at 24 hours (SMD, 2.74; 95% CI, -1.93 to 7.41; 4 studies, 133 patients), 72 hours (SMD, 2.77; 95% CI, -0.63 to 6.17; 4 studies, 133 patients), and 7 days after surgery (SMD, 1.42 SMD; 95% CI, -1.34 to 4.18; 4 studies, 133 patients). PRACTICAL IMPLICATIONS Evidence suggests that adjuvant ozone application can offer some benefit for reducing pain, improving quality of life, and decreasing mean intake of analgesics after impacted mandibular third-molar surgery, but it is not effective in reducing facial swelling and trismus, which paves the way for future research.
Purpose The purpose of this study is to compare the suture versus sutureless surgery in impacted ... more Purpose The purpose of this study is to compare the suture versus sutureless surgery in impacted mandibular third molar and to evaluate the morbidity and complications associated with each technique. Materials and Methods A total of 50 patients with asymptomatic impacted mandibular third molars were randomly divided into two groups of 25 patients each. Radiographs were taken to assess the angulation and degree of eruption in the third molar. A small modified Szmyd, V-shaped flap was raised in all cases, and teeth were extracted. In Group I-Suture group (suture was used to close the flap), and in Group II-Sutureless group (no suture used to close the flap). The post-operative pain, swelling, trismus, haemorrhage, periodontal pocket, and alveolar osteitis were evaluated at 24 h, 48 h, 5th days, 7th days, and 2 weeks after surgery. The statistical analysis was done using the Chi-square ''t'' test and Independent Samples ''t'' test. Observations and Results Pain, swelling, and trismus were found to be significantly reduced especially in the immediate post-operative period in the sutureless group as compared to the suture group (p \ 0.001). There were no incidences of intra-operative and post-operative haemorrhage in any case. Follow-up of all the patients showed that there was no difference in periodontal sequelae and alveolar osteitis Conclusions Sutureless surgery with small flap was found to be less invasive, time-saving, and also a cost-effective method. This technique significantly reduced the early crucial phase of patient discomfort and demonstrates good results.
Background Oral submucous fibrosis (OSMF) is a chronic disease of the oral cavity which presents ... more Background Oral submucous fibrosis (OSMF) is a chronic disease of the oral cavity which presents clinically with burning sensation, leathery consistency of oral mucosa with palpable fibrous bands leading to reduced mouth opening. Though the evaluation of quality of life (QOL) in health care is gaining importance, researches regarding the evaluation of QOL in OSMF individuals are very sparse. Aim The aim of the present study is to evaluate the QOL assessment in OSMF patients through WHOQOL-BREF questionnaire. Methodology The study includes a total of 300 participants recruited from the outpatient department. The quality of life was assessed using the WHOQOL-BREF questionnaire. The raw scores for the physical health, psychological health, social relationships and environmental health domains were done on 4-20 scale suggested by the WHOQOL procedural manual. The analysis of variance (ANOVA) was used for the simultaneous comparison of mean scores for the four domains, and independent t test was used for the comparison of two means of domain scores. Results The participants with OSMF have a significant negative impact on the quality of life when compared with the participants without OSMF (P = 0.002). The environmental factors in the WHOQOL-BREF have shown a significant difference in the QOL of participants with OSMF than without OSMF (P = 0.001). Conclusion The oral submucous fibrosis has a negative impact on the quality of life in participants with OSMF specifically in social and environmental domains of the WHOQOL-BREF questionnaire. Keywords Oral submucous fibrosis Á Quality of life Á WHOQOL-BREF Á Oral premalignant condition Á Environmental health
Occupational exposures to blood borne pathogens can occur as a result of percutaneous injuries du... more Occupational exposures to blood borne pathogens can occur as a result of percutaneous injuries during periodontal procedures. Detailed attention to the pattern of injuries could help in developing improved strategies to further minimize their incidence. We surveyed 12 residents enrolled in the Master of Dental Surgery (MDS) course for one year to find out how many percutaneous injuries occurred during periodontal procedures. Survey questionnaire inquired in detail about the circumstances, site and the nature of injury. We also noted the risk status of patient and device which caused the injury. A total of 48 percutaneous injuries (7.84%) were received in 612 periodontal interventions consisting of 265 surgical and 670 non surgical procedures in the 1 year survey. the injury rate was 4/year/resident and individual residents suffered from 2-7 injuries during the study. the difference in number of percutaneous injuries sustained in surgical periodontal procedures (41/265) was highly significant statistically (p<0.0001) when compared to those in non surgical interventions (7/670). Most injuries occurred from suture needle followed by Castroviejo and injection needle. there is a low probability of occupational transmission of blood borne diseases in periodontal procedures. The findings of this study could possibly contribute further in efforts to reduce the incidence of percutaneous injuries during periodontal procedures.
Objective To compare the efficacy of CRP and TLC as markers for monitoring the course of odontoge... more Objective To compare the efficacy of CRP and TLC as markers for monitoring the course of odontogenic space infections (OSI) in 50 patients. Methods A Clinical severity scale (CSS) was developed to grade the severity of infections in patients. Blood samples were taken preoperatively and postoperatively at day 1, day 2, day 3 and day 7 for measuring the levels of CRP and TLC. The trends of CRP and TLC were analysed against the CSS. The data was subjected to paired ''t'' test, ANOVA, Spearman rank correlation, Pearson's bivariate correlation as appropriate. Results The CRP values were elevated in all 50/50 (100 %) patients as compared to TLC which were elevated in 32/50 (64 %) patients only. The CSS displayed a high internal consistency and reliability (Cronbach a = 0.748). A significant strong positive correlation (q = 0.754) was found between CRP and CSS as compared to a moderate correlation (q = .607) between TLC and CSS. Conclusion CRP displayed a more consistent relation with clinical severity of the infection than TLC. Hence it could be more reliably employed to judge the progress in a patient with OSI.
Life-threatening infections of odontogenic or upper airway origin may extend to potential spaces ... more Life-threatening infections of odontogenic or upper airway origin may extend to potential spaces formed by fascial planes of the lower head and upper cervical area. Complications include airway obstruction, mediastinitis, necrotizing fascitis, cavernous sinus thrombosis, sepsis, thoracic empyema, Lemierre&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s syndrome, cerebral abscess, orbital abscess, and osteomyelitis. The incidence of these &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;space infections&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; has been greatly reduced by modern antibiotic therapy. However, serious morbidity and even fatalities continue to occur. This study reviews complications of odontogenic infections. The search done was based on PubMed and Google Scholar, and an extensive published work search was undertaken. Advanced MEDLINE search was performed using the terms &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;odontogenic infections,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;complications,&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;risk factors.&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;
International journal of oral and maxillofacial surgery, Jan 20, 2015
The aim of this study was to evaluate the incremental improvement in mouth opening following coro... more The aim of this study was to evaluate the incremental improvement in mouth opening following coronoidectomy. Twenty-three patients with unilateral temporomandibular joint (TMJ) ankylosis (Sawhney types I-III) were assessed preoperatively; physical and radiological examinations were done (panoramic radiography and computed tomography). Data including demographic and clinical parameters were recorded. Patients with bilateral ankylosis, recurrent cases, and those with Sawhney type IV TMJ ankylosis were not included. The improvement in mouth opening was measured after ostectomy, after ipsilateral coronoidectomy, and after contralateral coronoidectomy. The improvements in mouth opening at each stage were analysed using the Student's t-test and Pearson's correlation coefficient. There was a marked improvement in maximal incisal opening (MIO) from 5.7±4.2mm to 23.7±5.9mm after removal of the ankylotic bony mass. MIO was significantly increased after ipsilateral coronoidectomy (31.6...
Journal of investigative and clinical dentistry, 2011
Prion diseases are a group of fatal neurodegenerative diseases that are rapidly progressive and f... more Prion diseases are a group of fatal neurodegenerative diseases that are rapidly progressive and fatal, with no definite cure. There are no reported cases of prion disease transmission arising from dental procedures. Nevertheless, there is a theoretical but real risk of transmission of prion disease from dental instruments. A review was made of studies up to 2008 to provide an update of the characteristics, risk of transmission, and the infection-control implications of prions in the field of dentistry. As the prions are resistant to conventional sterilization methods, highly-specific, cross-infection control measures are required when managing patients infected with these.
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